Plethora, Insomnia, Headaches

PLETHORA.
In this affection we use movements such as will attract the blood from the head and produce muscular activity. The most important part of our treatment is the massage of the neck and head. By the former we can relieve the blood-pressure on the brain to a remarkable extent, the patient often after the treatment telling us: "How much lighter my head feels." Both methods of massage of the neck may be used, but that of Hoeffinger should be selected as the introductory massage, to reach the deeper veins and give an outlet for the congested circulation.
1. Massage of neck and head.
2. Half L. rotation of leg.
3. S. rotation of body.
4. Half L. rotation of feet.
5. S. rotation of head.
6. Kn. turning of body.
7. Beating of sacrum.
8. S. rotation of arms.
9. S. percussion of head, with shaking and stroking.

INSOMNIA.
There are certain movements which so affect the central or the sympathetic nerve-system that they are called by some authors "sleeping-movements." As a rule, the general active movements are sufficient. The treatment should always be applied at bedtime. The following manipulations and treatments will prove beneficial:
1. Firm general massage.
2. S. depression and elevation of arms.
3. Half L. flexion and extension of legs.
4. S. turning of body.
5. Separating and closing of arms.
6. L. raising of body.
7. St. bending of knees.
8. Massage of head.

HEADACHES.
During the past few years the author has had such exceptional results in the treatment of peripheral headaches that he wishes to pay some special attention to their treatment by massage. It has been clearly established that many cases of headaches with negative eye-conditions have been cured by thorough massage of the neck and head. Dr. Gustaf Norstrom has shown us in his excellent little book on headaches, that many of these cases are caused by myositic deposits in the neck, generally in the nape, but frequently also in the respective anatomical extremes of the neck. This may seem rather strange to many, but the trained masseur knows and almost daily experiences the fact that the " spontaneous pain has not always the same seat as the lesion." The cases are readily defined; the oculist reports that there is no condition of the eyes that could possibly cause the suffering. Then let us carefully examine the neck and head. The first thing to look for is this: is there a cerebral congestion of some standing? Hoefiinger's method of massage of the neck will tell us that. We as a rule find this congestion, particularly in the plethorics who have obstructions to the circulation in the upper part of the trunk. In the nape of the neck we find many lumps or myositic deposits, which in contradistinction to the ganglia and lymphatic glands are movable only with the particular muscle of which they form a part.

Pressing of a myositic deposit will cause acute pain, often extending to the supraorbital nerve and eyelid of the corresponding side. These deposits may be recognized in three stages or degrees (Norstrom): we may have a swelling only, or a resistive touch, or an actual induration where the consistency is very hard and the deposit consequently well defined. Now to the practical application of massage for headaches. First of all we must give strong, thorough strokings with both hands from the base of the skull to the acromion processes. This is our introductory massage to relieve not only the cerebral congestion, but also the pronounced congestion of the nape of the neck. The first few treatments should consist of these manipulations only, with a few strokings of the head added, but as soon as we can clearly define the deposits we commence with our strong frictions and kneadings, picking up the lump separately and squeezing it between the thumb and fingers. This causes pain often to such a degree that it becomes necessary to allow the patient some rest occasionally; the whole treatment should never exceed twenty minutes, and by that time not only the patient but also the operator has had enough ! The patient should be compelled to take a rest in a recumbent position for fifteen minutes after the treatment. It is not sufficient to massage the muscles and their deposits only but the nerves of the scalp and of the forehead should receive attention, particularly in those cases where we are able to find local structural changes.

In regard to the Swedish movements we have principally the following as the most useful:
1. Susp. bending of head (concentric).
2. Sitting bending of head.
3. St. bending of turned body sideways.
4. Sitting turning of the head.
5. Ostrom's combined resp. movement
In the movements marked 3 and 5 the reader will notice that the author wishes to act upon the organs of the trunk which are apt to become congested, especially the liver. I have had several cases of headaches in plethorics which did not yield at all until I carefully treated the liver. It is well to mention that in all the cases the author has watched and treated, there was invariably a history of gout or rheumatism, consequently we must not lose sight of the necessity of proper diet and medication to prevent the further formation of deposits - massage is effective only for what has been formed by impaired digestion and stored up in the muscles by locally impaired circulation.