Chest
Asthmatic breathing, worse after supper. Wheezing, rattling under sternum, worse during or after eating. Tickling under sternum. Great soreness of upper chest, when coughing must hold it with hands. (Burning from throat to lungs.) Sudden attack of a terrible sensation of a burden on chest, for a few moments it seems as if she would burst, gradually followed by an intense depression of spirits. Eruption on chest over the ensiform appendix, size of a shilling, with intense itching.
Back and neck
Small, painful boil on left side of back of neck, not inclined to suppurate. Neck so weak and emaciated that child cannot hold its head up. Muscles of back of neck seem too short, weakness and all-gone sensation in small of back. Skin about neck wrinkles and hangs in folds. Dull, aching pains between scapulae on awaking in morning, as if he had lain in a cramped position all night. Deep- seated pain in muscles of spine, especially toward left side. Soreness and stiffness in back, which is not affected by breathing, better from motion. Rheumatic pains in shoulders, especially left, the only improvement is from heat, patient sits with back to fire. Pain worse from moving shoulders or lifting arms up, cannot place arms on head or behind body. Sharp pain from least turning, must hold himself stiff and turn whole body in order to look around. Inclines head forward to ease pain in muscles at back of neck. Sharp pain at inner angle of left scapula on putting head back. L. scapular region very sore. Weak, tired, broken sensation in lumbar region, coming on just after rising in morning, and gradually increasing till noon, then decreasing till its disappearance, about 6 or 7 p.m. Sensation in lower lumbar region that the vertebrae were gliding past each other, felt especially when rocking in a chair. A dislocated sensation in last lumbar vertebrae. Backache, with burning sensation across lumbar and sacral regions, better from gentle exercise or lying flat on back, worse when sitting. Region of coccyx sore, as if excoriated. Coldness along spine, worse on going into cool air or when sitting still, better from external warmth and motion. Back very painful at noon. Sensation that the back is in two pieces. Back becomes tired and weak from walking over snow. After a strain, lameness and stiffness of back in morning, better after moving about. Catch in back on reaching or straining. Gooseflesh on back. Small boils on back that do not mature.
Limbs
Restlessness with pains in joints. Stiffness and pain in limbs when rising in morning, worse on first beginning to move. (Numb feeling in limbs). Cold, clammy sweat on limbs.
Upper Limbs
Constant pain in right shoulder-joint, worse from motion.Constant dull pain in right arm and shoulder, with a sense of coldness from elbow up. Sore, bruised feeling on outer side of left forearm and hand, worse by slight pressure more than by hard. Drawing pain on outside of upper arm to elbow on lifting arm, worse on rising in morning and from a change to damp weather. Cannot raise arm or put it behind him on account of sharp pains. Large oval spot on ulnar side of left arm, of dusky colour, attended with itching, it turns red after scratching. Gooseflesh on arms. Boils on wrist that do not mature, hard and painful, but not very red, pain extends to axilla. Profuse sweat in axilla. Excoriation in axilla. Hands swollen and stiff on awaking in morning. Cracks on hands exuding blood and watery fluid and forming crusts. Eruption on hands of small vesicles exuding a watery, sticky fluid. Itching eruption on hands. Eczematous eruption appearing on outside of first joint of thumb on left hand, spreading by new pustules over ball of thumb, back of hand and wrist, also to back of right hand. Burning, smarting soreness, with deep, angry, ragged cracks of hands, worse cold weather. Hands as cold as though handling ice. Burning of palms. On putting hands together they sweat until it drops from them. Knuckles of fingers crack and leak. (Hangnails.).
Lower Limbs
Rheumatic pains in left hip-joint, worse from motion and cold, yet not better by rest. Reddish pimples on inside of thighs with itching, particularly the 1., worse on undressing at night. Sore, bruised sensation in front of right thigh, worse from light pressure. Tingling sensation in one or the other lower limb, like an electric current, ending with a twitch, worse on first going to bed. Sore pain whole length of lower limbs, especially in upper portion. Tired, dull, heavy feeling in lower limbs, with inclination to change position, no position is comfortable. Child’s legs emaciated. Child cannot walk or stand alone at sixteen months of age. After walking pain begins under Popuart’s ligament on right side, extends along course of anterior crural nerve to the inside of joint, then to front, causing limping, better from rest. Bruised pain in left ischium. Rheumatic pains in knee-joints. Sharp pains in left knee-joint come on suddenly, causing him to cry out. Tiredness of knees. Sore, bruised feeling on inside of both knees, worse from light pressure. Severe pain in hollow of right foot, foot swollen, causing restless wakefulness. Sore, sprained feeling in left foot, worse from bending. Burning of feet, especially soles, wants to put them in cool place, in water, or uncover them. Cold, clammy feet. Cramp in feet in bed at night, they are so cold. Sweat on soles as though he had stepped in cold water. Stockings feel sticky. Sweat between toes, making them sore, with foul odour.
Generalities
Dread of usual work on account of weakness and exhaustion, with irresistible desire to lie down. Restlessness, hard to remain long in one position, better from motion. No rest day or night, always worse from 9 p.m. till after midnight. Child kicks off clothing even in coldest weather. Wants to lie on something hard. Great soreness. Stiffness and lameness of parts. (Child looks old, dirty, greasy, and brownish.) Progressive emaciation.
Skin
Skin dry and flabby. Itching worse by scratching. Pimples on face. Boils on wrist. Eczema exuding sticky fluid: behind ears, on wrists, fingers, toes. Cracks on fingers. Skin covered with fine rash all over. Body attended with severe itching at night. (Copper-coloured syphilitic sores).
Sleep
Awakes at night with arms under head. Frequent waking at night. Restless, uneasy sleep, awakens at 3.30 a.m. Awakes soon after going to sleep with a start and twitch. Child is restless during sleep and awakes cross and crying. She awakens her companion to search for a tramp in her room, gets up and looks under the bed for him. On waking child rubs eyes and nose with its fist. Cannot bear any one to lie close to or touch him. Lascivious dreams. Dreams of robbers and cannot sleep till the whole house is searched. Dreams of murder and remorse.
Fever
Chilliness all day, worse in warm room. The cold air chills him. Sensation that chills are coming on. Chill every day at same time. Chill begins in lower extremities. Chill every night lasting an hour, beginning between shoulders, thence extending to arms, fingers, and whole body, (intermittent, three weeks after labour.) Thirst during chill, none during heat or sweat. (Chill at 8.30 a.m. Chill at 5 p.m. Chill postponing two hours. Chill every other day, fever lasting all night. Drinks before chill.) Whole body feels too hot at night. Sweat most where limbs cross each other or touch the bed. Begins to sweat as soon as covered. Sweats on first falling asleep, mostly about neck, wetting clothing through. Cold, clammy sweat on occiput and neck, those parts feel like a wet stone. Sweat from above downward over whole body. High fever every night with sleeplessness. Whole body feels too hot at night. (Wants to move to a cool part of bed.) Sweats on side lain on. Hungry during sweat, water tastes bitter.
