498 
ON MYoITIS. 
shew that disease may exist unsuspected, and producing marked 
and peculiar symptoms which have been overlooked, unheeded, or 
referred to a wrong cause. In so doing, howeveT, I have entered 
rather closely into one or two conditions of the disease ; but I will 
endeavour to describe the more particular forms with which I have 
become acquainted in as succinct and plain a manner as I can, and 
shall close my observations with these specialities ; but before I do 
so I still think that a few further general remarks may not be out 
of place. 
It may appear in an abstract sense but of little import what 
character or kind of injurious agent maybe specially acting in any 
one case, that is to say, when a given state is positively established, 
as, for instance, “stringhalt.” Now it so happens that this disease, 
or, if you will, derangement of function of the hinder extremities, 
whether of one or of both, may arise from two distinct causes ; the 
one from disease situate within the theca vertebralis, or at the 
origins of the nerves ,* the other locally, in some one or more of the 
muscles of the limb. It therefore follows that the parts in the one 
case are in a very different condition to what they are in the other, and 
susceptible of different treatment, and of diagnosis ; yet, outwardly, 
the characters are almost, if not quite, identical. Many other dis- 
eases and their combinations might be adduced in exemplification 
of these views, but every reflecting practitioner will bear me out 
on this point. 
The nearest disease in character to the one I am here attempt- 
ing to describe is rheumatism, and one, too, of frequent occur- 
rence, and much pains are requisite in diagnosis to distinguish the 
one from the other : the difference between them, according to 
my view, is this ; — “myoitis” is an affection of the muscular fibre; 
“ rheumatism” of the nerve, or its supplying neurilema, or of the 
nervous fibrillse distributed within or belonging to a muscle or 
muscles, or the contiguous parts. Now these two states at once 
shew different conditions of the system requiring different methods 
of treatment. 
The next form of disease to which allusion has to be made is 
one not of very frequent occurrence as a distinct disease, though 
common enough as an adjunct, viz. disease or derangement of the 
cellular tissue ; and the indications to be attended to here are too 
manifest to require comment. 
I need not repeat that it is necessary to inquire into the con- 
ditions of the tendon as well as the body of the muscle itself. 
Lastly, it is absolutely imperative to carefully investigate dis- 
ease, or, more properly, its symptoms, so as to be certain that the 
diagnosis does not confound effects for causes, and vice versa: 
for example, inflammation in the fibres of a muscle — the result of 
