Massage Of The Nose, The Ovaries, The Uterus, The Prostate Gland

XV. MASSAGE OF THE NOSE.
Position. - The patient reclining.
The forefinger of each hand of the operator is applied, with mild pressure, to each side of the nose of the patient. A stroking downward is slowly and carefully performed. In removing scars on or near the nose stretch the part and work crosswise, as described under massage of the face.

XVI. MASSAGE OF THE OVARIES.
Position. - The patient should be flat on her back without head-rest and the knees drawn up so as to completely relax the abdomen.
1. Stroking with both hands. The operator stands with her back to the patient placing her hands near the crests of the ilium, stroke simultaneously with both hands downward and inward to the center.
2. Friction with the tips of the fingers. This manipulation is used particularly when we wish to break down adhesions. The patient should be instructed to breathe deeply. Massage of the ovaries is freely recommended by European gynecologists and we have many remarkable reports of complicated cases successfully treated.

XVII. MASSAGE OF THE UTERUS.
Position. - The same as for massage of the abdomen (see Fig. 17). The external method is merely a modification of the massage of the abdomen. The patient must be in a half lying position, with the knees flexed in order to relax the abdominal muscles. Begin with the circular manipulations, from right to left, following with stroking and friction over the lower part of the abdomen. It is generally used for atony of the uterine organs, and must always be succeeded by percussion or beating of the lower part of the back. The Swedish movements are a valuable auxiliary, controlling as they do, the circulation in the abdomen and the lower extremities. The massage increases the current in the blood-vessels and the lymphatics, the resorption is restored, and the muscular organs in the smaller pelvis are strengthened. Special manipulations of the intestines relieve the bowels, which in cases of uterine affections must be of great importance. A second method is rather difficult to perform, as one or two fingers must be inserted in the vagina or the rectum, against which we work from the outside.

It should be performed only by a person who has a thorough knowledge of the parts; in fact it belongs to the practice of the gynecologist alone. Dr. Homer C. Bloom, of Philadelphia, has written a valuable little pamphlet on " Pelvic Massage." He describes the treatment and furnishes reports of some few cases. There is one part which is particularly interesting to every scientific masseur. Dr. Bloom, after summarizing the results, says : "It has been noticed that, in a great number of these cases, there was a concomitant condition of hemorrhoids, which were relieved in every instance." Dr. Norstrom, in Paris, recommends in massage of the uterus:

• 1. Graduate the pressure of the uterine body after you have seized it.
• 2. In order to get a good hold, push down during expiration ; maintain the distance gained during inspiration and start again during the next expiration.
• 3. Be careful not to increase by any sudden movements, the painful impression experienced by the patient when the uterus is first taken hold of; wait a moment before beginning pressure. The pressure sometimes produces reflex pains in various parts of the body.
• 4. Devote all your attention to supporting the uterus. This is easy when it is large and soft; very difficult when it is small and hard; it is then that it moves with great facility to one side or the other.

XVIII. MASSAGE OF THE PROSTATE GLAND.
Two methods are used, one external and one internal. In the first the patient is placed flat on his back, holding himself, the reproductive organs stretched up on the abdomen. The perineum is massaged with strokings and frictions. In the other method the operator inserts his covered index or if necessary index and middlefinger in the patient's rectum, and fixing the gland he supports it from the inside while the thumb and the fingers of the other hand perform the manipulations. The bladder should always be evacuated before beginning the treatment. Some forms of vibrations have proved very useful, particularly when applied through the rectum internally.