A Lecture on Lumbago: Its Lessons and Analogues

GENTLEMEN,-There are many ways of acquiring knowledge of disease. Perhaps the most effective-although certainly the least agreeable-is personal experience. Symptoms that are felt, sufferings which have to be endured, are impressed upon the mind as they cannot otherwise be. I do not desire for you this effective way of gaining knowledge, but there are some maladies which you can scarcely hope to escape. You will be exceptionally fortunate if you do not have opportunities, if indeed they have not already come to you, for the subjective study of the disease which I take as my text to-day -lumbago. What is lumbago? Our conception of its symptoms is sufficiently clear, precise, and perhaps vivid. But our conception of its nature is not at all precise or clear. We think of it as muscular rheumatism-and correctly. But if we are asked what muscular rheumatism is, I am afraid the reply which would be given is that "it is rheumatism of the muscles," an answer which, you will admit, does not carry us far. Nor does it conduce to better understanding to call the affection "myalgia," a term which is not much used at the present time, perhaps because its analogy with "neuralgia" suggests spontaneous pain, unexcited. Consider the symptoms of lumbago. Its great characteristic is pain in the lumbar muscles, but felt only when they contract or are extended. In health we are conscious of no sensation in them. We may, indeed, by attention, become aware of