n 1877, several of the members of the staff of the Infirmary for
Nervous Disease, and especially my colleague, Dr. Wharton Sinkler,
obliged me by studying with care the influence of massage on
temperature, and some very interesting results were obtained. In
general, when a highly hysterical person is rubbed, the legs are apt to
grow cold under the stimulation, and if this continues to be complained
of it is no very good omen of the ultimate success of the treatment. But
usually in a few days a change takes place, and the limbs all grow warm
when kneaded, as happens in most people from the beginning of the
treatment.[19] The extremely low temperature of the limbs of children
suffering with so-called essential paralysis is well known. I have
frequently seen these strangely cold parts rise, under an hour's
massage, six to ten degrees F. In such small limbs, the long contact of
a warm hand may account for at least a part of this notable rise in
temperature. In adults this can hardly be looked upon as a cause of the
rise of temperature produced by massage, first, because the long
exposure of large surfaces incident to the process is calculated to
lessen whatever increase of heat the contact of the hand may cause, and
secondly, because this rise is a very variable quantity, and because
occasionally some other and less comprehensible factors actually induce
a fall rather than a rise in the thermometer as a result of massage.

In very nervous or hysterical women, ignorant of what the act of
kneading may be expected to bring about, and especially in such as are
thin and anaemic and have either a somewhat high or an unusually low
normal temperature, we may find at first a slight fall of the
thermometer, then a fairly constant rise, with some irregularities, and
at last, as the health improves, a lessening effect or none at all.

The most notable rise is to be found in persons who, owing to some
organic disease, have acquired liability to great changes of
temperature.

It is impossible to observe the increase of heat which follows both
massage and electricity without inferring that these agents must for a
time, like exercise and other tonics, increase the tissue-waste by the
stimulus they cause of the general and interstitial circulations, and by
the direct influence they seem to have on the tissues themselves. I have
sought to study this matter carefully by placing patients on a fixed and
competent diet of milk alone, and by es