The Principles and Practice of Medicine

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9781230431888: The Principles and Practice of Medicine

This historic book may have numerous typos and missing text. Purchasers can usually download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1903 edition. Excerpt: ... SECTION XL DISEASES OF THE MUSCLES. I. MYOSITIS. Definition.--Inflammation of the voluntary muscles. A primary myositis occurs as an acute or subacute affection, and is probably dependent on some unknown infectious agent. Several characteristic cases have been described of late years. That of E. Wagner may be taken as a typical example. A tuberculous but well-built woman entered the hospital, complaining of stiffness in the shoulders and a slight oedema of the back of the hands and forearms. There was paresthesia, the arms became swollen, the skin tense, and the muscles felt doughy. Gradually the thighs became affected. The disease lasted about three months. The post mortem showed slight pulmonary tuberculosis; all the muscles except the glutei, the calf, and abdominal muscles were stiff and firm, but fragile, and there were serous infiltration, great proliferation of the interstitial tissue, and fatty degeneration. Similar cases have been reported by Unverricht, Hepp, and Jacoby, of New York. In the case reported by Jacoby the muscles were firm, hard, and tender, and there was slight oedema of the skin--dermato-myositis. The cases usually last from one to three months, though there are instances in which it has been longer. The swelling and tenderness of the muscles, the oedema, and the pain naturally suggest trichinosis, and indeed Hcpp speaks of it as a pseudo-trichinosis. The nature of the disease is unknown. Senator's case presented marked disorders of sensation, and there is a question whether the peripheral nerves are not involved with the muscles. Wagner suggests that some of these cases were examples of acute progressive muscular atrophy. The separation from trichinosis can be made only by removing a portion of the muscle. It...

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