he corpuscular elements
makes it seem at least probable that what happens is, that in all the
conditions in which anaemia 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
anaemia 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.

"It is evident that our present definitions of anaemia are insufficient.
An essential part of the description in all of them is that there are
defects of number, of color, or of both in the blood. This is not
necessarily or always true. The fault may lie in a lack of activity or
of availability in the corpuscles. The state of things in the system may
be like the want of circulating money during times of panic, when gold
is hoarded and not made use of, and interference with commerce and
manufactures results.

"Neither an anaemic appearance nor a blood-count is alone enough for a
certain diagnosis. Other signs must be u