Skin is dry, with some evidence of eczema of hands, which is worse t night and in winter. Reflexes are normal. Eyes are astigmatic. Ears and nose normal. Teeth are in good condition and X-rays show no evidence of infection. Tonsils are atrophied. Lungs are normal. Chest wall shows scars of breast amputations. Heart has no murmurs, but shows a weak muscle tone.