Muscular rheumatism or myalgia is a pain ful affection of various voluntary muscles and of the fasciae and periosteum to which they are attached. It is most common in youth and and among those exposed to cold and damp when overheated and those who over use certain muscles. Heredity, goutiness and lithmmia are predisposing causes. The disease is never fatal, whether it is neuralgic in char acter or is an inflammation of muscular tissue (myositis) is not determined. The symptoms include local pain and tenderness, increased by contraction or movement of the affected mus cle; usually the pain is an intense dull ache. There is seldom any heat, swelling or redness. Occasionally the muscle cramps and is most comfortable if semi-flexed. Sometimes there is fever. In torticollis or stiff-neck (unilateral) some of the muscles of the neck are involved. The patient dreads to move the head, and moves the body instead. In kleurodynia one side is affected (generally the intercostal muscles, but sometimes in the serratus andpectoralis), usually the left. Pain is increased by move ments, coughing or sneezing.
Lumbago, a muscular rheumatism affecting the muscles of the lumbar region and their tendinous attachments, is bilateral, quite fre quent, and is often caused by strain of the muscles of the loins. An attack often begins
suddenly with an excruciating pain when the sufferer is attempting to rise from a sitting posture, or to change his position in bed. If the loin-muscles are kept rigid the patient may be able to move about. Treatment calls for rest of affected muscles (best in bed), the ap plication of heat and anodyne liniments, ironing the loins with a hot flatiron over a few thick nesses of flannel or thick wrapping paper, or galvanism.
Muscular rheumatism is distinguished from neuralgia by localized pain, increased by volun tary movements, and by the absence of tender spots. Recovery usually occurs in a few days, except in debilitated persons, those with rheu matic tendencies or subjects of chronic al coholism.
Preventive treatment requires freedom from damp and cold, and from muscular strain, sponging and friction, vegetable diet and warm underclothes. Massage and a Turkish bath may prevent an attack. For local treatment rest, heat, turpentine stupes and anodyne liniment are of use. Medicine is of little value. In pleurodynia, strapping the cheit, or the use of a wide flannel binder, is often of much service.