Massage Of The Glutei And The Abdomen
V. MASSAGE OF THE GLUTEI.
Position. - The patient is standing with the body bent
forward and supported on a lounge or bedstead. The operator stands behind and
performs:
1. Stroking with both hands from the spine outward, downward (see Fig.
16).
2. Friction with the hand; one side at a time.
3. Beating in circles, one side
at a time.
If the patient is suffering severe pain from standing the manipulations may
be performed while he is in bed, with a couple of pillows placed underneath his abdomen
and thighs. FIG.
16. Stroking of the Glutei.
VI. MASSAGE OF THE ABDOMEN.
Position. - The patient is lying flat on his back,
generally without head-rest, and with the knees drawn up, so as to relax the abdominal
muscles (see Fig. 17). FIG. 17. Position
in Massage of the Abdomen and the Ventricle.
It is most convenient for the operator to sit at the patient's right side.
1. Friction
with the tips of the fingers in circles from right to left over the umbilical region of
the abdomen, thereby acting upon the smaller intestine. Begin with a very gentle pressure,
gradually increasing the strength of the manipulation (see Fig. 18).
2. Spread the
right hand over the abdomen so that the ball of the hand covers part of the ascending
colon ; press over that part upward to the transverse colon; then stroke with the radial
border of the hand firmly over to the left side. Here the tips of the fingers should be
used for the downward pressure over the descending colon. The manipulation is repeated in
circles without interruption (see Fig. 19). These two manipulations are schematically
illustrated in Figs. 18 and 19, and the operator should teach the patient how to perform
them on himself every morning, particularly in cases of constipation. A cannon ball
covered with leather is also very useful in manipulation No. 2, when the patient for some
reason is obliged to do it himself. They can be procured from Charles Lentz and Sons,
Philadelphia.
3. Kneading with the heel of the hand over
the whole abdomen, going carefully at first and avoiding any sore places. Fecal lumps are
often found and they should be gently and gradually broken up. Near the sigmoid flexure we
can sometimes accomplish more by substituting this manipulation for that of the friction
with the tips of the fingers. The reason for that is that we can reach in deeper and our
efforts become more localized. The same refers to the breaking up of adhesions of the
appendix and the ovaries. This manipulation will sometimes produce an unpleasant sensation
at first, which is frequently caused by the patient not breathing properly. Talk to him so
as to make him forget that he is being treated. Some operators place one hand as a support
under the patient's back, and it is a very good idea, as the manipulation feels more
comfortable and we have a better and more fixed control over the abdominal viscera.
4. Vibrations over the descending colon.
5. Turn the patient on his face and perform
firm beating of the sacrum in circles so as to act upon the rectum.
Massage of the
abdomen must never be applied soon after a meal is partaken of. It is well to tell the
patient to evacuate the bladder before beginning the treatment. In chronic cases of
constipation it is a good plan to have the patient take an enema, so as to clean out the
sacculated colon before starting the first treatment. The indiscriminate and continued use
of injections will produce a relaxed condition of the bowel, while on the contrary massage
will strengthen and stimulate to normal activity its various membranes.
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