Reach-grasp-standing Reach-grasp-sitting Back-hacking (Fig. 120).

Given rather strongly, either lengthwise, with one hand on either side of the spinous processes, or diverging, more or less transversely. Repeated three to five times.

Effects And Uses

Longitudinal

Back-hacking produces stimulation of the posterior branches of the spinal nerves, which is then carried to the spinal cord and its nerve cells. Here various reflexes arise, and, since the reflex apparatus in nearly the whole length of the cord is brought into action, these extend over the whole body and increase vitality generally.

It is used on this account in the treatment of many diseases of the spinal cord, such as tabes, etc., in neurasthenia and debility of the nervous system, and in general weakness. Even the activity of the heart is affected reflexly, so that it becomes stronger, and above all quieter.

Divergent Back-hacking is used in treating the back muscles, especially to break up products of inflammation in them.

Stretch-Grasp-Side-Arch-Standing Side-Hacking And -Clapping

Given strongly, but only over the lung. Stretches adhesions between the lung and the chest wall.

Heart-hacking, or, more correctly, Local Heart-treatment (Fig. 121). - The patient is best placed in lying or half-lying starting position. The gymnast stands or sits at his side. The treatment consists of several different manipulations: -

(1) Soothing stroking over region of heart; (2) Light gentle

Fig. 120.

Fig. 121.

Hacking; (3) Stroking; (4) "Tapotement a Vair comprime'," in which the cupped and relaxed hand is carried over the heart region and is extended so that the palmar surface becomes convex, the convexity touching the chest wall in passing with a light elastic tap; the rate of movement must correspond with the desired heart-rate; (5) Stroking; (6) Vibrations. This series is repeated usually twice; the whole lasts three to five minutes.

Effects And Uses

Hacking produces probably a mechanical stimulation of the heart muscle and its ganglia, whereby the contractions become stronger and less frequent.

Tap6tement a l'air comprime produces a rhythmical stimulation of the heart, which then attempts to make its rate coincide with the stimulus.

Stroking has a soothing effect.

Vibrations in general soothe the heart's action, but not always. Experience shows that different people react differently to them.

Local heart treatment is used in the treatment of heart diseases, but irritates some patients, to whom naturally it is not given. It is very possible that suggestion often plays a greater or lesser part in the effect of the treatment.

Clapping.

Usually done with the palmar surface of the hand. The wrist must not be held stiff, but must be quite relaxed.

Effects in general similar to hacking, but it is used especially when one wishes to produce stimulation of the skin, e.g., in diminished sensation, or to cause an increased production of heat. For cold feet Foot-clapping with rod is used.

Chest-clapping merits a special description.

Heave-grasp-standing Chest-clapping (Fig. 122). - The gymnast stands in front of the patient and begins the clapping on the back of the chest over the upper parts of the lungs, continues from there down the back and forward over the sides, then to the front of the chest, where hacking is given along the lower ribs, and up the sternum to the upper part, when clapping is again given. From there clapping is continued on the sides of the chest close under the axillae and round again to the back, after which the whole is repeated three to four times.

Fig. 122.

Clapping is given rather strongly over the back and upper parts of the sides; but on the lower parts of the sides and in front it is done lightly, otherwise it feels uncomfortable. In hacking along the lower ribs in front, hacking over the pit of the stomach must be carefully avoided. Finished by giving Forward-drawing a few times.

Chest-clapping is often combined with Walk-st. 2 (double) Arm-carrying-outw.-upw.-outw.-downw.

Effects And Uses

If chest-clapping is given correctly it produces a gentle shaking through the chest cavity, so that : -

(a) Vitality of the lung tissue and cells of the bronchial tubes is increased, and consequently their power of resistance to disease.

(b) Interchange of gases between the tidal air and the residual air is facilitated, and thus the output of C02 and the intake of oxygen is increased.

(c) Loosening and expectoration of mucus is assisted. For these reasons chest-clapping is very much used, both in treatment of lung and heart diseases and in treatment of general weakness.

Beating is performed with loosely-closed hand and loose wrist. In general it is used when a particularly strong tapote-ment is indicated, as, e.g., to break up the products of inflammation or to produce an active hyperaemia. The following have a special effect: -

Arm-Lean-Stride-Standing Arm-Lean-Stp

std. -standing Arm-lean-sip.-std.-sitting