MECHANICAL AIDS 
IN THE 
TREATMENT OF 
Chronic Forms of Disease. 
By GEO. H. TAYLOR, M. D., 
Author of " Health by Exercise," " Health for Women," " Pelvic and 
Hernial Therapeutics," Manual Massage," etc. Consulting 
Physician to The Improved Movement Cure Institute, 
71 East 59th Street, New York. 
Copyright, 1893, by the Improved Movement Cure Institute 
NEW YORK: 
GEORGE W. RODGERS, PUBLISHER 
1893. CONTENTS. 
PAGE 
The Postural or "Lifting" Couch, - 1 
For Relieving Pelvic Affections-Mechanical, Surgical, 
Gynaecological and Medical. 
The Chest Developer, 20 
An Apparatus adapted to Correct Thoracic Asymmetry 
and to Restore Proper Function to the Respiratory 
Mechanism. 
Massage, 36 
Its Principles, Varieties, Factors and Adaptations. 
Therapeutics of Slow Massage, 51 
Auto-Massage-Kneading. 
Therapeutics of Rapid (Mechanical) Massage, - 74 
Its different forms and effects. THE POSTURAL OR " LIFTING " COUCH. 
FOR RELIEVING PELVIC AFFECTIONS- 
MECHANICAL, SURGICAL, GYNAECOLOGICAL AND 
MEDICAL. 
THE apparatus whose description follows is 
adapted to raise and to sustain the contents 
of the pelvis, however depressed and confined 
by morbid adhesions; to re-establish and to 
maintain an adequate outflow from the pelvis of 
the venous circulation ; and to increase such out- 
flow to the extent required by pathological indi- 
cations. The above-noted effects of the use of 
the apparatus will therefore indicate the funda- 
mental nature and requirements of malpositions 
and of errors of nutrition to which ^the varied 
contents of the pelvis are notably subject, in- 
cluding those which- too often prove intractable 
to medical skill. 
The mechanism for attaining these ends is very 
simple, and requires only moderate tact for its 
successful use. It is not a medium for presenting 
new ideas and principles, but for the successful 
application of those well established and undis- 
puted in the realm of mechanico-physiology 
which have suffered neglect, and which are 
vitally important in their therapeutic application 
in different branches of the art of medicine. 2 
MECHANICAL AIDS IN 
The apparatus includes a light frame, with a 
well-upholstered top, convenient for supporting 
the body in a lying position. The top is in four 
sections. Two are hinged to the ends of the frame, 
and admit of being lowered and raised like lea ves of 
a table, as may be required. One of these is a 
head-rest; the other supports the legs. Next to 
the head-rest is the functioning section, which 
extends to the hips. It is hinged under the shoul- 
ders, but free at the end supporting the hips, so 
that it admits of being pushed upward like 
a trap door. A lever at the side of the frame 
extends by means of connections to the free end 
of this section, so adjusted that, when depressed, 
the section swings upward. The pressure of the 
operator's foot causes the section with the part 
of the body resting upon it to assume any angle 
with the horizontal that may be desired. The 
remaining portion of the top of the couch is per- 
manently fixed to the frame. 
Two principal uses are made of this apparatus, 
both superinducing positive and incontestable 
remedial effects. One passively restores any 
displaced organ or viscera of the pelvis and 
adjacent parts, and removes obstacles in the 
local circulation, both in the vessels and inter- 
vascular parts; the other contributes actively 
and permanently to maintain these advantages- 
that is, restores the health of the pelvic region. 
The passive method, and the therapeutic princi- 
ples it represents, will first receive attention. CHRONIC FORMS OF DISEASE. 
3 
The patient lies upon the back, head resting on 
its supporting piece, both hands bearing on the 
top (not the back) of the head, with fingers 
firmly interlocked ; the feet drawn up near the 
hips and firmly planted on the couch. Before 
proceeding further, it is indispensable that the 
physiological consequences of the position de- 
scribed be clearly understood. 
The mechanism of respiration now operates 
without the least restraint, changing its twenty 
to thirty cubic inches of air fifteen to twenty 
times every minute, as before; but the anatomi- 
cal parts engaging in the act are radically differ- 
ent. The raised arms cause tension of all the 
muscles attached to the humerus; this tension 
draws apart and increases the distance between 
the side walls of the chest; it also renders them 
immobile. The exterior of the chest can no 
longer participate in the respiratory act. The 
rhythmic changes of chest space now devolve on 
the diaphragm, with the co-operation of the ab- 
domen. The fluctuations of chest-space involved 
by respiration now reach the exterior by way of 
the abdominal and the pelvic contents, and in no 
other way; and the same number of cubic inches 
of space is represented without loss at the infe- 
rior contour of the body that was previously at 
the chest exterior. Respiratory rhythm is 
therefore continued by another set of muscles. 
One is readily convinced of the completeness of 
the transfer described. A moderate pressure of 4 
MECHANICAL AIDS IN 
the hand at the pubic region of the abdomen causes 
the respiratory motions to be seen and felt at that 
point-slightly increased by reflex incitation, 
while the exterior chest walls are motionless. 
The next point of interest is the altered shape 
of the abdomen. Lateral distention of the chest 
increases the circumference of the upper or dia- 
phragmatic portion of the abdomen two or three 
inches, and its space proportionally. This change 
of space necessitates a redistribution of the con- 
tents of the whole cavity, including the pelvic. 
These contents inevitably pass into the space 
provided, and retire from that previously occu- 
pied. The exterior shape changes to correspond 
to the redistribution of contents. The contents of 
the whole cavity of the trunk, considered as a 
unit, are lodged higher up. 
The way is now clear to see that the respira- 
tory rhythm is indubitably pump-like, and that 
its effects accord with its action. The mass of 
contents of the common spaces, abdominal and 
pelvic, engage in rhythmic oscillations and alter- 
nations of pressure. One now sees what is nat- 
ural and spontaneous in all healthy vertebrate 
creatures-that motor and pressure oscillations 
are not confined to the chest, but normally ex- 
tend through the whole cavity of the trunk, and 
are physiologically required for the health of the 
contents of each division of the cavity. One ef- 
fect of motor rhythm is its indisputable sustain- 
ing power. The respiratory muscles, now en- gaged, unite their power to elevate the dia- 
phragm, thereby producing a tendency to a 
vacuum below it. The inevitable consequence is 
the urging upward of the whole visceral mass by 
atmospheric pressure. This effect is more read- 
ily seen when slightly increased-as by going up 
stairs with both hands pressing the crown of the 
head. The location and the interrelations of the 
pelvic contents, therefore, practically depend on 
the overlying mass, are subject in health to the 
motor changes of this mass, and are controllable 
through it. 
Another indispensable effect of respiratory 
rhythm is its agency in returning the venous cir- 
culation. The organs in the pelvis, being devoid 
of muscles adapted to this end, are, in the absence 
of normal rhythm, as helpless as the contents of 
the skull, and inevit- 
ably suffer hyper- 
aemia and its conse- 
quences, the proofs 
of which will appear 
further on. 
Having thus pre- 
s e n t e d necessary 
physiological data, 
we may proceed with 
the apparatus. The 
operator, standing near the patient's head, 
presses the lever with his foot. The force is 
transmitted to the movable section on which the 
CHRONIC FORMS OF DISEASE. 
5 6 
MECHANICAL AIDS IN 
trunk lies. By the arrangement of levers and 
connecting rods this portion is thrown into an in- 
clined position, the degree of inclination being 
always such as is agreeable to the patient. The 
body is next allowed to descend to the commenc- 
ing position, and this act of raising and lowering 
the central part of the body may be frequently 
repeated, suspending it at the elevated stage. 
Respiration and gravitation now unite their 
forces, and the weight of visceral organs and the 
power of the chest muscles are combined and ex- 
tended to the contents of the pelvis, urging the 
latter from the pelvic cavity toward the space 
provided at the other or upper end of the ab- 
domen. 
It being realized that the union of forces urging 
upward the contents of the pelvic cavity is actual 
and positive, and that the direction of such ac- 
tion is desirable, it may now be shown that its 
degree may easily be increased to any extent re- 
quired. The traction affecting local organs of 
the pelvis and vicinity, impelling them upward, 
may be made equal to any emergency. The ad- 
ditional force required to overcome great resist- 
ance is secured by adding pressure from the hand 
of the operator. If during expiration the abdom- 
inal mass be urged by the hand of the operator 
from the base of the abdomen, it is evident that 
the force thus applied co-operates with both the 
muscular power of respiration and the gravita- 
tion of the mass. The added force may be ten- CHRONIC FORMS OF DISEASE. 
7 
tatively applied and adapted to the therapeutic 
requirements, whether these require one or one 
hundred pounds, or more if needful, to overcome 
whatever resistance the pathological condition 
may present. The process is entirely passive and 
painless, may be varied to suit conditions and cir- 
cumstances, and is incapable of causing disagree- 
able feelings or consequences. 
The remedial utility of this class of processes may 
be thus summarized: It causes the physiological 
gliding of the peritoneal surfaces of contiguous 
viscera, a function for which they are adapted, 
and which is indispensable for their health. It 
elevates the overlying digestive viscera, thus pro- 
viding the space requisite for replacement up- 
ward of the pelvic contents. This effect is an 
absolutely necessary preliminary to ascent and 
rectification of position and interrelation of parts 
of the pelvic organs, and the want of it insures 
practical failure of instrumental methods and of 
manual procedures, however deftly supplied. 
The same process causes progressive or rapid 
divulsion of morbid attachments, and inaugu- 
rates the natural gliding of peritoneal surfaces 
which obviates recurrence of fixation. 
Even more significant, if possible, are the reme- 
dial advantages superinduced in the nutrition of 
the pelvic organs by the agency of the same and 
similar processes. Fluid constituents of a part 
are naturally more sensitive and obedient to 
physical impulses than masses are. The return 8 
MECHANICAL AIDS IN 
circulation from the contents of the inferior por- 
tion of the cavity of the trunk, and especially 
from the pelvis, physiologically depends on 
rhythm. The accessories of rhythm supplied by 
art have, therefore, inestimable remedial value. 
The physiological drainage (so to speak) of the 
pelvic contents is practically effected by this 
agency, and a defect or absence of rhythmic im- 
pulse plunges the pelvic organs into difficulties 
which are well-nigh the opprobrium of medicine. 
These organs are, in this case, in the condition 
resembling that of a submerged water wheel. 
The return of function depends on removing the 
back water. Accumulated local residuals of 
pelvic organs are removed through abundant 
venous outflow, for this is indispensable to local 
absorption, and therefore to healthy nutrition. 
Warned by practical failures of promising 
theoretic remedial devices, the medical reader 
naturally (and commendably) desires demon- 
strative evidence of the correctness of preceding 
statements. This he may have. Apparatus is 
not indispensable for the most searching and 
conclusive investigation. He should see, feel 
and positively know, the validity of the evidences 
afforded, and be able to eliminate all possibility 
of misunderstanding or deception. Strangulated 
hernia fulfills the test requirements. In this 
condition visceral displacement is unequivocal, 
morbid fixation is extreme, pent-up fluids are 
rapidly degenerating. The reader may accom- CHRONIC FORMS OF DISEASE. 
9 
pany me to the bedside of an actual patient, and, 
by noting procedures may himself secure as 
good results in any similar case, however grave. 
The following is one of repeated instances: 
The present instance is that of a laborer, about fifty 
years old, belonging to the charity class. The physician, 
after prolonged, fruitless, and, I may add, injurious efforts 
to reduce the strangulated protrusion by taxis, called in 
the operating surgeon, who was prepared to seek relief by 
use of the knife. I was known by the latter to be near at 
hand, and was called in, probably not from the most com- 
mendable motives, as it was conceded to be a case of des- 
peration, and would afford an extreme test of the value of 
my methods in this class of cases. I found the patient in 
extreme suffering; he was constantly retching and had 
been vomiting for several hours; had a strained and al- 
most ghastly appearance, and was surrounded by weeping 
wife and children. The protrusion appeared to be of the 
inguinal variety at the right side, as large as one's fist, 
tense, shining, bluish. The patient was req«ired to clasp 
his hands on the crown of his head, and to keep them in 
this position. Next, the wife's ironing board was slid 
lengthwise under his back, reaching his shoulders. His 
hips were raised ten or twelve inches by a prop under the 
board. Slight pressure at the pubic region indicated that 
the rhythm of respiration now included the lower abdo- 
men. This motion was gently increased in extent by the 
assistance of pressure during expiration. This part of the 
abdomen gradually flattened. Taking advantage of this 
fact, the compression of my hands, united with stroking 
toward the diaphragm, worked something of a local con- 
cavity. This facilitated a more vigorous engagement of 
my hand3 with the abdominal mass, enabling me to push 
in co-operation with the muscular strife thus superinduced. 
The motor push, as relates to the diaphragmatic direction, 
includes the whole mass, and is a pull as relates to the 10 
MECHANICAL AIDS IN 
inferior boundary of the cavity. It was directly seen that 
decided traction was made on the interior portion of the 
entrapped loop of intestine and omentum. The tension 
was made certain to touch by placing the finger properly 
at the constriction. Retching now ceased, and calmness 
replaced the agonized expression. My medical associates 
pointed to the changed appearance of the tumor-whose 
glossy, tense surface had become dull and covered with 
minute lines or wrinkles. The fluid contents of the sac 
were making their way through the constricted neck. I 
had charge of the case abouthalf an hour, and gave proper 
directions for accelerating the returning process after its 
advance to a suitable stage, which, however, were not fol- 
lowed. The surgeon called at my room the next morning 
to say that the reduction was completed in the night, that 
no other attention had been bestowed, but to see that the 
prescribed positions were maintained (which gave not the 
least fatigue), and that the patient was well. Much less 
time would probably have been sufficient if the process 
had been properly assisted at the pillars of the canal. No 
truss or other support is required for after treatment in 
these cases, whether acute or chronic. 
A proper understanding by physicians of the 
mechanico-physiological principles connected with 
pelvic affections (including in this term all the 
anatomical contents of the cavity) is so indis- 
pensable that I hope to be pardoned if led to 
make superfluous explanations. Pathological 
manifestations in and near the pelvis admit of 
being treated as if composed chiefly of fluids, as 
indeed they are. Solids offer resistance due to 
dimensions-a consideration which maj7 be neg- 
lected in the case of fluids. These yield to the 
slightest impulse, because the infinitesimal parts CHRONIC FORMS OF DISEASE. 
11 
maybe impelled, though an entire mass could 
not be. The mass is incorrigible, but its ulti- 
mate molecules obey in a continuous outflow. In 
these and similar cases it is only necessary to 
superinduce a difference of pressure in the two 
cavities connected by the hernial neck. The 
fluid contents inevitably pass in the direction 
of least resistance. The conditions available 
for securing difference of pressure are clearly 
these: Exterior to the neck are fifteen pounds 
per square inch of atmospheric pressure on the 
sac; interior, the pressure is diminished by 
the force represented by the diaphragm act- 
ing as a broad piston by means of its own 
and associated muscles, assisted by gravi- 
tation of the abdominal viscera; now prac- 
tically reversed, and re-enforced by compres- 
sion from the hand, the whole of which, act- 
ing in the same direction, takes effect at the 
point of confinement. However pinched or 
vitally deteriorated, the tissues are still wet 
at the constriction, and the independent mo- 
lecules yield in countless, minutest streams 
throughout its sectional area, and speedily trans- 
fer the pent-up fluids to the interior abdominal 
vessels. 
The same mechanico-physiological principles 
have equal application to the whole inferior end. 
region of the trunk. These principles are inde- 
pendent of considerations of sex, anatomical 
structure, form, substance, multiplicity, and de- 12 
MECHANICAL AIDS IN 
gree of nervous irritability of the special organs 
to which they may be applied. 
The provisions incorporated in the organic 
mechanism for securing a continuous and abun- 
dant outflow from the pelvic organs are ample to 
the point of superfluity and equal to the most 
trying emergencies. We have called this func- 
tion physiological drainage, the better to suggest 
the ill consequences certain to arise from its in- 
adequacy, the most important of which consists 
of qualitative degeneration of the retained super- 
fluous local ingredients. The plain therapeutic 
indication, whatever be the morbid stage, is to 
submit all localized ingredients to the organic 
chemistry, through the agency of the circulation. 
In the light of the above statements of princi- 
ples, the stumbling-block of pelvic therapeutics 
becomes apparent. It is the assumption that 
mechanico-physiological functions which inhere 
in the vital organism may be neglected, even 
ignored, in favor of theoretical substitutes. 
