Mrs. L., a very thin, feeble, and bloodless woman, æt. 29 years:
| Before Massage. | After Massage. |
| 99 | 100 |
| 98-1/2 | 99-1/5 |
| 98 | 98-2/5 |
| 99 | 100 |
| 98-2/5 | 98-4/5 |
| 99 | 99-4/5 |
| 100 | 100-1/5 |
| 99 | 99-4/5 |
Mrs. P., æt. 31, feeble and anæmic, nervous, slight albuminuria and chronic bronchitis. Liable to fever. 3 P.M.:
| Before Massage. | After Massage. |
| 101-3/5 | 102 |
| 100 | 100-4/5 |
| 99 | 99-4/5 |
| 100 | 101 |
| 99-2/5 | 100-1/5 |
| 99-4/5 | 100-3/5 |
| 100-3/5 | 101-3/5 |
| 100-2/5 | 99-4/5 |
| 100-3/5 | 100-2/5 |
| 100-3/10 | 100-9/10 |
| 99-1/5 | 99-4/5 |
These facts are, of course, extremely interesting; but it is well to add that the success of the treatment is not indicated in any constant way by the thermal changes, which are neither so steady nor so remarkable as those caused by electricity.
If now we ask ourselves why massage does good in cases of absolute rest, the answer—at least a partial answer—is not difficult. The secretions of the skin are stimulated by the treatment of that tissue, and it is visibly flushed, as it ought to be, from time to time, by ordinary active exercise. Under massage the flabby muscles acquire a certain firmness, which at first lasts only for a few minutes, but which after a time is more enduring and ends by becoming permanent. The firm grasp of the manipulator's hand stimulates the muscle, and, if sudden, may cause it to contract sensibly, which, however, is not usually desirable or agreeable. The muscles are by these means exercised without the use of volitional exertion or the aid of the nervous centres, and at the same time the alternate grasp and relaxation of the manipulator's hands squeezes out the blood and allows it to flow back anew, thus healthfully exciting the vessels and increasing mechanically the flow of blood to the tissues which they feed. It is possible also that a real increase in the production of red corpuscles is brought about by repeated applications of massage, as will be seen later on.
The visible results as regards the surface-circulation are sufficiently obvious, and most remarkably so in persons who, besides being anæmic and thin, have been long unused to exercise. After a few treatments the nails become pink, the veins show where before none were to be seen, the larger vessels grow fuller, and the whole tint of the body changes for the better.
In like manner the sore places which previously existed, or which were brought into sensitive prominence by the manipulation, by degrees cease to be felt, and a general sensation of comfort and ease follows the later treatments.
Although this plan of acting on the muscles seems to dispense with any demands upon the centres, it is not to be supposed that it is altogether without influence on these parts. In fact, extreme use of massage occasionally flushes the face and causes sense of fulness in the head or ache in the back. The actual large increase in the number of corpuscles in the circulation brought about by massage may be one of the reasons for this. We have added, perhaps, millions of cells to the number in the vessels in a very short time, and need not be astonished if some signs of plethora follow. Moreover, in some spinal maladies it has effects not to be altogether explained by its mechanical stimulation of the muscles, nerves, and skin.
That the deep circulation shares in the changes which are so obvious in the superficial vessels has been shown by various observers of experimental and clinical facts. Firm deep muscle-kneading of the general surface will almost always slow and strengthen the pulse. If the abdomen alone is thoroughly rubbed the same effect appears in the pulse, but less in degree, and massage of the abdomen has also a distinct effect in increasing the flow of urine, a fact worth remembering in cases of heart-disease. In a case of albuminuria from exercise, W.W. Keen has shown that massage did not cause the return of the albumin after rest, though exercise did, a difference due to the opposite effects upon blood-pressure of the two forms of activity. Lauder-Brunton has shown that more blood passes through a masséed part after treatment. Dr. Eccles and Dr. Douglas Graham both found a decided decrease in the circumference of a limb after massage, showing how completely the veins must have been emptied, for the time at least,—an emptying which would surely be followed by an increased flow of arterial blood into the treated region. Dr. J.K. Mitchell, in 1894,[21] made a large number of examinations of the blood before and after massage, some in patients under treatment for a variety of disorders affecting the integrity of the blood, and a few in perfectly healthy men. With scarcely an exception there was a large increase in the number of corpuscles in a cubic millimetre, and an increase, though of less extent, in the hæmoglobin-content. Studies made at various intervals after treatment showed that the increase was greatest at the end of about an hour, after which it slowly decreased again; but this decrease was postponed longer and longer when the manipulation was continued regularly as a daily measure.[22] The author's conclusions from these examinations were interesting, and I quote them somewhat fully. The fact that the hæmoglobin is less decidedly increased than the corpuscular elements makes it seem at least probable that what happens is, that in all the conditions in which anæmia is a feature there are globules which are not doing their duty, but which are called out by the necessities of increased circulatory activity brought about by massage. If this is the first effect, yet as it is observed that the increase of corpuscles, at first passing, soon becomes permanent, we must conclude that massage has the ultimate effect of stimulating the production of red corpuscles.