A. In Massage of the Limbs. Massage is a form of surface stimulation that can produce a muscular contraction by reflex; antagonistically it can also secure muscle relaxation. We invoke instinctively the aid of massage for its mechanical effect in day to day activity, for example rub our eyes hard to reduce intra-ocular tension, or press upon temple or forehead after a day of great fatigue.
B. In Massage for Diseases of the Nervous System -In the treatment of an irritable neurasthenic, the victim of insomnia.
C. In Abdominal Massage- According to Kleen mechanical stimulation of abdomen does not produce chemical stimulation in producing, secretion of active digestive juices.
It is possible that by mechanical means we can help empty a dilated stomach, and we can certainly assist in the softening and molding of scybala, in those very exceptional cases where they are palpable, and therefore amenable to manipulation. In this event we can also assist their passage along the bowel. However during general abdominal massage we must rely in the main on the reflex response to mechanical stimulation of the unstriped muscle to hasten the onflow of the contents of the bowel.
Other examples of reflex action of abdominal massage:
1. A certain stimulation of the skin over the abdomen can be shown to originate peristaltic movement in the stomach.
2. Stimulation of the skin round the spine of the fifth thoracic vertebra causes the pyloric sphincter to relax. Similar stimulation round the seventh cervical spine has the opposite effect.
3. The reflex contraction of the muscle in the rectum in response to sacral beating and to hacking over the left sciatic nerve where it emerges from the cover of the great sacro-sciatic notch.
4. It is possible that other abdominal organs can be influenced by reflex, e.g., the unstriped muscle of the spleen may contract in response to mechanical stimulation transmitted from the ribs, or applied to the organ itself if it is enlarged.
5. Professor Wide, of Stockholm, has shown by means of a blood-count, before and after treatment, that the number of red corpuscles in the blood is increased by abdominal massage. This, together with the general toning up of the vascular system, must re-act indirectly on all the abdominal organs.
6. The uterus is the abdominal organ to which massage treatment is very frequently applied. The reflex response to mechanical stimulation of the unstriped uterine muscle is a well-known aid to parturition.
7. The use of massage for stimulation of the heart is recognized in surgery, and it is performed in emergency by the "abdominal route." Reflex response by contraction to mechanical stimulation is thus more readily assured. It has been claimed that tapotement over the chest has the effect of lowering the rate of the heart-beat. This presumably is due to reflex action on the vagus.
Whenever massage treatment is ordered it is necessary to take the age of the patient into consideration, and more particularly when we are aiming solely to secure a reflex action. The reflex arc in the child is highly sensitive, and the fullest effect is thus secured rapidly. In the aged it is possible to cause fatigue with equal rapidity, and treatment then produces an irritative effect. In the young, therefore, and in the aged the duration of massage treatment should be curtailed.