A MANUAL OF INSTRUCTION 
FOR GIVING 
Swedish Movement 
AND 
Massage Treatment. 
BY 
PROF. HARTVIG NISSEN, 
Director of the Swedish Health Institute, Washington, D. C. ; Late Instructor 
in Physical Culture and Gymnastics at the Johns Hopkins Uni- 
versity, Baltimore, Md. ; Author of "Health by 
Exercise without Apparatus." 
WITH 29 ORIGINAL WOOD ENGRAVINGS. 
Philadelphia and London: 
F. A. DAVIS, PUBLISHER. 
1889. Entered according to Act of Congress, in the year 1889, by 
F. A. DAVIS, 
In the Office of the Librarian of Congress, at Washington, D. C., U. S. A. 
All rights reserved. 
Philadelphia: 
The Medical Bulletin Printing House, 
1231 Filbert Street. PREFACE. 
Since my address on " Swedish Movement and 
Massage Treatment," delivered before the Clinical 
Society of Maryland in March, 1888, appeared in 
several medical journals, I have frequently been 
asked by the medical profession to write a 
manual, and also to give instructions on the 
subject. 
Although there are numerous articles and 
books on massage, there are, to my knowledge, 
no manuals of Swedish movement and massage 
treatment in the English language which give 
any information how to apply the treatment in 
different diseases. 
As such a treatise seems to be desirable, I have 
tried to write a practical hand-book, describing 
the most useful movements, many of these illus- 
trated by cuts, and giving in addition prescrip- 
tions for their use in those cases where they are 
III IV 
PREFACE. 
most likely to be successfully applied in the sick- 
room and without any apparatus. 
I trust this will supply a need, and be accepted 
as a practical help in the treatment of the sick. 
Hartvig Nissen. 
Washington, D.C., 
May, 1889. CONTENTS. 
CHAPTER I. 
PAGE 
History, 1 
CHAPTER II. 
Classification of Movements, .... 5 
Massage, 6 
The Purpose of this Manual, .... 6 
Who Should Apply the Treatment, . . .10 
The Variety of Movements, . . . .10 
How Often the Treatment Should be Re- 
peated, . . . . . . .12 
How to be Dressed, 13 
Physiological Effects of Movements, . . 13 
Passive Movements, 14 
The Active and Resistive Movements, . . 16 
The Movements May be Spoken of as, . . 17 
CHAPTER III. 
Description of Movements, 19 
Positions, 19 
Movements of the Arms, .... 20 
Movements of the Legs, . . . .36 
Movements of the Trunk, .... 45 
Movements of the Head, .... 56 
Can the Human Hand be Substituted for 
Apparatus? 57 
The Vibrator, 60 
V VI 
CONTENTS. 
CHAPTER IV. 
Diseases and their Treatment. 
group I. 
PAGE 
Constitutional Diseases, 63 
A. Chlorosis and Anaemia, Neurasthenia, 
Hysteria, and Hypochondria, . . 63 
B. Insomnia, 72 
GROUP II. 
Local Diseases, 75 
Diseases of the Brain, Spinal Cord, and 
Nerves, 75 
Congestion of the Brain, . . . .75 
Anaemia of the Brain, 76 
Paralysis as a Result of Apoplexy, . . 76 
Congestion of the Spine, .... 82 
Sciatic Neuralgia, 82 
Writer's Cramp, 92 
Cramp of the Legs, 92 
Chorea, 93 
group in. 
Diseases of the Organs of Circulation, . . 94 
Chronic Heart Diseases, .... 94 
Cold Hands and Feet, 96 
GROUP IV. 
Diseases of the Respiratory Organs, . . 97 
Catarrh of the Larynx, Catarrh of the 
Lungs, Congestion of the Lungs, 
Emphysema of the Lungs, Spasmus 
Bronchialis and Tuberculosis, . . 97 CONTENTS. 
VII 
GROUP V. 
Diseases of the Organs of Digestion, . . 98 
Dyspepsia, 99 
Constipation, 100 
Hyperemia of the Liver, . . . .101 
GROUP VI. 
Diseases of the Urinary and Sexual Organs, . 102 
Chronic Catarrh of the Bladder, . . 102 
Chronic Catarrh of the Womb, . . . 103 
Displacement of the Womb,. . . . 103 
Irregularity and Painful Menstruation, . 103 
GROUP VII. 
Diseases of the Organs of Movements, . . 104 
Scoliosis, 104 
Muscular Rheumatism of the Right Arm,. 107 
Of the Neck, 107 
Lumbago, 108 
Rheumatism of the Joints, . . . .Ill 
Stiffness of Joints and Tendons,. . . 112 
Sprains, 115 
Hydrarthrus, 119 The Swedish Movement 
AND 
Massage Treatment. 
CHAPTER I. 
History. 
It is a known fact that bodily exercise was 
used as a curative agent in the earliest days. 
2Esculapius, Apollo's descendant, is said to 
have been the inventor of the art of gymnastics. 
Medea procured health and youth by gymnastics. 
It was four hundred to five hundred years 
before Christ that Iccus, and later Herodicus, re- 
duced bodily exercise to a system, and Herodicus 
made it a branch of medical science to preserve 
the health and cure diseases by the use of gym- 
nastics, and among his many pupils was the 
famous Hippocrates. 
Diocles, Praxagoras, Herophilus, Asclepiades, 
Athenreus, Celsus, and Galen recommended 
"■movement treatment," and srave rules for it. 
1 2 
Mercurialis wrote in the sixteenth century a 
book, "De Arte Gymnastica," or the science of 
bodily exercise, which he divided into "Gymnas- 
tics for Athletes, for the Military, and for the 
Cure of Diseases," to which, as used by the 
Greeks and Romans, he gave especial attention, 
and pointed out the use of the different move- 
ments in different diseases, and also gave rules for 
their application in special cases. 
Thomas Fuller, an English physician, published 
in 1704 "Medicina Gymnastica," treating of the 
power of exercise in preserving health and curing 
disease. 
Clement J. Tissot, a French physician, who 
several times gained the prize of the Academic 
Royale de Chirurgie for his lectures, published in 
Paris, 1781, " Gymnastique Medicinale." 
Gutsmuth, Jahn, Clias, and Spiess worked 
with energy to spread the German gymnastics or 
" Turnkunst," but paid no attention to gymnastics 
as used for the treatment of diseases. 
As Herodicus observed the curative effects 
of gymnastics on his own delicate health, and 
thereby was brought to use movements in ther- 
apy, so did the Swede, Pehr Henrik lang, in 
the beginning of this century, study the move- 
SWEDISH MOVEMENT AND MASSAGE. HISTORY. 
3 
ment treatment because he had cured himself of 
rheumatism in the arm by gentle percussions. 
Ling formerly had been only a fencing-master 
and instructor of gymnastics; but afterward, 
studying anatomy and physiology, and the influ- 
ence of the movement and manipulations in dif- 
ferent chronic diseases, he founded a system of 
gymnastics corresponding with the knowledge of 
physiology, which is universally known as " the 
Ling System," or the 
"SWEDISH MOVEMENT TREATMENT." 
By ardent study and labor, Ling succeeded at 
last in making his new ideas recognized, and in 
1813 the first college for pedagogical, military, 
and medical gymnastics, called the " Royal 
Gymnastic Central Institute," was established in 
Stockholm at the expense and under the super- 
vision of the Swedish Government, and Ling was 
its first President. 
The principal studies for graduation at the 
present time are: Anatomy, Physiology, Pa- 
thology, Hygiene, Diagnosis, Principles of the 
Movement Treatment, and the use of exercises 
for general and local development. 
Ling died in 1839. His pupils, Brandting, 4 
SWEDISH MOVEMENT AND MASSAGE. 
Georgii, Liedback, and G. Indebetou, published 
Ling's theories, and by this means and through 
the many foreigners who studied at the Central 
Institute, of Stockholm, Ling's system soon 
became known in a great part of the world. 
Dr. Joseph Schreiber, of Vienna (in his " Man- 
ual of Massage and Muscular Exercise," page 
21), says: " The most powerful impetus, however, 
given to the revival of mechano-therapy origi- 
nated with a Swede, the creator of the modern 
' movement cure,' whose doctrines, spreading to 
England and to Germany, have, after many de- 
cades, and in spite of being marked by some 
extravagances, gained universal recognition." 
De Ron, in St. Petersburg ; Georgii, Indebetou, 
Bishop, and Roth, in London; Rothstein and 
Neumann, in Berlin; Richter, in Dresden; 
Schrcber, in Leipzig; Melicher, in Vienna; Eu- 
lenburg, in Baden ; Laisne, at the " Hopital des 
Enfants Malads," in Paris; Taylor, in New 
York, and many others, established special insti- 
tutions for movement treatment, and published 
their results partly in medical papers, partly in 
books. CHAPTER II. 
Classification of Movements. 
Endowed with depth of thought as well as 
creative genius, fortified by sound scientific infor- 
mation, and sustained by an untiring devotion to 
his task, Ling was early led from result to result 
by a careful classification of movements and by 
a scientific examination of their different results. 
Ling distinguished, in the first instance, between 
" ACTIVE " AND " PASSIVE " MOVEMENTS, 
active movements being such as the subject per- 
forms entirely by voluntary muscular contraction, 
and passive movements such as the subject takes 
no part in beyond allowing the operator to move 
the whole or any portion of his body-as flexion, 
extension, and rotation-and to manipulate it, as 
in stroking, kneading, pressing, percussing, etc. 
These simple movements Ling combined into 
RESISTIVE, OR DUPLEX MOVEMENTS, 
viz., active-passive, or " concentric duplex " 
movements, such as the patient makes, while the 
5 6 
SWEDISH MOVEMENT AND MASSAGE. 
operator resists, and passive-active, or " eccentric 
duplex " movements, such as the operator over- 
comes, while the patient resists; duplex, because 
two individuals engage in it; concentric, be- 
cause the patient's muscles have to overcome a 
resistance which prevents flexion-a movement 
toward the trunk; eccentric, because the force 
acts in a direction away from the body. 
The word massage means kneading, but is 
now generally used to describe the handling and 
manipulating of the flesh, as in stroking, press- 
ing, kneading, percussing, etc. 
Thus " massage " is only a part of the 1,1 pas- 
sive " movements, and constitutes a very small 
part of the " Swedish movement treatment." 
The Purpose of this Manual. 
It would be impossible for any one to gain a 
thorough knowledge of this system, and how, 
understandingly, to give a full treatment, from a 
brief manual like the present one. 
Two or three years of hard study is required 
at the Royal Central Institute of Stockholm in 
order to be graduated there. 
But there are hundreds of cases where the 
passive movements, together with a few of the THE PURPOSE OF THIS MANUAL. 
7 
most useful resistive movements, will not only 
give a great relief, but even effect a cure, when 
applied judiciously and according to physiolog- 
ical laws. 
For the treatment of those cases where the 
doctor himself, or an operator under the doctor's 
direction, will apply the " movements," or what 
is commonly called the " massage," in the sick- 
room, and without the use of apparatus, it is the 
object of this manual to describe. 
There is also another reason why a manual of 
this kind is necessary, namely, a great many 
physicians, as well as others, consider this treat- 
ment to be a humbug, but this is due partly to 
prejudice and partly to their entire ignorance of 
the system. 
Others think that "Swedish movements" mean 
regular active gymnastics, and think of " mass- 
age" only as a kind of "magnetism or rubbing." 
Again, some physicians, anxious to find out 
what there is in this treatment, have em- 
ployed persons calling themselves "masseurs" 
to apply massage to patients. As a natural 
result of this, in many cases the treatment proved 
of no value whatever, and in some instances 
actual harm was done. 8 
SWEDISH MOVEMENT AND MASSAGE. 
It has happened more than once to the author 
of this book that he has been called in by phy- 
sicians to apply " massage " to patients who were 
already suffering with a high fever, and he inva- 
riably declined to do so. In one of these cases 
the patient died the following day. Had the 
physician's request been acceded to, the massage 
treatment would have been accredited with has- 
tening or causing the sick man's death. 
At other times the writer has asked the phy- 
sician in charge what the illness was, and has 
been told that it was unnecessary for him to 
know. 
Some physicians seem to have the idea that we 
specialists are their rivals and their opponents. 
Still, we have frequently repeated that we are 
not physicians and do not practice medicine. 
We are specialists, and, as such, necessarily 
physiologists, and have the practical experience 
gained by the practice of many years in this one 
branch. 
But it is co-operation between the medical pro- 
fession and the specialists which is desirable and 
necessary in order to produce the best results. 
Therefore, it is the aim of this little book to 
enlighten those who want to know, and to show THE PURPOSE OF THIS MANUAL. 
9 
how the treatment should be applied in different 
cases. 
Swedish movements and massage are based on 
plain physiological laws, and have nothing in 
common with " magnetism," nor is it " regular 
gymnastics," nor " rubbing." 
When the physician desires to have this treat- 
ment applied to a patient, and does not want to 
execute it himself, he should always take care 
that the one employed thoroughly understands 
his business. 
As Dr. D. Graham says: "It is not to be 
wondered at that many a shrewd, superannuated 
auntie, and others who are out of a job, having 
learned the meaning of the word massage, im- 
mediately have it printed on their cards, and 
continue their 'rubbin,' just as they have always 
done." 
Finally, it must be said that it is not our 
claim to cure all kinds of diseases by movements. 
Far from that. Some diseases, it is true, can be 
cured quicker by this method than by any other. 
In most cases, however, it has to be used together 
with medical treatment, for the same reason that 
electricity, baths, etc., are very often employed to 
bring about a cure. In other cases it should be 10 
SWEDISH MOVEMENT AND MASSAGE. 
resorted to only as an after-cure, or as a means 
of exercise. 
Who Should Apply the Treatment. 
After a little study and practice no physician 
should have any trouble in treating a case of 
neurasthenia, insomnia, acute muscular rheuma- 
tism, sprains, etc., but he will hardly have either 
the facilities, dexterity, patience, or time to treat 
sciatica, ankylosis of years' standing, confirmed 
constipation, heart disease, or spinal curvatures, 
etc. A specialist should always be called for the 
treatment of such cases, for he will not be dis- 
couraged by the apparent lack of success in the 
beginning (often extending over months), and 
has, besides, apparatus by the use of which he 
can facilitate the cure; or may, indeed, have an 
establishment of his own wherein trained assist- 
ants devote all their time and energies to this 
method alone. 
The Variety of Movements and Duration 
of treatment is of great importance. 
It is an utterly false idea that "massage" is 
merely "rubbing," and needs only to be applied 
by a strong hand and for an hour's time. VARIETY OF MOVEMENTS AND DURATION. 
