The Stomach.—1. The thumb of the right hand is placed lengthwise and obliquely in the ^-shaped space between the ribs, and between the sternum and umbilicus the fingers are spread out towards the spleen. A movement, partly kneading, partly friction, is made with the whole hand, but working more deeply on the soft part with the ball of the thumb, pressure being made towards the pylorus.

2. Kneading with ends of fingers, one hand on the other over same region, following the curve of the costal cartilages, and working into the A space.

3.   Deep stroking many times with both hands.

4.   Fingers of both hands meet under patient's body, and are drawn upwards and forwards with good pressure till they meet in front, thus compressing liver and stomach. A shaking movement may be given at the same time if thought necessary

5.   Tapping with outspread fingers, or hacking.

Fig. 83.—Shaking of Stomach.

For dilated stomach a good movement is as follows : Standing at the left side, about on a line with the patient's shoulder, who may be sitting or lying with the shoulders well raised, the palms of the hands are placed on the region of the stomach, the fingers are bent inwards and under, a fairly vigorous shaking is given to the stomach several times, then pressure over same region and shaking repeated. This is a stronger and deeper movement than vibration.

To be followed by circumduction of the trunk. This is done sitting, and preferably astride a stool of convenient height ; the movement is made from the hip-joints. Flexion of thorax is also useful.