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JAMA 100 Years Ago
June 21, 2000

REPORT ON MASSAGE.

Author Affiliations
 

JAMA 100 Years Ago Section Editor: Jennifer Reiling, Editorial Assistant.

JAMA. 2000;283(23):3046. doi:10.1001/jama.283.23.3046

BY DOUGLAS GRAHAM, M.D.
BOSTON.

When we come across good things in medical literature it should be our duty and pleasure to pass them along to those who have not easy access to the same. Hence the need of occasional reports. . . .

In 1884 your reporter wrote that no more fertile field awaits the investigations of physiologists than that of ascertaining the similarities and differences existing between exercise and massage.1 Partly in fulfillment of this prophecy we present the following:

The effects of baths, massage and exercise on the blood-pressure.

The effects of baths, massage and exercise on the blood-pressure.

In The Lancet for June 10, 1899, Drs. Edgecombe and Bain have given a detailed account of their experiments to determine the effects of baths, massage and exercise on the blood-pressure. For arterial pressure the radial artery was taken, the subjects being in the recumbent posture, with the arms extended in a line with the heart. For venous pressure the veins in the back of the hand were taken in some, in others those of the forearm. Ten subjects were experimented on, and the results were confirmed by repeated observation.

The effects of baths, massage and exercise on the blood-pressure.

Cold.—The effect of the cold bath was to raise the arterial and to lower the venous pressure. When to cold, percussion was added in the form of a strong needle douche applied simultaneously to the surface of the whole body, the arterial pressure became raised to a greater extent than with cold alone.

The effects of baths, massage and exercise on the blood-pressure.

Heat.—The effect of warm baths of plain water, on the other hand, was to reduce the arterial pressure to an extent roughly proportionate to the increase of temperature. The fall in venous pressure was in greater proportion than the fall in arterial.

The effects of baths, massage and exercise on the blood-pressure.

Heat and cold alternately.—In the alternating needle-bath or Scotch-douche, where the temperature is made to rapidly oscillate between warm and cold, the net result was a rise in arterial with a slight fall in venous pressure.

The effects of baths, massage and exercise on the blood-pressure.

Massage.—Observations led Drs. Edgecombe and Bain to the conclusion that general dry massage, in the form of pétrissage, while it may cause an initial rise of blood-pressure of brief duration, produced as the net result a fall in arterial pressure both mean and maximum, provided the abdomen was not masséed too vigorously. Deep massage and compression of the abdomen caused an immediate rise in blood-pressure by dispersion of blood accumulated in the splanchnic veins into the systemic circulation. The venous pressure was observed to be always relatively, and in some cases actually, raised; the amount of rise appearing to depend to some extent on the temperature of the room, being greater in a warm atmosphere. . . .

The effects of baths, massage and exercise on the blood-pressure.

Wet massage in the form of the Aix douche, in which massage is administered under a warm douche conveyed by a flexible pipe playing between the hands of the masseur, causes an increased effect—temperature added to massage. Here was observed a greater fall in arterial pressure than was obtained with dry massage, and coincidently an actual rise of venous pressure.

The effects of baths, massage and exercise on the blood-pressure.

On the other hand, wet massage in the form of the Vichy douche, in which massage is administered under a warm needle spray, the patient being in the recumbent posture, causes a rise in all pressures, maximum, mean, arterial and venous. The difference between this bath and the preceding is due: 1, to the percussion of the needle-spray tending to raise the pressure, and 2, to the fact that the patient being in the recumbent posture abdominal massage is more efficiently performed and hence a rise in pressure results. Vigorous abdominal massage would seem to abolish the fall produced by massage of the limbs and the rest of the body, and when this was but slightly performed, the net result was a fall. The influence of warm temperature plus massage was to considerably augment this fall. In all probability the factor primarily and chiefly disturbed by massage is the peripheral resistance rather than the output of the heart, and the result is to be attributed mainly to diminished resistance from arteriolar dilatation.

The effects of baths, massage and exercise on the blood-pressure.

Exercise.—The effect of exercise on the blood-pressure depends on the severity of the exercise. In all forms an initial rise in arterial pressure occurs; if the exercise be mild there is a fall during its continuance; if severe, the rise is maintained; after exercise, moderate or severe, a fall takes place. The venous pressure is raised during all forms of exercise and remains raised during the subsequent arterial fall. The return to normal after exercise takes place more or less rapidly according to the gentleness or severity of the exercise and the temperature of the atmosphere. . . .

The effects of baths, massage and exercise on the blood-pressure.

JAMA. 1900;34:1536-1537.

1. A Practical Treatise on Massage, 1884.

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