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18 PASSIVE MO YEMENTS
order to promote freer respiration. The patient is not allowed
to lift the head up, because then the abdominal muscles at once
contract, as any one may see for himself by lying down and
Fig. 6.
raising the head. This result is very natural. The muscles which
lift the head have their steady attachment on the thorax, and in
order that this may be able to act as a point of leverage, it must
itself be steadied by the abdominal muscles.
In general petrissage of the abdomen, the whole of the
palmar surface of the hand is in contact with the abdominal
wall. The hand is spread out over it, the fingers lying to the
left in the interval between the lower ribs and the iliac crest,
but somewhat nearer the former, while the thumb has the same
position on the right side, and the base of the hand is a little
above the pubic arch, with the strongest part, the ball of the
thumb, near the right iliac fossa.
As this manipulation and others of the abdomen are never
given on the bare body, it is of the highest importance that the
part of the abdominal wall under the hand should follow it in
its movements, otherwise irritation of the skin is caused. In
order to decrease the possibility of this, the dress nearest to the
skin ought not to consist of wool, but should be made of silk or
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