The Art of Massage J. H. Kellogg, M.D. 1895   RECENT ADVANCES IN MECHANICAL MASSAGE.  
 
    Within the last ten years great progress has been made in all branches of physical, or physiologic, therapeutics.  Mechanical massage, a branch of mechanotherapy, has made rapid advance along with phototherapy and radiotherapy, and other branches of this department of rational medicine. Zander has made a few improvements in his machines.  Herz, of Vienna, has devised a number of interesting machines which cover much the same ground as those of Zander, and several inventors have produced excellent devices for producing strong vibratory effects.  The writer has likewise developed a considerable number of improvements in his efforts to still further perfect the apparatus which he has used for many years, some of which in their newer forms and shown in the accompanying cuts. (Plates E and F.)
    In the vibratory chair, the vibratory bar, and the apparatus for vibration of the feet, a new principle has been utilized for producing the vibratory effect which renders possible a much higher rate of vibration, as high as sixty movements a second, and even more, being attainable.  This high rate of vibration is produced by a special mode of construction which entirely obviates the use of eccentrics or cranks, and hence obviates the noise which was such a disturbing feature with the old types of apparatus.  The vibrating mechanism is attached to the floor in such a way as to prevent entirely the transmission of strong vibratory impulses, so that there is no shaking of the floor, and the element of noise is reduced to a minimum.  These improved forms of apparatus are in daily use at the Battle Creek Sanitarium and allied institutions, and have proved themselves immensely superior in every way to the cruder forms of apparatus previously employed.
 

ANTHROPOMETRY AND MASSAGE.

    In order to appreciate the value of massage as a therapeutic agent, it is important that those who employ it systematically should make, before beginning the treatment, and from time to time during the course of treatment, records based upon careful determinations of the patient's conditions, particularly those conditions which are especially influenced by massage.  A blood count should be made every two to four weeks, and at least once a month a careful measurement of the strength of the individual groups of muscles should be made.  The total strength of the whole body may then be obtained by simple addition of the figures obtained for the individual groups.  The total strength of the muscular system is ordinarily the best measure of vital stamina.  A chronic invalid nearly always has weak and flabby muscles.  An increase of muscular strength is an indication of improved nutrition, resulting in improved nerve and muscle tissue and tone.  The dynamometer is capable of showing a gain of this sort when no improvement could possibly be detected by means of the tape line.
    After ten years of constant efforts, the writer finally succeeded in perfecting an apparatus for testing the strength of individual muscular groups, which has been termed the "Universal Dynamometer." This apparatus is now in use in the leading gymnasiums of the United States, and is employed by the United States Government for the examination of the students in training at West Point and elsewhere.
    The dynamometer may be used to great advantage in the treatment of patients by massage, not only in cases in which there is a general lack of muscular strength or tone, but also in cases in which individual muscular groups are weakened by disease.  It is possible by this device to determine with exactness the degree of loss of muscular power, and to note from week to week any change for better or worse.
    Scientific physical culture is not possible without a dynamometer, by means of which all the principal groups of muscles of the body may be tested.  The various dynamometers long in general use for testing leading groups of muscles, serve a very useful purpose in the testing of the strength of persons who are in ordinary health, and who have a fairly symmetrical development; but these instruments are of very little use in the examination of invalids, whose muscular development is often found to be exceedingly irregular because of sedentary habits or other artificial conditions or special pathological changes.
    The dynamometer is used in connection with diagrams, which show the average strength of each group of muscles for persons of various heights.  Separate diagrams are used for men and women.  With patients under treatment by massage, with carefully graduated exercise and manual Swedish movements, which must always be included with massage in a complete system of physical training, it is not uncommon to  observe a gain of a thousand pounds in strength within three or four weeks.  Patients usually double their total strength within three or four months. In the case of bedridden invalids, the proportionate gain in strength is very much greater.
    The interest of the patient is much more easily enlisted when he is conscious of the fact that an exact determination has been made of his condition at the beginning of treatment, so that he himself may be able to observe from time to time the progress of his case, and to note any change for better or worse, knowing that there is a basis for positive and exact information.