The temporary results he obtained were so remarkable that I began soon after to employ it in locomotor ataxia, in which it sometimes proved of signal value, and in other forms of spinal and local disease.

At first I had to train nurses to use it, but I soon found that, although it was of some service to their patients, no one could use massage well who was not continually engaged in doing it.

Some men do it better than any woman; but I prefer, nevertheless, for obvious reasons, to reserve men for male patients, except that in cases where _strength_ is of moment, as in the forced movements and the very hard rubbing needed for old articular adhesions, in which force must be exercised without violence, it is usually impossible to secure the necessary power in a feminine manipulator.
A few years later I resorted to it in the first cases which I treated by rest, and I very soon found that I had in it an agent little understood and of singular utility.
It will be necessary, in pursuance of my plan, to describe as minutely as the limits of a chapter will allow how and why this means is employed.

The process and order of what is known to the manipulator as "general massage" follows.
After three or four days in bed have somewhat accustomed the patient to the general routine of treatment, a masseur or masseuse is set to work.
If any special care is needed,--the avoidance of manipulating one part or added attention to another, tender handling of a sensitive or timid patient,--these matters have been ordered in advance by the physician.
An hour midway between meals is chosen, and, the patient lying in bed between blankets, the manipulator begins, usually with the feet.

A few rapid rubs of the whole foot and leg are given to start with; then the leg, except the foot and ankle, is covered up, and the operation commences upon the foot, of which the skin is picked up and rolled between the fingers, the whole foot receiving careful attention,--the toes are pulled, bent, and moved in every direction, the inter-osseous groups worked over with the thumbs and fingers or finger-tips, the larger muscles and subcutaneous tissues squeezed and kneaded, and last the whole mass of the foot rolled and pressed against the bones with both hands.