POLYMYOSITIS AND MYOSITIS 157 



that what remains consists simply of the exact number 

 of sarcolemmar sheaths representing the muscle fibres 

 involved, minus their former sarcous or proper contents, 

 and because we think that nature must not be here held 

 responsible for the performance of redundant work in this 

 evolution of pseudo-hypertrophy from the residual dis- 

 organised and amorphous sarcous materials, together with 

 the non-sarcous muscle elements. 



If these views are to be accepted as a " working theory," 

 so to speak, it seems to us that a very large problem in 

 what may be called pathological bio-chemistry, connected 

 with the disease under discussion, awaits solution, and, it 

 further seems to us, that if a simple and yet scientific 

 method of escape can be provided whereby the necessity 

 of rinding the solution on the old lines can be averted and 

 fruitless efforts and, it may be, precious time saved, it is 

 desirable that it should be made available for the purpose. 



We have, therefore, to state that, feeling our inability 

 to find the solution of the problem referred to, as well as 

 many kindred problems on what may be called the ' ' old 

 lines," we have felt ourselves compelled to renew or con- 

 tinue the task on new and, we think, or, in fact, are 

 convinced, more promising lines, and, hence, we have 

 been constrained to substitute a nervine theory, which 

 seems to us shortly and simply to explain the nature and 

 sequence of the pathological changes involved, and, to 

 some extent, to indicate the methods or lines along which 

 the treatment of the disease, therapeutic and otherwise, 

 may most consistently and hopefully be conducted or 

 directed. 



Polymyositis thus regarded seems to us to be due to 

 the invasion of the muscle sheaths primarily, at which 

 stage it is not an inflammation, and, secondarily, of the 

 individual muscle fibres, by a virus circulating along the 

 intra-neurilemmar spaces from the cerebro-spinal cavity 

 in which it has been incubated or produced, and from 

 which it has passed along the lines of least resistance in 

 such wise as this : 



A chill or succession of chills having been experienced 

 by the subject of the coming attack, a stasis or series of 

 stases of the cutaneous excretion and exhalation are pro- 