More plainly, efforts are made to lodge and 
maintain the uterus and its appendages in loca- 
tions already pre-empted, so to speak, by di- 
gestive organs, innocently regardless of the 
necessity of first elevating the overlying mass. It 
is further assumed that dislocations and flexures of 
parts of the pelvic contents are amenable to cor- 
rection, while stray masses of omentum and loops 
of the digestive tube continue to crowd aside the 
accused, but thoroughly innocent, pelvic organs. CHRONIC FORMS OF DISEASE. 
13 
Even more unjustifiable and injurious are the 
assumptions respecting the fluid contents of the 
pelvic organs. Therapeutic ingenuity is exer- 
cised without limit in devising impracticable and 
evanescent ways of disposing of offending local 
residual fluids, while the natural venous outlets 
remain unemployed, and when, as shown, only 
the feeblest mechanico-physiological preponder- 
ance is sufficient for the thorough drainage of 
the whole pelvic region. 
The second of the two principal uses of the 
postural or " lifting " couch is adapted to se- 
cure permanency for the effects above described. 
Permanency of therapeutic effects is acquired by 
incorporating such effects, so that they become 
the standard and continuous physiological con- 
dition. The mode of so directing the ordinary 
physiological processes as to achieve most 
notable therapeutic results is typified by the ac- 
tive and semi-active process for which the ap- 
paratus is adapted. 
In this process the patient assumes a position 
on the couch exactly the reverse of that before 
described; his feet are near the standing place 
of the operator, his face looking down, and he 
rests upon his elbows, which must be perpen- 
dicular to his shoulders and at such a point as 
will bring the middle portion of his thighs to rest 
on the well-padded, free end of the hinged part 
of the apparatus. Care is required to maintain 
unmoved the points of support at the elbows and 14 
MECHANICAL AIDS IN 
the thighs, for the mechanical effect of the pro- 
cess depends on this. 
The operator, with one foot upon the lever, 
grasps the limbs of the patient in the vicinity of 
the ankles ; he then presses down the lever with 
his foot, and 
si multaneously 
draw's the body 
backward and 
upward to cor- 
respond with the 
same motion 
communicated 
to the body from 
the hinged part 
of the couch. 
The limbs of the 
patient, if a woman, are closely wrapped in 
skirts and a shawl. The angle of elevation 
shown in the cut is extreme and seldom neces- 
sary. The shoulders and hips may attain the 
same level, or the latter may become transiently 
a little higher. 
The following mechanical consequences are to 
be noted. The abdomen, unsupported, assumes 
the form and functions of a pouch, into which 
the viscera descend by their weight. The pelvic 
viscera, being continuous and in juxtaposition 
with the abdominal, necessarily retreat in the 
same direction, aided by atmospheric pressure. 
So far the process is passive. The backward and CHRONIC FORMS OF DISEASE. 
15 
upward motion of the trunk, while the elbows 
are fixed, pulls the arms in the same direction, 
causing them to become parallel with the trunk. 
This act produces extreme muscular tension and 
renders immovable the side-walls of the chest, 
and expands the diaphragmatic region to an ex- 
treme degree. This distension produces no void 
space, for the contents of the whole cavity move 
toward and fill it, causing corresponding shrink- 
age at the lower end. The pelvic contents neces- 
sarily recede as far as their normal connection 
with the pelvic walls will allow; morbid adhe- 
sions, should they exist, are, however, first sub- 
jecteel to the whole strain. 
As in the position previously shown, respira- 
tion is not restricted, but, on the contrary, its 
scope is increased, since gravitation is changed 
from an impediment to a direct assistance. At 
each rhythmic act the contents are subjected to 
a vigorous pull down the sharp incline of the 
pendulous abdomen. The process may be re- 
peated a number of times. 
The forces which are made to combine in 
changing the location of the pelvic mass and the 
viscera of the lower abdomen, and in sundering 
impediments to the change, may now be under- 
stood at a glance. 1. Gravitation of the viscera, 
practically reversed. 2. The conversion of the 
diaphragm into a broad piston, having- an area of 
something like one hundred and fifty square 
inches, whose slightest motion takes effect with 16 
MECHANICAL AIDS IN 
great power in co-operation with atmospheric 
pressure in detaching adhesions at any point of 
the inferior portion of the cavity. 3. Greatly 
increased extent of respiratory rhythm, engag- 
ing the whole power of the act in drawing from 
the pelvis. To the above may be added the fol- 
lowing adjuvants: 4. Reflex contraction of ab- 
dominal muscles, secured by placing the hand of 
an operator on the abdomen of the patient driv- 
ing the process. 5. Concentration of the effect by 
diminishing the time-that is, by a quick instead 
of slow execution of the process-converting the 
pelvic pull into something approximating a bloiv, 
for securing divulsion. 6. Prolongation of the 
process at its stage of elevation, thereby obtain- 
ing the advantages of repetitions of rhythm, 
concentrating and multiplying its force at the 
pelvic region. 7. The energetic co-operation of 
the will of the patient in the execution of the 
process, thus vastly increasing the above-de- 
scribed effects. 8. Allowing the patient to re- 
main on the couch for some time after this pro- 
cess, lying face down, arms extended beyond and 
each side of the head, and in a horizontal line 
with the body. Continuance of this position causes 
continued expansion of the diaphragm and con- 
tinued extension to the pelvis of the concentrated 
pump-like function of rhythm. 
The process described insures expulsion from 
the pelvic organs of excess of fluids, interstitial 
as well as vascular, degenerate as well as nor- CHRONIC FORMS OF DISEASE. 
17 
mal. In the vital organism, chemico-physics are 
controlled by motor physics; the former are in- 
corrigible when the latter is persistently defec- 
tive. 
The last described function of the postural 
couch establishes and renders permanent the 
mechanical effects so plainly secured by that 
first described. In other words, most desirable 
mechanical effects are rendered physiological 
and indefinitely continuous-the highest aspira- 
tion of therapeutics. This consequence arises 
from directing and concentrating the full force 
of the organic energies on mechanico-physio- 
logical processes, whose previous defects are the 
fundamental source of both malpositions and 
disease of the pelvic contents. The processes 
aided by the couch conclusively prove the nature 
of the greater number of pelvic affections. 
There can be no better evidences of the nature of 
a cause than the prompt disappearance of its 
effects on removing the cause. These processes 
also typify the nature of the cultivation required. 
Other and similar processes, executed without 
the aid of the couch, are effective in the same di- 
rection. 
We may now briefly recapitulate the uses of 
the postural or "lifting" couch-uses which 
also extend to other mechanico-physiological 
processes adapted to similar ends: 
1. The highest function of the apparatus is 
educational. Its use quickly develops and es- 18 
MECHANICAL AIDS IN 
tablishes beyond cavil setiological principles and 
facts dominating the surgery and therapeutics 
of the pelvic and contiguous abdominal regions. 
Its scope includes not only the uterus, ovaries, 
tubes, ligaments, and connective tissues, but 
their blood-vessels and interstitial fluids. It 
equally includes the rectum, its vessels, the pel- 
vic floor, and the base of the abdomen. It 
affords physicians facilities for testing the ac- 
curacy of the statements of mechanico-physio- 
logical principles above explained, and of con- 
victing the author of inaccuracy, or else of 
according to them the merit to which they are 
entitled. 
2. It establishes remedial principles for restor- 
ing strangulated hernia, effective in any case not 
moribund. It shows the practical mode of re- 
moving chronic hernia, even when long irre- 
ducible and held by adhesions. No bandages, 
trusses, or other supports are needed for after- 
treatment. 
3. It establishes the principles of permanent 
uterine sustentation, which includes the removal 
of retro and other flexions, and ovarian dis- 
placements. All so-called supporting instru- 
ments, internal and external, are rendered 
superfluous. This remedial principle includes 
continuous and permanent sustentation, secured 
through proper cultivation and development of 
the natural fundionaI support. 
4. The same apparatus indicates the practical CHRONIC FORMS OF DISEASE. 
19 
method of securing- effective and complete physi- 
ological drainage of all organs within the pelvic 
cavity, whatever be the pathological form of the 
consequences of defect of this function. The 
methods pointed out for securing this purpose 
are effective in all varieties of haemorrhoids and 
other morbid states of the rectum, in varicocele 
and hydrocele, in ovarian and uterine tumors, as 
well as in malpositions and minor troubles of the 
female organs. 
5. It is important to keep in view the combina- 
tion of mechanico-physiological operation which 
conduce to the radical curative effects men- 
tioned. Respiratory rhythm is extended into, 
and its extent or play is increased in, the pelvis. 
The gliding of organs and parts due all serous 
surfaces is secured. The pelvic contents are sub- 
jected to fifteen or twenty alternations of pres- 
sure every minute constantly, affording the 
spontaneous massage normal to the parts. The 
venous vessels are subjected to incessant organic 
aspiration. Morbid as well as normal inter- 
stitial outflow results from the operation of the 
same mechanico-physical law. Deteriorated lo- 
cal fluids are submitted to the chemistry of the 
whole organism. The higher aims and more 
radical purposes of pelvic therapeutics are 
served. 20 
MECHANICAL AIDS IN 
THE CHEST DEVELOPER. 
AN APPARATUS ADAPTED TO CORRECT THORACIC ASYMMETRY 
AND TO RESTORE PROPER FUNCTION TO THE RESPIRATORY 
MECHANISM. 
IT IS well known that the mechanical capacity 
of the chest is far in excess of its ordinary 
function; that the twenty or more cubic inches of 
air exchanged at each respiratory act during quiet 
is easily increased by vigorous exercises, by strong 
voluntary effort, and by other means of incitation, 
to ten times that amount. Nature, therefore, 
provides a very large excess of capacity of the 
breathing function beyond its ordinary use avail- 
able for emergencies. This surplus capacity is 
highly valuable in therapeutics. 
It is also open to observation that the extent of 
the motion of the chest incident to the respiratory 
act is not necessarily uniform and equal in all 
parts of the chest. A variety of causes-vocation, 
habitual position, nervous defects, disease, etc.- 
may restrict muscular power, and the consequent 
participation of some portion of the chest in the 
respiratory act, while other portions are conse- 
quently forced to engage in excessive action and 
expansion. For example, the greater part, even 
the whole, of the change of air space may occur 
at the right or the left side, at the top or the hot- CHRONIC FORMS OF DISEASE. 
21 
tom of the chest, while the remainder participates 
but little, perhaps not at all, in the process. 
These statements are confirmed in several ways. 
The most abundant and conspicuous instances are 
of the pathological order. Disease of a portion 
of the lungs partly, sometimes wholly, excludes 
respiratory changes in the diseased portion, a fact 
easily recognized by defect or absence of motion 
of the chest-walls over the diseased site. In de- 
formities of the chest and spine the air change in 
the convex or bulging portion often greatly ex- 
ceeds that of the shrunken part. Finally, it is 
well known that certain vocations and certain 
prolonged, fixed positions of the body, which in- 
volve excessive use of a part of the muscles of the 
chest and restraint of other muscles, are certain, 
when sufficient time is given, to produce unequal 
development of chest space and of the chest walls 
which control the chest space. 
Now, the fluctuations of chest space, whether 
normal or otherwise, are produced solely by the 
mechanical movements of the walls which inclose 
the space. The instances above noted of irregular 
and partial expansion of the chest may be due at 
times to excessive actions of local muscles, but it 
is more generally due to defective action and de- 
terioration of power of some part of the respiratory 
mechanism. In some one direction or other there 
is partial, perhaps complete, inhibition of natural 
respiratory movement; this indicates loss or de- 
fect of the power which moves, involving both 22 
MECHANICAL AIDS IN 
the involuntary and the voluntary control of the 
function. 
This condition is clearly abnormal. Whether 
the fault is functional only, or is associated with 
well-developed pathological features, it is clearly 
outside the scope of medicinal remedies. Thus 
the ablest physician finds himself confronted by 
pathological phases of the gravest moment, for 
which ordinary remedies have no adaptation. He 
may medicate the diseased lung, but how about 
the absence of motion of the overlying chest wall, 
the default of which prevents the "cure" from 
doing any good ? In case of deformed spine and 
chest, how are shrunken and useless air cells of 
the flattened side to be restored under continued 
defective functional movements of the adjacent 
chest wall ? 
The therapeutic indications are clearly mani- 
fest in the nature of the defect, whether it be re- 
garded as purely functional or as having acquired 
specific pathological forms. It is plain that the 
mechanical phase of the defect of direction and 
extent of chest movement admits of mechanical 
aid and re-enforcement. Such aid is, indeed, fre- 
quently invoked, but generally in so clumsy and 
inadequate a manner as to practically fail of its 
specific purpose. 
The inferior wall of the chest has far more ex- 
tended physiological relations than its side walls. 
It follows that corresponding extended and com- 
plicated pathological consequences arise from CHRONIC FORMS OF DISEASE. 
23 
defects of function of this part of the chest walls. 
This is because while side walls are exterior 
boundaries, the inferior is not. Instead of beat- 
ing against the air, its motions, in respiration, 
are propagated through the visceral mass in 
reaching the bodily exterior. It is reasonable to 
infer that this mechanical arrangement is an in- 
dispensable part of Nature's plan in the physio- 
logical system; that defective function of the 
inferior wall and the insufficient motor waves in 
visceral parts, at least border on pathology and 
superinduce decided pathological consequences. 
To show that this defect of function, as well as 
its consequence, is remediable by means direct 
and unequivocal, is therefore of unbounded thera- 
peutic importance. 
The instrument of which a description follows 
is adapted to serve the several purposes above 
noted in a therapeutic degree. This will appear 
from a description in detail of its parts and mode 
of action. 
A standard or post, as shown in Fig. 1, having 
an upward extension by means of a slide and 
ratchet, is fixed to the floor. The top of the slid- 
ing part bears a short, horizontal pad, B, for ad- 
justment to and support of one's back or side. 
The acting part of the instrument is the pendulum, 
A, pivoted to the standard, opposite the pad. 
The weighted end of the pendulum just escapes 
the floor in swinging. A lever, C, bearing the 
transverse handle, D, is ratcheted to the pivoted 24 
MECHANICAL AIDS IN 
end of the pendulum, and may be adjusted to the 
pendulum at any angle, according to the capacity 
of the patient, and also to the height of his up- 
stretched hands. 
The action of the instrument and the mechanico- 
physiological and consequent therapeutic effects 
thereby secured may now be rendered intelligible. 
After adjusting the pad to the lower border of 
the shoulder blades and the handle to the height 
that it may be comfortably grasped, the user or 
patient imparts a slight impulse to the lever, 
*ig. 1. 
Fig. 2. CHRONIC FORMS OF DISEASE. 
25 
which causes the pendulum to swing backward, 
the weight rising in the arc of a circle, whose 
radius is the length of the pendulum, to an extent 
proportioned to the impulse. The force of gravi- 
tation immediately returns the pendulum, and, 
acquiring momentum equal to the impulse, it 
passes the perpendicular and describes another 
arc in front equal to that behind. The forward 
extension of the swing carries backward the lever, 
hands and arms, with considerable force. In 
this process the pad is made a fulcrum, over which 
the chest is bent through the leverage afforded by 
the extended arms. The momentum of the falling 
weight is so much force expended in whatever 
muscles are exposed to the action. It is evident 
that by placing one side instead of the back 
against the pad, and grasping the handle with 
one instead of both hands, the effects will be re- 
ceived by one lateral half in place of the whole 
anterior portion of the body. In many cases this 
use of the instrument is to be preferred. 
After the first impulse is given, the pendulum 
continues to swing almost independent of effort. 
The action is non-fatiguing, imparts only agreea- 
ble sensations, and one is inclined to continue its 
use indefinitely. 
The mechanico physiological effects may now 
be briefly analyzed. The tension of chest muscles 
and tendons caused by the returning swing me- 
chanically urges apart the side walls of the chest, 
and thus increases the circumference to the extent 26 
MECHANICAL AIDS IN 
of three or more inches at the turning point of the 
excursion of the pendulum. This greatly distends 
the diaphragm. Simultaneously the lower borders 
of the ribs are raised, and the diaphragm is con- 
sequently forced to a higher position. 
This increase of transverse measure at the base 
of the chest does not materially increase its in- 
closed space, for its perpendicular measurement 
is proportionally diminished. The form of the 
chest is changed, being flattened from below up- 
ward. 
The muscular tension involved in the process is 
continuous, and becomes a practical inhibition of 
motion of the side walls of the chest. Respiration 
is now maintained only through changes of place 
of the inferior chest wall. The diaphragm and 
its associated muscles engage in the respiratory 
rhythmic motions, to compensate for the lack of 
those of the side walls, and, under the circum- 
stances, even to a greater extent. 
The mechanical consequences are readily under- 
stood. While the side walls are motionless, the 
inferior wall is resolved into a huge piston, work- 
ing perpendicularly in the cavity of the trunk. 
