The operator stands in front, but rather to one side of the patient, who is seated.

The head is steadied with one hand, the fingers of the other hand are drawn together, and firm friction is made over every part of the scalp. The pressure must be sufficient to move the scalp thoroughly on the skull. This is sometimes difficult, owing to the tight and matted condition of the scalp ; sometimes the scalp on one side of the head is freely movable, and on the other almost fixed. Friction may also be done with the whole palmar surface of both hands working together.

Much relief is felt from these movements when the head is tired and heavy. They are said also to promote the growth of the hair.

A very soothing movement, useful in nervous headaches and to promote sleep, is done with the cushions of all the fingers of both hands, working slowly in circles from occiput to forehead, without pressure ; the wrists are raised. Circular movements on the crown of the head are most soothing, as also are circular movements round the mastoid process.

If used to induce sleep, the patient would probably be in bed ; in this case the movement should begin at the crown.