I. Introduction

The treatment that acts on the skin and muscle of the body technically by hands and fingers is called massage.

According to Records of the Historian in China, Bianque, a famous physician in Qin Dynasty (221-206BC), had cured Prince Guo's Shi Jue Zheng (deathlike faint disease) by using massage. From the Qin Dynasty till now, massage has had a history of more than two thousand years. The oldest monograph on massage should be the Yellow Emperor's Canon of Massage(in ten volumes), but it's a pity that the book had lost. Massage was also mentioned in the Yellow Emperor's Internal Canon of Medicine. In ancient times, Chinese was able to treat various diseases with massage, such as limb paralysis, debility, faint, moist disease, chill and fever, etc.

There are so many advantages of massage, for example, it is easy to learn, convenient to practice, economical, and an alternative for medicine as well. Massage plays a role of analeptic as well as sedative, respectively, for it can either make people refreshed or calm down.

It is relatively safe for general chronic diseases or overly weak patients, because massage is propitious to circulation and metabolism. As to children who are inconvenient to take medicine, massage could boost up the constitution and function of the children's body. Regarding some complicated diseases, this method could be used cooperatively with acupuncture and medication. However, as to some acute or hyperpyretic infections, or organs having pathological changes such as typhoid, pneumonia, pulmonary tuberculosis and so on, massage only has supporting effects. Patients having serious or acute diseases such as tumor, acute suppurative appendicitis, intestinal perforation, cholecystitis due to bilis duct ascarid etc. should get nosocomial first aid.

For married women with sudden intense pains at lower abdomen, who have had menoschesis for about two months, it is suggested to immediately send them to hospital in order to determine whether ectopic pregnancy or any other acute diseases exist.

II. Indications and Contraindications of Massage

Indications

Wrick, joint disarticulation, strain of lumbar muscles, amyotrophy, migraine, fore and back headache, trifacial neuralgia,inter-rib neuralgia, femoral neuralgia, sciatica, waist & back neuralgia, arthralgia (including shoulder, elbow, wrist, knee, ankle, toe); facial neural paralysis, facial muscle spasm, gastrocnemius spasm; muscle pain due to rheumatism, including muscle pain in shoulder, back, waist, knee, etc., as well as acute or chronic rheumatic arthritis, gall of joint synovium, ankylosis, etc.

Other indications include neurogenic vomiting, dyspepsia, habitual constipation, gastroptosis, chronic gastritis, insomnia, spermatorrhea, dysmenorrhea and neurosis as well, all of which can be treated through massaging.

Contraindications

Various acute infections, acute osteomyelitis, tuberculous arthritis, infective dermatosis, eczema, scald by water or fire, cutaneous ulcer, tumor and all kinds of sore, as well as menses and pregnancy of more than five months, acute peritonitis, acute purulent peritonitis, acute appendicitis, weakness because of long-term sickness or senility and serious cardiovascular disease.

III. Categories and Techniques

The massage is usually classed into two categories. One is called active massage or self-massage, which is a method of health care by massaging oneself. The other is passive massage, which is used by doctors as massage therapy. The frequently used techniques of massage include pressing, rubbing, bunting, seizing, kneading, pinching, quivering and beating. However, the above techniques are not used alone but usually cooperatively.

Pressing

The pressing is fingertip or finger plate rising and falling rhythmically on proper position of the patient's body, which usually can be done by one hand or both hands.

Generally, one-hand or two-hand pressing is applied below ribs or on abdomen in clinic. While on back or other muscle-thick parts, one-hand pressing with added pressure is applied, that is, the right hand presses the finger back of the left hand placing on the body with gentle strength and vice versa.

Rubbing

Rubbing means touching -- touching softly on the proper part of the patient's body with the finger or palm, which is often used cooperatively with pressing and bunting. There are one-hand rubbing used for upper limbs and the shoulder end, and two-hand rubbing used for the chest.

Bunting

Driving in force ahead is called bunting. Clinically, two frequent methods include one-hand and two-hand bunting. Bunting and rubbing cannot be separated and often are utilized together because rubbing is involved in bunting. Bunting and rubbing should be used on muscle-thick parts, such as arms and legs.

Seizing

Seizing is taking up the skin of proper part slightly with fingers.

The usually used method in clinic is one-hand seizing on legs or muscle-thick places. In case of sudden choke with chest jam like asphyxia due to tenderness and exasperation, one-hand seizing could be applied. Concretely, at the joint part of the shoulder and the back above clavicle, the doctor should grab the muscle and then set down, repeat twenty times at a speed of twice per second and take a rest, then repeat twenty times again. After that, breath will become regular gradually.