It rises and falls with each swing of the pendulum. 
The action of the instrument guides the direction 
and dominates the extent of the respiratory acts. 
Even more significant are the mechanical effects 
below the diaphragm. The upward movement 
of the inferior wall of the chest causes the mass 
below it to closely follow-the same effect as is CHRONIC FORMS OF DISEASE. 
27 
everywhere observed of piston movements. Such 
motion in an inclosed space produces what is 
known as suction; technically, as aspiration; 
in scientifie language, tendency to vacuum; and 
is instantly supplemented by atmospheric pressure 
at the whole exterior below the diaphragm. The 
mechanical effect of this pressure is inversely as 
the resistance; and as the exterior of the abdo- 
men and the inferior wall of the pelvis are prac- 
tically non-resisting, the principal mechanical 
effect is exteriorily manifested at these points. 
The inevitable consequence of these wall move- 
ments is that the contents-the visceral mass 
inclosed by the walls, whether abdominal or 
pelvic, solid or fluid-are impelled upward. 
While the space remains completely filled, the 
whole mass below the diaphragm has been urged 
to a more elevated position, and all, even the 
minutest portions of the contents of the common 
cavity, have participated in this mechanical 
effect. 
A proper estimate of the therapeutic value of 
modifying the direction and the form of the 
respiratory act by the use of the instrument re- 
quires that each of the several consequences be 
separately considered. The most obvious of 
these is the special cultivation of defective 
muscles, for which the instrument is adapted. 
The muscular action is either semi-active or pas- 
sive, and therefore causes no perceptible fatigue. 
It increases the nutrition of the muscles selected 28 
MECHANICAL AIDS IN 
for the process without inordinately increasing 
waste. It is therefore adapted to the feeble-to 
any one, child or adult, who can, by the help of 
the handle, maintain the erect position. The 
muscles are pulled by the swing of the pendu- 
lum, and nutrition therein is superinduced. 
Suppose, for example, it is desired to correct 
thoracic symmetry with or without curvature. 
The bulging or overdeveloped side of the chest is 
applied to the pad, while the hand of the oppo- 
site or shrunken side grasps the handle and 
causes the pendulum to swing. The muscles re- 
lated to the defect are set in action, the tendons 
are made tense, the side wall of the chest is 
drawn out, the ribs assume a more obtuse angle 
with the vertebral column, the local chest space 
is increased and is filled out by expansion of the pre- 
viously contracted portion of the lung. The con- 
sequences ultimately appear in gradual but per- 
manent correction of deformity of chest and spine, 
through the rehabilitation of lost powers. 
The time factor of the process should be duly 
appreciated. The action of the pendulum and 
its effects are completed by a return swing. The 
excursion is performed in accurate, unvarying 
time. Neither effort on the part of the patient, 
nor the lack of effort, causes the least variation 
of the time-rate. Nowt, it is interesting to note 
that this rate corresponds with that of ordinary 
respiratory rhythm. The consequence is that 
the motion imparted to the inferior chest wall, CHRONIC FORMS OF DISEASE. 
29 
and the involuntary motion of respiration, fall 
together; they are conjoined in one act-the 
same act. The instrumental and the physiologi- 
cal processes, both involuntary, become merged 
and inseparable. It follows that the use of this, 
or a similar form of apparatus, serves to cultivate 
the respiratory mechanism, restores its natural 
degree, and raises its efficiency to'the physiologi- 
cal standard. 
Of even greater therapeutic significance is the 
change which is easily and surely superinduced 
in the direction of the respiratory movements 
by the use of the instrument. This effect has 
above been shown to be due to the more or less 
complete fixation of the side walls, compelling 
extreme functioning of the inferior or diaphrag- 
matic wall of the chest. The consequence is ex- 
tension of respiratory rhythm in the axial, in- 
stead of the transverse, dimension of the trunk. 
The respiratory wave now penetrates all the 
viscera, including those of the pelvis, and the 
movements of the inferior chest wall are wholly 
represented at the anterior abdominal and in- 
ferior pelvic boundaries. 
The visceral mass in the cavity of the trunk, 
including that of the pelvis, is, through the 
operation of the forces described, subjected to 
vertical rhythmic oscillation to an extent cor- 
responding with the swing of the pendulum, for 
the depth as well as the direction and time of the 
act is now controlled by the instrument. The 30 
MECHANICAL AIDS IN 
patient can, however, vary the degree of the act 
at will to suit his desires. 
The vertical motion superinduced includes the 
contents of the venous blood and lymphatic 
vessels of every size. It is decidedly and power- 
fully aspiratory in relation to these vessels. 
The least upward motion of the inferior wall of 
the chest produces a difference in the degree of 
compression between the proximal or upper seg- 
ments of these vessels and their distal segments. 
An upward flow of their contents is therefore a 
mechanical necessity. The return flow continues 
synchronously with the respiratory impulse and 
is proportioned to its extent. The constant 
repetition of the impulse, modified by the vascu- 
lar elasticity, insures continuous flow, and prac- 
tically and promptly extracts all fluids entering 
these vessels. 
The portal division of the venous circulation 
enjoys the advantage of being more exposed to 
compression from combined muscular contrac- 
tion and atmospheric pressure, and the aid of 
valves is therefore unnecessary. The mechan- 
ism of the combined aspiration and compression 
and their effects are of such therapeutic import- 
ance as to justify being somewhat dwelt upon. 
Physiologically, the expansion of the chest and 
the coincident contraction of the lower part of 
the abdominal and pelvic spaces is but a single 
act; for the mechanical tension which separates 
the side walls and distends the inferior wall by CHRONIC FORMS OF DISEASE. 
31 
being continued below the diaphragm, produces 
contraction or tension, which diminishes the 
subjacent abdominal space. The space at the 
upper part of the cavity is increased while that 
at the inferior part is proportionally diminished. 
The contained mass is necessarily urged by this 
act into the freer space above and from the nar- 
rowed space below. 
The therapeutic importance of understanding 
the functions of the inferior wall of the chest re- 
quires that it be properly understood, for thereby 
much of the local medication so freely bestowed 
on localized diseases of these organs may be ob- 
viated. Further explanations and illustrations 
of the principles involved may therefore be justi- 
fiable. It is not necessary to imagine that the 
whole column of venous blood and lymphatic 
fluids are directly lifted to the chest, or that the 
vessels are squeezed like the bulb of a syringe. 
It is only needful to reflect that respiratory 
rhythm produces a series of lowered resistances 
toward the chest; that even minute differences 
of pressure between the proximal and distal seg- 
ments of these vessels determine the direction 
of the flow of their contents, and that this is se- 
cured by the respiratory mechanism, acting 
through the inferior wall of the chest; and that 
not the least important of the functions of this 
mechanism is to secure complete, uninterrupted, 
and never-failing drainage of the pelvic viscera 
under all circumstances of health and of local 32 
MECHANICAL AIDS IN 
disease of any of the pelvic organs. It is thus 
seen that any gain at the thoracic segment of 
the conduits for fluids secures movement of the 
contents of the whole line. The minutest and 
most distant pelvic capillaries are, in health, 
constantly subjected to the mechanism which 
effectually and completely removes all superflu- 
ous contents of whatever nature. This physio- 
logical provision obviates local accumulation of 
fluids, stagnation, surrender of vital control, and 
the chemical degeneracy that would otherwise 
be inevitable. The utility, indeed the necessity, 
of assistance for securing these ends, by means 
typified by the instrument whose operation is 
above described, is obvious. 
The grosser therapeutic uses of the instrument 
are therefore the correction of misdirected res- 
piratory rhythm, the consequent drainage of 
pelvic organs through physiological channels, 
and the submitting of local morbid ingredients 
to the organic chemistry through the circulation. 
The radical therapeutics of well-defined patho- 
logical states in advanced stages of development 
is practical extension of the same agencies. We 
may safely take the purpose of the average 
therapeutist as pointing out the true remedial 
indication. He uses such means as he has to re- 
move some local superfluity, excess, or degener- 
acy. Now, this something to be removed can 
exist as a local concrete entity only because of 
antecedent defect of the mechanico and chemico- CHRONIC FORMS OF DISEASE. 
33 
physics of the vital organism, as related to pelvic 
organs. The consequence is, local residual in- 
gredients, in process of chemical deterioration. 
The turgescence of the parts proclaims defec- 
tive outflow of interstitial ingredients into the 
capillaries permeating the diseased mass. But 
outflow from tissues is infallibly assured by vas- 
cular onflow, for the superficial area of capillary 
walls is far greater than their transverse area. 
It is therefore plain that absorption is propor- 
tionally in excess of inflow from the arterial side, 
when the conditions above defined-viz., aspi- 
ration and contraction accompanying the 
rhythm of the inferior wall of the chest-are 
present. 
The principle involved in local imbibition by 
returning vessels is well illustrated in Liebig's 
writings, in the experiment of causing water to 
flow through a segment of fowls' gut, arranged 
to traverse a vessel filled with water. It is 
shown that the whole of the water exterior to 
the animal membrane penetrates it and joins the 
outflowing stream. The conditions which con- 
trol the emergence of interstitial fluids of the 
pelvic organs are similar to those above referred 
to. The pelvic tissues may be drained com- 
pletely by employing the physiological mechan- 
ism adapted to secure venous outflow. The 
means pointed out only need to act with sufficient 
persistency, and, perhaps, to be slightly exagger- 
ated, to comply with the most urgent thera- 34 
MECHANICAL AIDS IN 
peutic demands and become fostered by adequate 
cultivation into a habit. 
To amend the vito-chemical deterioration of 
an important organ is always a perplexing 
problem for the therapeutist. This problem is 
greatly simplified by the energetic oxidation 
superinduced by the processes of the instrument 
described. A larger proportion of systemic 
residuals become oxidized to the emergent forms. 
Imperfect products of waste, obstructive and 
inimical ingredients, are rendered bland and in- 
nocuous under the suitable degree of physio- 
logical oxidation. This, in fact, is the indis- 
pensable condition for health; and the restoration 
of the oxidizing function is obviously essential 
for successful therapeutics. The cure of disease 
that is being constantly reproduced can not ad- 
vance very rapidly, however suitable the remedy 
may otherwise be. 
The aid afforded by the instrument is not only 
general, but reaches, with therapeutic energy, 
the diseased tissues. For arterial blood, bearing 
abundance of oxygen both in solution and in 
loose combination, readily parts with this ele- 
ment in favor of unstable ingredients whenever 
contact occurs. This is the physiological mode 
of maintaining, therefore of restoring, organic 
integrity. Unstable, noxious matters are thus 
normally reduced to innocuous, emergent forms, 
wherever in the vital system such contact be 
had. CHRONIC FORMS OF DISEASE. 
35 
This therapeutic end is secured by simply caus- 
ing arterial blood to pervade the diseased parts. 
Indispensable to this object is the venous and 
lymphatic outflow, easily and thoroughly secured 
by the process which has been detailed. It is 
hence seen that healthy local nutrition, in dis- 
tinction from perversion of the nutritive process, 
and the removal of local impediments thereto, 
are in a sense identical. Nature's provisions for 
maintaining the health of the pelvic organs and 
tissues in male and female are physiologically 
abundant; her provisions for restoring health 
which inhere in the physiological mechanisms 
appear to be equally ample. It is due that these 
parts be the healthiest of the vital organism. It 
only requires that this inherent mechanism and 
its uses be better understood by those whose 
profession and interest lie in that direction. 36 
MECHANICAL AIDS IN 
MASSAGE : 
ITS PRINCIPLES, VARIETIES, FACTORS AND ADAPTATIONS. 
THE resources of mechanico-therapeutics and 
its applicability in chronic affections are by 
no means exhausted in the statements of princi- 
ples and practice already shown. Even more 
valuable adaptations of the same remedial agent 
are available for physicians inclined to investi- 
gate this department of medical practice. Not 
only abdominal and pelvic, but numerous other 
forms of chronic suffering, local and general, have 
been and may be successfully treated by careful 
adjustments of this class of remedies. Mechanical 
remedies in the sense implied in these articles are 
agents of power; and misconception of their 
physiological and pathological relations easily 
leads to their misapplication. It is, therefore, 
important that their nature and effects under the 
different circumstances presented by disease be 
carefully investigated, to avoid errors and secure 
the advantages this class of resources is capable 
of affording. 
The department which seems next to invite at- 
tention has been used to some profit, although in a 
fragmentary manner, under the name of massage. 
The processes coming under this designation ap' 
pear simple only because their varieties and ad- CHRONIC FORMS OF DISEASE. 
37 
justments to varying and diverse pathological 
states are not well understood. It therefore be- 
comes necessary, first, to consider the nature of 
the factors of massage, so as to determine the 
suitability of each of these for correcting cer- 
tain morbid states of the vital system and its 
parts. 
Massage is popularly understood to be pressure 
with motion imparted to the person of an invalid 
for remedial purposes by the hands of a competent 
individual, hence called an operator or masseur. 
In its ordinary application the direction, degree 
or force, extent, time, rate and other particulars 
which are necessary factors of the process, are 
left to chance and receive little or no considera- 
tion, as though of no value. But, since these are 
susceptible of almost unlimited varied proportions 
to each other, it is clear that either may prepon- 
derate and, by giving character to the process, 
m ly greatly influence, or even control, the physio- 
logical effect, and therefore its suitability as a 
remedy. For example, massage may be confined 
to any special region or location ; may be slow or 
quick; superficial or deep; prolonged or short; 
applied to chest, abdominal viscera, muscular 
parts, or skin; may give precedence in order of 
processes to any particular part or functioning 
department; and in each case its suitability for a 
given case may vary from perfect adaptation to 
extreme unfitness and even hazard. Massage, to 
be entitled to the appellation of remedy, must 38 
MECHANICAL AIDS IN 
therefore comply with the varying needs of chronic 
infirmities. 
We may now follow the combination of pressure 
and motion from the hand of the operator, and 
note what becomes of it in the vital organism of 
the patient. For purposes of identification, we 
may call it motor energy-energy in the motor 
form. Motor energy is transmitted to the vital 
tissues and the fluids which pervade them in the 
form of waves, whose length and depth are de- 
termined by the amount of pressure and extent of 
motion the hand affords. But it no longer re- 
mains motor energy; neither is it lost or even 
diminished, force or energy being in its nature 
indestructible. It simply assumes other :orms, 
which, together, are the exact equivalent of that 
transmitted, and which has its source in the me- 
chanico-vital tissues of the operator. The changes 
of form are wrought by qualities which inhere in 
the receiving medium, and are partly of the physi- 
cal and partly of the vital or function-perform- 
ing order. 
The motor area is a blended mass of vital and 
non-vital, fluid and semi-solid, elastic and non- 
elastic, stable and unstable ingredients. Each of 
these is enriched by an accession of energy, which 
each disposes of in accordance with its differing 
physical constitutions and relations. The new 
accession of energy assumes the form, merges 
with, and thus re-enforces that pre existing m 
whatever part receives it. The additional energy CHRONIC FORMS OF DISEASE. 
39 
derived from exterior sources reappears in cog- 
nizable form in the physical phases of function, 
contributing to the highest physiological purposes 
of the organism. We will next see just how 
manual massage becomes therapeutically useful. 
The pressure or compression of the hand dis- 
places the fluids under it, whetner these be vas- 
cular or interstitial. Following lines of least re- 
sistance, these fluids are urged along channels 
anatomically provided: the pressure, therefore, 
merges with the natural impulse which impels 
blood and other fluids, and removes both func- 
tional and mechanical impediments, wnose pres- 
ence detracts from health. Massage supplies 
motor force to render the physiological impulse 
equal to its purposes. 
When some degree of adhesion exists between 
surfaces of objects, however minute, if impelled 
at different rates of motion, resistance, in the form 
of friction and of elasticity, appears. At the 
same time the motor energy expended is freely 
transformed to heat energy, as when two sticks 
are rubbed together, or a piece of rubber is 
stretched. The vital organism is an extensive 
area for this mode of transformation, and its op- 
eration is constant. The physiological provision 
for disposing of excess of heat renders its morbid 
accumulation from this cause improbable; per- 
haps impossible. 
The forcible contact and collision of the minutest 
ingredients of the organism is an inevitable con- 40 
MECHANICAL AIDS IN 
sequence of the reciprocating form of massage. 
The endings of the motory excursions are com- 
parable to blows of infinitesimal hammers. It 
follows that the minutest components of the mo- 
tory area suddenly receive accessions of energy, 
quickening and increasing that previously inher- 
ing therein. The diverse elemental parts are af- 
fected by this cause in varied degrees. The free 
oxygen present readily participates in the new 
influence, and rearrangements of atomic constitu- 
ents or chemical changes are rendered inevitable. 
