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NERVE VIBRATIONS. 69
the operator are held somewhat differently, dependmg on the
place where they are applied. Between the shoulders, the back
of the fore-finger nail, steadied by the thumb, as seen in fig. 38,
is used, because otherwise it is very difficult in this position to
give a good friction.
Below and above this point, the palmar surface of the last
phalanx is worked with. The direction of the friction is
obliquely from below, upwards or outwards, or the reverse,—as,
for instance, if the patient lies on his back, and has the frictions
after general petrissage of the abdomen. For the general treat-
ment of these nerves both hands are used at the same time (one
on each side), and we generally pass up and down the back
three or four times, pausing here and there over places that
may be painful, and consequently need more special manipu-
lation.
One ought not to pass carelessly up and down the back, or
discard frictions in this region without full trial. It must be
remembered that every pair of sensory nerves, springing as they
do from the posterior primary divisions of the spinal nerves,
may be regarded as being each in connection with its own
segment of tlie spinal cord, while we must also bear in mind the
intimate relations between the spinal nerves and the sympathetic
ganglia. Indeed, it is found that in patients with heart disease
or acute affections of the lungs, the region between the shoulders
is very sensitive, and the effect of continued frictions extremely
beneficial. I do not wish to be considered as saying too much
before others have had the same experience, but I have, and
my brother before me, treated cases of pneumonia with nerve
frictions between the shoulders and vibrations on the thorax for
the lungs, nerve frictions in the neck and over the dorsal sensory
nerves for the fever and headache, and petrissage of the abdomen
for the circulation generally, without help of medicine, and have
always succeeded. Any one who has some little knowledge of
the treatment, may easily obtain confirmation of the fact tha’fc the
sensory nerves on the side corresponding to the diseased lun^
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