Treatment.—In acute cases we should have recourse to revulsives and to analgesic and antiseptic remedies, such as salicylate of sodium and asaprol. Quinine and antipyrin may also be of service.
In chronic rheumatic myositis there are three therapeutic meas ures which may give good results, viz., hydrotherapy, electricity, and massage; these may in special cases be employed alternately or in combination.
Among the hydrotherapeutic measures which we may prescribe are vapor baths, very hot turpentine or sulphur baths, and hot douches. The patient may with advantage be sent to some watering place suitable for the treatment of these cases. Among these places I would class in the first rank "Nevis and Aix-les-Bains. In the latter station massage of the affected muscles, well carried out under the douche, gives excellent results.
In addition to hydrotherapy we have mentioned massage and elec tricity. The former applied at the proper time is often an efficacious means of combating the atrophy. As regards electricity, some writ ers, among others Weissflog and Minion, express a preference for the faradic current, while others (Erb and Remak) recommend the con tinuous current; others again (Larat and Vogt) regard the action of sparks from the static machine as the most efficacious in the treat ment of chronic rheumatic myositis.
Doumer claims to have derived great advantage from the employ ment of franklinism under the form of effinvation. He attaches no importance to the mode of application, whether on the uncovered skin or through the clothing, and says that equally good results are obtained whether the parts are naked or covered, although the sen sations of the patient differ somewhat in the two cases. When effiu vation is practised on exposed parts the patient feels a sensation as of a fresh current of air, while when the parts are covered he feels a little pricking and formication. In either case there is a sensation of heat in the parts and very soon the pain disappears or is greatly diminished. A few sittings are usually sufficient to bring about this favorable result. My own preference in the treatment of chronic rheumatic myositis is franklinism, either spark's or the effluvation practised in the way recommended by Doumer. • Surgical procedures may be required for the relief of the shorten ing of a muscle that may take place in chronic myositis. In the case of torticollis, for example, we may be able by means of tenotomy to reduce the deformity caused by the contracture of the sterno-cleido mastoid muscle.