The new chemical products contain more oxygen 
and are more stable; at the same time energy in 
some form has been liberated. 
The absorption of motor energy for the purpose 
of converting unstable organic ingredients of the 
organism to stable chemical forms appears to be 
a leading purpose of the physical plans of animal 
life. In health its spontaneous introduction is 
sufficient to secure this end. But transmitted 
motor energy or massage, in case of insufficiency 
consequent upon ill health, supplies the defective 
chemical energy, and the vital organism is ena- 
bled to imbibe the oxygen required to neutralize 
and discharge ingredients which would otherwise 
immediately become prejudicial and noxious. 
It is hence apparent that the ordinary changes 
of composition of nutritive ingredients in their 
progress in the vital organism depend very much 
on the motor energy coincidently developed there- 
in. The chemical phase of physics secures the CHRONIC FORMS OF DISEASE. 
41 
innocuousness and final dismissal from the sys- 
tem of all its superfluous ingredients of whatever 
quality, even though such quality may have Peen 
the consequence of such adverse circumstances as 
have lessened the usual predominance of chemical 
activity, and even though deteriorated chemical 
products may have accumulated to a considerable 
amount. 
Judging from the usual character of ordinary 
remedies, chemical energy is what is chiefly ex- 
pected of them. The relations which drugs sus- 
tain to the morbid function, and especially to 
morbid effects and products, is the leading con- 
sideration in their selection-that is, in thera- 
peutics. Traditional medical practice, therefore, 
yields its tacit approval to the chemical phase of 
massage. And this is not all. The medical pro- 
fession has always freely used changes of tem- 
perature (heat-making) in its most convenient 
forms as a remedy , and in modern times frequently 
employs electricity, which is well known as an 
equivalent, derivative and convertible form of 
motor energy, for the same purpose. These facts 
appear to countenance and even afford cumula- 
tive approval of the remedial use of direct ad- 
justable supplies of the same agent through mas- 
sage. 
The ultimate purpose of all remedies is simply 
to support the vital manifestations, and coinci- 
dently to remove impediments thereto. By vital 
manifestations is understood the growth of or- 42 
MECHANICAL AIDS IN 
ganic structures, their reproduction in compen- 
sation for their waste; and more particularly the 
support of those changes in organized tissues from 
which proceed the special forms of energy which 
characterize the individual-namely, the varieties 
of nervous and muscular power. 
These vital forms of energy are the product of 
vital cells and the result of the complex processes 
of nutrition. The direct purpose of the physical 
modes of energy into which motor energy is plainly 
resolvable is to provide the conditions indispensa- 
ble for nutrition. Motor energy transfers ingre- 
dients to and from the vital cell; heat at an un- 
varying standard is indispensable for the required 
transformations, while chemical energy steps in 
to diminish the latent store of the vital cell, which, 
liberated, assumes the form impressed upon it by 
its organic instrument or tissue. 
The nature of the assistance which massage 
affords to the struggling purposes of the organism 
through its influence on the changes due the con- 
tents of the vital cell is therefore fairly intelligible. 
This recourse compensates in a manner for faulty 
preceding conditions. Very prominent among 
causes of defective health are faults of spontaneous 
physical activities. Some parts and some func- 
tions are overworked, others are insufficiently 
active. Massage supplies action in default of 
auto action. By the latter the different forms of 
cell life, however diverse in function, are benefited 
in equal degree, so that pre-existing relations of CHRONIC FORMS OF DISEASE. 
43 
function are preserved. This is health. Ill health 
is a proclamation of differences, so that the nec- 
essary balance of functions is lost. The nutrition 
of important parts-as, for example, the respira- 
tory or any other special mechanism-declines, 
and objective local consequences necessarily ap- 
pear, demanding redress of therapeutics. 
Now, massage acquires its value, which is truly 
remedial in distinction from hygiene, by its ad- 
justability, by which it becomes adapted to diverse 
and often opposing pathological conditions, even 
when these have attained an extreme development. 
These apparently opposite effects are attainable 
by giving judicious preponderance to one or an- 
other of its separate and distinct factors. For, as 
before shown, massage is a composite agent. It 
unites pressure or force, which is susceptible of 
great variability, with motion, whose rate or ve- 
locity also admits of infinite variations. The fac- 
tors largely controlling the effects of massage- 
that is the modification into which its energy may 
be transformed-are therefore those of degree or 
force and rate. Massage is susceptible of speciali- 
zation to the extent of the variability of its factors. 
It is important that the adjustments of massage 
whereby contrary results of a curative nature are 
secured be clearly apprehended. To illustrate 
the principle stated, let it be supposed that the 
living body is composed of strata or layers from 
the surface inward. If compressed by the hand 
(as in massage), the anatomical parts immediately 44 
MECHANICAL AIDS IN 
beneath it become bound by the increase of adhe- 
sion into a uniform mass. The hand makes short 
motory excursions, and the whole mass moves 
with it, while the component parts fail to move 
upon each other. All molecular inter-motion is 
effectually prevented; no physiological effects of 
the transmitted motion are possible in the com- 
pressed area. The massage process reaches the 
stratum beyond where the diminution of compres- 
sion permits the anatomical constituents to glide 
upon each other. Here, and here only, is the 
communicated energy converted into its physio- 
logical equivalents and uses. 
It follows from this mechanical explanation that 
by dexterous application of the massage process 
its factors may be rendered available for any lo- 
cality, whether superficial or deeply seated ; and 
that for massage purposes the seats of important 
functions may be practically isolated, while other 
parts are in suspense and negation. 
It is equally feasible to address massage to any 
specially function-performing tissue by adjust- 
ments of the methods so as to increase, or to di- 
minish, its normal incitation. The activity and 
nutritive support of one function may be used as 
the means of withholding nutritive support of 
morbidly competing functions. Thus muscular 
power arising from nutritive incitation of muscle 
cells, or nervous power arising from appropriate 
nervous centers, may either of them be incited 
and nourished at will at the expense of the other. CHRONIC FORMS OF DISEASE. 
45 
An illustrative example will render clear the 
principle stated. Massage with least pressure is 
confined to the surface; the motion traverses the 
sensory and reflex nerve endings or loops situated 
in the skin, and no effect is produced in subjacent 
tissues. The necessarily preponderating effect of 
this class of impressions is to cause nutritive 
changes in the nerve centers, which are the source 
of sensory and reflex nerve energy, while but little 
advantage accrues to muscles. Persistent incita- 
tion of sensory nerve centers, however effected 
and for whatever purpose, is sure, ultimately, to 
produce a morbid supremacy of the nervous func- 
tion and to destroy the natural equipoise that ob- 
tains in the healthy organism. For example, if 
the fauces are touched with a feather, or if the 
finger tips are passed lightly over the bared sole 
of the foot, or other parts abundantly supplied 
with nerves, the senses are inordinately impressed 
and reflex action comes immediately to the rescue 
of the assaulted part. Violent spasms accompany 
the too intense sensibility. In case of inordinate 
irritability, constitutional or acquired, serious ills 
may follow, especially should the power of the 
sensory centers be made to increase by undue and 
morbid cultivation. It is readily seen that no 
corresponding nutritive effects are superinduced 
by these and similar impressions in the sources 
of muscular power. 
If, however, the pressive factor of the process 
be made to predominate, the physiological effects 46 
MECHANICAL AIDS IN 
are reversed. The nerve endings in the skin are 
not traversed, the skin moves along with and to 
the extent of the hand ; more deeply seated ana- 
tomical structures are reached and the nutritive 
consequences inure to the advantage of the mus- 
cular structures and those associated therewith, 
while the nervous powers are in complete abey- 
ance, functionally and nutritively. Massage, 
therefore, presents a practical method of solving 
one of the most difficult problems with which the 
physician is called upon to deal-namely, that of 
redressing the morbid relations of the two great 
energy-evolving tissues - the muscles and the 
nerves. This recourse has always been regarded as 
invaluable for increasing development of defective 
parts,and "gymnastics," " Swedish movements," 
"localized exercises," are well-known means of 
securing this end. It is now seen that by giving 
prominence and force to an isolable factor of 
massage, similar results are secured in regard to 
function-performing tissues whereby ineffective 
function may be raised to its normal state, and 
the relative excess of counterpoising function at 
the same time corrected. In this way erring 
functions are remedially caused to acquire the 
natural counterpoise indispensable to health. 
The other property of massage susceptible of 
acquiring physiological preponderance, and 
thereby therapeutic value, and which demands 
separate consideration, is that of rate. By rate 
is meant the number to the minute of motory ex- CHRONIC FORMS OF DISEASE. 
47 
cursions or vibratory waves to which the vital 
parts are subjected by the massage process. 
Rate relates only to time, and is distinct from 
the extent of the motory excursion. 
The question of the rate of massage processes 
is of leading importance, inasmuch as this factor 
largely determines the nature of the transforma- 
tion of motor energy, and, consequently, the phy- 
siological effects superinduced. It has been 
shown above that, whether transmitted to or 
having its source within the vital organism, 
motor energy is resolved into its equivalents, 
and, besides, mechanical propulsion of fluids, 
abundant heat and chemical action are devel- 
oped. 
We are now prepared for the statement that 
the relations these secondary forms of energy 
sustain to each other depends largely on the rate 
of the process. The higher the rate, the greater 
the resolution into the chemical, and the less into 
the other forms of energy, and contrariwise. 
Convincing evidence of the correctness of this 
statement will subsequently be given. The prac- 
tical conclusion is that while the lower rates or 
slow massage are efficient for promoting general 
nutrition and development, the higher rates of 
reciprocating action, or vibratory motion, are 
efficient in promoting the chemical phase of phy- 
siological activity. The one supplies nutritive 
ingredients to the vital cell, promotes respiration 
and circulates the blood, while the other applies 48 
MECHANICAL AIDS IN 
oxygen to organic uses, and resolves unstable 
ingredients into exit products; the higher the 
rate of massage (within certain ill-defined limits), 
the more searching and efficacious is this latter 
effect. 
At this point the therapeutic world is con- 
fronted by an embarrassing lack of experience 
and knowledge; for other rates than those nat- 
ural for the hand of an operator to supply are 
scarcely conceived. The vast outlying area, 
both above and below the narrow line of human 
capability, invites exploration. 
The rates of manual massage are but very 
slightly, and at most but transiently, controlled 
by the operator or masseur, but by universal 
law. The limbs in action necessarily beat time 
as inevitably as the swing of a pendulum. This 
is because the predominating force engaged is 
gravitation; the constancy of this force ulti- 
mately compels the muscles to act synchronously 
with it, spite of opposition of the will. The op- 
erator quickens his actions at the expense of his 
motory and nervous resources; these failing, sus- 
pension of endeavor quickly follows. A quick- 
ened rate of manual massage defeats its purpose 
to communicate the motor form of energy-ac- 
tion ceases before effects can rise to an appreci- 
able extent. 
Similarly, lower rates than those fixed by phy- 
sical law are difficult to execute by the hand, be- 
cause of the control of the same law; and though CHRONIC FORMS OF DISEASE. 
49 
the operator's resources may be prolonged, the 
process is brought to an early and generally inef- 
fective end, for unnaturally slow motions require 
fatiguing restraint by the will and superinduce 
nervous depression, and effort is thereupon sus- 
pended. 
The actual time-rate of the extremities in ordi- 
nary, well-sustained occupations is not, in gen- 
eral, far removed from that of a pendulum beat- 
ing seconds, and accords with the rhythm of the 
arterial system. Extreme deviations from such 
rates are necessarily transient. When, there- 
fore, a masseur writes or talks about his practice 
of more rapid rates, it is in depreciation of the 
value of his performance. He is powerless to 
surmount Nature's barriers in the way assumed. 
These considerations naturally lead to inquiries 
respecting the vast outlying field of ratesand de- 
grees of motor energy, extending below and 
above the narrow scope of the operator. It is in- 
teresting to inquire whether in this limitless ex- 
tension there be rates of motor energy which are 
legitimately of medical service. Any desired 
extension of scope of motor energy is attainable 
by the aid of mechanical adaptations and con- 
trivances. In the pursuit of this purpose science 
affords close analogies, for, by the aid of mechan- 
ical contrivances, the universe has been enor- 
mously extended and unfolded to our observation 
and its exploration goes on. We have been 
shown that what to our senses are the far differ- 50 
MECHANICAL AIDS IN 
ing phenomena of light, heat, electricity, motion, 
and other forms of energy, are but variations of 
rate and degree of essentially the same thing- 
differing forms and conditions, modified by ma- 
terial agents, of wave-like or vibratory motions. 
By the aid of appropriate apparatus, we may also 
investigate the consequences of vibratory or 
wave-like motions, at their different rates, when 
transmitted to the complex components, vital 
and non-vital of the organism, and learn what we 
may of the laws governing this procedure and 
the objects attainable thereby-matters which 
are as a sealed book to those whose observations 
have been limited to the degrees and rates of 
motor energy which emanate from the masseur. 
We may next turn attention to the physiologi- 
cal and remedial effects of massage whose rates 
are below those of which the human hand is ca- 
pable; and to the adaptation of these to special 
forms of disease of the abdominal and pelvic 
contents. CHRONIC FORMS OF DISEASE. 
51 
THERAPEUTICS OF SLOW MASSAGE. 
AUTO-MASSAGE-KNEADING. 
THE vital organism is never motionless in its 
quietest moments. Its different parts and 
organs are constantly pervaded by spontaneous 
and unconscious wave-like motions. This is es- 
pecially and conspicuously true of the contents of 
the trunk and pelvic -cavities-the visceral or- 
gans. These motions inhere in the mechanical 
structures wdiich dominate the parts referred to; 
and so important are they to the welfare of the 
vital organism that Nature has rendered them 
mostly independent of the intelligence, will, and 
the senses, which are notoriously liable to err. 
As the motions to be described are intimately 
associated with mechanical structures whose 
functions are maintained by other causes than 
those emanating from the reflective power, they 
may properly be called auto-motions; and since 
they may be shown to bear a close resemblance, 
in form, to the imparted motions known as mas- 
sage, in being reciprocating or wave-like and sus- 
ceptible of variations of degree and of rate, there 
is much propriety in classifying the differing 
grades and varieties of spontaneous motions 52 
MECHANICAL AIDS IN 
found in the vital organism under the common 
designation of auto-massage. 
Auto-massage belongs decidedly to the slow 
variety of massage processes-that is, its rates 
of motion are at and below those which the hand 
of an operator can naturally and easily execute. 
This is readily seen from the fact that auto- 
massage appertains particularly to the visceral 
organs-the contents of the cavity of the trunk. 
Although some of the auto-motions have their 
source in the general muscular system and others 
in special motor mechanisms, yet the motions 
thus evolved appear to inure to the advantage of 
the organs contained in the cavities mentioned. 
This shows that the purposes of auto massage 
are essentially the promotion of nutritive proc- 
esses, of which the before-mentioned parts are 
the source and seat. 
The contents of the cavities of the body are 
soft, yielding, and have a slippery exterior, and 
are therefore perfectly adapted to be moved upon 
and among each other, and to yield to the slight- 
est mechanical impulses derived from exterior 
sources or generated in their own tissues. 
Whatever the cause or the origin, all such mo- 
tions necessarily have the qualities of pressure 
and rate, thus further justifying the designation 
of massage. We may now pass in review these 
several auto-motions, and note separately their 
source, rates, purposes, and distinguishing char- 
acteristics. CHRONIC FORMS OF DISEASE. 
53 
Bodily Motions.-The ordinary activities of 
the average individual, whatever their purpose, 
necessitates the bending, twisting, and unending 
combinations of these movements of the trunk 
for exterior purposes. All such trunk move- 
ments produce mechanical effects-that is, ex- 
pend motor energy among the visceral contents. 
Some degree of compression, mild or seveYe, 
with displacement of organs, inevitably results. 
Similar mechanical consequences might be noted 
were a bag, of similar size and shape, compactly 
filled with loose objects, as balls, subjected to 
similar combinations of bending and twistings. 
The contained objects would be displaced; they 
would be subjected to alternations of pressure ; 
the great extent of surface would glide or scrape 
against each other; and if composed of rubber, 
the elastic property would be fully brought into 
exercise, with its special result of heat develop- 
ment. 
The gravitation-that is, weight-of the vis- 
ceral mass causes far greater pressure at its 
inferior than its superior portions. Whether this 
difference of pressure be beneficial or prejudicial 
depends on circumstances which it is highly 
important for the therapeutist to weigh carefully. 
Difference of pressure is a factor of great signifi- 
cance and is easily turned to the highest thera- 
peutic account. 
