The active movements, as well as hacking and beating of the affected parts, are of great benefit in cases of rheumatism. In severe attacks the treatment should be applied twice daily. The patient must move his limbs freely instead of keeping them inactive.

Begin with general massage around and over the affected part; continue with local massage on the diseased muscle or joint and finish the treatment with a few movements that give effect upon the circulation and respiration.

The operator should study his case carefully and by passive and active movements of the affected part try to localize the rheumatic deposits. How important this is will be clearly illustrated to the reader in the following case :

A gentleman was sent to me for massage for a "rheumatic shoulder"; he had been treated for some time with massage applied locally, i. e., right over and close to the joint. The result had been unsatisfactory and he had no faith in the treatment. The joint was carefully examined and was found all right. He could raise the arm and he could rotate it without pain or difficulty, but when I told him to throw the arm downward and backward, I then saw that his trouble was located in the latissimus dorsi. This muscle was then carefully treated and with very satisfactory result. He at first ridiculed the idea of curing an affected shoulder by treating the lower part of the back, but is today a very enthusiastic believer in scientific massage.