Mrs. H. M. R., from Mass., age 20. Sept. 16, 1890. Enlargement of the left heart; has had this trouble since she had Scarlet Fever. Palpitation over entire chest and pulsation felt in extremities; (<) after eating. Sharp pain compelling her to sit up. Cannot lie on right side, but can lie on left side. Lilium-Tig.
Sept. 17. The prolapsus with bearing down, for which she has been treated has been somewhat relieved. Choked sensation when preparing to do anything. Wakens choking, dreams of choking. Anxiety when preparing for church often brings on diarrhoea or headache. When excited, pain in hypogastrium and ovaries, (>) by urination, for which there is urging; she must urinate or she will have pain. Copious colourless urine when excited. Any kind of talk that interests her in a cause of excitement. Very enthusiastic. Back of neck pain with stiffness. Extends up into occiput. Followed by headache in forehead behind eyes. Argentum-n. 40m. Sach. Lactis powders.
Sept. 30. Reports herself decidedly better in every way. Can lie on the right side now. Sach., lactis powders.
Oct. 8th. Restless, anxious, tearful, hysterical, (<) from meeting people and from 1 to 3 a. m. Palpitation, heartbeats strong and visible, must have clothing loose.
Oct. 20 Generally condition is better, trough some paroxysms of almost all the old troubles. Gaining in strength and endurance. Occasional palpitation. Occasional sharp pain caused apparently by flatulency. Boring pain especially at night. More difficult to lie on right side. Slight paroxysm of choking before begins to sleep. Anxiety not so noticeable but followed by the desire to urinate, as reported. Stiffness is back of neck and head but less pain. Numbness of the left side considerable. Headache with heat. Menstrual period less pain.
Oct. 29. Not so well for the past week. Heart pain almost constantly, a boring pain. Thinks it has been caused by over-exertion. Had one of the severest paroxysms of the sharp pain that she has had; it was of longer duration than usual. Palpitation and trembling sensation as if something were fluttering in the region of heart. Exhausted after she went to church Sunday. Too nervous to attend a meeting Tuesday. Excitement intense and an unusual desire to urinate, even in the night. Stiffness in the neck and headache less. Argentum nitricum 40m.
Nov. 18. After taking last powder she began to improve; this improvement lasted about a week, then her M. P. came and she has not been well since. She suffered more pain than last month, and heart also troubled her at the time. Very little sharp pain, but considerable pain in heart. No faintness. Left side aches constantly, and is worse in the night; sensation of soreness in the morning. Very little choking in the night. Less anxiety. Some urging to urinate with dragging pain. Pain in back of neck severe at times, but not constant. Much headache with heat in head. About two weeks ago her jaw became so painful that she could not eat, the trouble is at the joint. Often in chewing the bone appears to slip out of the socket, usually there is no pain but at the time it pained her it was quite swollen in that region. The pain has gone out now, but the slipping continues to occur. A number of pimples on face lately, more than usual. Heart pain intense. Sach. Lac.
Dec. 1. All the old symptoms have been much less noticeable since last report, but has discovered two new symptoms. Headache almost constant in the top of head and down the back into the base of the brain. Nausea accompanies this headache if she attempts any mental work. Has also been troubled with neuralgic pain coming quickly and suddenly disappearing. Bladder: much dragging pain at times low in the abdomen. Frequent desire to urinate. Urine often quite thick and cloudy in appearance. Physical exertion produces only a temporary effect, but mental exertion uses her up completely. Any anxiety or worry causes that dull aching in heart, and a general nervous depression. Sach. lac.
Dec. 17. A general improvement in all the symptoms. No attack of sharp pain, but slight palpitation. The dull pain comes with excitement or worry as usual. No faintness and less nausea. Some pain in the back of head and stiffness of the neck. Uncomfortable when lying on right side but does not produce pain. Pain in ovaries and urging to urinate are the most prominent symptoms at present. Suffered extremely at menstruation, more than for years.
