The lumbar regions receive their manipulation last.

If it is desirable to give special attention or an extra share of manipulation to any part of the spinal region, this is done as the physician may have ordered, and the whole process is completed by downward friction over the spine, given vigorously and as rapidly as possible.
The chest is the next region to be handled, the patient turning from the prone to the supine position.

In women the breasts are usually best left untouched unless special conditions demand their treatment.
The last and perhaps most important part of the process of general massage is the rubbing of the abdomen.

Particular care is needed to secure complete relaxation, as nervous patients and, still more, hysterical patients are apt to present extreme rigidity of the abdominal muscles.

The head is raised by pillows, the knees are slightly flexed and sometimes supported by a folded pillow also.