Position

The patient is lying flat on the back, without head-rest, and the arms placed at the sides.

1. Stroking with both hands, one on each side of the sternum. The manipulation should be performed upward and outward, making a somewhat circular motion. (See Fig. 2.)

2. Friction with thumb over pectorales major and minor, with repeated strokings. Always from the origin (sternum) toward the insertion (the arm).

3. Kneading with the thumb and fingers (pinching) if the muscles of the one side be paralyzed.

4. Hacking or clapping over the chest may also be used, according to circumstances. Punctation in circles around the heart has also been recommended, but if used, great care should be taken.

As a rule, all percussions applied to the thorax should be used with discretion.

In massage of the breast place the hands at the outer circumference and by alternate frictions proceed upwards to the nipple. In cases of caked breasts it is often necessary to use frictions with the tips of the fingers over hard places to relieve distended ducts. Always finish the treatment with the so-called "fulling" consisting of gentle pressure from the base of the breast upward with both hands alternately. Massage with camphorated oil is a great relief in over-distended breasts. The operator should always be careful not to bruise the glands in any way, as tumors are liable to develop in after years and cause no end of trouble. Massage and exercise are the only means by which the bust can be properly developed. The patient should be taught how to breathe properly and for the quick development of the mammary glands use in the massage as above described the following preparation, recommended by Dr. W. J. Haynes:

This preparation has not a fine odor, but produces a pleasant sensation in the skin. It is a valuable compound wherever we wish to develop a part, but should not be used on the face.