11 
As Dr. D. Graham says: "The argument, too 
often used, that massage can do no harm, if it 
does no good, is a dangerous one. When a man 
understands one branch of the medical profes- 
sion well, one of the commonest errors is to sup- 
pose that he understands all the rest equally 
as well, as if our knowledge of massage, like 
everything else, did not come through experi- 
ence." 
For instance, in a case of synovitis, or gland- 
ular enlargement, the manipulations should al- 
ways be directed centripetally, toward the heart; 
but in case of insomnia, or very painful neural- 
gia, the manipulations should be directed down- 
ward, from the shoulder toward the fingers, from 
the hips toward the toes, in order to ease and 
quiet the nerves. In cases of congestion, move- 
ments must be applied to drive the blood from 
the part; in other cases, as ancemia, it is necessary 
to increase the flow of blood to the part. 
Now, for instance, there are two patients, a 
delicate woman and a strong, robust man, both 
suffering with rheumatism. It might be fair to 
treat the man for about an hour, but it would 
surely be too much to let the woman undergo 
the same treatment for the same length of time. 12 
SWEDISH MOVEMENT AND MASSAGE. 
Always bear in mind that the old maxim, "If a 
little does good, more will do more good," is an 
exploded theory. A good operator can accom- 
plish more in fifteen minutes than a poor one in 
an hour. 
How Often the Treatment Should be 
Repeated. 
It is a mistake, frequently made by physicians, 
to recommend their patients to try movement or 
massage treatment only two or three times a 
week, "because they cannot stand it," or, "they 
are too weak to try it oftener." 
The weaker a patient is the oftener he ought 
to have the treatment. The treatment should be 
applied at least once a day, and sometimes twice, 
in order to derive the most benefit from it. The 
effect which is derived from one treatment should 
not be lost before the next treatment is applied. 
It is the treatment which builds up the pa- 
tient's strength, but if only tried once in a while 
he will feel tired and stiff a day or two afterward, 
and naturally conclude that the treatment does 
him harm--just as a man who takes a ten-mile 
horseback ride once a week feels sore and stiff 
each time, and never gets over it until he repeats 
the riding several times weekly. HOW TO BE DRESSED. 
13 
To a weak patient the treatment has to be 
given very gently in the beginning, and, pro- 
viding it is applied regularly, may soon be in- 
creased in force, and thus more vigor is given to 
the patient. 
How to be Dressed 
when under treatment is a frequent question. 
In all cases where the manipulations are to be 
directed centripetally, it is necessary to strip the 
body; but in other cases it is preferred that it 
should be clothed, as that will lessen the pain 
which sometimes is produced by the manipula- 
tions, and the skin (not being the seat of the 
trouble) will be more protected. 
The dress should be as light as possible, and 
all tight clothing dispensed with. 
Physiological Effects of Movements. 
These may be divided into two groups:- 
First. Purely mechanical effects to secure the 
removal of lymph, exudations, extravasations, 
etc., softening of exudations, and loosening of 
adhesions. 
Second. Increased circulation by stimulating 
the muscular and nervous system, causing mole- 14 
SWEDISH MOVEMENT AND MASSAGE. 
cular changes, changes in sensation, and changes 
in the nutritive functions. 
Dr. J. Schreiber says: " We understand by 
Passive Movements 
all movements performed by the physician upon 
the patient, the latter remaining passive. 
"The following results are obtained:- 
"1. Extravasations occurring about dislocated 
joints are, by pressing and rubbing the tendons 
and ligaments in which they are imbedded, 
finally liquefied, and thus more quickly absorbed. 
" 2. In stiffness of joints the contracted muscles 
and tendons are forcibly but gradually elongated, 
and any existing exudations or vegetations within 
the joints are disintegrated and absorbed. 
" 3. By the forcible stretching of the muscles 
their nerves are likewise stretched, molecular 
changes being thus set up in both. 
"4. Forced extension of the muscles causes 
pressure on their blood and lymphatic vessels, 
thus accelerating the circulation. 
" 5. Finally, such muscles as have by rheumatic 
or neuralgic pains been kept in a state of inac- 
tivity have some of their much-needed exercise 
restored to them. Passive movements thus form PASSIVE MOVEMENTS. 
15 
in certain diseases, as in neuralgia and rheuma- 
tism, the introduction, as it were, for the more 
painful active motions which have to follow." 
Dr. D. Graham, " Treatise on Massage," page 
23, says: "In 1844 the Supreme Medical Board 
of Russia appointed two members of the Medical 
Council to inquire into the merits of the move- 
ment and manipulation treatment as practiced by 
M. de Ron, one of Ling's disciples at St. Peters- 
burg, who had been using it then for a period of 
twelve years. From the highly commendatory 
report of the Councillors we quote the following: 
' All passive movements, or those which are exe- 
cuted by an external agent upon the patient, as 
well as active ones produced by the effort of the 
voluntary muscles, and the different positions 
with the aid of apparatus or without it, are 
practiced according to a strictly defined method, 
and conducted rationally, since they are based 
upon mechanical as well as anatomical prin- 
ciples.' 
" Experience teaches us the usefulness of the 
institution, as many patients thus treated have 
recovered their health after having suffered from 
diseases which could not be cured by other reme- 
dies 16 
SWEDISH MOVEMENT AND MASSAGE. 
The Active and Resistive Movements 
cause an increased flow of blood to the muscles 
and soft parts, increasing thereby the circulation 
and removing accumulation of tissue waste. 
They cause resorption of exudations, transuda- 
tions, and infiltrations, and a separation of adhe- 
sions in tendon-sheaths and in joints. They in- 
crease the oxidizing powers of the blood; they 
relieve the congestion of the brain, lungs, intes- 
tines, uterus, liver, and kidneys, by increasing 
the flow of blood to the muscles; they stimulate 
directly the sympathetic nervous system, thus in- 
creasing secretion, and rcflexly the activity of un- 
striped muscle-fibres, and so relieve various 
functional derangements. 
And they educate morbidly affected muscles to 
convert abnormal into normal actions and to 
suppress useless movements. 
Thus movement treatment influences the liv- 
ing organism- 
First, by increasing the circulation, respiration, 
and temperature, improving the digestion, ab- 
sorption, and nutrition, and facilitating excretion. 
Second, the muscles become developed, the 
bones and the whole human frame better pro- 
portioned. ACTIVE AND RESISTIVE MOVEMENTS. 
17 
Third, appetite is increased, and food is taken 
with greater relish. 
Fourth, sleep is facilitated. 
Fifth, the brain acts more vigorously and is 
freed from psychical depression. 
Sixth, relieves pain and removes congestion. 
The Movements May be Spoken of as 
"Strengthening" movements, such as flexion, 
extension, torsion, etc. 
" Stimulating " movements, as percussion, vi- 
bration, etc. 
" Quieting " movements, as rotation, friction, 
etc. 
"Derivative" movements, with special move- 
ments of the extremities. 
" Purgative " movements, as kneading, press- 
ing, and active movements of the abdominal 
muscles. 
Some movements have a special effect on the 
" respiration," others on the " circulation," etc. CHAPTER III. 
Description of Movements. 
positions. 
Ling distinguished between five different fun- 
damental positions, viz.:- 
Standing. 
Kneeling. 
Sitting. 
Lying. 
Hanging. 
These he subdivided into a number of starting 
positions with the arms, legs, trunk, and head, as 
Standing-hands on hips, 
arms horizontal, 
arms vertical, 
Sitting-astride sitting, 
forward bent sitting, 
Lying-reclining, 
knees bent, 
on back lying, 
on front lying, 
which, combined in various ways, make nearly 
19 20 
SWEDISH MOVEMENT AND MASSAGE. 
twelve thousand positions in which the different 
movements may be either taken or given. And 
so the number of movements may be said to be 
endless, to suit each particular ailment. 
MOVEMENTS OF THE ARMS. 
A. Passive Movements. . 
1. Centripetal stroking, pressing, kneading, 
circular friction, and vibratory friction are all to 
be given from the tip of the fingers toward the 
shoulder. 
Grasp the patient's finger with your thumb 
and two first fingers, and make a firm pressing 
and stroking movement upward toward the hand; 
at the same time let your fingers glide in a cir- 
cular way round the patient's finger, describing 
the motions of a screw. Let your fingers glide 
easily back to the starting-point (the tip of the 
patient's finger), and repeat the motions fifteen to 
twenty times on each finger. 
In treating the hand, use your fingers and the 
palm in pressing and stroking, and continue the 
same way toward the elbow. Then knead the 
muscles from the fingers toward the elbow by 
picking up each group of muscles with the one 
hand (Fig. 1, A), and when releasing the grasp MOVEMENTS OF THE ARMS. 
21 
make an upward pressure with the other hand 
(Fig. 1, B, kneading). 
Fig. 1.-Kneading, 
Again, grasp the hand with both of yours, and 
make upward pushing movements, constantly 22 
SWEDISH MOVEMENT AND MASSAGE. 
moving the hands and fingers in a circular direc- 
tion, thereby making a sideways friction together 
with the upward stroke (circular friction, Fig. 2). 
Now, let the patient's arm rest in your left 
hand, and with your right make a pressure and 
shaking movement of the different muscles, con- 
stantly gliding upward (vibratory friction). The 
Fig. 2.-Circular Friction. 
same movements are to be made from the elbow 
to the shoulder. 
When the whole arm has been worked over in 
this manner from four to -ten times, make firm 
strokes from the fingers to the shoulder, clasping 
the limb around with both your hands, from five 
to ten times. MOVEMENTS OF THE ARMS. 
23 
These movements are given in order to remove 
lymph, exudations, transudations, etc., and to 
effect the solution and removal of adhesions. 
2. Nerve Compression.-Grasping the limb 
with both hands, a firm pressure is made around 
and down the whole arm, from the shoulder to 
the fingers. Repeated three to five times (Fig. 3). 
Fig. 3.-Nerve Compression. 
This stimulates the nerves and increases the 
circulation of the blood. 
3. Muscle Rolling.-Grasping the limb with 
the palms of both hands (Fig. 4), and making a 
quick, alternate pushing-and-pulling motion, and 
gradually gliding downward from the shoulder, 
the muscles of the arm will be rolled against 
each other, whereby the circulation of the blood 
is very much increased. Repeated three to five 
times. 24 
SWEDISH MOVEMENT AND MASSAGE. 
4. Slapping.-This is performed with the 
palm of both hands, with a light motion of the 
wrist-joint, and the whole arm is slapped from 
the shoulder downward from three to five times. 
Useful in rheumatism, lameness, cold hands, etc. 
5. Friction is performed with the fingers and 
palm of the hand from the shoulder and down- 
Fig. 4.-Muscle Rolling. 
ward, grasping around the limb with both hands, 
repeated ten to thirty times. This should be 
done in slow time. This has a quieting effect on 
the nerves, and by irritating the walls of the 
blood-vessels the circulation of the blood in the 
capillaries is stimulated. 
Nerve compression, muscle rolling, slapping, 
and friction are frequently used together as an MOVEMENTS OF THE ARMS. 
25 
excellent way to increase the circulation of the 
blood and quiet the nerves. 
6. Percussion is performed with the edge of 
the extended fingers (Fig. 5), which are kept 
loose, and with a quick motion of the wrist-joint 
the fingers are flung across the muscles from the 
shoulder toward the hand. 
Fig. 5.-Percussion. 
7. Beating is performed with the clenched fist 
(Fig. 6, A) on and around the fleshy part of the 
limb with a loose and light movement of the 
wrist-joint (Fig. 6, B). 
These two motions have a stimulating effect, 
and are useful in lameness and weakness of the 
muscles, in rheumatism, etc. 
8. Vibration.-The operator takes hold of the 26 
SWEDISH MOVEMENT AND MASSAGE, 
patient's hand and makes a slight pull and a 
very rapid vibration (shaking) of the whole arm. 
Repeated three to five times. This has a stimu- 
Fig 6.-Beating. 
lating and strengthening effect on the nerves 
and also on the respiration. 
9. Finger Rotation.-The joint between the MOVEMENTS OF THE ARMS. 
27 
finger and hand is fixed by the operator's one 
hand, and with his other the finger is rotated in 
its joint, first ten to twenty times one way, then 
as many times the other way. 
10. Hand rotation is performed by taking 
hold of the wrist with one hand and of the fin- 
gers with the other hand, and describing a circle 
in the wrist-joint from ten to twenty times each 
way. 
11. Forearm Rotation.-The patient's elbow 
is fixed in the operator's one hand, who, with 
the other hand, takes hold of the patient's wrist 
(see Fig. 9) and moves the forearm, which is 
kept on a right angle, in a circle in the elbow- 
joint, from ten to twenty times each way. 
These movements are used in stiffness of the 
joints and cold hands, and as derivative from the 
chest and head. 
12. For the same purpose is given arm, hand, 
and finger flexion, "passive," by alternately 
bending and stretching the joints. 
13. Arm Rotation (A, Single}.-The operator 
takes hold of the patient's shoulder with one 
hand and of his elbow with the other hand, 
moves the arm forward, upward, backward, and 
down and reverse, so as to describe a circle of 28 
SWEDISH MOVEMENT AND MASSAGE. 
the shoulder-joint, from five to ten times each 
way. 
This increases the circulation and limbers the 
shoulder-joint, and has a derivative effect on the 
chest and head. 
Fig. 7.-Forward Arm Rotation, 
14. Forward Arm Potation-Sitting (B, 
Double).-The operator, standing behind the 
patient, the latter resting his back against the 
operator's chest, then takes hold of his arms 
just below the elbows and moves them in a 29 
MOVEMENTS OF THE ARMS 
circle forward, upward, sideways, and down, 
from ten to twenty times (Fig. 7). 
This expands the chest and has a great effect 
on the respiration and the circulation. 
Fig. 8.-Shoulder Rotation and Chest Lifting. 
15. Shoulder Rotation and Chest Lifting-Sit- 
ting.-The patient sits on a stool or box, and the 
operator, standing behind, takes hold under and 
in the front of the patient's shoulders, moves 
them upward, backward, and down, at the same 30 
SWEDISH MOVEMENT AND MASSAGE. 
time pressing his chest against the patient's back. 
Repeated eight to fourteen times (Fig. 8). 
This is a mild but effective movement in 
weakness of the lungs and heart, as it deepens 
the inspiration followed by a stronger expiration, 
Fig. 9.-Arm Flexion and Extension. 
thereby stimulating the flow of venous blood to 
the heart. 
B. Resistive Movements. 
16. Hand and Finger Flexion and Extension. 
-Position as in rotations. Resistance is made MOVEMENTS OF THE ARMS. 
31 
alternately by the operator and the patient. This 
develops and strengthens the muscles of the fore- 
arm, hand, and fingers, and increases the flow of 
blood to them. 
