Excision of the scapula for progressive chronic interstitial myositis associated with obliterating endarteritis / by W. Barton Hopkins.

  • Hopkins, William Barton, 1853-
Date:
[1903]
Catalogue details

Licence: In copyright

Credit: Excision of the scapula for progressive chronic interstitial myositis associated with obliterating endarteritis / by W. Barton Hopkins. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    called attention to the fact, that it is purely a muscle and skin affection, and that the nerves are never involved in this condition. Of the clinical symptoms the muscle changes occupy the first and most important place. The muscles become cedematous, and may swell so much as to deprive the limbs of all characteristic form. The oedema pits but slightly and the structures do not lose their consistency, this, if anything, increasing in extent. Next to the oedema ranks the pain; this appears very early in the disease, manifesting itself on the slightest motion and pressure. All the muscles of the body may become affected, but oftenest those of the extremities, trunk, and neck; at times, also, the laryngeal, oesophageal, and respiratory muscles, including the diaphragm. After involvement of the pharynx, larynx, and diaphragm the patient usually succumbs, the disease usually lasting from one to three months. The skin changes are almost as frequent as the muscle changes, and may appear early; they are noted in nearly all cases at some stage of the disease. The cutaneous diseases include urti- caria, erythema, erythema contusiforme and nodosum, erysipela- tous eruptions and macular exanthemata. The nervous system never manifests any changes, as proven by clinical and pathological examinations. The fever is constant, but extremely variable as to time of appearance and disappearance, intensity and character. It may be typhoidal in character (Senator), or it may terminate by crisis (Plehn). It may last but a day, may be remittent, or rarely there may be no fever at all. Free perspiration occurs frequently. In some cases the spleen is enlarged, in others it is of normal size. In but one case was nephritis reported; in three cases slight albuminuria; in all others the urine has been reported normal. Concerning the cause of the disease very little is known, but it is probably an infection ; the fever, the behavior of the spleen, and occasionally of the kidneys speak for it. but all bacteriological examinations up to date have been negative. The theory of auto- intoxication has been brought forward by Senator, and their own case with its duodenal ulcers and accompanying dyspeptic symp- toms speaks for it; or the disease may begin as an infection and terminate as an autointoxication. Their own case concerns a twenty-three-year-old peasant woman, in whom the disease began a year before she came under