In the present case a sharp bending of the trunk, 
say to the right, mechanically necessitates dimin- 54 
MECHANICAL AIDS IN 
ished, perhaps entire relief of, pressure at the op- 
posite, or left inferior, portion of the contents of 
the cavity. 
As regards the venous and lymphatic vessels, 
the act is one of suction, so called, and affords a 
direct and positive upward impulse to the con- 
tents of these vessels, which effect is repeated as 
often as the same or similar motions recur. The 
usual motions of the body, whether simple or 
compound, therefore superinduce auto-massage 
of the contents of the trunk, the mechanical con- 
sequences of which are naturally increased by 
the greater gravitation at its inferior part. The 
physiological effect of this form of auto-massage 
is the onward and upward movement of the fluids 
of the pelvis and abdomen and the outflow of in- 
terstitialjuices. Such outflow is an indispensable 
preliminary to arterial inflow and to the renewal of 
local nutrition; the contents of the intercapillary 
spaces, whatever they may be, are drained into 
the portal and lymphatic vessels. Auto-massage 
superinduced by trunk motions has no special 
rate; it may, under full occupation in health, av- 
erage ten per minute. 
Rhythmic Motions of Respiration.-If an an- 
imal at rest be carefully inspected, it will be seen 
that the respiratory movement includes the ab- 
dominal wall, and that the inferior wall of the 
chest and the anterior of the abdomen act syn- 
chronously. The whole mass of the digestive or- 
gans is located between these boundaries, and is CHRONIC FORMS OF DISEASE. 
55 
consequently subjected to the oscillating motions 
of the respiratory acts and participates in its var- 
iations of rate and degree. Since this motion in 
the human species is approximately perpendicular 
it follows that it is attended by differences of 
gravitation, the difference being greatest when 
gravitation becomes greatest by reason of loca- 
tion; the upward part of the act removes pressure, 
while the downward part restores pressure to 
the lower portion of the visceral mass. What- 
ever circumstances may cause deepening of the 
respiratory act, extends the effort to the visceral 
contents in the form of increased difference of 
pressure; in other words, increased degree of the 
auto-massage of the abdominal and pelvic viscera. 
Respiratory auto-massage evidently includes all 
the hollow organs of the viscera-the stomach 
and the digestive canal to its inferior termina- 
tion. It subjects their contents to the motions 
which tend to urge them on their course of con- 
tact with the interior surfaces of the canal. It 
causes the exterior surfaces of the different seg- 
ments to glide upon each other. The secreting 
glands which line the walls are subjected to the 
same constant rhythmic changes of pressure, 
mechanically facilitating the discharge of secre- 
tions. The same oscillations of pressure impel the 
contents of absorbent vessels, and are a most 
important consideration in accounting for the acts 
of absorption. The same rhythmic changes of 
pressure applied to the venous and lymphatic 56 
MECHANICAL AIDS IN 
circulatory vessels manifestly exercise a control- 
ing' influence in the movements of the contents of 
these vessels, an influence which experience shows 
can not be even partly dispensed with without 
serious damage to health. It is not only the chief 
agent for the transfer of the products of digest- 
tion to the blood-vessels, and the support of the 
system at large, but it is the efficient agent for 
maintaining the health of the inferior organs- 
those of the pelvis-by insuring their full and 
constant drainage under all adverse circum- 
stances. The rate of this leading and constant 
form of auto-massage is fifteen to twenty per 
minute. 
Locomotion.-If the top of the head of a per- 
son progressing over a level surface is observed, 
it will be seen to make a series of perpedicular 
oscillations, to the extent of from one to three 
inches, according to his rate of progress. The 
motion is superinduced by the spring he commu- 
nicates to his body by the exertion of the muscles 
of feet and legs. 
In this act the contents of the cavity of the 
trunk necessarily participate in the form of auto- 
motion, in which variations in gravitating force 
are produced, affecting the mass in general, and 
the contents of the vessels in particular, since 
all variations of vascular pressure indicate move- 
ment of vascular contents in the direction of least 
resistance. 
If ascent is made in locomotion, as up stairs CHRONIC FORMS OF DISEASE. 
57 
or an acclivity, other factors are engaged in the 
act. Muscular energy to lift the body, far greater 
than that required to impel it over a level sur- 
face, is now added. This demand for voluntary 
motor energy requires more blood and more air 
from which oxygen is taken ; these are supplied 
to the muscles through proportionate increase of 
both respiratory and locomotive auto-massage. 
The degree or force of the auto-motion increases 
first, afterward the rate, and both factors be- 
come conspicuous throughout the viscera. These 
obvious facts are conclusive evidence that the 
slow or kneading form of massage, whether sup- 
plied from exterior causes or automatic, is in- 
dissolubly associated with nutrition and is di- 
rectly tributary thereto. The rate of locomotive 
massage is about the same as that of manual 
massage, being controlled by gravitation. The 
interesting fact should be noted that locomotion 
temporarily hastened by the will increases its 
degree-that is, deepens its extent more than its 
rate. 
The Circulatory System of Auto motions.- 
The heart and arteries are a very conspicuous 
field of auto-massage. The energy represented 
in motions of these vascular walls does not, how- 
ever, extend into surrounding tissues, but is ex- 
pended chiefly within the walls of the vessels, in 
the form of continued or untransformed motion, 
and in chemical changes, for which the rate, 
being quicker than the other forms of auto- 58 
MECHANICAL AIDS IN 
massage, renders it adapted, so that depurative 
effects become possible, even within the blood- 
vessels. 
The Vermicular Motory Function of the Di- 
gestive Organs.-This form of auto-massage 
has, unfortunately, monopolized the attention 
which should have been distributed impartially 
among all the varieties above described. The 
consequence is, that faults are ascribed to the 
digestive canal which in reality belong some- 
where else; that defects of its special movements, 
are sought to be remedied by medicinal impres- 
sions of its interior, which are due from other 
sources. The natural and wholesome incitants 
of digestive organs arise exteriorly. The ver- 
micular motion requires the mechanical impres- 
sions naturally supplied by the combined auto- 
motory processes, which have been described, as 
its incitant. The substitution of drugs whose 
influence is confined mainly to the digestive tract 
practically withdraws the normal incitant. The 
consequence, as all who have much experience 
know, is that the power of the several forms of 
auto-massage declines, and the digestive tube 
and appendages no longer receive due motory 
incitation of auto-massage ; the interior or drug 
incitation is substituted. 
The reasonableness of dependence of the ver- 
micular upon the other forms of auto-massage 
is shown by the following physiological con- 
siderations : Digestion, and the consequent dis- CHRONIC FORMS OF DISEASE. 
59 
charge of digestive residuals, is naturally pro- 
portioned to, and largely dependent on, muscular 
expenditures, of which auto-massage constitutes 
no small share. The occasion or necessity for 
vermicular action, therefore, only exceptionally 
arises from interior incitation, hut from that 
afforded exterior to the organs in which it is de- 
veloped. The vermicular function is thus super- 
induced by its purposes. 
When, therefore, this action is superinduced 
by drugs, the nutritive purpose suffers defeat, 
for ingredients destined for the support of vital 
powers are by this means consigned to the cate- 
gory of useless residuals and lost, to the ob- 
vious detriment of the auto-functions from which 
normal incitation of vermicular massage is due. 
The due maintenance of the auto-muscular func- 
tions of the digestive apparatus is highly impor- 
tant, as is shown by the following considerations : 
The discharge from the organism of residuals 
of digestion is a comparatively subordinate pur- 
pose of its auto-motions, inasmuch as the quan- 
tity discharged is far inferior to that absorbed. 
Absorption is therefore the greater purpose, and 
this is defeated by drug incitation of the auto mo- 
tion,but secured by natural or massage incitation. 
Other purposes of vermicular action arising 
from its legitimate incitants-the mechanical aid 
to the secretions, especially from the pancreas 
and liver; mechanical assistance for local venous 
and lymphatic vessels, and the due maintenance 60 
MECHANICAL AIDS IN 
of the nutrition of the muscular coats of the 
digestive apparatus, which is secured only by 
their proper, not by forced, exercise-are ap- 
parent. 
It is important to note that the vermicular 
function of the digestive canal responds only to 
slow mechanical impressions, and not to those of 
rapid rates. The normal incitants pointed out 
have conspicuously slow rates of motion; 
quicker motions are therefore incapable of merg- 
ing with these to re-enforce their power to con- 
trol the vermicular act. Although the trans- 
mission of massage at rapid rate to the visceral 
organs is frequently indicated by the nature 
of the disease requiring this form of remedy, yet 
in this case the vermicular function is restrained 
and not increased by motory processes exceeding 
the rate of normal auto-massage. 
The considerations above presented show that 
structure and function are conjoined in the or- 
ganism to render indispensable certain slow 
auto-motory processes ; that these are normally 
communicated in the form of deep waves through 
the visceral organs; that these have adequate 
motory sources, independent of the influence of 
the will; and that the physiological necessity 
for this class of activities is asserted by the mul- 
tiple provision within the organism for securing 
the same. 
In considering the proposition to supply by art 
the defects of natural or auto-massage, it is CHRONIC FORMS OF DISEASE. 
61 
essential that the characteristics of the latter be 
particularly noted, for therapeutic success must 
depend on compliance with the demands indi- 
cated by the auto-process. 
The special field of auto-motions is evidently 
comprised within the cavity of the trunk, or 
cavities, if the pelvic be regarded as mechani- 
cally distinct from the abdominal. 
The rates of the auto-processes extend from 
that of the limbs (governed by gravitation) to 
those indicated by the single numerals per minute, 
rates which can not be effectively mantained by 
manual methods. 
The degree, depth, or force of auto-massage is 
sufficient to include the whole visceral mass. 
The scope includes visceral organs and excludes 
the surface, and, indeed, all parts highly endowed 
with sensory nerves. 
The mode of action of auto-processes of mas- 
sage is the production of differences of pressure in 
different portions of the visceral mass and the 
vessels therewith connected. 
The effect-or consequence of difference of com- 
pression of different parts, including both solids 
and fluids of the viscera, is to urge whatever is sub- 
jected thereto in the direction of the less pressure. 
The direction in which this auto-motory cause 
acts as a whole is vertically, or, in opposition to 
gravitation. The differences of pressure also 
cause gliding of distinct organs and parts upon 
each other in obedience to variations of pressure. 62 
MECHANICAL AIDS IN 
The direct mechanical consequences are com- 
plete drainage of the visceral mass of all super- 
fluous fluids and the rendering of local stasis and 
its morbid effects impossible. 
The same mechanical cause also obviates undue 
and prolonged contact of organs and parts of or- 
gans with each other, and of viscera with the con- 
taining abdominal walls, and of inferior loops of 
digestive viscera with those of the pelvis. 
The therapeutic consequences of the above- 
stated mechanical effects of auto-massage, and 
of any massage which approximates it in form, 
rate and degree, can not be over-estimated, for 
thereby is solved its most difficult problems; for 
not only is the origin of a variety of morbid mani- 
festations clearly demonstrable, but the way is 
suggested for not only obviating the maladies, 
medical and surgical, which depend thereon, but 
also of extending the scope of such means to in- 
clude the well-developed morbid consequences. 
The above-stated fundamental principles are 
confirmed by comparative physiology. The vis- 
ceral organs of four-footed creatures are mechani- 
cally poised between anterior and posterior sup- 
ports, and thereby subjected to the extreme me- 
chanical effects of the motion of the limbs iff all 
their varieties of pace. The consequence is auto- 
massage of viscera more constant and far exceed- 
ing that posssble in the human subject. There is 
perpendicular oscillation of great weight, sec- 
tionalcompression, pressure-gliding, and rubbing CHRONIC FORMS OF DISEASE. 
63 
from unequal displacement of organs; great ex- 
tremes in degree, though uniformly slow rates of 
auto-motion, and almost entire immunity from the 
digestive and pelvic ills to which the human species 
is notoriously subject. 
This illustration is an object lesson in physi- 
ology, establishing an indisputable point of aeti- 
ology, for faults of motion (which is really func- 
tion) when prolonged, develop consequences in 
the tissues entitled to special designations, defin- 
ing local and sensorial characteristics. 
It hence appears that the conversion of a 
pathological condition into the physiological con- 
sists essentially in restoring function-that is, 
in re-establishing in full force the agency by 
which health is maintained. In case of chronic 
suffering of the visceral organs, slow auto- 
motions are the fundamental factor of their func- 
tions, and means are to be sought which serve to 
raise these to their normal degree. 
The causes of the decline of the auto-motory 
functions have in part been shown, but for clear- 
ness may be restated. The fundamental cause 
lies in physiological habits unconsciously faulty; 
for it is hardly supposable that rational beings 
will deliberately and consciously cause their 
powers, and therefore the sum of their enjoyments, 
to diminish. The advantages of civilization are 
thus far accompanied by serious disadvantages 
and drawbacks arising from misdirection and 
perversion of the senses, the subordination of the 64 
MECHANICAL AIDS IN 
judgment to this faulty influence, and the in- 
crease of these defects through heredity. 
While the vocations of large numbers afford 
sufficient, often an excess of exercise, this is 
liable to be partial and physiologically misdi- 
rected; and such persons suffer from disorders of 
visceral parts scarcely less than those whose 
exercises are insufficient. In both cases the 
trunk-motions react on the viscera with insuffi- 
cient mechanical force, and there is consequent 
marked immobility of the intestinal convolutions 
and stasis of the visceral circulation. An intesti- 
nal fold or knuckle impinges with continuous, in- 
stead of the natural interrupted, pressure against 
some point at the lower border of the abdomen, 
thinning its walls and causing protrusion at the 
slightest provocation, or it intrudes upon the 
sacred rights of the female generative intestine, 
insinuating behind this, before that, between 
other parts, urging them aside and dislocat- 
ing them. The same immobility prevents the 
full return of the circulating fluids for aeration, 
re-enrichment of ingredients and redistribution, 
allowing them to stagnate in vascular pockets, 
and in parts least subjected to auto-massage and 
finally to ripen into local disease. 
These statements bring into view two dis- 
tinct conceptions of the nature of chronic affec- 
tions of the visceral organs. These may be dis- 
tinguished as the nosological and the cetiological 
conceptions. The nosological has its basis in CHRONIC FORMS OF DISEASE. 
65 
variability of manifestation. It emphasizes the 
common, distinctly defined morbid appearances, 
notes the results of exploration, and lays special 
stress on the disagreeable sensations-conse- 
quences of defective functioning. Any point 
from stomach to rectum may serve as a locality; 
the specific manifestation may be any secreting 
process from the liver to the minutest follicle; 
and hyperaemia and consequent tissue change, 
and hyperplasia and degradation of interstitial 
ingredients, morbid discharges, abscesses, ulcer- 
ations and pain, become objective purposes for 
medical combat. 
The cetiological conception fully appreciates 
these and a multitude of other objective features 
of disease, but it regards them as products in a 
state of incompleteness. They are evidences of 
inadequate functioning and are rendered im- 
possible in proportion as functioning approaches 
completeness. The physical energies of the organ- 
ism fundamental to functioning processes are ill- 
developed and misapplied. 
The therapeutic purposes under these different 
conceptions of pathology also differ radically. In 
the one case remedial measures are adjusted to 
the apparent local requirement, to suspend pain, 
to relieve local hyperaemia, to oppose mechanical 
dislocation of parts by direct local mechanical 
obstruction, and to give vent to confined fluids. 
The other mode of considering the pathology 
leads to supplying the lacking physical energy in 66 
MECHANICAL AIDS IN 
kind, rate and degree, approximating as nearly 
as possible those which naturally appertain to 
the suffering viscera. This class of measures are 
not substitutes for auto-massage, but serve to 
cultivate the non-sensory powers of the visceral 
organs and the mechanism intimately related 
to visceral functions. In this way a permanent 
increase of their spontaneity of action is secured. 
The correctness and therapeutic value of this 
statement invite the most rigid and critical tests. 
These are afforded by simply supplying massage 
of the slow and deep variety to the suffering 
viscera. This recourse is commended by being 
normal to the tissues and organs, and no higher 
or more cogent justification is conceivable. 
The adjustment of massage to visceral organs 
requires conformity to anatomical as well as 
physiological peculiarities. The supplied process 
should, as nearly as possible, resemble the auto- 
process in the particulars of rate, degree, loca- 
tion, position of body, and whatever circum- 
stances conduce to natural or physiological ef- 
fects. 
Slow massage of visceral organs is popularly 
known by the term kneading, from its resem- 
blance to that well-understood practice, and it 
will be more convenient to use this term in de- 
scribing the details necessary in the process. The 
nature of the adjustments required to comply 
with therapeutic purposes has been, in the main,, 
indicated, but may here be recapitulated : CHRONIC FORMS OF DISEASE. 
