I. It is rather difficult to fix the time for a massage treatment. Dr. Mezger works only a few minutes (five to twelve minutes), but I am satisfied that he accomplishes more in that time than many do in half an hour. As a rule, use shorter time for a local than for a constitutional affection.

In the rest-cure some eminent physicians begin with fifteen to twenty minutes, gradually increasing the time to an hour or even longer.

II. The weakest person may be treated by massage, since it is a remedy so easily adapted to circumstances and so perfectly controlled.

III. The patient must not feel any severe pain or disagreeable fatigue after the treatment. Should such be the effect, stop the treatment for a few days, and on resuming it regulate the pressure carefully.

IV. After each treatment the patient should rest for at least an hour in a comfortable position.

V. The patient should be urged to refrain from excessive eating and drinking, and the treatment should not be applied within two hours after meals.

VI. The operator must breathe freely while giving the treatment, and must be in a proper position, neither too close to the patient nor too far off.

VII. The temperature of the room should be 70°-75° F.; the operator should always be careful to cover up the part masseed and avoid having any draft from windows or doors.

VIII. The operator should possess vigorous health and muscular strength. He should be cheerful and of refined habits, and should have a fair education, with a perfect knowledge of the principal facts in anatomy and physiology.

IX. Massage treatment is an art which can not be self-acquired, but must be taught by an experienced instructor.

X. The manual treatment of disease ought to be regulated by the medical profession; hence the physician's order should be properly carried out, even though the operator be of a different opinion.

XI. A student of massage should have the treatment applied to his own body, by that ascertaining the proper pressure to be used upon the various tissues.

There is no medical agency that has been so much abused as massage. When I came to America I was anxious to find out how the manual treatment of disease was carried on here. I soon learned that there were no laws requiring registration, but that I could find the masseurs through the physicians and the daily papers. I visited several of these, and submitted myself to treatment by some. I discovered there was no science whatever in their treatment; some seemed to entirely ignore the fact that nature had provided me with sensitive nerves. Most of these operators used no oil, and consequently the hair bulbs of the limbs operated on by them became inflamed. I do not know where they had acquired their knowledge of massage, or, as they termed it, "the rubbing." One of them was sure that he had an inherited power of magnetism, etc., because his father had been "a prominent rubber" in Germany. Another, I understood, had been working in a hospital, and while the building was undergoing repair he was offered a position in the basement,-whether to wash dishes or not, I could not find out,-but he declined, and left the place to become "a rubber," and is rubbing still.

Not only is the massage treatment practised by-such persons whose muscular power should be exerted on something less sensitive than the diseased and weakened human body, but it has also been used as a cloak for vicious purposes.

It is reported that the police in Chicago have raided a number of "massage shops," and one of the leading daily papers of Philadelphia asserted that a raid had been made upon similar houses in this city, where the massage treatment was used as a cloak for vice.

So long as there is an abundant supply of both masseurs and masseuses, there is no necessity that a woman should be treated by a man, or a man by a woman. There are, of course, exceptions, as, for instance, that of a trained scientific masseur or of a trained female nurse who is attending a patient in his family.

I see no reason why such a powerful, remedial agency as massage should not be fully controlled by the medical profession, as it is in Europe.

It seems to me that the physician who recommends an incompetent person to attend his patients does wrong, and we have frequently heard sad experiences from patients whose social standing ought to have protected them from being imposed upon by incompetent, uneducated persons.

Some time ago there was a masseur in this city who was given a case of sprain at the ankle-joint. The surgeon performed a very slight flexion of the foot, so as to ascertain the amount of contraction in the tissues around the joint. At one of the first seances this masseur thought he would repeat the flexion and a fracture was the result.

Such things are unpleasant to bring before the public, but it is quite proper they should be noticed in a text-book on massage, when there is danger that one of the most natural and powerful medical agencies will be neglected because it has not been duly protected, but practised by persons who would be more appropriately employed at the wash-tub or in the kitchen.

Let me now say a few words about educated practitioners of the manual treatment. Some of them, and especially females, have been accused of thinking too much of themselves, of being too independent. Masseurs and masseuses should remember that they are only using one special remedy that nature has taught man to employ to arrest disease. Persons who are properly trained will not attempt to enter into competition with medical doctors, but confine themselves to the scientific treatment that we have endeavored to analyze in this little text-book.

Were it not for abuses that have prevailed, the manual treatment of disease would no doubt be more universally adopted and recommended by the medical profession and the general public.

From this short sketch we conclude:

1. That the massage and movement treatments should be applied only by educated and properly trained persons, with due regard to the physician's directions.

2. That the operator (if not a medical doctor) should be of the same sex as the patient, with only the two exceptions before mentioned.

3. That there should be a place where skilful and trained operators could have an opportunity for passing an examination and for registering, thus protecting not only themselves and the profession, but the general public as well.