If the patient can remain prone for a sufficient length of time, it is well to perform the massage of the legs on their posterior surfaces. A pillow must be placed under the ankles so that the feet may rest comfortably (cf. position shown in Fig. 14,P. 49).

Fig. 128. - Stroking the abdomen with both hands. The end of the stroke. It is a very difficult movement to perform rhythmically, and requires much practice. The use of one hand at a time is much more simple.

Five or six minutes' stroking from buttock to heel, or vice versa, should suffice, the rate being some ten or twelve movements to the minute. Each several movement should be an exact replica of those which precede and follow it. There must be no variation or deviation.

Fig. 129. - Deep stroking of the colon: nearing the end of the stroke.

The back massage must be performed in a line which is exactly parallel to the spine. It should start over the high dorsal region and descend to the sacral area, or the reverse. It is rarely wise to use both hands together, one on either side of the spine, as it is almost impossible to maintain the rhythm. It is much wiser to work for, say, three minutes on one side, then three minutes on the other. The rate of stroke is about the same as that on the leg. The central area over the spine itself then receives attention for about five minutes. The first three are spent in duplicating the movements already performed at the sides, or the number of strokes may be increased - the rapidity of passage of the hand must remain unchanged - by the use of the two hands alternately (see Fig. 126). During the last two minutes the hand, or hands, should begin the movement a little lower down the spine (or should cease the movement if working upwards), and the area treated should become smaller and smaller till only the lower lumbar area is treated.

The arms are treated in a similar manner. They must rest on the bed supported throughout their whole length. The number of strokes per minute will be increased, as they are shorter. The rapidity remains unaltered.

The abdomen also is treated in the same way, the stroke following the line of the lower six intercostal nerves from the mid-axillary line to the centre of the body (see Figs. 127 and 128). If constipation is present, deep stroking with one hand up the ascending colon and down the descending with the other may be performed (see Fig. 129). It must be slow and rhythmical and vibrations should not be added. Nothing must be allowed to disturb the general rhythm of the whole seance. A dilated stomach may be treated by transforming the superficial stroking of the right side into deep stroking over the upper part of the abdomen; the hands may work alternately (see Fig. 130). If any deep stroking is to be performed the knees must rest on a pillow to flex the thighs and so relax the abdominal wall.