67 
The rate at which abdominal kneading best 
complies with therapeutic requirements is found 
by experience to be about twenty-five impulsions 
or wave-motions a minute. This rate, it will be 
noted, is about the average of the different mo- 
tions propagated through the viscera in health, 
proceeding from the respiratory mechanism, from 
bodily motions, from locomotion and other motory 
stimuli which co-operate to impress the digestive 
and the pelvic systems of organs as masses of 
substance pervaded by fluids having a predestined 
onflow. It is necessary here to state what will 
subsequently be explained in detail, that quick or 
vibratory motions can not practically be substi- 
tuted for the slow variety when the effects of the 
latter are desired, since the former exercise con- 
trol of another department of nutritive processes 
at variance with the purposes of kneading. 
The decree or force of the transmitted motor 
impressions should be sufficient to include the 
whole visceral mass in the motory wave. This 
mass is largely continuous anatomically, and the 
motory impulsion should extend to all parts of 
the portal vein and its branches and to the whole 
visceral lymphatic system. Interstitial absorp- 
tion of all fluids of whatever character and their 
submission to the chemistry of the organism is 
the direct consequence. Superficial motory im- 
pressions are useless for this purpose, and are in 
other ways possibly injurious. 
The posture of the patient during the kneading 68 
MECHANICAL AIDS IN 
process should be that of lying face downward, 
so that the mechanical impulse shall be from be- 
neath the visceral mass. The reasons for this 
position may be readily understood. Nature en- 
forces the action in this position throughout the 
world of inferior animals-an evidence that the 
desired effects are thus best secured. The back- 
ward-lying position is excluded because pressure 
of the abdomen in this position forces its contents 
toward the pelvic end of the cavity, producing 
mechanical effects it is desirable to remove, ob- 
structing the flow of the venous and lymphatic 
vessels, impacting the organs, preventing their 
natural intermobility, wedging the intestinal folds 
against the lower part of the abdominal wall, and 
insinuating them among the pelvic contents, nar- 
rowing- and mechanically obstructing the ali- 
mentary canals. These consequences are aggra- 
vations of pre-existing difficulties for which reme- 
dies are sought. 
Exactly opposite effects flow from kneading the 
abdomen in a reversed posture-that is, face 
downward-as is clearly shown by the aid of the 
illustrations and descriptions following : 
The posture of the body required for effective 
kneading renders its manual application imprac- 
ticable. Not only is the rate of auto-massage 
which requires to be re-enforced too slow to be- 
come merged with manual rates, but the abdo- 
men of the patient in the required position is 
practically inaccessible for a manual process; be- CHRONIC FORMS OF DISEASE. 
69 
sides, the time during which the process should 
be continued at each seance is longer than meets 
the approval of the manual operator. The patient 
is the sole judge of the agreeable and the disa- 
greeble in the process, and is, therefore, solely 
competent to adjust the process to his feelings. 
This principle excludes the manual method, con' 
trolled at haphazard or by some pet theory of the 
masseur. 
Apparatus for Kneading.-Three forms of 
apparatus may now be described, which are con- 
structed with the purpose of complying with the 
requirements for the therapeutic efficacy of the 
process. That shown at Fig. 1 may be called the 
direct kneader. The patient lies at full length, 
face downward, upon it, exposing the abdomen 
through a broad opening in the upholstered top 
to the action of the mechanism. The purpose is 
to give slow vertical, oscillating motion to the 
visceral mass. This is effected by the alternate 
impingement of two broad kneading heads, acting 
at right angles to the abdominal exterior at its 
Fig. 1. 70 
MECHANICAL AIDS IN 
two sides. By means of a suitable lever and 
ratchet the patient regulates the degree of the 
impingement so as to make it agreeable to his 
feelings. By slightly turning and moving his 
body he also instinctively still further secures ad- 
justment. This apparatus is particularly effica- 
cious in cultivating the vermicular auto-motor 
functions of the digestive canal in all its parts. 
Fig. 2 shows the revolving form of kneading 
apparatus. The couch, with a wide opening at 
its central portion, amply upholstered, on ■which 
Fig. 2. 
the patient may comfortably lie, face downward, 
resembles that shown at Fig. 1. The impinging 
part consists of two thick rollers, whose axis are 
at the ends of an arm extending through a re- 
volving shaft, to which the rollers are eccentric. 
At each revolution of the shaft these rollers 
engage the soft overlying abdomen, and urge the 
mass upward and forward, the two rollers acting 
alternately at its two sides. The practical effect CHRONIC FORMS OF DISEASE. 
71 
of the process is to shift the abdominal mass 
from the lower to the upper part of the abdominal 
cavity, and not only to remove abdominal pres- 
sure from the contents of the pelvic cavity, but 
even to cause these to recede as far as their at- 
tachments will allow. 
Fig. 3 shows the rotating kneader, which sup- 
plies conveniences for the application of the pro- 
cess identical with those before described. In this 
case a single ball or sphere is made to revolve 
horizontally in contact with the abdomen, its 
track being approximately over the course of the 
Fig. 3. 
large intestine and in the direction of the natural 
course of its contents. The mechanical effect 
also extends to the whole mass of abdominal 
viscera, particularly affecting those parts usually 
regarded most at fault in case of constipation. 
The advantages derivable from the mechanism 
above shown may be briefly recapitulated : 
The position of the trunk and the unsupported 
abdomen conjoin in causing the contents of the 72 
MECHANICAL AIDS IN 
whole cavity, including those of the pelvis, to re- 
cede from their location and rise to a higher point 
in the cavity. 
This position compels the patient's arms to be 
extended laterally and upward; the muscular 
connection subjects the upper portion of the 
cavity to the widest possible distention, and thus 
provides space into which the abdominal mass 
passes. 
The impingement of the acting part of the 
apparatus narrows the lower part of the abdomi- 
nal space, and urges the mass from the pelvis. 
The apparatus shown at Fig. 2 causes posi- 
tive, forcible traction from the pelvis, without 
in the least impinging upon any part of its con- 
tents. The transfer upward of the abdominal 
contents causes those of the pelvis to recede in 
the same direction, to fill the space that other- 
wise would become vacant, aided by atmospheric 
pressure; in this way all causes of dislocation 
are removed, even though adhesions from pre- 
vious inflammation have long existed. 
The above-shown kneading processes act 
through the abdominal wall, as one's hand 
might afford a similar impulsion to the loose 
contents of a bag. 
It is plain that all the muscles of the abdomi- 
nal wall are, by the kneading process, subjected 
to means best adapted to promote their nutrition, 
development, and resumption of their natural 
agency in the auto-massage of the visceral mass. CHRONIC FORMS OF DISEASE. 
73 
The most constant and satisfactory evidence of 
health is this auto-function; the most constant 
concomitant of ill-health are its defects, for these 
conduce, whenever long continued, to abdominal 
(digestive) and to pelvic manifestations of dis- 
ease. 74 
MECHANICAL AIDS IN 
THERAPEUTICS OF RAPID (MECHAN- 
ICAL) MASSAGE. 
THE prevailing idea that massage is neces- 
sarily manual in mode of application, and 
therefore limited to the motory resources of a 
masseur, is an error that has served to restrict 
the study of the most beneficent phases of this 
medical recourse. The chronic invalid, even the 
very feeble, has receptive capacity for rates of 
massage far beyond that of the medium and com- 
paratively neutral scope of manual power. We 
have seen that rates of massage much slower 
than the hand can supply corresponds to certain 
spontaneous or auto-processes of the vital organ- 
ism, and that these slow rates therefore comply 
with fundamental therapeutic requirements. 
But to secure the proper rate, and to adjust its 
applications to parts of the body difficult of ac- 
cess, mechanism is necessary. This shows that 
therapeutic advantages may be derived from 
sources which, without mechanism, are incapable 
of being even tested. The remedial capabilities of 
slow massage being thus rendered available in 
therapeutics, naturally suggests the possibilities 
which may lie hidden in untried higher rates of the 
same agent waiting to be tested, studied, and ex- 
posed to professional judgment and service. CHRONIC FORMS OF DISEASE. 
75 
Massage at rapid rates-those beyond the limits 
■of the hand to execute-likewise requires the in- 
tervention of mechanism for the purpose of multi- 
plying the rate of the motor processes. Mechani- 
cal adaptations are also required to adjust the 
applications to the different regions of the trunk 
and extremities, to adapt the degree of the force 
to special curative requirements, and to give in- 
stant control of the action, especially as regards 
degree, to the person to whom it is applied, for 
only by this provision can he always derive agree- 
able and no other sensations from the applications. 
Quick massage is simply vibration of the fleshy 
mass receiving it, without reference to its form, 
■degree, or source. The essential peculiarities of 
vibration are shortness of the linear extent of the 
motion, and the consequent frequent reversal of 
its direction. This causes very numerous endings 
-of the motion, which returns over the same line. 
Vibration may be compared to the blows of an 
infinitesimal hammer, under continuous and very 
rapid action. To show the significance, physical 
and physiological, of this mode of delivering energy 
is the purpose of the present chapter. 
Apparatus suitable for communicating vibra- 
tion, quick massage, to the body and its parts, 
admits of considerable variety of form. The 
physical nature of flesh, being soft, yielding and 
elastic, permits vibratory waves to pervade its 
mass. The action is propagated in flesh as it is 
in fluids, and reaches all its innermost parts at 76 
MECHANICAL AIDS IN 
the same rates and in nearly equal degree. Such 
applications are by no means superficial. Struc- 
tural parts, cells, membranes, fluids, whether 
interstitial or coursing in different directions in 
appropriate channels, vital organs and non-vital 
ingredients are pervaded alike by this agency. 
The vibrations thus mechanically transmitted 
to the vital system are lost only in appearance, 
being, in fact, changed without loss to other forms 
of energy, and subject to identification by other 
tests than the direct senses. Both the vitalized 
and the non-vitalized ingredients encountered by 
this agent present fields for its transformation. 
As the motion of a meteor, on striking the atmos- 
phere, becomes not only retarded but changed to 
its equivalents, so does the motion transmitted 
to tissues, on being retarded therein, become 
changed in several ways, according to the nature 
of the ingredients obstructing its pathway. 
The study of the effects of vibration or quick 
massage becomes of interest from the following 
separate and distinct considerations : 
It is of scientific interest to determine just 
what equivalent forms of energy arise in the vital 
organism under the different forms and rates of 
vibratory action, and what conditions^ on the 
part of the organism, serve to promote, restrain, 
or modify its physical effects. 
It is of physiological interest to determine 
whether the different classes of vital functions 
may be increased, transposed or diminished by CHRONIC FORMS OF DISEASE. 
77 
means of directing motor energy from outside 
sources to their respective vital organs. Also to 
determine whether such transformed energy is 
identical in form with that developed by the or- 
ganism, and whether that arising from the two 
sources is capable of becoming merged and physi- 
ologically undistinguishable. 
And it is of high medical interest to determine 
the consequences of the effects of vibration above 
suggested in pathological states of the organism, 
the therapeutic values derivable therefrom, and 
the conditions and cautions necessary for render- 
ing such therapeutic influences practical. 
It hence appears that a wide and almost virgin 
field for exploration is opened by the proposition 
to subject the vital organism and its non-vital 
constituents, its diverse functioning activities, 
and its varied incorporated and spontaneous 
chemical tendencies, to the influences flowing 
from transmitted vibration. 
The difficulties which this study has presented 
have arisen chiefly from the fact that the inquirer 
is very apt to seize upon some one effect or fact, 
and neglect others even more worthy his atten- 
tion. It shall be my endeavor to place before the 
reader such facts as seem to establish principles 
available for the physician. The nature of the 
case does not permit of a strictly scientific order 
in the arrangement of the subject; the topics em- 
braced therein will therefore be presented in the 
order of the presumed interest of the inquirer. 78 
MECHANICAL AIDS IN 
Vibration as an Anaesthetic.-This agent is 
somewhat known as a means for securing the sus- 
pension of pain, and even for permanently remov- 
ing chronic neuralgic affections which have proved 
intractable to other remedies. Notwithstanding 
the well-proved efficacy of this agent, its restricted 
use for this purpose is easily accounted for by the 
fact that facilities for its proper administration 
are not usually at hand, and the necessary prac- 
tical details are unfamiliar to the physician. 
Most physicians have seen references to the effi- 
cacy of this agent in their reading, especially of 
English medical periodicals of a dozen years ago. 
In these days of prevalence of neuralgic disorders 
and of much seeking of remedies adapted to 
ameliorate if not to obviate pain, this effect of vi- 
bration is entitled to renewed consideration, and 
a just estimate of its nature and value should be 
acquired. Is this special remedial effect tem- 
porary or permanent? 'Is it to be classified with 
the so-called sedatives, or with some heretofore 
imperfectly investigated class of remedies ? 
Different investigators have arrived at radi- 
cally opposite conclusions respecting the reme- 
dial effects of vibration in painful nervous dis- 
orders. Some have accepted the easily demon- 
strated fact as a fundamental principle; others 
regard suspension and even the radical cure of 
pain as secondary and dependent on certain 
changes superinduced in the ordinary physiologi- 
cal activities, which are neglected by the sedative- CHRONIC FORMS OF DISEASE. 
79 
seeking inquirers. These differences are doubt- 
less due to prepossession of opinions or their ab- 
sence on the part of the investigator. Experi- 
menters are apt to find what they are seeking, 
especially when the search is obscure. Very 
much depends on the kind of instruments em- 
ployed, and their adaptation to determine the 
facts sought. 
A better understanding of this interesting sub- 
ject may be attained by bringing forward some 
of its historic as well as its scientific particulars. 
Medical literature is indebted to Dr. J. Mortimer 
Granville, of London, England, for setting forth 
his experience and conclusions in a book published 
in 1884, entitled Nerve Vibration and Excita- 
tion, or Stimulating Percussion for Functional 
Nervous Disorders. The applications are de- 
scribed as light, rapid blows of a percuteur-a 
small hammer with an ivory point, which, under 
the reciprocating motion imparted to it, trans- 
mitted vibratory action to the skin and flesh 
underneath. The operator's hand was evidently 
the source of power in the earlier experiments, 
but irregularities of rate and degree, and the 
very limited time it was possible to sustain the 
action, rendered the effects uncertain, and so 
clockwork mechanism, operated by a spring, was 
substituted. The apparatus while in action was 
moved about upon and near the painful region, 
and therefore communicated rapid waves of vi- 
bration to the flesh underneath. There is no- 80 
MECHANICAL AIDS IN 
statement of the vibratory rate. The action was 
frequently interrupted by necessity for rewinding 
the machine, and irregular from the varying 
force of the spring. A small electro-motor was, 
in a few instances, substituted for the spring, 
but no hint of its superiority appears, or that the 
conclusions previously made were in any way 
modified by this motor recourse. 
The purpose in view in these vibratory appli- 
cations was avowedly the single one of arresting 
pain. There was absence of expectation of other 
effects, and such others as necessarily accom- 
panied the suppression of pain were quietly ig- 
nored. A long array of cases of neuralgic and 
other painful chronic affections, successfully 
treated by vibration, are given in support of the 
claim for the therapeutic power and efficacy of 
this agent. 
Dr. Granville engaged the attention of several 
physicians of eminence, among them Sir Hugh 
Campbell, who repeated the experiments, appar- 
ently without attempting any variations, and 
added confirmation to Dr. Granville's views. At 
about the same time similar experiments were 
conducted by M. Boudet and M. Vigoureux, of 
Paris, leading to the same conclusion; not, how- 
ever, without a vigorous dispute as to priority 
of discovery of what was regarded as a remedial 
principle. Readers of the medical literature cur- 
rent a dozen or more years ago will doubtless re- 
tain some memory of these discussions. Most CHRONIC FORMS OF DISEASE. 
81 
remarkable is the unanimity with which these in- 
quirers excluded all consideration of other effects 
of the agent whose powers they examined, except 
the single one of suspending pain. They did not 
even intimate that sensations of an agreeable 
kind are also suspended by the same agent. 
The above statements respecting the control 
of pain in chronic affections by proper applica- 
tions of vibration (or quick massage) are fully 
supported by my personal experience in employ- 
ing this agent for the class of invalids mentioned. 
This experience, it is due to say, has unquestion- 
ably been more extended and varied than those 
which have above been referred to. This state- 
ment will, I hope, be sufficient justification for 
presenting facts additional to those with which 
the medical profession is most familiar, and 
which lead to far different as well as broader 
conclusions respecting the nature and effects of 
the agent under discussion. 
