The three items under "Physical Treatment": 28. _Gymnastics_, 29.
_Massage_ and 30. _Breathing_, require only a few explanatory remarks.
Their common object is, by means of external mechanical aid, to
stimulate the circulation of the blood which is undergoing the process
of regeneration. They remove obstacles to circulation and produce
movements and reactions. While, in the case of massage, this external
aid must, as a rule, be given by a third person in order to be
effective, gymnastics and breathing exercises depend upon the patient
himself. All of them, however, have the common attribute that, in order
to be useful, they must be strictly individual. The old proverb: "No one
thing is good for everybody," is fittingly applied in this case.
There are few things that are so much abused as this rule in regard to
gymnastics. I cannot urge too strongly the importance of caution in
advising such exercises. While much of what is claimed for them may be
good and true, the governing question as to _what is suitable in an
individual case_, can obviously not be determined by any such impersonal
advice. It is the exclusive right and the duty of the attending
physician to prescribe whether, and to what extent, these exercises
should be applied in each case.
This is true of gymnastics even when practised by reputedly healthy
people. By executing certain movements, they may develop disease and
weaken certain organs, through ignorance of their abnormal condition.
In case gymnastics or breathing exercises are prescribed as part of a
treatment they should be executed in strict accordance with the order
of the attending hygienic-dietetic physician.
One of the great principles never to be overlooked in gymnastics is,
that in order to have the desired effect they must be carried out with
the greatest regularity.
As to massage, this requires knowledge of anatomy in general, and of the
anatomy of the individual to be treated, in particular. Only in this way
can the desired effect be produced on certain muscles and nerves, with
the further consequence that their movements promote the correct and
health-giving circulation of the blood. Here again the governing factor
must be the prescription of the hygienic-dietetic physician who has
studied the individual case and knows the effect he wishes to produce by
means of massage, and how to procure the same.
Books on massage and its general practice without knowledge of the
particular case, will really accomplish nothing.