Jan. 20, 1891. Heart feels dull. Aches even up under arms. The old symptoms are all lighter, but she has undergone a wonderful constitutional gain. Chokes when she sleeps, even in daytime. Urine thick with brick or pink coloured sediment. Decided improvement of heart. Numbness in left lower limb when sitting. Dull pain in back of head. Has had no medicine for two and one-half months. Argentum-n. 3 cm.
Jan. 29. Some palpitation. Chokes when going to sleep. Old symptom?: sees figures dressed in white come and clutch the heart; ghosts, but knows they are dreams. Nightmare; makes noises in sleep. Menstruation, pain during-Amel. by the flow (usual). If pain is not relieved by the flow fainting or vomiting and diarrhea, copious sweat. Flow thick and dark clotted. Flow returns after ceasing if she overworks. She thinks she once had a right-sided inflammation in ovary. Sach. lac.
Feb. 25. Health has been pretty good since returning home, although she had several acute attacks caused by some undue excitement. The ache in left side around region of heart continues. Sometimes the dull pain extends into arm and leg producing numbness.
May 14. Has been quite well up to now. Has had a return of several of her unpleasant symptoms. Aching and numbness in left side. Unpleasant sensation in heart. Stiffness and pain in back of neck. Argentum-n. 3 cm.
June 26. Health very good since last report. Heart very well during the day but sometimes at night it pains – Has had much backache. (<) on the left side which is very tender. At intervals in the last few weeks she has had a severe twitching of right eyelid and a wooly sensation along the edge of the lid, making clear vision impossible, (<) by using the eyes intently for a while. Constant application to almost any kind of work causes headache and backache.
Aug 20. Remarkably well until within the last two weeks. The last attack of pain has left her completely exhausted, and she does -not seem to recover her former tone. One or two sharp attacks of pain in heart; much of that dull ache which she had when in Phila., with an unusual amount of numbness extending over entire left side. Head aches in the entire left side. Pain in the lower part of the brain is sometimes intense with much stiffness of the neck. Has a frantic feeling at times which she can hardly explain, as if head would burst and she should be insane or idiotic. Choking in throat the last few nights. Anxiety and excitement, with the old pain in the ovaries and urging to urinate returned. Argentum-n. 3 cm.
Oct. 4. In almost as bad a condition now as when she first went to you for treatment. She has been overworked this summer and likewise has been subjected to an intense mental strain. She has felt that her heart was going back on her for some months, and at the time of M. P. she has suffered considerable. The past few weeks she has been suffering constantly, and has become very weak and depressed. Palpitation. She notices this whenever she meets anyone unexpectedly, or otherwise startled, but it is slight compared to the flatter apparently within the heart, which comes without any apparent cause, and is always followed by intense weakness. Sharp pain, compelling her to sit up, occurs only occasionally. Worse when lying on right side; always worse when lying prone, she keeps moving back and forth but finds no satisfactory position. Choking very seldom, usually in the night. Anxiety extreme. Excitement, pain in ovaries, urging to urinate, all very marked. Pain in back of neck with stiffness, suffering also from swollen glands in neck and a fierce headache. Symptoms are identical with the ones previously reported. Argentum-n. 40m. Sach. lac. powders one each night.
Oct. 9. Very much better since last medicine. Heart much better. The pain comes occasionally but soon passes. No stiffness in back of neck. Choking in night, at times, is the moat prominent symptom now.
July 5, 1902. After taking the last medicine she was so much better that she thought it unnecessary to report. Since that time she has been as well as usual, heart troubling only when physically overworked, or under extreme nervous excitement. The heart is still enlarged, at times it presses out the ribs quite prominently, but it gives very little trouble.
This case-report is worth more than a casual reading. To the careful student, it reveals the very remarkable restoration of strength, comfort and activity in a woman, rapidly declining and about hopelessly helpless from long-continued illness and cardiac weakness. The reader must image the picture sketched by the several reports, to realize the result accomplished. It affords a good text for study of the remedies prescribed, and carries many lessons.