(1) The acupoints and reflecting areas and their integrated application, the methods and techniques of manipulation, and the use of supplemental instruments and tools should all be learned well and mastered; and the hand and foot massage should be constantly applied to the patient to obtain the best therapeutic results.

(2) The manipulation pressure should be modified according to the patient, the disease, and the function of acupoints, reflecting areas and maneuvers. This does not mean heavier stimulation necessarily produces a better therapeutic effect or that the heaviest stimulation produces the best result. On the contrary, an adequate but persistent stimulation may produce a much better therapeutic result. One exception is that in cases of extreme and severe pain stimulation should be increased to the maximum level.

(3) Hand and foot massage is best applied at a fixed time, for example before noon or at night before going to bed. A regular massage should last 20-30 minutes and be done 1-2 times a day. These times may be modified depending on the disease and the condition of the patient.

(4) The hand and foot massage is very useful, but of course not universally effective, and may be used in conjunction with other therapies if necessary.

(5) The safety of this treatment must be ensured and harmful effects corrected before arranging the next session.

2) Contraindications:

(1) The massage is strictly prohibited for hands and feet with marked ulcerations, bleeding, or infectious skin diseases before they are completely cured. It may be applied to the normal hand or foot on one side, even if the other hand or foot is afflicted.

(2) The heavy stimulation is prohibited for acupoints and reflecting areas on the hand and foot of pregnant women, especially for those acupoints and areas related to the female genitalia, but the gentle pressing and kneading maneuvers may be adopted for use.