Course and Prognosis. Diagnosis. 813 



process is interfered with. Rather frequently the disease will 

 jump from one part of the body to another, whereupon the 

 form of the functional disturbances varies. 



The sensibility of the skin remains unchanged as do also the 

 reflexes, unless the voluntary fixation of certain joints hinders 

 the releasing of tendon reflexes on account of the pain. 



Fever is not usually present in muscular rheumatism ; only 

 in severe cases where a considerable part of the body is in- 

 volved there is a rise of temperature of 1 to 1.5" C. On the 

 contrary one finds the pulse almost always quickened and tense, 

 and the breathing frequent and superficial. The appetite re- 

 mains undiminished for the most part. 



Complications occur very seldom; only exceptionally an 

 acute inflammation of the serous membranes and catarrh of the 

 respiratory or digestive tract follow upon muscular rheuma- 

 tism, and in horses inflammation of the tendons, laminitis and 

 possibly arthritis. 



In foals Tatray observed acute iritis and choroiditis in 

 about 5% of the severe cases wdth deposits of fibrinous exudate 

 in the anterior chamber of the eye. In 90% of the sick animals 

 the eye trouble disappeared within 6 to 8 days, in 10% attacks 

 similar to periodic inflammation of the eyes were repeated and 

 were finally followed by blindness. 



Course and Prognosis. The disease usually runs an acute 

 course and lasts only a few days or at most a week, whereupon 

 the disturbances in motion disappear completely; sometimes, 

 however, an inclination to relapses persists, so that the prog- 

 nosis is somewhat less favoral)le, especially in horses. 



Functional disturbances similar to those of muscular rheu- 

 matism may accompany inflammatory diseases of the tendons 

 and fasciae and the muscular sensitiveness may be found in 

 strain, in overextension or in partial tearing of muscles. 



Diagnosis. From all these complaints muscular rheuma- 

 tism may be distinguished apart from the special signs noted 

 in surgery, especially by its sudden occurrence, often after a 

 chill, the "firm consistency of the muscles, the gradual decrease 

 of discomfort in movement and particularly the sudden transi- 

 tion of the complaint from one part of the body to another. — In 

 contrast to tetanus only single groups of muscles are usually 

 attacked in muscular rheumatism, a real trismus is wanting and 

 the reflex irritability remains unchanged. — Paralytic hemo- 

 globinemia is distinguished by severe derangement of motion, 

 lack of pain in the muscles, loss of reflex movement as well as 

 by the hemoglobin constituents of the urine. — Compression of 

 the spinal cord and pachymeningitis spinalis were in former 

 times often mistaken for chronic muscular rheumatism, the oc- 

 currence of which seems to be doubtful ; but these diseases may 

 easily be eliminated by a careful examination of the nervous 



