Too much care cannot be used to cover with stockings and warm wraps the parts after in turn they have been subjected to massage.  As to time, at first the massage should last half an hour, but should be increased in a week to a full hour.  I observe that Dr. Playfair has it used twice a day or more, and I have since had it so employed in some cases, letting the masseuse come before noon, and allowing the nurse to use it at night if it does not interfere with sleep, which is a matter to be tested solely by experiment.  Commonly, one hour once daily suffices.  I was at one time in the habit of suspending the use of both massage and electricity during menstruation, because I found occasionally that these agents disturbed or checked the normal flow.  Of late, however, I continue to employ both agents, but confine them to the limbs.  I have met with rare cases in which almost any massage gave rise to a uterine hemorrhage, and in which the utmost caution became necessary.

Women who have a sensitive abdominal surface or ovarian tenderness have of course to be handled with care, but in a few days a practised rubber will by degrees intrude upon the tender regions, and will end by kneading them with all desirable force.  The same remarks apply to the spine when it is hurt by a touch; and it is very rare indeed to find persons whose irritable spots cannot at last be rubbed and kneaded to their permanent profit.

Sometimes when the patient is found to be much exhausted by massage, it is well to give some stimulating concentrated food afterwards; occasionally it may be necessary both before and after.  In this case it would be well to see that the rubbing was not being made too severe.

Very rarely I find a patient to whom all massage is so disagreeable or produces such annoying nervousness as to make manipulation impossible; sometimes, though very rarely, massage, especially frictional movements, causes sexual excitement when applied in the neighborhood of the genital organs, or even on the buttocks and lower spine, and this may occur in either sane or insane patients:  if the rubber observe any signs of this, it will of course be best to avoid handling the areas which are thus sensitive.

Another complaint sometimes made is of chilliness after treatment, and especially of cold feet.  If this is not lessened after a few days, the lower extremities may be rubbed last instead of first, or as is now and then useful, the whole order of massage may be changed so as to begin with the abdomen, chest, and upper extremities and conclude with the back and legs.[17]