17. Arm Flexion and Extension.-Position 
as in " forearm " rotation. The patient first 
stretches and bends his arm, in the elbow-joint, 
during the resistance of the operator, " active- 
passive." Then the operator stretches and bends 
the arm, during the resistance of the patient, 
" passive-active." Repeated from three to ten 
times (Fig. 9). 
This develops and strengthens the flexor and 
extensor muscles of the arm and increases the 
circulation. 
18. Vertical Arm Flexion and Extension- 
/Sitting.-The operator stands behind and a little 
higher than the patient and takes hold of both 
his hands, resisting the patient when he bends 
and stretches his arms, "active-passive," in a slow 
movement, the elbows being kept well out to the 
side. The operator's knee should be pressed 
against the patient's back with a small pillow 
between. Repeated from five to fourteen times 
(Fig. 10). 
This strengthens the muscles of the chest and 32 
SWEDISH MOVEMENT AND MASSAGE. 
back as well as of the arms, and it expands and 
deepens the chest. 
19. Horizontal Arm Flexion and Extension- 
Sitting.-The patient's arms are raised horizon- 
Fig. 10.-Vertical Arm Flexion and Extension, 
tally and kept well back, with the forearms 
sharply bent upon them; the operator, standing 
behind, pressing his chest against the patient's MOVEMENTS OF THE ARMS. 
33 
back, takes hold of both his wrists (Fig. 11) and 
resists, when the patient stretches and bends his 
arms at the elbow-joints, " active-passive." Re- 
peated from five to ten times. 
This strengthens the muscles of the upper 
Fig. 11.-Horizontal Arm Flexion and Extension. 
arms; it expands the chest and is a good respir- 
atory and derivative movement. 
20. Horizontal Arm Separation and Closing- 
Sitting.-The operator, standing in front of the 
patient, who holds his arms straight ont to the 34 
SWEDISH MOVEMENT AND MASSAGE. 
sides, takes hold of his wrists and pulls the arms 
forward under resistance by the patient, " pas- 
sive-active." Then the patient brings his arms 
back to the former position resisted by the oper- 
ator, " active-passive." Repeated from five to 
ten times (Fig. 12). 
Fig. 12.-Horizontab Arm Separation and Closing. 
This acts on the muscles of the back of the 
shoulders, whereby the shoulders are straight- 
ened ; it has a good effect on the respiration 
and the circulation. 
21. Lateral Arm Elevation and Depression.- 
The operator, standing behind the patient, takes MOVEMENTS OF THE ARMS. 
35 
hold of his forearms, which are hanging down, 
and resists when the patient raises his arms side- 
ways, upward, and when he brings them down 
again, " active-passive. " The elbows should be 
kept straight. Repeated from five to ten times 
(Fig. 13). 
Fig. 13.-Lateral Arm Elevation and Depression. 
This is a very effective movement to widen the 
chest and to strengthen the muscles of the 
shoulders and upper arms. It has a good effect 
on the respiration and circulation. 
22. Arm Torsion.-The patient takes hold of 36 
SWEDISH MOVEMENT AND MASSAGE. 
the middle of a stick with one hand and keeps 
his arm straight. The operator takes hold of 
each end of the stick and resists the patient 
when he twists his arm outward and inward, 
" active-passive." This movement may be 
changed by letting the patient resist when 
the operator twists the arm, " passive-active." 
Repeated from five to ten times. 
This is used in stiffness of the shoulder-joint 
and in abnormal enervations of the muscles of 
the arm, and is a good derivative from the chest 
and head. 
MOVEMENTS OF THE LEGS. 
A. Passive Movements. 
23. Centripetal stroking, pressing, kneading, 
circular friction, and vibratory friction should 
all be applied in the same manner as to the 
arms, beginning with the toes and gradually 
proceeding toward the hip. (See Figs. 1 and 2.) 
24. Nerve compression, muscle rolling, slap- 
ping, and friction from the hip toward the foot 
are similar to those movements given the arms, 
as above described. (See Figs. 3 and 4.) 
25. Percussion, as applied to the arms. (See 
Fig. 5.) MOVEMENTS OF THE LEGS. 
37 
26. Beating, as applied to the arms. (See 
Fig. 6.) 
27. Vibration.-The operator, taking hold of 
the patient's heel and ankle, makes a slight 
pulling and shaking movement of the whole limb. 
This has a stimulating effect on the nerves. 
28. Foot Rotation (A, Single).-The operator 
Fig. 14.-Foot Rotation, Double. 
fixes the patient's ankle with one hand, and, 
taking hold of the toes with the other hand, 
moves the foot around in a circle ten to twenty 
times one way, and reverses. 
This is useful in stiffness of the ankle-joint 
and cold feet. 
29. B, Double.-The patient, in a lying or 38 
SWEDISH MOVEMENT AND MASSAGE. 
reclining position, rests the back of his heels 
against a cushion. The operator, sitting in front 
of the patient, takes hold of his toes (Fig. 1-4) 
and moves both feet in a quick circle twenty to 
thirty times the one way, and reverse. The legs 
should be kept straight during the motion. 
Fig. 15.-Thigh Rotation. 
This has a very good effect on the circulation, 
and, by increasing the flow of blood to the feet, 
acts as a good derivative from other organs. 
30. Foot and toe flexion, passive, is generally 
used in connection with the rotation. 
31. Thigh Rotation.-The operator takes hold MOVEMENTS OF THE LEGS. 
39 
of the patient's foot with one hand and of his 
bent knee with the other hand (Fig. 15); the 
knee is now pressed upward, then moved out- 
ward and downward so as to describe a circle in 
the hip-joint; the knee should not be moved to 
pass the middle line of the body Should be re- 
peated from live to ten times each way. 
This is very useful in equalizing the circula- 
tion and as a derivative from diseases in the 
pelvis and abdomen, as well as to limber the hip- 
joint. 
B. Resistive Movements. 
32. Foot Flexion and Extension (A, Single, 
and B, Double, Fig. 14).-Positions as in foot 
rotation. The patient bends and stretches his 
feet during resistance by the operator, " active- 
passive." 
These strengthen the muscles of the calf and 
foot and limber the ankle-joint. It is a good 
derivative movement, and is especially beneficial 
in cases of cold feet. 
33. Leg Flexion and Extension.-The opera- 
tor, standing by the side of the patient, takes 
hold of his heel with one hand and of the ball 
of the foot with the other hand (Fig. 16). The 
leg is bent without resistance, and then the 40 
SWEDISH MOVEMENT AND MASSAGE. 
patient stretches it out, when the operator resists 
by pressing the leg upward and slightly giving 
way till it is perfectly straight, "active-passive." 
Repeated from five to ten times. 
This is an excellent movement to strengthen 
the extensor muscles of the whole limb, and also 
Fig. 16.-Leg Flexion and Extension. 
as a derivative from diseases of the pelvis and 
abdomen. 
34. Upward Knee Traction.-The operator 
takes hold of the back of the patient's heel with 
one hand and on the front of his foot with the 
other hand and resists, when the patient bends 
his leg-pulling his knee upward-by holding MOVEMENTS OF THE LEGS. 
41 
it straight, and slightly giving way till it is 
doubled up; it is again straightened without re- 
sistance. Repeated five to ten times (Fig. 17). 
This movement strengthens the flexor muscles 
of the leg and the muscles of the abdomen, and 
thus has a purgative effect. 
Fig. 17.-Upward Knee Traction. 
35. Knee Flexion and Extension.-The oper- 
ator, sitting by the side of the patient, whose 
thigh is resting on the operator's knee (Fig. 
18), fixes the patient's knee with one hand and 
takes hold with the other hand around his ankle, 
resisting, when the patient bends, and stretches 
his knee. Repeated five to ten times. 42 
SWEDISH MOVEMENT AND MASSAGE. 
This is useful in stiffness and weakness of the 
knee-joint and to strengthen the muscles of the 
thigh. It has a derivative effect. 
36. Leg Elevation and Depression-Lying.- 
The patient, keeping his knee straight, raises his 
leg upward by bending the hip-joint, the opera- 
tor making slight resistance with his hands on 
Fig. 18.-Knee Flexion and Extension. 
the patient's knee, "active-passive." Then the 
patient resists, while the operator presses the 
limb down again, "passive-active" (Fig. 19). 
Repeated five to ten times. 
This may also be performed with both legs at 
the same time when the patient is young and 
strong. MOVEMENTS OF THE LEGS. 
43 
The muscles of the abdomen, the flexor mus- 
cles of the thigh, and the extensor muscles of the 
leg are hereby brought into play. It has a pur- 
gative as well as a derivative effect. 
37. Leg Separation and Closing-Lying.- 
The operator takes hold of the patient's ankle 
Fig. 19.-Leg Elevation and Depression. 
and resists him when he brings his leg out to 
the side, "active-passive." Then the patient re- 
sists while the operator presses the leg into its 
former position, " passive-active." Repeated four 
to eight times. 
This strengthens the muscles of the hip and 44 
SWEDISH MOVEMENT AND MASSAGE. 
thigh and is a good derivative from the organs 
of the pelvis. 
38. Bent Knee Separation and Closing.-The 
patient bends his knees to a sharp angle, the feet 
resting on the bed or chair; the operator puts his 
hands on the outside of each knee (Fig. 20) and 
Fig. 20.-Bent Knee Separation and Closing. 
resists when the patient separates the knees. 
Then the operator changes his hands to the in- 
side of the knees and resists while the patient 
closes them, " active-passive." Repeated three to 
five times. 
Now the movement is reversed so that the MOVEMENTS OF THE LEGS. 
45 
operator separates and closes the knees when the 
patient resists, "passive-active." Repeated three 
to five times. 
The feet should be kept firm in their place 
during the moving of the knees. 
This brings into play the muscles of the hips, 
pelvis, and thighs, and is a derivative movement. 
39. Leg Torsion.-The patient keeps his legs 
straight and the operator takes hold of the feet 
and resists while the patient twists his legs out 
and inward by separating and closing the feet, 
the heels being kept together. Repeated five to 
ten times. 
This is useful in stiffness and weakness of the 
hip-joint and as a derivative from the organs of 
the pelvis. 
MOVEMENTS OF THE TRUNK. 
A. Passive Movement. 
40. Chest Kneading and Friction. - First 
make a few strokes with both hands from the 
middle of the chest-the sternum-and out to 
the side. Then knead and vibrate the skin and 
the muscles all over the chest, always commenc- 
ing at the middle and working outward, and fin- 
ish with frictions. 
41. Chest Slapping.-The operator, standing 46 
SWEDISH MOVEMENT AND MASSAGE. 
in front of the patient, brings his hands on the 
back of the patient's shoulders and slaps him 
over the traction of the lungs, then moving for- 
ward under the arms to the chest and all over 
the chest up to the shoulders. Repeated three 
to six times. 
- I I 
Fig. 21.-Chest Lifting and Vibration. 
This is useful in weakness and emphysema 
of the lungs, organic diseases of the heart, and in 
nervous palpitation. 
42. Chest Lifting and Vibration.-The oper- 
ator, standing in front of the patient, puts his 
hands on each side and under the shoulders of 
the patient, then lifts him slightly (Fig. 21) and, MOVEMENTS OF THE TRUNK. 
47 
by shaking his hands, effects a vibration of the 
whole trunk. Repeated four to eight times at 
short intervals. 
This stimulates the lungs and heart. 
43. Stomach friction is made with both hands 
all over the abdomen from the middle and out to 
Fig. 22.-Stomach Kneading. 
the sides several times, followed with an upward 
stroke with the one hand on the right side and 
over to the left in the direction of the ascending 
and transverse colon, and then a downward 
stroke with the other hand on the left side in the 
direction of the descending colon. Repeated four 
to eight times. 48 
SWEDISH MOVEMENT AND MASSAGE. 
Useful in indigestion, dyspepsia, constipation. 
44. Stomach Kneading.-With the slightly 
bent knuckles of the fingers an alternate pressure 
is made with both hands all over the abdomen 
several times (Fig. 22). Then a kneading and 
rolling of the flesh and muscles is made in a 
circle from the right upward, over to the left and 
downward, in the direction of the ascending, 
transverse, and descending colon. Especially 
useful in constipation. 
45. Stomach Vibrations.-The operator presses 
his slightly bent fingers under the patient's ribs 
on the left side and applies a rapid vibration on 
the ventricle; the hands should be moved so as 
to apply the vibration all over the left hypo- 
chondriac. Repeated three to six times, and 
followed by a stomach friction. 
Useful in cases of dyspepsia and chronic catarrh 
of the stomach. 
46. Bowel Vibration-Standing.-The oper- 
ator, standing behind the patient, puts both his 
hands on the patient's abdomen, and by a rapid 
pushing and pulling motion of his hands an 
effective vibration is applied to the whole bowel. 
Repeated three to six times. 
Very useful in constipation. 49 
MOVEMENTS OF THE TRUNK. 
47. Bowel Concussion-Lying. - The opera- 
tor's both hands are placed on the patient's bowel, 
and a pressure is made. Then the hands are 
quickly taken off, allowing the abdomen to 
spring back like a rubber ball. Repeated three 
to five times. 
Fig. 23.-Loin Vibration. 
This strengthens the abdominal muscles and 
the digestive power. 
48. Loin Vibration-Sitting.-The operator, 
standing behind the patient, who sits on a 
lounge or box, presses his hands on each side of 
the patient just above his hips (Fig. 23), and 50 
SWEDISH MOVEMENT AND MASSAGE. 
applies a very rapid alternate pushing and pull- 
ing movement with his hands (reciprocating 
vibration). The hands must be firm and not 
glide on the flesh. Repeated three to six times 
at short intervals. 
This has a very stimulating effect on the 
liver and stomach and on the lungs and the 
diaphragm. 
49. Loin Traction-Lying. - The operator 
presses his hands on each side and under the 
loin of the patient, and pulls his hands forcibly 
forward, just above the hips. Repeated four to 
ten times. 
Useful in cases of indigestion and constipation. 
50. Breech beating is applied with the 
clenched fist of the one hand from the small 
of the back, down the sacral bone, and all over 
the buttocks to the beginning of the thigh, in 
slow time. Repeated five to eight times. 
This acts on the sacral nerves and is useful in 
weakness of the bladder and sexual organs and 
in constipation. 
51. Back kneading, vibration, and friction is 
applied from the base of the skull downward, 
and from the spinal column outward to the sides, 
all over the back (Fig. 24). A very good MOVEMENTS OF THE TRUNK. 
51 
movement in connection with these is to put the 
heel of the hands on the spinal column at the 
neck and apply a rapid shaking movement, 
letting the one hand slowly glide downward to 
the end of the spine. The whole manipulation 
Fig. 24.-Back Kneading. 
should always be followed by long and slow 
frictions on both sides of the spinal column. 
These movements increase the circulation, 
stimulate the action of the nerves, and have a 
very soothing and quieting effect. 
