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A Lecture on Polymyositis: Delivered at the National Hospital for the Paralysed and Epileptic

1899; BMJ; Volume: 1; Issue: 1985 Linguagem: Inglês

10.1136/bmj.1.1985.65

0959-8138

W. R. Gowers,

Heterotopic Ossification and Related Conditions

GENTLEMEN,-I desire to direct your attention to-day Tare disease, which is important because it is malady and, though uncommon, has close ,others which are more common and more familiar.is disease that has been termed "polymyositis."It in the simultaneous inflammation of many of some nerves-an inflammation that is symmetrical distribution.I am not sure that it has yet obtained in English descriptive medical literature or in the teaching on which you chiefly depend for your knowledge; but the case I have to show you is an extremely well-marked example of the affection in a severe degree, and fore serve to impress on you its most features.Let me first remind you of some facts relating neuritis, with which this affection is closely allied, indeed, forms part of it; the nerves suffer in association the muscles, although, it would seem, less widely.all, no doubt, acquainted with multiple neuritis," tively new to our nomenclature, but doubtless, parison, old in undiscerned familiarity.Its causes been always with us, and their effects cannot absent.The names we apply are not entirely We call it"polyneuritis," "multiple neuritis," "peripheial neuritis."These terms, however, also cable to other affections.We meet with many nerves of quite different characterThe designation"peripheral neuritis" has also wise used, and it describes three features of inflammation nerves-the fact that the affection is chiefly localised peripheral extremities; the fact that it affects peripheral extremities of the limbs; and it has also ployed as a designation of affections of the nerve trunks distinction from central disease.No term which is the chief characteristic of the disease, symmetry.The motor nerves may be most conspicuously involved, or the sensory nerves may be primarily ,excited to spontaneous sensations or to hyperiesthesia-or they maybe impaired so as Io produce diminished:sensi- bility, but in all cases the symptoms are bilaterally sym- metrical.The symmetry is not always absolute; may be affected somewhat earlier, or in rather than the other; but the correspondence of the affection two sides, whether it be in the arms or legs, dominant feature.The two seldom present conspicuous ferences, either in the area involved or in the symptoms, and the correspondence is often precise.