The Diagnosis and Treatment of Lumbago

Pain in the small of the back is a complaint which brings many, especially otherwise healthy adult males, to the outpatient room. The exciting cause is apparently in the majority of cases exposure to damp and cold. Three classes of cases may be distinguished?those of rheumatic myalgia, rheumatic neuritis, and renal pain associated with hyperacidity of the urine?and if the differential diagnosis be made, it is found that treatment is thereby much simplified and restoration to health more readily brought about. The patients of the third class complain of a dull aching pain in the lumbar region on both sides. The pain, which is constant and not made worse by movement, is not confined to the lumbar region ; it extends forwards round the trunk into the groins, and occasionally into the testes. The patient generally complains of scalding during micturition, and the urine, which is quite clear on first being passed, is very acid in reaction and