52. Spinal Nerve Compression.-The operator 
presses with his fingers first on the one side of 
the spinal column and then on the other side 52 
SWEDISH MOVEMENT AND MASSAGE. 
from the neck and downward. Repeated three 
to six times. 
Relieves backache and stimulates the nerve 
centres. 
53. Back percussion is applied with the edge 
of both hands alternately from the neck and 
downward on both sides of the spinal column. 
On the upper part of the back, from the shoul- 
ders to the lower end of the lungs, the percus- 
sion may also be applied outward to the sides. 
Repeated six to ten times. 
This has a very stimulating and strengthening 
effect on the nerve-centre. 
54. Trunk Rotation-Astride Sitting.-The 
patient sits astride over a box or lounge, while 
the operator, standing behind, takes hold of the 
patient's shoulders and moves his trunk from the 
waist, describing as large a circle as possible, first 
to the left, then to the right, the patient being 
perfectly passive. Repeated eight to sixteen 
times each way. 
This has a good effect on the spine and the 
portal system, and is a quieting movement. 
B. Resistive Movements. 
55. Trunk Torsion-Sifting.-The patient sits 
on a stool, or lounge, with hands on hips. The MOVEMENTS OF THE TRUNK. 
53 
operator, standing behind, puts his right hand 
on the front of the patient's right shoulder and 
his left hand on the back of his left shoulder, 
and resists the patient when he turns or twists 
his trunk to the left. (See Fig. 25.) Then the 
Fig. 25.-Trunk Torsion-Kneeling. 
operator changes his grip, reverses the hands, and 
resists when the patient turns to the right. Re- 
peated four to eight times to each side. 
56. Trunk Torsion-Kneeling.-The patient 
kneels on a lounge or bed with hands on hips. 54 
SWEDISH MOVEMENT AND MASSAGE. 
The operator, standing behind and fixing the pa- 
tient's back with his one knee, takes hold and 
resists, as in the former movement. Repeated 
four to eight times (Fig. 25). 
Both of these movements have a good effect 
on the spine, the nerves, and circulation; the 
Fig. 26.-Forward Trunk Flexion and Extension. 
former lias a special effect on the respiration and 
the latter on the digestion, by strengthening and 
elevating the muscles of the abdomen. 
57. Forward Trunk Flexion and Extension- 
Sitting.-The patient, sitting on a lounge or box, 
with hands on hips, bends forward, and, while MOVEMENTS OF THE TRUNK. 
55 
rising up to the former position, the operator puts 
his hands on the patient's back and resists him 
(Fig. 26). Repeated four to eight times. 
This strengthens the muscles of the back and 
straightens the spine. 
C. Active Movements. 
58. Trunk Elevation-Lying.-The patient, 
lying on a lounge or bed, with the lower legs 
Fig. 27.-Trunk Elevation-Lying. 
hanging down, raises his body to a sitting position, 
the operator fixing the patient's knees (Fig. 27). 
Repeated two to six times. 
This strengthens the abdominal muscles and 
is a purgative movement. 56 
SWEDISH MOVEMENT AND MASSAGE. 
MOVEMENTS OF THE HEAD. 
A. Passive Movements. 
59. Head Percussion, Vibration, and Friction.- 
With the edge of the hands percussion is applied 
from the forehead and backward to the neck, 
three to five times. Then a rapid percussion is 
given alternately, with the finger-tips of both 
hands, all over the forehead and temples, the 
crown of the head, and the neck, four to eight 
times. Then one hand is placed on the patient's 
forehead and the other is pressed with the inner 
edge on the neck just below the base of the skull, 
and shaken in a very rapid manner. Repeated 
three to five times. 
Now a circular and vibratory friction is applied 
with the finger-tips several times over the fore- 
head and temples and backward to the neck, 
finished up with straight frictions by both hands 
and fingers from the middle of the forehead out 
to both sides, and backward and down the neck. 
These movements are very useful in cases of 
headache, weariness, insomnia, etc. 
60. Head Rotation-Sitting.-The operator 
places his one hand on the patient's neck, and 
the other hand on his forehead, and slowly moves MOVEMENTS of the head. 
57 
the head in a circle, five to ten times one way, 
then as many times the other way. 
This acts on the blood-vessels and nerves of 
the neck and throat; it is a derivative movement 
from the brain, and has a quieting effect. 
B. Resistive Movements. 
61. Neck Flexion and Extension-Standing or 
Sitting.-The operator places his one hand on 
the back of the patient's skull and resists him 
when he bends his head backward as far as pos- 
sible. Repeated five to ten times. 
This acts on the muscles of the neck and the 
upper part of the back and on the blood-vessels 
and nerves of the neck and throat. It is deriva- 
tive from the brain, and it tends to straighten the 
upper part of the spine. 
Can the Human Hand Be Substituted for 
Apparatus ? 
On this head the following from Dr. J. 
Schreiber may be quoted :- 
" Many devices have been invented for saving 
the manipulator's strength, such as Klemm's 
muscle-beater, the elastic rods with rubber balls 
of Graham, and the machines run by steam of 
Zander. 58 
SWEDISH MOVEMENT AND MASSAGE. 
" All these are well enough in their way for 
treating certain phases of diseases; but, in general, 
they may be said to be wholly inadequate to our 
needs, and are quite apt to degenerate into mere 
playthings. No better results can be obtained 
than with the practiced hand, which surpasses 
even the best of instruments, and the skilled 
operator needs no other aid, no matter what kind 
of manipulation he may wish to perform. In 
the fingers, the fist, the edge of the hand, and in 
the forearm and arm we have an armamentarium 
possessed of the greatest variety of effects, for 
their use is capable of infinite multiplication by 
the variously graded force with which they may 
be employed. On the other hand, in executing 
passive and active muscle exercises, apparatus 
can be used to the advantage of both patient and 
physician. Indeed, without it, treatment would 
often be rendered far more difficult. Neverthe- 
less, it is possible to dispense with special appa- 
ratus, and, by employing instead such household 
furniture as may be at hand, still attain one's 
end and effect a cure. 
" The physician will have frequently an oppor- 
tunity to display on these occasions his ingenuity 
and intelligence." SUBSTITUTION OF HAND FOR APPARATUS. 
59 
The author agrees with the above-mentioned 
authority in this, although there are many cases 
where the use of some kind of apparatus would 
Fig. 28.-Thorax Vibration. 
greatly hasten the cure and even would be a 
necessity. 
None of all the different movements are so 
fatiguing to the operator as the vibrations, as 
these must be executed with a great deal of 60 
SWEDISH MOVEMENT AND MASSAGE. 
perseverance and velocity to produce the proper 
physiological effect. There must consequently 
be a great advantage in having these movements 
executed by machinery. Such an instrument, 
" THE VIBRATOR," 
has been invented by Mr. J. W. Osborne, of 
Fig. 29.-Back Vibration. 
Washington, D. C., for the use of the author, 
Lt has been used for over three years at his insti- 
tute in Washington, and has proved a great suc- 
cess in many cases where hardly anything would 
have been accomplished without it. THE VIBRATOR. 
61 
This instrument (Figs. 28, 29) is portable; is 
constructed and adapted for being brought up to 
the patient and applied in whatever position it 
may be desirable to place him, whether standing, 
sitting, or lying. The rapidity of vibration is 
subject to very great variations, and may rise from 
four or five per second to fifty, sixty, or even 
seventy impulses in the same time. The power 
of the vibration may be altered so as to suit the 
strongest as well as the most delicate and feeble 
person, and the vibration may be applied to any 
part, muscle, or nerve of the human body. 
On tired or aching muscles or nerves the 
vibratory movements have a very refreshing and 
soothing effect. Pain is lessened, indeed, is very 
often entirely subdued, by a single vibration last- 
ing only a few minutes. 
On the other hand, a truly physiological stim- 
ulation of a nerve may be effected the intensity 
of which may be easily controlled. 
When a percussive vibration is given on the os 
sacrum, the patient can easily feel tlie walls of 
the rectum arid bladder contract. 
Vibration, applied to the ear and surrounding 
tissues, or to the nose and larynx, stimulates the 
nerves (or the parts), thus increasing the circula- 62 
SWEDISH MOVEMENT AND MASSAGE. 
tion of the blood, whereby the mucous membrane 
function is facilitated; the feeling of heat and 
pressure disappears; respiration is easier; the 
uneasy, burning sensation in the throat and in 
catarrh of the larynx is relieved, and the voice 
will be clearer. 
Vibration of the chest (the thorax vibration) 
has a specific action not only on respiration, but 
on the heart also. Its contractions become less 
frequent but more effective. 
In many cases its effect on the respiration is 
remarkable. In several instances the number 
of respirations per minute have been reduced 
from thirty-four to twenty-two, with a single ap- 
plication of half a minute's duration. 
Slow vibration of the heavy muscles and vis- 
cera are most effective in promoting the venous 
circulation in such organs, and therefore their 
nutrition and elimination of effete matter. 
Fig. 28 shows the machine in position to 
apply "thorax vibration." 
Fig. 29 shows the "back vibration." CHAPTER IV. 
Diseases and Their Treatment. 
GROUP I. 
Constitutional Diseases. 
A. CHLOROSIS AND ANA5MIA, NEURASTHENIA, 
HYSTERIA, AND HYPOCHONDRIA. 
The character of these diseases is weakness, 
therefore it may seem strange to treat them 
with movements. To apply fatiguing move- 
ments would also be as absurd as to prescribe 
weakening medicines, but by stimulating and 
strengthening movements re-establishment may 
be accomplished. 
Dr. J. Schreiber says: " For the treatment of 
this group of diseases, considered as a whole, the 
following physiological principles should be kept 
in mind:- 
" The muscles being the chief site of chemical 
change occurring in the body, stimulating and 
63 64 
SWEDISH MOVEMENT AND MASSAGE. 
increasing their action leads to increased oxygen- 
ation of the blood; to greater combustion of 
oxygen and elimination of carbonic acid; to in- 
creased metabolism and consequently to greater 
desire for food and to better digestion; to produc- 
tion of more and better blood; to improved nour- 
ishment of the nervous system; to an increase, 
both in number and strength, of the muscle- 
fibres; to the endowment of the whole body 
with vigor and elasticity, and to a consequent 
revival of all the mental faculties." 
Although these arc the principles of treatment, 
the prescription of movements in each of these 
diseases will require considerable variation. 
" In chlorosis and anosmia the blood-vessels 
are both thin-walled and of narrow calibre; 
therefore, active and resistive movements should 
be used, which stimulates cardiac activity and 
increases the blood pressure. The augmented 
haemic oxygenation thus brought .about leads 
both to an increase in the number of red corpus- 
cles as well as of the amount of haemoglobin 
contained in each. At first, owing to the general 
lassitude from which chlorotics suffer, the move- 
ments will have to be of a very gentle nature." 
Although there may be a little difference in CONSTITUTIONAL DISEASES. 
65 
the treatment of two different persons, it should 
always be directed so as to restore the digestion, 
circulation, and respiration. 
In the first two or three weeks the following 
prescription would be most acceptable. 
Prescription I. 
1. Shoulder rotation and chest lifting-sitting. 
2. Foot rotation-double-reclining. 
3. Stomach vibration-reclining-knees bent. 
4. Forward arm rotation-sitting. 
5. Trunk rotation-astride sitting. 
6. Knee flexion and extension-sitting-re- 
sistive. 
7. Stomach friction-lying. 
8. Back percussion and friction. 
The first movement is a respiratory one; the 
chest is expanded, the inspiration becomes deeper 
and is followed by a stronger expiration. Thus 
a greater amount of oxygen is taken and waste 
matter given off. This must stimulate the func- 
tions of the organs and thus accelerate the 
process of renewal and an exchange of material 
in all parts of the body. 
The second movement equalizes the circula- 
tion by increasing the flow of blood to the feet. 66 
SWEDISH MOVEMENT AND MASSAGE. 
• The third movement has a direct effect on the 
stomach, and will improve the appetite and the 
digestion. 
The fourth movement is a respiratory one and 
has a similar effect as the first one. 
The fifth movement brings the muscles of the 
waist and bowels into play, and acts on the cir- 
culation, especially in the portal system. 
The sixth movement has a strengthening effect 
on the flexors and extensors of the legs and pro- 
motes the circulation. 
The seventh movement promotes operations of 
the bowels. 
The eighth movement has a stimulating effect 
on the nerve-centres. 
When the prescription has been applied for a 
while, and the patient has improved in strength, 
the treatment may be changed in force, but 
according to the same principle. 
Prescription II. 
1. Forward trunk flexion and extension- 
sitting-resistive. 
2. Foot flexion and extension-double-re- 
clining-resistive. 
3. Trunk torsion-sitting-resistive. CONSTITUTIONAL DISEASES. 
67 
4. Vertical arm flexion and extension-sitting. 
5. Forward trunk elevation-lying-active. 
6. Leg flexion and extension-reclining-re- 
sistive. 
7. Stomach friction-lying. 
8. Breech beating-standing. 
9. Back percussion and friction-standing. 
"In the treatment of neurasthenia and its 
allied affections, hysteria and hypochondria, we 
seek to attain a three-fold end: First, to regen- 
erate the mass of blood as a whole; secondly, to 
combat individual symptoms; and, thirdly, to 
favorably influence the mental state. 
"Beard, who claims for neurasthenia that it is 
a new, and especially American disease, considers 
movement treatment as not only essential, but 
absolutely indispensable for those cases which it 
seems advisable to confine in bed." (Dr. J. 
Schreiber.) 
Dr. Weir Mitchell says, in his "Fat and 
Blood," that he has applied massage to deprive 
rest of its evils. 
Amid all the numerous morbid manipulations 
accompanying neurasthenia, hyperesthesia and 
muscular weakness are probably the most promi- 
nent, so that Arndt has declared the nature of 68 
SWEDISH MOVEMENT AND MASSAGE. 
the disease to consist in increased irritability, 
with rapid tendency to fatigue, especially of the 
muscular system. 
In neurasthenia, all the morbid processes oc- 
curring in the muscles are more rapidly influ- 
enced by movement treatment than by either 
hydro- or electro- therapy. Of all symptoms the 
various hypersesthesias most frequently engage 
the physician's attention. 
These are generally regarded by the friends as 
founded either on exaggeration or upon affectation. 
Patients complain of muscular pains, especially 
in the extremities and back, and of pains along 
the spinal column, the latter being, indeed, con- 
sidered quite characteristic of the disease ("spinal 
irritation "). 
Besides these, neurasthenics suffer from the 
greatest variety of symptoms referable to the 
brain, as headache, and a feeling of weight or 
constriction in the head, eye, and ear, photopsia, 
scotoma, roaring and ringing in the ears, hyper- 
sensitiveness to odors, and other similar idiosyn- 
crasies. Or there may be liability to sudden 
changes of temper, or to depression and sadness, 
or dizziness or insomnia may exist. Indeed, the 
large number of various feelings of apprehension CONSTITUTIONAL DISEASES. 
