Identifier: practiceofsurger00mumf ()
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uscleitself. This last condition isdesignated myositis ossificans.There is a progressive form ofthis disease which begins earlyin life, involves the muscles ofthe back, and eventually rendersthe patient helpless. A wretchedcreature of this type will beshown in a museum as * the ossi-fied man. Myositis ossificansof a milder type may result frominjuries, but it is capable of curethrough surgical operations.Tuberculosis may also invade and destroy muscles.In all these forms of myositis surgical operations may be of greatbenefit. Acutely infected muscles should be laid open and treated onantiseptic principles, and the resulting deformities and contracturesshould be treated by exercises, the lenglhening of tendons, and by nervetransplantations. Tuberculous muscles should be excised. Syphilis and actinomycosis involve muscles. Syphilis must betreated constitutionally, while actinomycosis must be attacked withvigor—with the knife, curet, and copper salts—as I have described inChapter II.
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Fig. 499.—Volkmanns contracture. THE TENDONS 803 Hydatid cysts may bo treated by injections of mercury biniodid,by excision, and by drainage. Complete excision is the preferablemethod. Trichiniasis is distinctly a muscle affection. The embryos ofthe trichina spiralis enter the muscle through the blood-stream.The flat muscles are those usually involved. The embiyos becomeencapsulated and die, leaving small, hard, calcified nodules. Whenthe parasites are numerous in the muscles, they cause pain and sweUing,with general symptoms of prostration, loss of appetite, and edemaof the extremities. The disease is self-limited. Surgery can do Httlefor it, but while it lasts the patient should be treated with purgativesand tonics. Malignant tumors appear in the muscles. The carcinomata aresecondary, but the sarcomata often are primary. They are primary involuntary muscles, and arise from the connective tissue and from themuscle sheaths. Moreover, they are more common in women than inmen. Angioma

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