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Page 22
The visible results as regards the surface-circulation are sufficiently
obvious, and most remarkably so in persons who, besides being an�mic 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 mass�ed 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
h�moglobin-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
h�moglobin 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 an�mia 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.
One sometimes hears doubts expressed whether a patient with a high-grade
an�mia is not "too feeble for such strong treatment" as massage. This
study of one of the ways in which massage affects such cases may fairly
be taken as proof of the certainty and safety of its effect on them,
provided always it be done properly and with intelligence. Some check
upon this may be had, as is said elsewhere, by the general effect upon
the patient. It may be repeated that the pulse should be slower and
stronger after an hour of deep massage, and that this effect will not be
produced by superficial rubbing (indeed, with light or too rapid
manipulation the pulse may become both less strong and more rapid), and
finally the flow of urine should be increased. With these easily
observed facts to aid, it may readily be judged whether massage is being
rightly applied or not without the need of a visit from the physician
during the hour of treatment. A final test might readily be made by
examination of the blood and counting the red corpuscles before and
after treatment. No doubt in very bad cases a small increase or none
would be found at first, but a week of daily manipulation should show a
distinct addition to the blood count. A striking instance in which this
examination was repeatedly made is related on p. 184.
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