Kneading

Kneading means that the doctor keeps the hands touching patient's skin and rotates slightly, which is sorted to one-hand kneading and two-hand kneading. Fingers are usually used at some small part such as temples, while palm used at larger parts, e.g. the back. There is one-hand kneading with added pressure also, for example, pressing right hand on the left hand back keeping on the patient's calf and carrying out one-hand kneading with added pressure on the midleg.

Two-hand kneading could be done on the calf of the patient. Kneading can clear up blood stasis and harmonize the circulation of blood, so it is quite effective to cure partial pain.

Pinching

Nipping shin and muscle with fingers at proper parts is called pinching, which is similar with seizing carried out with full force. However, the force is stressed on fingers when pinching, while the seizing is much more forceful. Pinching is a fundamental technique of massage and is usually applied cooperatively with kneading.

Actually, pinching acts accompanied with the effect of finger squeezing. As a result of squeezing muscle slightly, activity of skin and muscle tendon improves, moreover, circulation of blood and lymph ameliorates. Simple pinching can easily remove cold and dissolve gores, while forceful pinching can treat pains of muscle, tendon and joint caused by cold and moist.

Quivering

Quivering, as one of the massage techniques, means vibrating and trembling quickly, hastily and equably. The preferable speed is 10 times per second, or 600 times per minute.

Quivering cannot be separated from movement, thus quivering is also called as vibrating.

Single-finger quivering means vertically pointing at the patient's pain point with the thumb, and then vibrating with the force of wrist, resulting in dithering of the thumb. Another kind of quivering is called two-finger quivering, which is done by wrist-shaking after placing thumb & forefinger, or forefinger & middle finger, on the patient's pain point or eyebrow.

Beating

Beating is also called knocking, which is usually applied after kneading and rubbing. It can also be carried out alone when necessary.

When carrying out beating, the strength must be well-situated. Only suitable application could relax the patient, otherwise it will result in uncomfortable experience.

Generally, both hands are used when beating, and the frequently used methods are side-palm chopping, flat-palm patting, across fist knocking and upright fist knocking, etc.

1. Side-Palm Chopping

Both palms Stand side to side, with the thumb upward and the little finger downward. Moreover fingers should have about one centimeter distance from each other. Following the fall of palms with shut fingers, raise hands with separate fingers. Raise and lay down both hands in turn.

2. Flat-Palm Patting

Put both palms on the muscle, and tap rhythmically in turn.

3. Across Fist-Knocking

Make a fist with hand-back upward and thumbs against each other, moreover loose with a little space between fingers and the palm. Knock across with both fists in turn. This method is usually used on muscle-rich parts, such as waist, leg and shoulder.

4. Upright Fist Knocking

Make an upright fist with thumb upside and little finger downside. Loose with a little space between fingers and the palm. This is usually used on the back and the waist.

Four methods of beating mentioned above are mostly utilized on muscle-rich parts, e.g. neck, shoulder, back, waist, thigh and crus. Knock gently at first, put on some force slowly, and then lose force gradually. The force here will never be extremely heavy. Anyhow, it is the most important to make patients feel comfortable. As to the speed of beating, it should be generally slow at the beginning and then fast. Two times per second at the beginning, and gradually increase to six or eight times per second.

It should be emphasized that no matter which method to use, no great force should be used at the beginning, and strengthening gradually. In order to comfort the patient, falling palms should be not only with force but also flexibility. Generally, knocking for one or two minutes, or three minutes at most, is enough. In very few cases, beating time could be prolonged or shortened according to the degree of the illness. Beating can be carried out after or along with other massage techniques.

IV. Attention

1. Before massage, trim nails and wash hands with hot water, and pick off any hindrance to massage such as rings.

2. Make sure to be kindly, solemn and careful. Explain patients' condition patiently to win their cooperation.

3. Arrange proper posture of the patient and the doctor. Particularly, the patient's pose should be not only comfortable but also convenient for the doctor's operation.

4. Massage should be suitably gentle or heavy. Observe the patient's expressions at any moment so as to make the patient feel comfortable.

5. Proper duration is 20~30 minutes each time and 12 times make up a period of treatment.

6. Do not massage the patient immediately when he or she is in a rage such as intense anger, happiness, fear and sadness.

7. Do not massage the patient immediately after overeating. It is much proper to practice massage 2 hours after meal.

8. If the patient falls asleep during the massage, the doctor should cover the patient with a towel to prevent him from getting a cold. Be careful to the room temperature, and do not massage against wind.