69 
experienced in neurasthenia has been the occasion 
for the manufacture, by various authors, of any 
number of "phobias." The restlessness so often 
seen in these patients is caused by the pains 
occurring in various muscle groups. 
The so-called "general massage" of the whole 
body will be found the most effectual in banishing 
the various anaesthesias and hyperaesthesias, while 
passive rotation, flexion, and extension cause a 
stretching of the nerves contained within the 
muscles, which reacts most favorably upon the 
mental state. 
Prescription I. 
1. Legs-centripetal stroking, pressing, knead- 
ing, circular and vibratory friction. 
2. Arms-centripetal stroking, pressing, knead- 
ing, circular and vibratory friction. 
3. Chest kneading and friction. 
4. Stomach kneading and friction. 
5. Back kneading and friction. 
6. Head friction. 
This treatment should be applied daily, and 
even twice a day, until the patient has gained 
some strength. 
Advisable to increase the treatment, as in the 
following:- 70 
SWEDISH MOVEMENT AND MASSAGE. 
Prescription II. 
1. Legs - centripetal stroking, pressing, 
kneading, circular and vibratory friction. 
2. Foot rotation-single. 
3. Thigh rotation. 
4. Arms-centripetal stroking, pressing, 
kneading, circular and vibratory friction. 
5. Hand, forearm, and arm rotation. 
6. Chest lifting and vibration. 
7. Chest kneading, slapping, and friction. 
8. Stomach kneading, vibration, and friction. 
9. Arms-nerve compression, rolling, slap- 
ping, and friction. 
10. Legs-nerve compression, rolling, slap- 
ping, and friction. 
11. Back kneading, percussion, and friction. 
12. Head percussion, kneading, and friction. 
All these different movements must, of course, 
be applied with great care and gentleness in the 
beginning, but by degrees the force may be in- 
creased until the patient no longer is confined to 
the bed, when the movements should be changed 
to 
Prescription III. 
1. Forward arm rotation-sitting-passive. 
2. Foot rotation-double-reclining-passive. CONSTITUTIONAL DISEASES. 
71 
3. Trunk rotation-astride sitting-passive. 
4. Vertical arm flexion and extension-sitting 
-resistive. 
5. Leg flexion and extension-reclining-re- 
sistive. 
6. Chest slapping-standing-passive. 
7. Arm-nerve compression, rolling, slapping, 
and friction-reclining. 
8. Leg-nerve compression, rolling, slapping, 
and friction-reclining. 
9. Stomach kneading, vibration, and friction. 
10. Back percussion and friction-standing. 
11. Head percussion, kneading, and friction- 
sitting. 
Hysteria and hypochondria are, according to 
Arndt, quite impossible to separate from neuras- 
thenia. He considered the numerous terms of 
different authors - such as spinal neurosis, spas- 
mophilia, spinal weakness or irritability, nervos- 
ism, eretheism, and others-to be but different 
names for one and the same condition. The dif- 
ferent writers seem, however, to be of the opinion 
that it is impossible to permanently cure this con- 
dition, and that no medicaments exist capable of 
permanently allaying the irritability of the hyper- 
aesthetic nerves. 72 
SWEDISH MOVEMENT AND MASSAGE. 
Nevertheless, a daily course of carefully system- 
atized exercise will always be of great value to 
these patients, and they, therefore, ought to be 
recommended to some establishment where move- 
ment treatment is a specialty. 
B. INSOMNIA. 
Of the numerous cases of insomnia which have 
come under the writer's observation, the follow- 
ing described one was considered by the attend- 
ing physicians to be exceedingly dangerous, and 
one in which the patient was so weak and irrita- 
ble that the greatest care and gentleness were 
imperative. 
The 1st of October, 1887, the writer was 
called to see a gentleman, forty years old, who 
had been without sleep for three weeks. He was 
very weak and complained of great pain in the 
back, legs, and wrists. He was very nervous and 
irritable, and had no appetite. 
The first two days only the following move- 
ments were applied:- 
1. Arms-friction-downward. 
2. Legs-friction-downward. 
3. Baek friction-downward. 
4. Head friction. CONSTITUTIONAL DISEASES. 
73 
The patient had some sleep the first night, 
which was increased a little every following 
night. 
The third day the treatment was increased as 
follows:- 
1. Arms - nerve compression, rolling, and 
friction. 
2. Legs-nerve compression, rolling, and fric- 
tion. 
3. Chest friction. 
4. Stomach friction. 
5. Back kneading and friction. 
6. Head kneading and friction. 
The force of the manipulation was increased 
a little every day. 
The seventh day the following treatment was 
applied:- 
1. Legs-thigh rotation. 
2. Arms-arm rotation and hand rotation. 
3. Chest lifting and vibration. 
4. Chest slapping, kneading, and friction. 
5. Stomach kneading and friction. 
6. Arms - nerve compression, rolling, and 
friction. 
7. Legs-nerve compression, rolling, and fric- 
tion. 74 
SWEDISH MOVEMENT AND MASSAGE. 
8. Back kneading, vibration, percussion, and 
friction. 
9. Head percussion, kneading, and friction. 
After two weeks' treatment the patient slept 
the whole night, and he did not complain of any 
pains, and accordingly resistive movements were 
added to the former ones in the following 
manner:- 
1. Legs-foot rotation, double-passive. 
2. Arms-rotation and hand rotation-pas- 
sive. 
3. Chest lifting and vibration. 
4. Chest slapping, kneading, and friction. 
5. Stomach kneading and friction. 
6. Arms-flexion and extension-resistive. 
7. Arms - nerve compression, rolling, slap- 
ping, and friction. 
8. Lei?s-flexion and extension-resistive. 
9. Legs-nerve compression, rolling, slap- 
ping, and friction. 
10. Back kneading, vibration, percussion, and 
friction. 
11. Head rotation-sitting. 
12. Head percussion, kneading, and friction. 
One month after the treatment began the 
patient was well. LOCAL DISEASES. 
75 
GROUP II. 
Local Diseases.-Diseases of the Brain, Spinal 
Cord, and Nerves. 
CONGESTION OF THE BRAIN (CONGESTIO CEREBRALIS). 
Severe acute congestion of the brain will 
hardly be favorable to movement treatment, but 
milder cases have often been treated with success. 
The movements should be directed so as to derive 
the blood from the brain, therefore movements of 
the extremities and the bowels should be applied. 
If the patient is not confined to bed the follow- 
ing prescription would be useful:- 
1. Shoulder rotation and chest lifting-sitting. 
2. Thigh rotation-reclining. 
3. Trunk rotation-astride sitting. 
4. Leg flexion and extension-reclining-re- 
sistive. 
5. Neck flexion and extension-standing- 
resistive. 
6. Foot rotation and flexion and extension- 
double-reclining. 
7. Forward arm rotation-sitting1. 
8. Breech beating-standing. 
9. Stomach kneading and friction-reclining. 76 
SWEDISH MOVEMENT AND MASSAGE. 
10. Knee flexion and extension-sitting-re- 
sistive. 
11. Head percussion, vibration, and friction. 
ANAEMIA OF THE BRAIN. 
The movements in these cases should be stim- 
ulating and strengthening. 
1. Chest lifting and vibration-lying. 
2. Leg nerve compression, rolling, slapping, 
and friction. 
3. Arm compression, rolling, slapping, and 
friction. 
4. Head rotation-sitting. 
5. Leg vibration-lying. 
6. Arm vibration-sitting. 
7. Stomach friction-lying. 
8. Back percussion and friction. 
9. Head percussion, kneading, vibration, and 
friction. 
PARALYSIS AS A RESULT OF APOPLEXY. 
The treatment here is to avoid new attacks as 
well as to improve the patient's condition, and 
for this reason the movements should not only be 
applied to the paralyzed arm and leg, but to the 
whole body. LOCAL DISEASES. 
77 
The following illustration of this mode of treat- 
ment gives the best example of prescriptions for 
such patients:- 
A gentleman, sixty-four years old, was stricken 
with apoplexy, resulting in a partial paralysis of 
the right side. Forty-eight hours later the writer 
was called in by his physician to try the movement 
treatment. The patient was at this time still un- 
conscious. 
The first day the following movements were 
applied very gently:- 
1. Right arm nerve compression and friction. 
2. Right hand and finger rotation. 
3. Right leg nerve compression and friction. 
4. Right foot rotation. 
5. Right leg muscle rolling and friction. 
6. Right arm muscle rolling and friction. 
The next day the patient seemed to know what 
was going on, as he saw the operator and ob- 
jected to have a stranger about him. Neverthe- 
less, by kind words and cheerfulness, he con- 
sented to the treatment. There was now a slight 
movement of the right leg, and there was applied, 
in addition to the former prescription:- 
Thigh rotation and leg flexion and extension, 
passive, to the right leg. 78 
SWEDISH MOVEMENT AND MASSAGE. 
The third day the patient was glad to see the 
operator and delighted to show him his improve- 
ment, as he now was able to draw his knee up, 
make a slight motion of the foot, and of the 
arm. 
His right hand and fingers were swollen 
and painful, and he could not see with his right 
eye, and he spoke with difficulty. 
Centripetal stroking and kneading was first 
applied to the right fingers, hand, and arm, to- 
gether with the following movements:- 
Right hand and finger rotation and flexion- 
passive; 
Right arm rotation and flexion-passive ; 
Centripetal stroking and kneading of right leg; 
Right foot rotation and flexion-passive ; 
Thigh rotation and leg flexion-both legs- 
passive; 
Both arms-nerve compression, rolling, and 
friction; 
Both legs-nerve compression, rolling, and 
friction. 
The fourth day no treatment was given. 
The fifth day considerable improvement was 
noticed in moving both the arm and leg; the 
swelling and pain of the right hand were very 79 
LOCAL DISEASES. 
much less. The same movements were used as 
at the last time. 
The sixth day no treatment was applied. 
The seventh day the improvement was aston- 
ishing, the swelling of the right hand had disap- 
peared, and the patient was able to take me by 
the hand and to move his foot and leg at will. 
Prescription was then changed to the following:-< 
Chest lifting and vibration ; 
Thigh rotation of both legs; 
Kight arm rotation; 
Foot rotation, double; 
Kight hand and finger rotation and flexion- 
passive; 
Kight leg nerve compression, rolling, and fric- 
tion ; 
Kight arm nerve compression, rolling, and fric- 
tion ; 
Kight leg vibration; 
Right arm vibration; 
Back kneading, percussion, and friction. 
This treatment was repeated the eighth, tenth, 
and eleventh days after the first visit. 
The twelfth day the patient was up and able 
to walk a little in his room, and the following 
prescription was then given:- 80 
SWEDISH MOVEMENT AND MASSAGE. 
Shoulder rotation and chest lifting-sitting; 
Thigh rotation, both legs-reclining; 
Right arm rotation-sitting; 
Right foot flexion and extension-sitting-re- 
sistive ; 
Right arm nerve compression, rolling, slapping, 
and friction; 
Right leg nerve compression, rolling, slapping, 
and friction; 
Rmht arm flexion and extension-resistive; 
Forward trunk flexion and extension-sitting 
-resistive; 
Right knee flexion and extension-sitting- 
resistive; 
Right arm torsion-resistive ; 
Right arm vibration-sitting; 
Trunk rotation-astride sitting-passive; 
Right leg torsion-resistive; 
Right leg vibration-reclining; 
Back percussion and friction-standing; 
Head kneading and friction. 
The improvement continued from day to day. 
The eyesight came back, the speech was clearer, 
and the patient gained more and more con- 
trol over his limbs. The treatment was con- 
tinued every other day for two weeks more, 81 
LOCAL DISEASES. 
when the patient commenced to take out-door 
walks. 
The fifth week only two treatments were ap- 
plied and then entirely discontinued, the patient 
being able to walk as well as before the stroke, 
and having full use of his arm. 
This case was a very favorable one, but there 
can be no doubt that the movement treatment 
hastened the improvement considerably, although 
the physician must be careful not to apply this 
treatment too soon, and that it is done in a very 
gentle and judicious manner. 
When the physician does not feel sure that the 
movements will have a good effect it will always 
be best to wait from four to six weeks before they 
are resorted to. 
The most cases of paralysis are slow to re- 
cover, and especially is the hand, as a ride, far 
behind the rest of the body in becoming well. 
The treatment is agreeable to this kind of pa- 
tients and it has a soothing and cheerful influence 
on them. 
Here it may be well to say that all persons 
who have been troubled once with apoplexy 
ought never to stop taking movement treatment, 
or at least only at short intervals, unless they 82 
SWEDISH MOVEMENT AND MASSAGE. 
have plenty of other healthful exercise, as it is 
the best means to prevent another stroke. 
CONGESTION OF THE SPINE. 
This disease has often been quickly improved 
by a proper treatment of derivative movements, 
which are herein set forth:- 
1. Forward arm rotation-sitting-passive. 
2. Foot rotation, double-reclining-passive. 
3. Vertical arm flexion and extension-sitting 
-resistive. 
4. Leg flexion and extension-reclining- 
resistive. 
5. Trunk torsion-astride sitting-resistive. 
6. Bent knee separation and closing-reclin- 
ing-resistive. 
7. Breech beating-standing-passive. 
8. Knee flexion and extension-sitting-re- 
sistive. 
9. Stomach friction-lying-passive. 
10. Shoulder rotation and chest lifting-sitting. 
SCIATIC NEURALGIA. 
Of all writers on the treatment of this malady 
Dr. J. Schreiber seems to have had the most 
experience and to have been the most successful 
in his cures. Upon this subject he says:- LOCAL DISEASES. 
83 
" As the greater number of sciaticas which 
have come under my notice have been combined 
with crural neuralgia as well, I think it best to 
consider these two conditions together. It seems 
advisable, also, to discuss the treatment according 
to a plan which may, with suitable modifications, 
be applied to each special case, and yet one which 
will embrace the details gleaned from numerous 
observations. Let us take a case :- 
" A patient suffering from well-marked sciatica 
and crural neuralgia of the right side applies for 
relief, after having been under treatment by others 
for many years in vain. He has used veratria, 
aconite, and belladonna ointments, morphine in- 
jections, electricity, sinapisms, and vesicants. We 
may assume, also, that for a considerable period 
he took arsenic, quinine, and potassium iodide 
and bromide, that he has been to a number of 
springs, like Gastein, Wiesbaden, Teplitz, and 
Ragaz, and also that neither sea-bathing nor 
hydrotherapy has had any effect upon his obsti- 
nate malady. He is only able to drag himself 
painfully along by the use of a cane, and every 
step causes acute suffering. Rising and sitting 
down can only be accomplished by aid of the 
arms, while for going up stairs or getting out of 84 
SWEDISH MOVEMENT AMD MASSAGE. 
bed the assistance of an attendant is necessary. 
