In the case which I have just sketched I have had in view syphi litic myosins of the biceps, which was chosen as the type of these affections because it is the one most commonly encountered. The symptoms will vary a little, of course, with the region involved, but taking into consideration the difference in location there will be little difficulty in arriving at a diagnosis.
Although pathological investigations of this condition are wanting I am convinced that the lesion is a myosins. According to Virchow, we have to do with an interstitial myosins due to a colloid degen eration of the muscular tissue. A new growth of connective tissue takes place, he holds, between the muscular fibres, leading to their atrophy and eventual destruction.
Syphilitic myositis is a benign c_ffection, hence we may readily understand why the study of its pathological anatomy is incomplete. Indeed this form of myositis is readily curable under appropriate treatment. Its duration is often rather long, it being a question not of days but rather of weeks or months. Three mouths has been given as the average duration.
Tfeatment.—Tbis is a question of the first importance in dealing with syphilitic myositis. Counter-irritation is here of not the slight
est benefit, and the entire subject of local treatment may well be left out of consideration. If the pain is very severe we may combat it by means of soothing local applications, but as a rule it is the general treatment that demands our special attention.
The two great remedies for syphilis are always mercury and iodide of potassium. We are constantly bringing out more and more clearly the special indications for the employment of one or the other of these remedies either alone or in combination ; and experience has shown that the iodide often is more efficacious, even at an early period of syphilis, than the mercurial preparations. Syphilitic myo sitis, which belongs more especially, as we have seen, to the secondary stage of the disease, is efficaciously combated by iodide of potassium. Fournier has very justly insisted upon this point; and he says that he has had the best results with small doses of the iodide. I am en tirely in accord with him in this opinion, and regard the iodide of potassium in small doses as a true specific in syphilitic myositis.