The physician who discharges his patient when she rises from her bed after her two or three months’ treatment, or who neglects to consider the moral and mental needs and aspects of each case, will find that many will relapse.  Even when the patient has left the direct care of the doctor and returned to home and its avocations she will find help and comfort in the knowledge that she can apply to him if necessary, and it is well to hold some sort of relation by occasional visits or correspondence, however brief, for six months or a year after treatment has been completed.

CHAPTER VI.

Massage.

How to deprive rest of its evils is the title with which I might very well have labelled this chapter.  I have pointed out what I mean by rest, how it hurts, and how it seems to help; and, as I believe that it is useful in most cases only if employed in conjunction with other means, the study of these becomes of the first importance.

The two aids which by degrees I learned to call upon with confidence to enable me to use rest without doing harm are massage and electricity.  We have first to deal with massage, and I give some care to the description of details, because even now it is imperfectly understood in this country, and because I wish to emphasize some facts about it which are not well known, I think, on either side of the Atlantic.

Massage in some form has long been in use in the East, and is well known as the lommi-lommi of the slothful inhabitants of the Sandwich Islands.  In Japan it is reserved as an occupation for the blind, whose delicate sense of feeling might, I should think, very well fit them for this task.  It is, however, in these countries less used in disease than as the luxury of the rich; nor can I find in the few books on the subject that it has been resorted to habitually as a tonic in Europe, or otherwise than as a means of treating local disorders.

It is many years since I first saw in this city general massage used by a charlatan in a case of progressive paralysis.  The temporary results he obtained were so remarkable that I began soon after to employ it in locomotor ataxia, in which it sometimes proved of signal value, and in other forms of spinal and local disease.  At first I had to train nurses to use it, but I soon found that, although it was of some service to their patients, no one could use massage well who was not continually engaged in doing it.  Some men do it better than any woman; but I prefer, nevertheless, for obvious reasons, to reserve men for male patients, except that in cases where strength is of moment, as in the forced movements and the very hard rubbing needed for old articular adhesions, in which force must be exercised without violence, it is usually impossible to secure the necessary power in a feminine manipulator.

A few years later I resorted to it in the first cases which I treated by rest, and I very soon found that I had in it an agent little understood and of singular utility.