He is never entirely free from pain, and there is 
generally a daily exacerbation lasting often 
several hours, and preventing much-needed rest. 
" Examination shows no other functional dis- 
turbances. There is great sensitiveness in the 
buttock, at the point of exit of the sciatic nerve, 
and many painful points exist along the outer 
and inner aspects of the thigh. The limb, fur- 
thermore, will be seen to be held in a character- 
istically pathognomonic position, namely, the 
thigh rotated inward and adducted, the knee 
slightly bent, and the foot not resting on the 
ground with the sole, but touching it with the 
toe only. 
" On sitting down, the patient supports him- 
self by his left arm, and lets himself fall, as it 
were, upon his left buttock, instead of perform- 
ing the usual movements of flexion with knees 
and hips. The involvement of the semitendinosus 
and semimembranosus muscles causes great sen- 
sitiveness to pressure over their tendons. Volun- 
tary abduction of the affected thigh is impossible, 
and abduction of even the well extremity cannot 
be performed on standing erect, on account of 
inability of the patient to support himself upon 85 
LOCAL DISEASES. 
the affected limb. External rotation is also im- 
possible. Hence it appears that the glutei, the 
pyriformis, the internal obturator, and the gemelli 
(external rotators) are all affected. Nor can the 
patient flex the thigh (involvement- of the iliac 
and psoas major), nor can he adduct it after it 
has once been passively abducted (involvement 
of the sartorius, internal rectus, adductors longus, 
brevis and magnus, and pectineus). But the 
greatest pain of* all is caused by rotating the 
thigh outward, as the sciatic is thus made to 
glide upon and rub against the quadratus femoris. 
" I have purposely selected a case in which all 
the muscles of the buttock, about the hip-joint, 
and of the thigh have become involved, and 
hence almost entirely deprived of function. 
Many years of experience and many trials have 
convinced me that the cure of these forms of 
sciatica will be most rapidly effected when, in 
addition to the mechanical interferences, passive 
and active motions of all the affected muscles are 
employed. It has also seemed to me best to 
begin the daily treatment with the passive and 
active movements, leaving the mechanical manip- 
ulations, which are very painful, till the last. 
They cause so much exhaustion, as a rule, that 86 
SWEDISH MOVEMENT AND MASSAGE. 
the patient is anxious only for rest, and will hardly 
have the energy necessary for performing acts 
which he knows must only increase his suffering." 
If the cause of the neuralgia is a pressure, as 
from a tumor, etc., it is of no use to try tliis 
treatment, but otherwise it will generally effect a 
cure. At the end of each day's treatment the 
patient will generally complain of much pain 
and fatigue, which usually diminishes considera- 
bly in about half an hour, although it sometimes 
lasts for hours afterward. In the beginning, too, 
the night's rest may be more broken than before. 
In six to twelve days usually a change for the 
better occurs, the night's rest becoming more 
tranquil, the pain less, and the first signs of 
approaching convalescence begin to appear. 
Dr. Schreiber says: " It is almost a matter of 
course that the physician will be confronted with 
every kind of doubt on the part of the patient 
regarding the ultimate results of treatment, but, 
as failures are rare where sufficient perseverance 
and the requisite skill have been employed, he 
may confidently combat these misapprehensions. 
The duration of the treatment will depend on 
the following various factors :- 
" 1. On the previous length of the illness. LOCAL DISEASES. 
87 
" The longer the disease has existed the more 
protracted will have to be the treatment. Eight 
weeks will, as a rule, be the limit; at least, that 
was the limit needed to cure one of my cases of 
a previous four years' duration. Cases of only a 
few months' standing often need but ten or 
twelve days for a cure. 
" 2. On the extent of the disease. 
" The greater the number of muscles involved 
the more numerous must the number of corre- 
sponding exercises be, and hence the longer the 
time required. 
" 3. On idiosyncrasy. 
" In sensitive individuals it is often necessary to 
proceed very cautiously and gently at first. More 
time is, therefore, required in these cases than 
where the patient is not of a timorous or com- 
plaining disposition. 
" 4. On the skill, the experience, and the perse- 
verance of the physician. 
" Familiarity with the methods frequently en- 
ables a piacticed hand to employ many devices 
which an inexperienced person very properly 
avoids. 
" 5. On the age and general nutrition of the 
patient." 88 
SWEDISH MOVEMENT AND MASSAGE. 
Two very interesting cases are illustrated by 
Dr. Schreiber, and lie claims to have cured nu- 
merous persons of very bad sciatica. His mode 
of treatment is in its character the same as the 
writer has been using, but as Dr. Schreiber 
already, the first day of treatment, uses some 
kind of apparatus, the description below given 
shows the method found by the writer to be the 
best where the patient is confined to his room, as 
in a case of sciatica of the right leg. 
The first day the treatment must be very gentle 
and of short duration, the patient lying down. 
1. Right leg flexion and extension-passive- 
four to ten times, according to his strength. 
2. Right leg nerve compression and rolling. 
3. Breech beating. 
4. Right leg (back of the thigh) percussion 
and friction. 
The second day the same treatment with more 
force. 
The third day the following is applied:- 
1. Right leg flexion and extension-passive. 
2. Right leg nerve compression and rolling. 
3. Right thigh rotation. 
4. Right leg vibration. 
5. Breech beating. LOCAL DISEASES. 
89 
6. Right leg nerve compression, percussion, 
and friction. 
The fourth day give :- 
1. Right thigh rotation. 
2. Right leg flexion and extension-resistive. 
3. Right leg nerve compression and rolling. 
4. Right leg separation and closing-passive. 
5. Right foot flexion and extension-resistive. 
6. Right leg vibration. 
7. Breech beating. 
8. Right leg nerve compression, percussion, 
and friction. 
The fifth) sixth) and seventh days we may apply 
deep kneading of all the muscles of the buttock 
and thigh, just before " breech beating," in 
connection with the former prescription. 
The next four or five days the following move- 
ments should be used :- 
1. Thigh rotation-both legs-passive. 
2. Right leg flexion and extension-resistive. 
3. Right leg nerve compression and rolling. 
4. Right leg torsion-passive. 
5. Right leg separation and closing-resistive. 
6. Kneading and beating of right leg and 
buttock 
7. Right knee upward traction-resistive. 90 
SWEDISH MOVEMENT AND MASSAGE. 
8. Hight foot flexion and. extension-resistive. 
9. Hight leg vibration. 
10. Hight leg nerve compression, rolling, and 
friction. 
The last prescription, which may be continued 
till the patient is well, has a more all-sided effect. 
1. Thigh rotation-both legs-passive. 
2. Hight leg nerve compression, rolling, and 
friction. 
3. Trunk rotation-astride sitting-passive. 
4. Hight leg flexion and extension-resistive. 
5. Kneading and beating of right leg and 
buttock. 
6. Forward trunk flexion and extension-sit- 
ting-resistive. 
7. Bent knee separation and closing-resist- 
ive. 
8. Kight leg percussion. 
9. Kight leg torsion-resistive. 
10. Breech beating. 
11. Foot rotation, double-passive. 
12. Kight leg nerve compression, rolling, and 
friction. 
In connection with this, it will be of great ad- 
vantage to let the patient walk and run on tip- 
toe, and to go up and down a few steps, or stairs. LOCAL DISEASES. 
91 
There should also be taken good care that the 
patient always sits straight and rests evenly on 
both buttocks. 
Of the many cases of sciatica which the writer 
has treated, the following one was cured in the 
shortest time, considering the previous duration 
of the disease :- 
A lady, twenty-nine years old, suffered from 
sciatica for ten months. She had been in bed 
most of the time, and all kinds of treatment 
had been tried without any relief. One day, in 
August, 1885, she felt well enough to be taken 
in a carriage and carried into the writer's Insti- 
tute, where the movement treatment was applied. 
It pained her a great deal, but after awhile it 
gave her relief, and she returned the next 
day. The fifth day she walked alone to the 
Institute, and after three weeks' treatment was 
cured. She has not had any return of the disease 
since. 
In this case the "vibrator" was used in con- 
nection with the other movements, giving a 
"fractional" vibration to the whole leg and a 
" percussive " vibration on the sciatic nerve, 
which has been found to be of a very great 
value. 92 
SWEDISH MOVEMENT AND MASSAGE. 
FOR WRITER'S CRAMP. 
These movements are useful:- 
1. Back percussion. 
2. Right arm centripetal stroking, pressing, 
kneading, circulatory and vibratory friction. 
3. Right arm rotation. 
4. Forward trunk flexion and extension- 
sitting-resistive. 
5. Right arm torsion-resistive. 
6. Right hand and finger flexion and exten- 
sion-resistive. 
7. Right arm vibration. 
8. Trunk rotation-astride sitting-passive. 
9. Vertical arm flexion and extension-re- 
sistive. 
10. Right arm nerve compression, rolling, 
slapping, and friction. 
CRAMP OF THE LEGS. 
1. Thigh rotation. 
2. Leg vibration. 
3. Foot flexion and extension-resistive. 
4. Trunk torsion-sitting-resistive. 
5. Leg nerve compression, rolling, and fric- 
tion. LOCAL DISEASES. 
93 
6. Leg flexion and extension-resistive. 
7. Trunk elevation-lying-active. 
8. Upward knee traction-resistive. 
9. Breech beating. 
10. Leg torsion-resistive. 
11. Leg nerve compression, slapping, and fric- 
tion. 
12. Back percussion and friction. 
CHOREA. 
This disease has been treated with great success 
by the Swedish movement. 
M. Napoleon Laisne has applied this treatment 
to hundreds of children at the "Hopital des 
Enfants Malades," in Paris, with the greatest 
success. Dr. Blache, the president of this hos- 
pital, addressed in 1851 an assembly of directors 
and prominent physicians upon the results of this 
treatment. He closed his report by saying that 
in four years not one of the choreic children thus 
treated had suffered a relapse. 
Both active, resistive, and passive movements 
should be used; but, as these cases require a 
great deal of patience and an experienced gym- 
nast to lead them on, no prescription for this 
treatment is given here. 94 
SWEDISH MOVEMENT AND MASSAGE. 
GROUP III. 
Diseases of the Organs of the Circulation. 
CHRONIC HEART DISEASES. 
In these cases movements must be given which 
shall diminish the pressure of the blood and 
decrease the activity of the heart. 
Inspiration acts as a pump on the circulation 
toward the heart. Muscle-contractions produce 
a pressure on the walls of the blood-vessels, 
whereby the blood is forced toward the heart; 
hence, respiratory and circulatory movements are 
here of great value. 
Dr. Gustaf Zander, of the Meehanico-Thera- 
peutic Institute in Stockholm, says: "In heart 
diseases, movement treatment is an uninterrupted 
necessity, at least during the winter. It is a pity 
when in such cases the patients have no oppor- 
tunity to use this- treatment. It is astonishing 
what excellent effects regular, gentle, but many- 
sided muscular exercises have on diseases of the 
heart. Some of these, when not too far gone, 
can be entirely cured, others can be stopped from 
further development, and all can be relieved." 
From Dr. llartelius, the Principal of the Koyal 
Central Gymnastic Institute, in Stockholm, we 
quote the following;- DISEASES OF ORGANS OF CIRCULATION. 
95 
"A lady, thirty years old, with a dangerous 
organic heart disease-stenosis of left ostium 
atrioventriculare, with insufficiency of mitralis. 
The action of the heart was very weak. The 
patient suffered with great shortness of breath 
and painful palpitations; a great deal of subcu- 
taneous effusion in the lower extremities and also 
considerable effusion in the peritoneum. Iler 
aspect was cyanotical. 
" Mild chest liftings and vibrations were given 
to produce strong inspirations, also rotation of 
the arms and legs to increase the circulation, 
gentle rotation and torsion of the trunk to act on 
the portal system, and centripetal friction on the 
lower extremities to promote resorption of the 
subcutaneous effusion. In the beginning the 
movements were very mild, but gave relief for a 
few hours at a time. Later the movements wore 
applied several times daily, and then more lasting 
effects were produced. Patient received great 
relief, more strength, and the effusion was les- 
sened, but her organic trouble could not be cured. 
"Experience tells us that each difficult heart 
disease must nearly always be under the influence 
of movement treatment in order to secure perma- 
nently good results." 96 
SWEDISH MOVEMENT AND MASSAGE. 
After this, it will be understood that the most 
advisable thing for those suffering to do is to go 
to a specialist who has the most experience in 
their treatment. 
Still, there are many cases where the patient is 
too weak to go out, and he may receive great 
relief in his room by the following:- 
1. Chest lifting and vibration. 
2. Foot rotation, double. 
3. Arms - centripetal stroking, pressing, 
kneading, and friction. 
4. Legs-centripetal stroking, pressi ng, knead- 
ing, and friction. 
5. Hand and finger rotation, flexion, and ex- 
tension-passive. 
6. Thigh rotation. 
7. Chest percussion. 
8. Loin traction. 
9. Leg vibration. 
10. Back percussion and friction. 
FOR COLD HANDS AND FEET 
the following movements are very useful:- 
1. Forward arm rotation-sitting-passive. 
2. Foot rotation, double-reclining-passive. 
3. Vertical arm flexion and extension-sitting 
-resistive. 97 
DISEASES of respiratory organs. 
4. Leg flexion and extension-reclining-re- 
sistive. 
5. Trunk rotation-astride-passive. 
6. Hand and finger flexion and extension- 
resistive. 
7. Foot flexion and extension-resistive. 
8. Arm nerve compression, rolling, slapping, 
and friction. 
9. Leg nerve compression, rolling, slapping, 
and friction. 
10. Arm vibration. 
11. Foot-sole slapping and friction. 
12. Back percussion and friction. 
GROUP IV. 
Diseases of the Respiratory Organs. 
Catarrh of the larynx, catarrh of the lungs, 
congestion of the lungs, emphysema of the lungs, 
spasmus bronchialis, and even tuberculosis have 
all been treated with success at different establish' 
ments by movements, but each of them requires 
quite a special treatment by a skillful and experi- 
enced gymnast, and, therefore, only a prescrip- 
tion for movements to be used where there is a 
disposition to a lung trouble, showing a narrow 98 
SWEDISH MOVEMENT AND MASSAGE. 
chest, round and stooping shoulders, and lack of 
muscular power, is here given:- 
1. Shoulder rotation and chest lifting-sitting. 
2. Foot flexion and extension-resistive. 
3. Trunk torsion-sitting-resistive. 
4. Forward arm rotation-sitting. 
5. Leg flexion and extension-reclining- 
resistive. 
6. Horizontal arm separation and closing- 
resistive. 
