Abdominal massage is useful in treatment of constipation. This method stimulates the peristalsis of the small intestines, tones up the muscles of the abdomen walls and mechanically eliminates the contents of both large and small intestines. Abdominal massage should not be done in general, femoral, inguinal and umbilical hernia, inflammation of the uterus, bladder, ovaries and fallopian tubes, kidney stones, bladder or gall bladder, ulcers of the stomach and intestines, and pregnancy. Abdominal massage should not be done after a heavy meal, but after two hours or so. The bladder should be emptied before the massage. The patient is made to lie on his back with his knees drawn up. This enables the abdomen wall to relax. The masseur should stand at the right side of the patient and use his finger tips for friction round the umbilical region from right to left. He should likewise alternatively knead the walls and roll with both hands, making deep and firm pressure. He should knead with the hand and finger tips and keep clear of any wound or tender places. He should later take up massaging of the larger intestines. The manipulation of the large intestine should begin on the right side. Keep it going upwards and across the transverse colon and move right down on the left side to the sigmoid flexure and rectum. Circular kneading should be done with the help of the three middle fingers. At the same time press into the contents of the abdomen, following the course of the larger colon with a crawling motion. Keep kneading by means of a few circular movements in one spot with the help of finger tips. Keep moving the fingers a little further along. Knead repeatedly. Use knuckles of the hand to make deep pressure along the large colon, moving the hands along after each pressure. Once the kneading of the abdomen is over, follow up by tapotement with both hands cupped or use the knuckles of the hand. Vibration may also be employed. The patient could also be asked to do some gymnastic exercises for strengthening the walls of the abdomen. Since blood pressure increases during abdominal manipulation, patients with hypertension should avoid abdominal massage. Massage should also be avoided in cases where there has been recent bleeding in the lungs, the stomach or the brain.