Dr. Granville and his associates adopted a 
theory respecting the nature and effect of vibra- 
tion which is best explained in words quoted from 
his book, written for this purpose. He says: 
"All nerve action is vibratile . . . the neu- 
ralgic state consists essentially in an abnormal 
set or series of vibrations into which the nerve 
has been thrown, perhaps by cold, or a mechani- 
cal or chemical irritant. This state may be 
changed by mechanical vibrations, propagated 
to the nerve sheath and its contents." Again, 82 
MECHANICAL AIDS IN 
"we deal with the nerve and not with its sur- 
roundings"-an evident mechanical impossi- 
bility. "No force is communicated by the ham- 
mer of the percuteur." What, then, is com- 
municated ? " The sole effect of vibration is to 
excite the centers and call out their potential 
energy, converting it into kinetic force. It can 
act only through the nerves." " Vibration, arti- 
ficially supplied, introduces discord into the 
rhythm of the morbid vibrations of the painful 
state, and a change that brings relief," etc. Dr. 
Granville's subsequent difficulties in securing the 
desired relief of pain by this means ought to have 
shaken his faith in the theory, for he says: 
" Great care and tact are necessary in treating 
pain by vibration." " By continuing the process 
too long, painful vibrations may be set up;" 
hence directions are given to approach the pain- 
ful region slowly, first subjecting non-painful, 
contiguous parts to the process-details of cases 
being given in which the non-success of previous 
treatment was changed to success by adopting 
this change of method. 
If these investigators had reflected that it is 
physically impossible to vibrate nerve tissue 
separately from its surroundings; that the other 
tissues and the fluids included in a fleshy mass 
exceed, according to trustworthy authorities, by 
a hundredfold that of the nerve filaments it in- 
cludes; and, further, that the fluid and solid, 
organized and unorganized, vitalized and non- CHRONIC FORMS OF DISEASE. 
83 
vitalized, contents of the mass include ingredients 
strongly predisposed to chemical changes-that, 
in fact, such changes, either normal in consonance 
of physiological purposes or in opposition to those 
purposes are inevitable-these factors would un- 
doubtedly have influenced their conclusions. 
Historical accuracy, the curiosity of the reader, 
and possibly justice, unite in requiring that certain 
dates be here recorded. In a correspondence, 
claiming priority over Dr. Boudetand the French 
claimants of the " discovery " of the pain-reliev- 
ing power of vibration, Dr. Granville says : " As 
a matter of fact, nerve vibration by percussion 
with instruments furnished by myself was tried 
at the National Hospital, in Queen Square, Lon- 
don, in January and February, 1878, these trials 
having been led up to by previous experiments 
by less satisfactory methods/' 
My personal investigations of the destiny of 
vibration in the vital organism, and the physio- 
logical and therapeutic effects flowing from this 
agency, assumed practical forms in 1864-'68, and 
very soon led to diversifying the mechanism 
whereby the effects may be varied and duly 
tested. The conclusions drawn from my experi- 
ence were embodied in my article in the Novem- 
ber, 1869, number of the New York Medical 
Journal, entitled " Inquiries Relating to the 
Therapeutic Effects and Uses of Vibratory Mo- 
tion." The succeeding March number of the 
same journal contained a second article, a sequel 84 
MECHANICAL AIDS IN 
to the above, entitled " On the Use and Force as 
Vibratory Motion in the Treatment of Diseases 
of the Nerves." My book, bearing a title nearly 
identical with that of Dr. Granville's book, was 
published in 1870. 
The foregoing account of transatlantic experi- 
ments determining the anaesthetic effects of vi- 
bration proves the detrimental influence of pre- 
conceived theory in the recognition and appre- 
ciation of facts. The experimenters, in discover- 
ing what they sought, neglected to observe 
facts of even greater importance. No evidence 
is shown that nerve energy is vibratory in its de- 
velopment or transmission; or that, if vibratory, 
such form of action bears any relation to that of 
any mechanism. No allusion is made to ultimate 
nutritive sources of nervous energy ; to its possi- 
ble deterioration from nutritive faults; to the 
consequences of imperfect cZenutrition, for nutri- 
tive waste is even more liable to defects which 
react on the sensorial powers than nutritive 
supply; of suffering caused by maldistribution, 
as well as from faulty development of nervous 
powers; of impressions of the consciousness from 
general and local excess, as well as from insuffi- 
ciency of nervous energy-all of which are topics 
inseparable from that of pain, its modifications,, 
suspension and remedies. 
My purpose in devising means for subjecting 
the organism and its parts to vibration was less 
that of subduing pain than that of reaching the CHRONIC FORMS OF DISEASE. 
85 
nutritive sources of pain by an adequate remedy. 
It seemed to me that the disagreeable and the 
painful impressions of the consciousness which 
invalids experience may be legitimate, denoting 
either faults of nutrition in the parts to which 
the undesirable sensation is referred, or obstacles 
in the line of sensory conduction. It is also 
notable that pain is intimately connected with 
appreciable defects of the other forms of energy 
which the vital organism coincidently develops, 
all of which depend on nutritive processes as 
their sources. True remedies therefore must ex- 
tend to the fundamental seat of energy, to the 
tissues wherein its distinctive forms are assumed. 
It follows that to correct morbid impressions in 
the seat of the consciousness, it is essential to 
rectify the nutritive source whence they spring, 
which, as we all know, may or may not be in 
nervous tissues. 
Now, nutritive acts necessarily include two 
considerations, both of which are equally in- 
volved in the consummation of the nutritive pur- 
pose, whatever the function or the tissue con- 
cerned in the nutrition may be as a whole. Nu- 
trition implies the supply of ingredients to, and 
the removal of the same from, the local point at 
which energy is evolved or other purposes com- 
plied with. Nutrition is far from consisting of 
accumulation of substances, vital or otherwise; 
it implies an equal amount of outflow or de- 
nutrition. The first is largely associated with 86 
MECHANICAL AIDS IN 
motor physics; for the latter. cAemwo-physics 
are indispensable. The supply and convoy of in- 
gredients to the vital arena are of no account, 
while the changes due their elemental consti- 
tution are unprovided for. In fact, the control- 
ling phase of nutritive purpose is the cZenutritive, 
chemico-physical excluding process. Now, since 
the energy for conducting these indispensable 
factors of nutrition is in health developed within 
the organism, and since defects of health are 
manifested in these factors, the suggestion of re- 
enforcing them by direct supply of energy from 
exterior sources when their insufficiency becomes 
apparant arose very naturally. 
This suggestion is strengthened by direct ex- 
periment which any one commanding sufficient 
manual dexterity may repeat and verify. By 
widely separating the fingers of the right hand so 
that when a smart blow is given the stroke of 
each finger falls distinctly separate, the rate of 
the impact or percussion is quadrupled, and vi- 
bratory waves are made to prevade any fleshy 
part subjected to the process and may be felt at 
its opposite side. In a proper case for vibratory 
treatment not only is pain abated, but the accom- 
panying soreness and swelling also. On account, 
however, of the impossibility of sustaining the 
required rate of motion, the recourse described is 
impracticable. 
Two direct effects of vibration serve to explain 
the salutary consequences of its application to the-. CHRONIC FORMS OF DISEASE. 
87 
vital organism. One of these is the contribution 
it affords in aid of the defective mot or physics of the 
physiological system; the other is the ready and 
abundant contribution it brings in support of the 
chemico-physics of the organism whenever this 
department of physiology is faulty-a department 
whose defects are the chief concern of the average 
therapeutist. 
How the mechanical or motory purpose is served 
by vibration is so obvious, even to the superficial 
inquirer, that but little explanation is required. 
The motor energy communicated from the ex- 
terior travels as such in the fleshy parts. But 
flesh is pervaded by conduits streaming with fluids 
(blood) in directions predestined by the mechan- 
ism of organization. The local aspect of chronic 
disease is marked by areas of detention of these 
fluids, by local mechanical obstructions, and by 
defective operation of the cause to which the out- 
flow of these fluidsis due. Now, vibration affords 
a succession of impulses direct to the contents of 
the vessels, urging them forward in the several 
directions required, thus becoming an effective 
auxiliary to pre-existing causes of the circulation. 
The same cause also restores the natural contrac- 
tile powers of the circulatory vessels, and these 
causes unite in impelling forward whatever me- 
chanical obstacles these motory defects may have 
superinduced, or which previously existed. 
The consequences of outflow of the contents of 
obstructed vessels are immediately apparent in 88 
MECHANICAL AIDS IN 
surrounding parts. Fluids of whatever quality, 
normal interstitial juices and those loaded with 
morbid materials, return directly to the venous 
vessels to become resubjected to the corrective 
chemistry of the organism as a whole. 
Important as these effects may be considered 
therapeutically, they are in reality the least of 
those superinduced by vibration. 
These experiments and observations were begun 
in 1862-'63, and soon led to others through am- 
plified means and diversified methods. The physi- 
ological inquirer is not content with generaliza- 
tions; he insists on specific tests for the facts he 
seeks. He submits each tissue, secretion, func- 
t on, or other object of investigation to separate 
and to conjoint experiment, and thus assures 
himself of the circumstances which influence the 
behavior of each part and of each to all. The 
mechanical scope of thehuman hand was evidently 
too restricted, and incapable of bringing further 
facts to light; its narrow field has been occupied 
and understood for ages, and is comprised largely 
of motor physics. What other important rela- 
tions of therapeutic significance might be opened 
by a survey for which mechanism is required re- 
mained to be developed. 
The Mechanical Apparatus.-A proper invest- 
igation of the higher rates of motory energy or 
vibration requires apparatus capable of comply- 
ing with the following particulars : 
It should transmit vibration at variable but CHRONIC FORMS OF DISEASE. 
89 
known rates to any selected part of trunk and 
limbs. 
It should impart this action in diversified forms. 
It should be capable of limiting the action and 
its effects to designated parts while other parts 
are omitted. 
It should be capable of confining its action to 
distinct classes of functioning tissues. 
It should be operated by adequate and un- 
tiring sources of mechanical power. 
In pursuance of these purposes above out- 
lined, I constructed (1864-'65) the several pieces 
Fig. 1. 
of apparatus shown below. The first (Fig. 1) im- 
parted rapid alternating motion to two percu- 
teurs in close proximity, which act upon any 
part exposed to them by means of necessary 
mechanism through an opening in the couch upon 
which the patient rests. The position of the 
patient is shifted at will, or as may be agreeable, 
and the degree of the impulse is controlled by the 
patient. 
The percuteurs are set in action by a very 90 
MECHANICAL AIDS IN 
short crank, rapidly revolved by a multiplying* 
wheel operated by a light motor or by hand or 
foot power . 
The most effective rate for this and other forms 
of mechanism for similar purposes was found to 
be in the vicinity of a thousand waves or 
Fig. 2. 
strokes a minute. Diminution or entire suspen- 
sion of pain was a pretty constant effect, provided 
the conditions before stated were complied with. 
The term then thought to afford a satisfactory 
explanation of this effect was revulsion, which 
referred to its mechanical rather than its physio- 
logical scope. Experience, however, brought tn CHRONIC FORMS OF DISEASE. 
91 
light other reasons for considering this term a 
proper one. 
Fig. 2 represents a form of apparatus made at 
this time in which the effect of impact or percus- 
sion upon the nerve centers through surface im- 
pressions is zvholly eliminated. Even a much 
larger amount of motor energy may be trans- 
mitted than by the apparatus shown at Fig. 1, 
but entirely without percussion and the effects 
arising therefrom in either the reflex or the sen- 
sory nerves of the part. The nerves of the skin, 
and for a distance regulated at option beneath it, 
are neither impinged upon nor traversed in the 
application of this process. The apparatus im- 
parts very short, perpendicular motory excursions 
to the fleshy mass compressed against a very soft 
elastic pad. The mechanical conditions are such 
that the pad grasps the flesh, which moves as a 
zvhole, while interaction of distinct anatomical 
partsis mainly prevented. The superficialnerves 
therefore wholly escape mechanical disturbance, 
and they convey no impressions to the nerve cen- 
ters. Nervous irritability becomes suspended 
while the muscles, or at least their deeper por- 
tions, are subjected to passive motions in the di- 
rection of the axes of their fibers. In short, mus- 
cle action, and consequently muscle nutritive 
changes, are in this way incited in opposition to 
nerve incitation and its consequences. This effect 
is nearly the reverse of that caused by No. 1. 
For distinction, this consequence of this applica- 92 
MECHANICAL AIDS IN 
tion may be called functional revulsion. The 
evidence of this effect is shown by diminished or 
suspended pain and inclination to sleep, effects 
which increase day by day as the treatment is 
pursued. 
This process may be extended to the arms and 
Fig. 3. 
legs as well as to all parts of the trunk, according 
to the requirements of the case, it being only ne- 
cessary to turn the body and to adjust the height 
of the action to the part which is to receive it. 
A similar process can be applied to- the arms, 
legs, and even the trunk, by including either of CHRONIC FORMS OF DISEASE. 
93 
these parts between two pads to which reciprocat- 
ing action is given. Fig. 3 shows the application 
to the arms of this form of vibration, the effects 
of which are intensified by pressure. The pres- 
sure is given by means of a lever under the hand 
of the patient and under instant control. Relax- 
ation of pressure diminishes or suspends the ac- 
Fig. 4. 
tion. It is perfectly safe to leave the control to 
the option of the recipient, the feelings in this case 
being a safe guide. The double pads do not in- 
crease the rate, but insure contact of molecular 
constituents, and thus secure the transformation 
of motor to other forms of energy. In this case 
also the superficial endings of nerves are neither 94 
MECHANICAL AIDS IN 
traversed nor impinged upon, as in Fig. 1, but 
other functional processes are incited, to be subse- 
quently explained. 
Vibration is transmitted to parts of the organ- 
ism by still another method, which may be called 
Fig. 5. 
oscillating, and is readily understood by reference 
to Fig. 4. A foot is snugly held by an appropri- 
ate device at the end of a shaft, which, by suit- 
able mechanism, is made to oscillate on its axis. 
The bone of the leg, being practically a continu- 
ation of the shaft, participates in the same action CHRONIC FORMS OF DISEASE. 
95 
to which it in turn subjects the flesh and the 
fluids of the limb. A similar device (Fig. 5) ap- 
plies to the hand and arm. 
In this use and form of vibration (the same rate 
as before stated being preserved) both percussion 
and compression are eliminated. It follows that 
the effects of vibration are secured in such a 
manner that nervous impressions are entirely 
absent, and all nerve functions-either afferent, 
efferent, or central-are in abeyance. 
The principal effects inure to the morphological 
elements, and especially to the chemical phase of 
all the constituents of the parts. Motor energy 
encounters various orders of resistance, compell- 
ing it to assume other and different forms. 
The above are samples of many forms of ap- 
paratus devised by me at the period above re- 
ferred to for transmitting motor energy in vibra- 
tory form to parts of the vital organism, and 
which enabled me not only to determine approxi- 
mately what forms were assumed by it under 
different circumstances, but also what physical, 
physiological, and therapeutic effects were super- 
induced, as well as the positive and relative value 
of these effects in different pathological states. 
The Chemico Physics of Vibration.-The fore- 
going description of apparatus affords a necessary 
preparation for understanding what is clearly 
the most important effect of the transmission of 
motor energy to the vital tissues, whether con- 
sidered in its physical, physiological or therapeutic 96 
MECHANICAL AIDS IN 
aspect. For the attending conditions are such 
that the motor energy of the vibration is largely 
transformed to chemical activity, and results in 
elemental changes and transpositions of matter 
in conformity with physiological purposes. 
These effects also accord with the purposes of 
therapeutics, especially in chronic cases. Cures 
are largely sought through remedies which have 
been proved by experience to re enforce the chem- 
ical phase of physiological activity, or which nat- 
urally tend to increase this form of action. This 
ultimate principle appears whenever the opera- 
tion of remedies in the cases referred to is fairly an- 
alyzed, and is sustained by experience, however 
empirical. 
Pathology, whether its manifestations be gen- 
eral or local, is easily understood to have its 
source in some form of degree of incompleteness 
of the chemical phase of physiology. For it is 
only through this cause that inj urious ingredients, 
tending to retrogression and to impair the vital 
structures and processes, can be retained by the 
vital organism to exert their destructive infl uence. 
And the correctness of this assumption is 
proved whenever the chemical phase of physio- 
logical activity is properly and judiciously pro- 
moted. 
Primarily, vibration consists of very short 
motory excursions between two endings or turn- 
ing points. The motory force is resisted by wha 1 
ever it meets or collides with at these endings ; CHRONIC FORMS OF DISEASE. 
97 
at these points the motor energy is imparted to 
whatever objects or ingredients may be present 
to receive it. Each distinct wave-ending is there- 
fore comparable to the blow of a light hammer • 
and vibratory applications become the continu- 
ance of such infinitesimal blows, having the 
shortest possible intervening time. The energy 
expended at each impact is taken up by the 
atomic elements of the ingredients thus forced 
into intimate relations. 