7. Neck flexion and extension-standing- 
resistive. 
8. Forward trunk flexion and extension- 
sitting-resistive. 
9. Lateral arm elevation and depression- 
sitting-resistive. 
10. Chest slapping. 
GROUP V. 
Diseases of the Organs of Digestion. 
The following prescriptions are given only for 
the most frequent cases, as dyspepsia, constipa- 
tion, and hypercemia of the liver. The treatment 
in these cases should be directed to strengthen 99 
DISEASES OF ORGANS OF DIGESTION. 
the whole system, as well as to act locally on the 
diseased organ. 
DYSPEPSIA. 
If the patient is very weak it will be necessary 
to give him a light treatment for the first two or 
three weeks, viz.:- 
1. Arm nerve compression, rolling, slapping, 
and friction. 
2. Legs the same. 
3. Stomach vibration and friction. 
4. Thigh rotation. 
5. Arm vibration. 
6. Chest lifting and vibration. 
7. Stomach kneading and friction. 
8. Leg vibration. 
9. Back percussion and friction. 
When the patient is improved and has gained 
some strength, not confined to bed, the following 
should be applied :- 
1. Forward arm rotation-sitting-passive. 
2. Stomach kneading, vibration, and fric- 
tion. 
3. Upward knee traction-reclining-resistive. 
4. Trunk rotation-astride sitting-passive. 
5. Stomach concussion and friction-lying. 
6. Leg elevation-lying-resistive. 100 
SWEDISH MOVEMENT AND MASSAGE. 
7. Vertical arm flexion and extension-re- 
sistive. 
8. Loin traction-lying. 
9. Leg flexion and extension - reclining - 
resistive. 
10. Back percussion and friction. 
CONSTIPATION. 
If the patient is in bed a local manipulation 
for about five to ten minutes twice a day will be 
most effective, viz.:- 
1. Stomach kneading, vibration, concussion, 
and friction-five to ten minutes. 
2. Breech beating. 
3. Loin traction. 
If the disease is of long standing it is neces- 
sary to apply strong muscular movements, as:- 
1. Forward trunk flexion and extension-sit- 
ting-resistive. 
2. Upward knee traction-reclining-resistive. 
3. Bowel vibration-standing-passive. 
4. Trunk elevation-lying-active. 
5. Trunk rotation-astride sitting-passive. 
6. Stomach kneading and friction-reclining. 
7. Trunk torsion-kneeling-resistive. 
8. Vertical arm flexion and extension-lying 
-resistive. DISEASES OF ORGANS OF DIGESTION. 
101 
9. Loin vibration-sitting-passive. 
10. Breech beating-standing-passive. 
11. Stomach kneading, concussion, and fric- 
tion. 
12. Shoulder rotation and chest lifting - 
sitting-passive. 
HYPER2EMIA OF THE LIVER. 
The following cited case of this disease will be 
especially interesting:- 
A gentleman of middle age had been ailing 
two years. He had grown very lean, the skin 
was yellow, and his feet and ankles were swollen. 
The liver was considerably enlarged, especially 
the left lobe. There was no organic heart dis- 
ease, but there was a mild catarrh of the lungs. 
Operations of the bowels were slow and difficult. 
He was treated twice every day by means of 
movements, and no other remedies were used. 
After one month the patient was considerably 
better, the liver was smaller, swelling had disap- 
peared, and his appetite and flesh had increased. 
Alter the second month, having been treated 
once a day, the patient was cured. 
The following prescription was used:- 
1. Shoulder rotation and chest lifting-sitting. 102 
SWEDISH MOVEMENT AND MASSAGE. 
2. Foot rotation, double-reclining. 
3. Trunk rotation-astride sitting. 
4. Vertical arm flexion and extension-re- 
sistive. 
5. Loin vibration-sitting. 
6. Thigh rotation-reclining. 
7. Chest lifting and vibration-reclining. 
8. Leg flexion and extension-reclining-re- 
sistive. 
9. Stomach kneading and friction - reclin- 
ing. 
10. Back percussion and friction-standing. 
GROUP VI. 
Diseases of Urinary and Sexual Organs. 
CHRONIC CATARRH OF THE BLADDER. 
The movements should be derivative from the 
pelvis and otherwise be directed according to the 
patient's condition-for instance :- 
1. Thigh rotation-reclining. 
2. Breech beating-standing. 
3. Bent knee separation and closing-resistive. 
4. Forward trunk flexion and extension - 
sitting-resistive. DISEASES OF URINARY AND SEXUAL ORGANS. 
103 
5. Leg torsion, double-reclining-resistive. 
6. Breech beating-standing. 
7. Lateral arm elevation and depression - 
standing-resistive. 
8. Foot rotation, double-reclining. 
CHRONIC CATARRH OF THE WOMB. 
1. Back percussion and friction-standing. 
2. Breech beating-standing. 
3. Leg separation and closing - reclining- 
resistive. 
4. Forward arm rotation-sitting. 
5. Trunk rotation-astride sitting. 
6. Knee flexion and extension-reclining- 
resistive. 
7. Forward trunk flexion and extension- 
sitting-resistive. 
8. Breech beating-standing. 
9. Trunk torsion-kneeling-resistive. 
10. Back percussion and friction - stand- 
ing. 
Displacement of the womb as well as irregu- 
larity and painful menstruation are often not 
only relieved but even cured by movement treat- 
ment, but these cases require a special study and 
experience. 104 
SWEDISH MOVEMENT AND MASSAGE. 
GROUP VII. 
Diseases of the Organs of Movements, 
scoliosis. 
In " lateral curvature of the spine," where 
the muscles on the convex side are weakened 
and pathologically changed, and the muscles on 
the concave side normal, it is clear that the 
weakened muscles on the convex side must be 
strengthened and developed. According to Dr. 
T. J. Hartelius, "The restoration of a patho- 
logically changed muscle cannot be produced by 
mechanical extensions, but only by muscular 
exercise and electricity. 
" But," he says, " lor the restoration of a 
curved spine extension is necessary. The ques- 
tion is, therefore, whether this can be effected by 
the organism's own remedies. This is easy 
enough to prove. In mild cases of lateral cur- 
vature, where there is not yet any deformity in 
the vertebrae, the spine is straightened at each 
extension of the back. By flexion to the convex 
side the spine is not only straightened, but it can 
be bent so far as to display a curve to the other 
side. In cases where the deformity of the ver- 
tebrae makes a full extension of the spine impos- DISEASES OF ORGANS OF MOVEMENTS. 
105 
sible, it is still possible by its own strength to 
produce an extension in its highest degree. 
" For instance, in a ' forward trunk flexion 
and extension ' the patient stands supported on 
the thighs and bends forward; when he raises 
himself up, the operator resists him on the neck. 
Or, in ' backward trunk flexion ' the patient is 
lying on the front of his legs and raises the back 
up backward. 
" These and a few other active and resistive 
movements can, better than any other mechani- 
cal remedy, straighten out the curved parts." 
In a one-sided scoliosis, for instance, with the 
convexity to the left, " lateral trunk flexion to the 
left " may be given. The operator puts his hands 
on the highest point of the curve and resists the 
patient when he bends down. This can be per- 
formed either with the patient sitting, standing, 
or lying on his right side, the last one being the 
most powerful and effective. Several other 
movements are also given with the view and in- 
tention of strengthening the muscles on the convex 
side and straightening out the spine, and should 
be used according to the strength of the patient 
and the particular shape of the deformity. 
Dr. Schreiber says: " The treatment of scoli- 106 
SWEDISH MOVEMENT AND MASSAGE. 
osis by the Ling system, which has scored some 
of its greatest successes in this very department, 
requires, however, quite a special study, and can 
hardly be carried out without both apparatus and 
trained assistants." 
Dr. M. Eulenberg, in " Die Schwedische Heil- 
gymnastick," Berlin, 1853, says:- 
" Ling's method is the only truly rational 
therapeutic means for the cure of chronic dis- 
turbances of motivity, such as result from spinal 
curvature, and from pseudo-anchylosis, the 
phthisical tendency, pigeon-breast, peripheral 
paralysis, etc. 
" Even in cases of paralysis from lesions of the 
cord, it may still effect a cure where all other 
measures, undertaken after the original diseases 
have run their course, will be found useless. 
Ling's gymnastics have an even greater and more 
certain effect upon enervation and nutrition than 
the common form of gymnastic exercises. Spinal 
(lateral) curvatures, resulting from faulty carriage 
(in consequence of a preponderance of muscular 
force on one side of the body), are nowadays 
never treated by any good orthopaedist by any 
other means than the Swedish system." 
Any one who will undertake the treatment of DISEASES OF ORGANS OF MOVEMENTS. 
107 
scoliosis should, make it a special study, as it 
requires great experience, skill, and knowledge 
to lead it on successfully. 
MUSCULAR RHEUMATISM. 
A. Of the, Right Arm. 
1. Centripetal stroking, pressing, kneading, 
circulatory friction, and vibratory friction of right 
arm. 
2. Thigh rotation-reclining. 
3. Right arm muscle beating. 
4. Trunk rotation-astride sitting. 
5. Right arm flexion and extension-resistive. 
6. Leg flexion and extension-resistive. 
7. Right arm torsion-resistive. 
8. The same as No. 1. 
9. Back percussion. 
B. Of the Neck. 
1. Forward arm rotation-sitting. 
2. Head rotation-sitting. 
3. Foot rotation-reclining. 
4. Neck percussion-sitting. 
5. Horizontal arm separation and closing - 
resistive. 
6. Trunk torsion-kneeling-resistive. 
7. Neck flexion and extension-resistive. 108 
SWEDISH MOVEMENT AND MASSAGE. 
8. Knee flexion and extension - sitting - 
resistive. 
9. Centripetal stroking, pressing, kneading, 
circulatory and vibratory friction of the neck. 
10. Back percussion and friction. 
C. Lumbago. 
1. Forward trunk flexion and extension - 
sitting-resistive. 
2. Thigh rotation-reclining-passive. 
3. Trunk rotation-astride sitting-passive. 
4. Breech beating-standing-passive. 
5. Vertical arm flexion and extension-sitting 
-resistive. 
6. Bent knee separation and closing-reclin- 
ing-resistive. 
7. Muscle kneading, percussion, vibration, and 
friction all over the small of the back and the 
buttocks. 
These three examples show how to arrange the 
treatment in the different cases of muscular 
rheumatism. Of course, if the patient is too 
sick to take the full prescription, we only apply 
the local treatment until he is able to take the 
whole, which has in view the increasing of 
the circulation and giving nutrition to the whole 
system, as well as to relieve the local disease. DISEASES OF ORGANS OF MOVEMENTS. 
109 
A few interesting cases it may be well to give 
here:- 
On September 24, 1886, a lady, fifty-five years 
old, came to the writer. She was five feet 
six inches tall, and weighed two hundred and 
thirty pounds. She complained of rheumatism 
in her legs and arms, and could only walk up 
one flight of stairs, and that with the greatest 
difficulty. On her arrival she was gasping for 
breath and sat down to rest for nearly an hour. 
Eight weeks later, having taken treatment 
every day, the lady asked if she might walk up to 
the top of the Washington Monument (about 
nine hundred steps). Although knowing tliat 
she had improved marvelously and had lost 
nearly thirty pounds, the writer told her that it 
would be better not to try it then, because there 
was no one to carry her down again if she 
became too tired. 
She laughed and said that she had walked up 
the monument the previous day, looked around 
for half an hour, and walked down and to her 
home, about a quarter of a mile distant. She 
felt very well after it, and had no lameness nor 
pain. 
After ten weeks' treatment the lady was 110 
SWEDISH MOVEMENT AND MASSAGE. 
entirely well, having had no rheumatism for the 
last five weeks, and her weight was then one 
hundred and ninety-six pounds. In the summer 
of 1887 she called to say that she still felt like a 
young girl, and was going West to live for the 
rest of her life. 
Other cases are as follow:- 
A gentleman, thirty-one years old, had suf- 
fered with muscular rheumatism in his right 
shoulder and arm for two weeks. He had not 
had any relief or sleep for several days when he 
came to the writer. Five days later he was cured. 
•7 
Dr. N. N., forty-six years old, had been in bed 
about three weeks with a very painful lumbago, 
and was unable to move himself when he sent 
for the author, in March, 1883. 
Movement treatments were applied six times, 
after which he was out attending to his own 
business. 
A gentleman, forty-two years old, had suffered 
from lumbago and indigestion for nearly eight 
months, and had given up all kinds of treatment. 
In April, 1883, the writer was called in by one 
of his friends. The patient, who had once been 
a very strong and healthy laborer, was run down 
to a thin, very feeble-looking man. He did not DISEASES OF ORGANS OF MOVEMENTS. 
111 
believe in the treatment, but he submitted to a 
trial of it. The first treatment being satisfactory, 
it was continued every day. The improvement 
was remarkable. The pain became less and less, 
and the appetite and strength were increased 
every day. 
After three weeks' treatment the patient had 
gained twelve pounds, and he was well enough 
to attend to his business. The treatment was 
then discontinued. 
Half a year later, when he felt some symptoms 
of the lumbago, he came to the Institute and 
took one month's treatment. He has been well 
ever since. 
RHEUMATISM OF THE JOINTS. 
If the joints are stiff and cannot be moved, 
local manipulations, as follow, are useful:- 
Centripetal stroking, pressing, kneading, beat- 
ing,friction of the diseased part and surround- 
ing muscles, from ten to twenty minutes, will 
include the full treatment for some time, and even 
for months; but when the joint finally responds 
to the treatment and allows of some motion, it 
will be most effective to treat it after the follow- 
ing method, given for rheumatism of the right 
knee:- 112 
SWEDISH MOVEMENT AND MASSAGE. 
1. Centripetal stroking, pressing, kneading, 
beating, and friction-five minutes. 
2. Right leg flexion and extension-resistive. 
3. Trunk rotation-astride sitting. 
4. Right knee muscle rolling-reclining. 
5. Forward arm rotation-sitting. 
6. Thigh rotation-both legs-reclining. 
7. Trunk elevation-lying-active. 
8. Right knee flexion and extension-sitting- 
resistive. 
9. The same as No. 1. 
In the first instance the treatment is given to 
increase the circulation in and around the joint, 
to promote absorption, and to squeeze exudations 
out of the joint. 
In the second instance the treatment tends to 
tone up the whole system by strengthening the 
circulation and digestive organs. 
STIFFNESS OF JOINTS AND TENDONS. 
From Dr. Schreiber the following is quoted:- 
"It not infrequently happens that, after arthri- 
tis, thickening of the periarthritic structures or 
even adhesion of the articular surfaces themselves 
may occur, leading to very considerable disability 
of motions. Only by mechanical means can we DISEASES OF ORGANS OF MOVEMENTS. 
