§ 170. Inflammation of the psoas muscle. - Psoitis.

This kind of inflammation is not very rare, but it is easily misapprehended when gradually developing itself out of a rheumatic affection of the lumbar region. It is known by the violent drawing, tearing, tensive, inflammatory, seated pain in the region of the kidneys, sometimes extending along the spine up to the shoulders, or down to the bladder and feet, without following exactly the course of the nerves. It is furthermore known by the sensation of debility and numbness of the thigh of the affected side, and by the pain being aggravated when the thigh is extended or drawn up. The pain is likewise aggravated in a recumbent posture, or by turning from side to side. The patient limps, and has to bend forward in attempting to walk. Swelling is rarely visible. The absence of urinary difficulties and of constipation distinguishes psoitis from nephritis. If suppuration should set in, the pus may discharge into the cavity of the abdomen, and thus lead to death, or it may burrow downwards, causing phthisis lumbalis, and suppuration in distant parts. The fever is generally a synocha.

In chronic psoitis the pain is less intense, more erratic, remitting, or felt only when drawing the thigh up or turning it, or when turning from side to side, or bending backwards; there is a feeling of numbness, of debility, or a peculiar kind of sensitiveness, without much fever at first. The pain becomes more and more seated, until at last, in the absence of proper treatment, perhaps after years, symptoms of suppuration show themselves. Psoitis is sometimes occasioned by a mechanical cause, violent straining, a blow, fall on the back, nates; rheumatism and piles are among the general causes.

§ 171. If the accompanying fever should be a syno-cha, Aconite has to be used until the fever and the other inflammatory symptoms abate. If typhoid symptoms should be present from the commencement, proper remedies have to be selected. Bryonia, Nux torn., and Bellad. have to be used when the pains increase during motion; Rhus t. and Puls, when the pains are worse during rest, or are aggravated by cool air blowing on the affected part; Cantharides, when the inflammatory affection is accompanied by ischuria, dysuria, or strangury; Mercurius and Chamomilla when the pains are most intolerable at night; Staph-ysagria when the pain is beating and points to incipient suppuration, in which case Arnica, Chamomilla, China, Mercurius, Hep. s., Stannum, Sulphur, Eupion, Kali carb., Aurum, Asa, are likewise useful. Belladonna, when the pains are drawing, tearing, and have a still somewhat inflammatory character. Belladonna is suitable for both acute and chronic psoitis; so are Rhus t. and Nux v., whereas Digit., Colocynth, Arg. fol., Plumb., Sil., are more adapted to the chronic form.