Rheumatic Myosotis—Subacute and Chronic

A GREAT variety of affections is included under the term rheumatism. Among the public, and even in the profession, any painful condition is apt to be considered as rheumatic. In joint affections especially there is a wonderful vagueness about the use of the terms chronic rheumatism, rheumatoid arthritis, arthritis deformans, osteo-arthritis, and rheumatic gout. This is not to be wondered at, however, when one considers the difficulty that often exists of drawing a line between the various affections, and of making certain to which variety any given case belongs. Some affections have very distinct and characteristic symptoms?for example, acute rheumatism and acute gout. The subacute affections are more apt to be confounded?acute (so-called) tubercular arthritis, gonorrhceal arthritis, and rheumatoid arthritis. The chronic joint affections are, however, the ones most difficult to differentiate?chronic tubercular arthritis, gonorrhceal arthritis, and rheumatoid arthritis in their later stages, Charcot's joint, chronic traumatic arthritis, chronic rheumatism, and chronic gout. Many cases are on the border line and not typical, and this variation may be due to constitution, inheritance, occupation, climate, diet, and other causes. I shall not venture into this subject, however tempting it may be. In the present paper I wish rather to draw attention to a few points in connection with subacute and chronic myositis. I shall deal with the subject in the common and convenient arrangement of causes, symptoms, diagnosis, and treatment.