Generalities
Emaciation. Marasmus resembling the third stage of phthisis. Nervous mobility, trembling, spasms. Spasmodic contraction of the muscles. Subsultus tendinum. Attacks of jerking of limbs, worse left arm, and of face, worse left side, with anxiety, apprehension and palpitation, one attack ended with vomiting and headache, once violent rolling of left eyeball, pupils contracted, facial muscles contracted, left corner of mouth drawn downward, mouth opened and closed numberless times while uttering unintelligible words, short rapid respiration, pulse hard and full, forehead, neck, and chest covered with sweat, face red, unconsciousness, after the paroxysm trembling, weeping, complaints of heaviness of left arm, abdomen small, soft, tongue white rather than yellow, efforts to vomit, better vomiting. Haemorrhage from nose, lungs, rectum. Paralysis. Sticking in left lower jaw, in tibia, left thigh, left forearm, in bones in forenoon, then in left ear, at last in tendon of hollow of left knee. Nervous susceptibility exaggerated. Sensation of turning around. Malaise. Irresistible desire to go into the open air. Vague indescribable feelings in head, back, and limbs. Restlessness. Weakness. Affects fibrous structures, as periosteum and capsular ligaments of joints. Most symptoms arise during rest, and are better motion. Consequences of rheumatic fever.
Skin
Purpura, miliary, non-pruriginous, sanguineous spots like purpura, in one case on thorax, in all others on legs only, more confluent anteriorly, sometimes an intermixture of petechia of different ages, the new being of a brighter colour than the old. Multiple haemorrhage from skin and mucous membrane. Erysipelatous swelling of cheeks extending towards temples, with redness, with a few spots on forehead. Itching tetter on face, and dry, on cheek. Pimple: on chin and nose, sticking burning, below corner of mouth, sensitive, on nostril, sensitive, on cheek, surrounded by redness and swelling, itching, on chin and exuding water. Erythema. Eczema impetigenoides. Small boils (like furuncles) on the neck, face, head, back, and chest. Ulceration and yellow colour of tip of left thumb, but it does not break. Vesicles of all sizes, becoming confluent and forming bull, on hands, arms groins, and feet, they contained a clear serous fluid, were on a hyperemic base, in the early stages those on hands resemble dysidrosis, but became semi-opaque and shrivelled and dried without forming crusts. Biting on nape and forehead, then burning after scratching. Itching on right nates, better scratching, on right instep in evening, worse scratching, on inner side of right upper arm, after scratching a dry red spot, which at first itches. Great itching of pubes. Unable to wash in cold water.
Sleep
Frequent yawning without sleepiness, frequent excessive yawning. Sleeplessness, almost all night, only sleepy towards morning. Waking every hours. Cried aloud in sleep towards morning. Starting up in first sleep, but soon falling asleep again. Restless confused sleep, and unrefreshing, from which he wakes with a start and distress as from some strong emotion or sense of calamity. Weeping during sleep. Dreams, wandering, joyous, of danger, anxious, that she would be killed, of falling and consequent violent starting up. Nightmare.
Fever
Chill: in afternoon, from afternoon till next morning, from 4 to 7 p.m., better in bed, with thirst, from 6 to I0 p.m., worse lying down, at night. Shaking chill at I0 p.m., at night on frequent waking. All night with shaking and frequent waking. Shivering, of whole body in morning, except head, which felt hot. Shivering. Creeping during menses, with coldness of hands and pressure and griping in hypogastrium. Creeping in back in evening, then coldness of whole body, chilliness from 6 to 8 p.m., creeping up back and extending over whole body, with sleepiness. At times chilly with dry skin, at other times with profuse perspiration. Chilliness not easily removed by external warmth. Heat in afternoon. Heat (flushes of), with dulness of head and discomfort of body, then sweat, from I to 3 p.m. Hot skin. Heat of head, with burning and redness of face, in forehead, eyes, nose and mouth, with anxious burning in throat extending behind sternum to ensiform cartilage, in feet. Sweat.