While blows of a hammer develop heat and 
rend cohesion, those of the percuteur and the 
other vibratory methods described are expended 
under radically different circumstances. The col- 
lision between ingredients of complex chemical 
constitution and of extreme instability is pro- 
duced. The component atoms of these ingredi- 
ents are very unlike in their nature, and are 
therefore receptive of the suddenly imposed 
energy in different degrees. The inevitable con- 
sequence is a destruction of the weak chemical 
equilibrium, and a new distribution of chemical 
affinities resulting in new compounds less un- 
stable in chemical character. In short, the effect 
of vibration in vital structures is largely chemical, 
arising from the transformation of motor to chem- 
ical physics, and the reduction of unstable, there- 
fore incomplete and injurious products, what- 
ever their source in the organism, to physiologi- 
cally completed and therefore normal and innoc- 
uous products which find immediate egress. 98 
MECHANICAL AIDS IN 
The school lecture-room affords abundant and 
apt illustrations of the principle above stated; 
as when phosphorus is made to ignite when the 
motion of a rapidly revolving wheel, to whose 
periphery it is attached, is suddenly stopped ; 
and when gun-cotton, nitroglycerin, and many 
similar bodies are exploded by sudden arrest of 
motion or concussion, although, perhaps, capable 
of burning on being ignited in the ordinary way. 
These are apt illustrations, derived from inor- 
ganic chemistry, of what occurs in the vital or- 
ganism under similar conditions-namely, that 
forceful contact is even more provocative of chem- 
ical change than any other circumstances; that 
the development of chemical energy is simulta- 
neous with the disappearance of motor energy; 
that unstable compounds subjected to chemical 
change from this cause are inevitably reduced to 
more stable forms; that vital energy arises co- 
incidently with the passage of an unstable body 
from a state of more chemical energy to one of 
less; that unstable ingredients, in becoming 
stable, are rendered indifferent, consequently in- 
nocuous ; that the vital endowment of matter in 
affording protection against the influence of chem- 
ico-physics is equivalent, for the time, to chemi- 
cal stability ; and that vibration or concussion of 
elements secures the extreme degrees of chemical 
products contemplated in the physiological pur- 
poses 
Turning to the vital organism, we find in it a CHRONIC FORMS OF DISEASE. 
99 
most admirable field for the physical processes 
and for insuring the physical consequences above 
indicated. Its components are exceedingly het- 
erogeneous, and the differing classes of ingredi- 
ents are largely diffused. The vitalized compo- 
nents are, for the instant, under protection of 
vitality. The non-vitalized are in various orderly 
stages of resolution. Everywhere are residual or 
waiting ingredients, and every where im perfect] y 
and improperly employed materials in which 
chemical reduction is due and in which chemical 
change is inevitable. Whether such change be 
in the progressive physiological order, or become 
disorderly and deteriorative, is determined by the 
extent and the degree of the chemico physics 
whose influence is brought to bear on the impend- 
ing act. All components of the vital organism 
occupy stages of a career; all are passing forward 
to the next stage ; and all are predestined to the 
chemical change which sigmalizes the evolution 
of either heat or other form of energy. Pathol- 
ogy is necessarily associated with imperfect ful- 
fillment of the chemical change wherein energy 
is liberated for the advantage of the individual. 
Oxygen, its Uses by the Vital System, and 
what determines its Consumption.-Of the oxy- 
gen, introduced by the respiratory process from 
the unlimited and ever-ready supply afforded by 
the atmosphere in which we dwell, just so much 
is taken in health as is required by the chemico- 
physics of the organism. Food of all kinds has 100 
MECHANICAL AIDS IN 
definite composition ; the completed products of 
its chemical change which pass from the vital 
system are also definite in composition, but in- 
creased by the exact amount of oxygen taken 
from the air of respiration. 
The purposes of oxygen in the vital system 
thus become clear, and the consequences of its 
defective use by the vital system are intelligible, 
although the pathological states which the phy- 
sician is called upon to correct are often referred 
to some intermediate circumstance which has lit- 
tle to do with the use or non-use by the vital sys- 
tern of oxygen. Why the system takes up less 
of this ingredient than is required to dispose of 
its waste and superfluous ingredients is seldom 
inquired. The pathology, which arises from 
faults of use being attributed to secondary 
causes, other than direct remedies are apt to be 
chosen for its correction. 
There has, indeed, been a vast amount of ex- 
perimenting based on the therapeutic need and 
artificial supply of oxygen, thus palpably con- 
necting its defects with pathology. Among these 
devices is that of increasing its proportion in the 
air respired ; that of condensing by pressure the 
air for respiration; that of liberating oxygen 
from chemicals in the air respired and in the 
digestive organs ; that of increasing the air space 
in the chest by developing its muscles, etc. These 
methods only promise increase of supply to, not 
use by, the system of this element-things very CHRONIC FORMS OF DISEASE. 
101 
different in practice. These devices all prove dis- 
appointing, not only because the supply thus af- 
forded is necessarily temporary while the need is 
continuous, but more emphatically because none 
of these devices are capable of supplying the 
thing wanting-that degree of chemico-physical 
action which ensures the appropriation by the un- 
stable residuals of the system of the oxygen 
which, though present, remains unappropriated. 
Oxygen is appropriated at all points where 
heat of other form of energy is disengaged, be- 
cause, under these circumstances, the systemic 
ingredients are passing into higher and usually 
into emergent forms of oxidation. It is clear 
that both motory physics and chemico-physics 
are required to secure the effect desired ; the one 
to transport ingredients to the several points of 
use; the other to effect the forceful contact 
whereby motory is transformed to chemical 
energy by its transfer to the elementary constit- 
uents of the changing materials. 
These effects arise spontaneously in health, 
and, though appearing to be causeless, are, in 
fact, intimately associated with the involuntary 
and the voluntary motory functions. The first 
have also the reciprocating form, and in the ar- 
terial department, which conveys oxygen on its 
being demanded, approaches the vibratory^ rate, 
while the voluntary motions seem to incite and 
perfect the involuntary. 
The therapeutic uses of vibration consist, there- 102 
MECHANICAL AIDS IN 
fore, in securing such higher degrees of perfec- 
tion in the faulty activities of the organism as 
shall remove the consequences of previous defec- 
tive mechanico-physics and chemico-physics. The 
effects of applications of vibration extends pri- 
marily to the oxidizable ingredients, whatever be 
the name of the affection of which such ingredi- 
ents are a fundamental factor. For reasons stated, 
those ingredients of the blood, interstitial fluids, 
and solids which possess the highest instability 
are the first to become destroyed on forcible con- 
tact with the oxygen which is always in readiness 
for this physiological purpose, and always effec- 
tive when the conditions prescribed in the or- 
ganic mechanism are complied with, whether 
these be classed as hygienic or remedial. 
The substantial reason now appears why vibra- 
tion allays pain and proves a trustworthy remedy 
in chronic neuralgias and other painful affections. 
This agent, by promoting physiological oxida- 
tion, removes the essential cause of pain, so far 
as this depends on impressions received by the 
nervous system from morbid environment. The 
pain is not the disease, local or general; it is the 
evidence of the presence of unstable ingredients, 
embarrassing nutrition, compromising the de- 
velopment of energy in other forms, defeating 
organic purposes, and affording timely warning 
of a severer fate. Pain is the disagreeable con- 
sciousness superinduced by these and similar phy- 
sical circumstances. It is these, rather than the CHRONIC FORMS OF DISEASE. 
103 
notification of their existence, which should be 
removed. 
The vital system necessarily at all times con- 
tains intermediate products in various stages of 
progress toward the final goal of the physiologi- 
cally perfected stage of oxidation, which stage is 
represented mainly by carbonic dioxide, water, 
urea, and salines. Faulty conditions diminish 
the degree attained by the oxidizing process; and 
the intermediate products, well known to chemi- 
cal investigators, necessarily increase, and there- 
upon assume abnormal and morbid phases and 
strange chemical forms. The discharge from 
the system of the above-named perfected products 
is diminished, but their equivalents are retained 
in some noxious form, awaiting better conditions, 
which shall render them inoffensive. 
If we may consider chronic neuralgia and other 
painful affections as resulting from the impres- 
sions the nerves and consciousness receive from 
the presence of adventitious ingredients inimical 
to vitality, the morbid condition may be under- 
stood by the term auto-poisoning, and bears an 
analogy to the poisoning arising from accumula- 
tion of oxidizable ingredients accidentally or will- 
fully ingested. The effects of alcohol, opium, 
ether, and the alkaloids and sedatives in general 
will answer for illustration. Experience proves 
that the most trustworthy remedial recourse in 
these cases is to promote and to intensify physio- 
logical oxidation by maintaining the respiratory 104 
MECHANICAL AIDS IN 
process by every means available till the poison, 
if the dose be not too large, is neutralized by oxi- 
dation. The effect of vibration proves that the 
same principle is practically available for remov- 
ing the cause of chronic neuralgic pains, and the 
rapidity and certainty of this effect indicates 
that oxidation, the cessation of pain, and the 
production of heat are synchronous in the part 
subjected to the process. 
Other Physical Effects of Vibration and 
their Physiological Consequences ; Heat.-It is 
clearly provable by many conclusive tests that 
heat production is very much increased by vibra- 
tory applications. The glow of warmth pro- 
duced in the skin, soon reaching the previously 
habitually cold extremities, affords satisfactory 
evidence of this effect. The temperature of the 
body, however, never rises above the normal 
standard, since the regulative powers, having 
their seat in the nervous system, are in effective 
operation. The increased heat becomes equally 
diffused; in part because the circulation is also 
diffused, but in greater part because the process 
of heat development is no longer limited to the 
central parts, but is restored in normal degree 
to peripheral parts. 
The rapid restoration of heat by vibration 
arises from two causes. One is the direct trans- 
formation of the motor energy to heat by fric- 
tion of anatomical components of the organism- 
the fibers and membranes, down to the minutest CHRONIC FORMS OF DISEASE. 
105 
morphological ingredients, "being compelled by 
motory waves, to glide with pressure upon each 
other-as when a piece of rubber is repeatedly 
stretched, or even rubbed, it becomes heated 
without chemical change. The other cause of 
heat arises from chemical acts arising from the 
increased consumption of oxygen. 
The sources of heat are the muscle cells, whose 
rate of heat development is greatly quickened by 
vibration, even though the motor function be 
suspended, and also the non-vital fluids, which 
pervade all tissues. These contain unstable and 
highly oxidizable ingredients, which only wait a 
due impact or collision of elements to be ren- 
dered stable, and necessarily yield heat in the 
act. 
The evidences of therapeutic oxidation are 
patent to the least scientific observer. These are 
of two kinds. One is the palpable increase of 
completed products of oxidation, whose emer- 
gence is due to the process. The urine becomes 
increased, assumes its natural odor and color, 
and ceases to yield a precipitate on cooling. This 
change is due to diminution of extractives, 
another word for the various products of defec- 
tive oxidation. The quantity of watery vapor 
transpired and exhaled is likewise sensibly in- 
creased, as we know must happen, since water is 
part of the product of the resolution of the same 
ingredients that also afford the urea and carbon 
dioxide which is disengaged. The other class of 106 
MECHANICAL AIDS IN 
evidences consists of positive appeals to the 
senses. These are indications through the feel- 
ings and the muscular powers of returning 
health, the most significant of which is subsi- 
dence of pain and increase of volitional manifesta- 
tions of energy, mental and physical. The mu- 
tuality of these relations appears to imply that 
pain is at the expense of the energy-evolving 
functions-that such energy requires guidance, 
not abatement or destruction; in short, that the 
central idea of remedying pain, legitimately, 
should be that of affording it more useful, and 
therefore agreeable, scope, through other than 
nervous channels of expenditure. 
The principle of transferring manifestations 
of energy from one to another functioning seat, 
which I have above shown to be practicable, is 
invested with deep scientific and physiological 
interest, since it appears to open the way for rad- 
ical change of therapeutic purposes. The desire 
to suspend the consciousness of disagreeable im- 
pressions, instead of abolishing their source, has 
greatly increased the number of drugs whose 
principal claim of merit is the possession of this 
power, which experience proves to be liable to 
enormous abuses. The practicability of chang- 
ing painful to agreeable manifestations of ner- 
vous power by rectifying the nutritive source 
whence such powers emanate naturally super- 
cedes, to the extent the method is practiced, the 
demand for drugs whose chief value lies in pre- CHRONIC FORMS OF DISEASE. 
107 
venting painful impressions from reaching the 
powers of the consciousness. 
Vibration, aside from the mechanical and 
chemical physics it introduces, is, however, en- 
tirely capable of suspending pain and the sen- 
sory powers of any local portion of the body. 
This effect appears to arise from the fact that 
when a part is subjected to vibration, its sensory 
nerves, each and all, thereby receive exactly the 
same impression. No differences exist and none 
are perceptible. The discriminating power of the 
consciousness is therefore abolished, because the 
effect of impressions is abolished, and with it 
feeling, both agreeable and disagreeable, includ- 
ing local pain. The fact stated is easily proved 
to the most incredulous, who is at liberty to 
adopt other reasons than those assigned. The 
well-attested effects of what is called hypnotism, 
in respect to pain, may be susceptible of similar 
explanation. The vibratory subject does not, 
however, need to have a special susceptibility. 
It is probable that this incidental effect of vibra- 
tion arrested and held the attention of the trans- 
atlantic investigators referred to in another part 
of this article. 
We may now briefly review some of the phy- 
siological and therapeutic effects superinduced 
by quick or vibratory massage : 
1. Vibration may be so applied as to impress 
the sensory nerves principally. This is when the 
impingement is on the skin. By this means the 108 
MECHANICAL AIDS IN 
nutrition of sensory nervous tissues, conductors 
and centers, is increased, and therefore their 
product of sensory nervous energy. This effect 
is easily carried to a morbid degree, to the detri- 
ment of other functioning parts. 
Vibration may also be so applied as practically 
to omit the nervous sensory tissues. In this case 
the motory physics, but more especially the 
chemico-physics, of the vital organism are in- 
creased, while the excess of nerve nutrition and 
the irregular, obstinate, excessive, and morbid 
manifestations of nervous power are thereby 
diminished and permanently remedied. This ef- 
fect of vibration has extensive application in ner- 
vous affections and the chronic diseases which 
are the usual accompaniments of nervous dis- 
eases. 
2. The remedial effects of vibration are by no 
means restricted to functional diseases. Its chief 
sphere is in the motory and chemico-physics of 
the organism. The curative powers of this agent 
through reduction by oxygen of injurious ingre- 
dients which spontaneously arise from faults of 
what may be called motory hygiene, require per- 
sonal investigation by the inquirer, to be under- 
stood or entitled to belief. 
Vibration is not exercise, and since the will is 
not engaged, causes no fatigue. The rate of 
vibratory motion is incompatible with muscular 
nutrition, which requires a slower rate. 
3. Vibration may be regarded as specific in all CHRONIC FORMS OF DISEASE. 
109 
chronic inflammations of whatever part of the or- 
ganism, and whatever may be the morbid product 
developed therefrom. 
The several effects of vibration which are con- 
joined in producing this remedial consequence 
may be noted. One is thorough diffusion of the 
circulation-increasing the amount of blood at 
will in any desired region of the body, and cor- 
respondingly diminishing it in other regions, es- 
pecially in that suffering from inflammation. The 
caliber of the capillaries is increased and con- 
tracted, in compliance with the disposition of 
their contents. Another is the urging forward, 
from the affected region, the obstructive con- 
tents of capillary vessels, including both morbid, 
chemical and other materials, thereby allowing 
interstitial, effused materials to return to the cir- 
culation, and so to remove the swelling. A third 
effect is the submission of these morbid ingre- 
dients to the chemico-physics of the organism, 
while this function is exalted to high efficiency by 
the addition from motor energy. Intimately con- 
nected with these is the modification of pulse- 
rate. The rate is never quickened, and in all 
cases of abnormally high pulse the rate is dimin- 
ished-in pulmonary affections to the extent of 
fifteen or twenty beats a minute, and often this 
effect becomes permanent. MECHANICAL AIDS 
IN THE 
TREATMENT OF 
Chronic Forms of Disease. 
By GEO. H. TAYLOR, M. D., 
Author of " Health by Exercise," " Health for Women," " Pelvic and 
Hernial Therapeutics," Manual Massage," etc. Consulting 
Physician to The Improved Movement Cure Institute, 
71 East 59th Street, New York. 
Copyright, 1893, by the Improved Movement Cure Institute 
NEW YORK: 
GEORGE W. RODGERS, PUBLISHER. 
1893.