ement. Their
routine use or over-use constitutes one of the defects of the system of
massage as usually practised by the Swedish operators; and when patients
tell me, as many do, that "they cannot stand massage," it is often found
that the performance of a great deal of this useless and fretting
manipulation has constituted a great part of the treatment, and that
deep, thorough, quiet kneading can be perfectly borne.

A few precautions are necessary to observe. The grasping hand should
carry the skin with it, not slip over the skin, as the drag thus put
upon the hairs will, if daily repeated, cause troublesome boils. The use
of a lubricant avoids this, and is a favorite device of unskilful
manipulators. It also does away with much of the good effected by
skin-friction, is uncleanly, very annoying to many patients, promotes an
unsightly growth of hair, and should be avoided except where it is
desired to rub into the system some oleaginous material. There are
exceptional cases where a very dry, harsh skin or a tendency to
excessive sweating during massage makes the use of some unguent
desirable. Cocoa-oil may be used, or what is perhaps more agreeable,
lanolin softened to the consistency of very thick cream by the addition
of oil of sweet almonds. As little as possible should be made to serve.

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 upo