ur, t.t-t completed by means of? ittd xt•rt,-, and passive move 1.J. Iv,.
Polymyositis.
l' VII -iti' i- a condition in which re is a •,..multaneous inflammation of i..u-tlts and of some nerves, the !'ai al-ation beinz symmetrical in its ti.-tr,i ut.on. (Gowers.) Symptoms.—Thc aiTection presents the ? mral d:-tribution polyneuritis so far • n ut lo,s of power is con trti d. I ut with a far wider implication inu-clr-s. of which many suffer that tz.,:apc in irdinary polyneuritis. first y arc viry tender, and later they un rgo 1.arden.ng and contraction, which 1.i. extreme in degree, and after a timf may he insuperable and resist all ,rk.rti: to overcome it.
tardinal symptoms are swelling- of f!-fp m;t'es. partly from muscular ,r e_11,ng. and partly from subcutaneous . 0-P• ma. viection of the muscles of res pfratic.n ard dcglutition. with disturb aip-Ps of thPir functions and an exan tt..m. .1.-derate fever, profuse sweats, ni wi-h death from inhala t-n-rneumonia or from saffTocation, are .rnm..n.
e r .uself s of the eye, ton/rue, and dialliragm are not involved. rase of a Trc:rnant voman. where the skin affec ticn. rcsen urticaria. was much more marked than the affection of the muscles. The patient recovered. Unver fiat (St. Petersbiirger ined. Wocli., Oct. G, Etiology.—The condition is ahnost ex clusively the result of exposure to cold, and seems to be due to a peculiar variety of the rheumatic poison produced in especially susceptible individuals, ren dered so by some influence that depresses the general health (Gowers). A table parasite, a toxin, and an animal parasite (gregarina) have been variously considered as pathogenic factors. Syph ilis gives rise to a condition resembling acute myositis.
Case of polym:vositis brought on by muscular overwork. Oddo (Marseille mCd., Dec. 15, '91).
Two cases, one occurring in a diabetic in whom evolution took place in four teen days, terminating in death, and the other in a healthy man, follow ing the eating of shrimps, and cured in two months. In the first intense interstitial myositis found, with proliferation of the nuclei between the fibres, particularly in the perifascieular and perivascular con nective tissue. The intrafibrillary tissue
was cedematous. Senator (Dent. med. Wadi., Sept. 28, '94).
Case presumably of syphilitic origin. The patellar reflexes were exaggerated. On incision into the lett gastrocnemius a light brownish-red fluid escaped con taining fragments of old blood-clots. Bacteriological examination of this fluid and of the excised muscle wcre negative. The excised muscle exhibited the diffuse inflammatory change, with hyaline de generation. James Herrick (Amer. Jour. of Med. Sci., Apr., '96).
Case in a married woman aged 36. The symptoms indicated that polyneu ritis, as well as polymyositis, was pres ent. W. R. Gowers (Brit. Med. Jour., Jan. 14, '99).
Case of acute hremorrhagic polymyo sitis in which microscopically the muscle fibres showed more or less degenerative change, increase in the number of nuclei, and interstitial lirnorrhages. There was also extensive round-cell infiltration in the muscles. Pure cultures of the staphylococcus pyogenes aureus were ob tained. J. Bauer (Deut. Archly f. kiln. Med., Dec. 13, '99).
TREATMENT.—The only hopeful treat ment of this condition consists in well directed measures applied during the stage of development.
Iodide of potassium, strychnine, and electricity seem indicated in these cases besides the symptomatic treatment usu ally recommended.
Muscular Hypertrophy.
True hypertrophy of the muscles dif fers from pseudomuscular hypertrophy in that it is attended by fewer disturb between the muscular fibres, occurring as a result of inflammation. Fulda con siders it as a trophoneurosis resulting in a true hypertrophy.
TREATMENT.—Treatment by electricity is valuable in these conditions, possibly along with a course of the iodides. The faradic current should be used five min utes every day and massage employed.
Progressive Ossifying IVIyositis.
Definition.—This consists of an in flammatory- affection of certain muscular tissues, resulting in a deposit of bony material in the course of the muscle, dis placing its substance and filially leading to ankylosis of the affected part.