returning downward more
lightly, yet without breaking its contact with the skin.

Care must be taken as the different groups of muscles are treated that
the leg is placed in the position which will most completely relax the
ones to be operated upon. Any tension of muscles wholly defeats the
effort of the masseur.

After completing the process upon both legs, the arm is next treated in
the same manner, the hand receiving somewhat more detailed attention
than the foot. Pains must be taken to reach the several groups of the
forearm by operating from both sides of the arm. The ordinary
manipulation of the shoulder can be accomplished with the patient lying
down; but if special conditions, such as articular stiffening, call for
unusual care or unusual force, it will be found best to treat the
shoulder with the patient seated. The treatment of the arms is concluded
with upward stroking (_effleurage_), as with the leg.

In the order usually pursued, the back is the next region treated. The
patient lies prone, folding the arms under the head; a firm pillow is
put under the epigastric region, so as to the better relax the back
muscles, which are too tense when a person lies flat. Beginning from the
occiput, both hands stroke firmly and rapidly downward and outward to
the spines of the scapulae, at first lightly, then with increasing force.
Then the whole back is vigorously rubbed--scrubbed one might call
it--with up-and-down strokes, as a preliminary application. The erector
spinae masses are treated by careful finger-tip kneading. Working from
the spine outward to the axillary line, the muscles of the ribs are
acted upon with flat-hand rubbing. The groups of the upper back and
shoulder-blades are kneaded and squeezed, the arms being partly
abducted so as to separate the shoulder-blades and allow the operator to
reach the muscles underlying them. The lumbar regions receive their
manipulation last. If it is desirable to give special attention or an
extra share of manipulation to any part of the spinal region, this is
done as the physician may have ordered, and the whole process is
completed by downward friction over the spine, given vigorously and as
rapidly as possible.

The chest is the next region to be handled, the patient turning from the
prone to the supine position. In women the breasts are usually best left
untouched unless special conditions demand their treatment.

The last and perhaps most important part of the pr