113 
then hope to break up the existing adhesions, to 
smooth the roughened articular cartilages, and to 
restore to the ligaments their former suppleness 
and elasticity. 
"All the mechanical interferences used-press- 
ing, stroking, kneading-as well as the passive 
exercises-must be performed with the greatest 
care, since it is quite possible to initiate fresh in- 
flammatory action by injudicious treatment. 
" The successful treatment of these cases 
affords one of the most difficult problems of the 
mechano-thereopist, for it requires untiring perse- 
verance and patience, as well as nice judgment 
and all the fruits gained by experience, to tide 
the patient over the necessary pain which for 
months he may be called upon to bear. 
"The modus operands in each case will be in- 
dicated by the mechanism of the particular joint 
to be treated, which sometimes will be found to 
be immovably fixed. At first the tissues sur- 
rounding the joint are to be gently rubbed, using 
in the beginning the finger-tips only; later, the 
force may be increased. 
"As soon as the part has, in a measure, become 
accustomed to the pain, the passive motions suit- 
able to the joint may be begun. 114 
SWEDISH MOVEMENT AND MASSAGE. 
"The adhesions existing within and around 
the joint may be of so firm and resistant a nature 
as to readily lead to the belief in the existence of 
bony ankylosis. At first the amount of motion 
obtained in the joint will be exceedingly small, 
but even with this we will be bound to rest sat- 
isfied, for an increase of mobility often does not 
begin for months; in the meanwhile the patience 
of both physician and patient will necessarily be 
put to a severe test. Nevertheless, keeping in 
mind the old saying, that 'constant dropping 
wears away the rock,' treatment must be con- 
tinued steadily and systematically. 
"The astonishing results which experienced 
mechano-thercopists often obtain in cases declared 
incurable by others can often be explained by 
the consistent and methodical treatment which 
they pursue. 
"The knee-joint is very often the seat of exten- 
sive synovial exudation in consequence of chronic 
rheumatism. Resorption is to be effected as in 
synovitis in general, namely, by centripetal strok- 
ing, pressing, and kneading." 
The following is an interesting case of stiffness 
of the right shoulder which the writer treated a 
few years ago:- DISEASES OF ORGANS OF MOVEMENTS. 
115 
A rather feeble lady, about forty-five years of 
age, was struck on her right forearm. There was 
no fracture nor sprain, but the arm was kept in 
a sling for two months. Then the lady found 
that she could hardly move her arm at the 
shoulder-joint. The adhesions were broken up. 
During the operation the shoulder was mechan- 
ically dislocated and reset. Inflammatory adhe- 
sions followed, and the operation was repeated 
with no better result. The joint was stift', with 
great inflammation of the deltoid and the adja- 
cent nerves and tendons, and so tender and sore 
that it could not be touched when the physician 
prescribed massage. 
The patient being under the influence of an 
injection of morphine administered by the phy- 
sician, the writer was enabled to apply treatment 
consisting of centripetal kneading and stroking. 
After a few days the injection was discontinued 
and passive motions were applied, in addition to 
the manipulations. Two weeks later active and 
resistive movements were used. After two 
months' treatment the patient was well. 
SPRAINS. 
In this class of diseases this mode of treat- 
ment has scored one of its greatest successes. 116 
SWEDISH MOVEMENT AND MASSAGE. 
In treating a sprain of the ankle we begin with 
gentle centripetal stroking, commencing at the 
toes and gradually proceeding upward to the 
knee. If the pain does not allow of touching the 
diseased part, it will be best to begin the strok- 
ing from above the painful point and gradually 
begin from a lower point till at last we shall be 
able to apply the stroking all over the ankle. As 
the pain diminishes more and more force may be 
employed, and kneading, circular, and vibratory 
friction be applied. 
This manipulation should be continued from 
seven to fifteen minutes twice a day. 
After the third or fourth sitting the movement 
of the ankle-joint will generally be quite free 
and almost painless, and passive flexion and ex- 
tension and rotation should be performed, soon 
followed with active and resistive flexion and 
extension. 
Provided there is no fracture, four to ten days 
is enough to cure the patient when the treatment 
is begun at once. If it has been allowed to go 
on for months and even years, this treatment will 
still prove to be most effective, and in the aver- 
age of these old cases a cure may be effected in 
from one to three months. DISEASES OF ORGANS OF MOVEMENTS. 
117 
Other joints are treated on the same plan. 
The hip- and shoulder- joints are more difficult 
to treat and require a much longer time in order 
to produce a cure. 
The following cited cases are especially note- 
worthy :- 
Case I. A gentleman, thirty-six years old, 
sprained his right ankle by a fall, and had been 
on crutches for eight months, when he came for 
treatment, May, 1883. There was no flexibility 
of the ankle, which was very tender and swollen. 
After six weeks' treatment once a day the patient 
was cured. 
Case II. A young lady had come to Washing- 
ton to see the inauguration of President Cleve- 
land in 1885. Three weeks before, she slipped 
on the icy pavement and sprained her right 
ankle. She was laid up, and all sorts of lini- 
ments, etc., were prescribed by her physician. 
After ten days he told her that there was nothing 
more to do but to keep quiet for two or three 
months, when she probably would be well. At 
this point the writer was called in, and the young 
lady told him, with tears in her eyes, why she 
had come to the city, and that now she was told 
that she would have to be quiet in her room for 118 
SWEDISH MOVEMENT AND MASSAGE. 
months, and she implored the writer to do his 
best. The ankle was still black and blue and 
very much swollen, and the pain did not allow 
of touching the parts. After the examination 
she was informed that she would probably be 
well in ten days if treatment was applied twice a 
day. To this she was only too glad to con- 
sent. 
The treatment was given twice that day. The 
next day the most of the discoloration had dis- 
appeared, and now she was told to walk a little 
at a time in her room. The improvement was 
remarkable from day to day. The ninth day 
after, the seventeenth sitting, she was cured, and 
went to the inauguration ball on the tenth day. 
She had no relapse. 
Case III. About two years ago one of the 
writer's assistants sprained his left ankle in a 
gymnasium. He was brought home by his 
friends and told to be quiet in bed. He kept on 
all night bathing the leg with hot and cold water, 
and came next morning to the Institute. The 
joint was slightly dislocated, the foot was turned 
upward and inward, and twice as large as usual. 
The patient was a strong young man, so that the 
writer at once went to work and succeeded in DISEASES OF ORGANS OF MOVEMENTS. 
119 
getting the joint straight, after which a full 
treatment was applied. 
After four days' treatment, twice a day, the 
young man was well. 
Prof. Dr. J. Nicolaysen, of Christiania (in 
Norsk Mag. for Loegevidenskab, 1874), commu- 
nicates the following case of hydrarthrus (water 
on the knee) :- 
" A man, thirty-two years old, had suffered 
from hydrarthrus for six and one-half years. 
Repeated punctures and evacuation had always 
been followed by a re-accumulation of the fluid. 
" Massage was used for several months, and 
the patient returned to his work. There was no 
relapse." 
Another gentleman, twenty-six years old, had 
suffered from hydrarthrus for two months, when 
he came to the same professor, who sent him to 
the writer, at that time in Norway. 
After two weeks' treatment the collection of 
fluid in the knee-joint disappeared, but the 
swelling of the capsule continued. 
After five weeks' treatment the patient was 
well. INDEX. 
PAGE 
Abdomen, derivative from diseases of 40 
diseases in 39 
Adhesions, solution and removal of 23 
Ankle-joint, stiffness of37, 39 
Apparatus ? Can the human hand be substituted for . . . 57 
Arms, movements of the . 20 
A. Passive movements 20 
beating 25 
chest lifting 29 
friction 24 
circular 22 
vibratory 22 
kneading 20 
muscle rolling 23 
nerve compression 23 
percussion 25 
pressing 20 
rotation, finger 26 
arm 27 
forearm 27 
forward arm 28 
hand 27 
shoulder and chest lifting 29 
slapping 24 
stroking, centripetal 20 
vibration 25 
B. Resistive movements 30 
elevation and depression, lateral arm 34 
flexion and extension, arm 31 
finger 30 
121 122 
INDEX. 
PAGE 
Anns, resistive movements (continued). 
flexion and extension, hand 30 
horizontal arm 32 
vertical arm 31 
separation and closing, horizontal arm 33 
torsion, arm 36 
Backache, for relief of 52 
Back, vibration60, 62 
Bladder, weakness of 50 
Blood, circulation, good effect on34, 35 
circulation of23-25 
in capillaries, stimulated 24 
increase of28, 29 
increased 51 
to equalize circulation of 39 
Blood-vessels, action on 57 
of neck, action on 57 
of throat, action on 57 
Brain, derivative from 57 
movement from 57 
quieting effect on 57 
Catarrh of stomach, chronic, good effect on 48 
Chest, derivative effect on 27, 28 
expansion of 29 
to expand 33 
and deepen 32 
Cold hands, treatment of24, 27 
arm, hand, and finger, flexion for 27 
feet, treatment of37, 39 
Constipation, good effect in 48 
useful in48, 50 
Derivative, chest and head 36 
effect42, 43 
good38, 44 
movement 83, 40, 45, 57 INDEX. 
123 
PAGE 
Derivation, good movement for 33 
Devices invented for saving manipulator's strength . . 57-60 
Diaphragm, stimulating effect on 50 
Digestion, good effect on50, 54 
to strengthen 49 
Diseases and their treatment63, 74 
Constitutional Diseases 63 
chlorosis and anaemia 64 
hysteria and hypochondria 71 
insomnia 72 
neurasthenia 67 
Diseases of the Organs of Circulation94-97 
heart disease as, chronic 94 
cold hands and feet 96 
Diseases of the Organs of Digestion98-102 
constipation100 
dyspepsia 99 
liver, hyperaemia of the101 
Diseases of the Organs of Movements104-119 
joints, stiffness of112 
rheumatism, muscular107 
lumbago108 
of the right arm107 
of the neck107 
of the jointsIll 
scoliosis 104 
sprains115 
tendons, stiffness of112 
Diseases of the Respiratory Organs97-98 
bronchialis, spasmus 97 
larynx, catarrh of 97 
lungs, catarrh of 97 
congestion of 97 
emphysema of 97 
tuberculosis 97 
Diseases of the Urinary and Sexual Organs . . . 102, 103 
bladder chronic catarrh of102 124 
INDEX 
PAGE 
Diseases and their treatment (continued'). 
menstruation, irregular and painful 103 
womb, chronic catarrh of103 
displacement of103 
Local Diseases 75-93 
brain, congestion of the 75 
anaemia of the 76 
chorea .... 93 
legs, cramp of 92 
neuralgia, sciatic82-91 
paralysis as a result of apoplexy 76 
spine, congestion of the 82 
writer's cramp 92 
Dyspepsia, good effect in 48 
Exudations, removal of 23 
Head, derivative effect on27, 28 
movements of the 56 
A. Passive movements 56 
friction, head 56 
percussion, head 56 
rotation, head 56 
vibration, head 56 
B. Resistive movements 57 
flexion and extension, neck 57 
Headache, good effect in 56 
Heart, organic diseases of 46 
specific action on 62 
stimulation of 47 
weakness of 30 
Hip-joint, stiffness and weakness of 45 
to limber 39 
Indigestion, good effect in 48 
Insomnia, good effect in 56 INDEX 
125 
PAGE 
Joints, stiffness of 27 
arm, hand, and finger, flexion for 27 
Knee-joint, stiffness of 42 
weakness of 42 
Lameness, stimulating effect in 25 
treatment of 24 
Legs, movements of the 36 
A. Passive movements 36 
beating 37 
compression, nerve 36 
friction 36 
circular 36 
vibratory 36 
flexion, foot and toe 38 
kneading 36 
muscle rolling 36 
percussion 36 
pressing 36 
rotation, foot 37 
foot, double 37 
thigh 38 
slapping 36 
stroking, centripetal 36 
vibration 37 
B. Resistive movements 39 
elevation and depression, leg 42 
flexion and extension, foot 39 
knee 41 
leg 39 
separation and closing, bent knee 44 
leg 43 
torsion, leg 45 
traction, upward, knee 40 
Liver, stimulating effect on 50 126 
INDEX. 
PAGE 
Lungs, stimulating effect on 50 
stimulation of 47 
weakness and emphysema of the 46 
weakness of 30 
Lymph, removal of 23 
Muscles, abdominal 43 
to strengthen 55 
abnormal enervation of arm 36 
back, action on 57 
to strengthen 55 
calf, to strengthen 39 
extensor, of leg 43 
flexor of thigh 43 
foot, to strengthen 39 
hip, to strengthen 43 
neck, action on 57 
of hips brought into play 45 
of pelvis brought into play 45 
of thigh, to strengthen . 44 
of thighs brought into play 45 
to strengthen abdomen 41, 49 
arm 32 
chest 32 
flexor, of leg ■ . . 41 
shoulder 35 
upper arm 33, 35 
to strengthen and develop finger 31 
flexor and extensor, of arm 31 
forearm 31 
hand 31 
weakness of, stimulating effect in 25 
Nerve centres, stimulation of 52 
and strengthening of 52 
Nerves and throat, action on 57 INDEX. 
127 
PAGE 
Nerves, good effect on 54 
stimulating effect on 37 
stimulating and strengthening effect on . . 26 
stimulation of . . . 23 
sacral, action on 50 
to quiet 24, 25 
to soothe and quiet 51 
to stimulate action of 51 
Nervous palpitation 46 
Pelvis, derivative from organs of 44 
disease of 40 
diseases in 39 
Purgative effect of upward knee traction 41 
movement .... 55 
Respiration, good effect on 29, 34, 35, 54 
good movement for 33 
stimulating and strengthening effect on 26 
Rheumatism 25 
treatment of 24 
Sexual organs, weakness of 50 
Shoulder-joint, stiffness of 36 
to limber 28 
Shoulders, to straighten 34 
Spine, good effect on 54 
and portal system, good effect on 52 
tendency to straighten 57 
to straighten 55 
Stomach, stimulating effect on 50 
Transudation, removal of 23 
Trunk, movements of the 45 
A. Passive movements 45 
beating, breech 50 
compression, spinal nerve 51 128 
PAGE 
Trunk, passive movements {continued). 
concussion, bowel 49 
friction, back. 50 
chest 45 
stomach 47 
kneading, back 50 
chest 45 
stomach 48 
lifting and vibration, chest 46 
percussion, back 52 
rotation, trunk 52 
slapping, chest 45 
traction, loin 50 
vibrations, back 50 
bowel . 48 
loin 49 
stomach 48 
B. Resistive movements 52 
flexion and extension, forward trunk 54 
torsion, trunk, kneeling 53 
sitting 52 
C. Active movements 55 
elevation, trunk 55 
Vibrator, the . 60-62 
Weariness, good effect in 65 
INDEX.