Plumbum Metallicum - Chest symptoms - T.F. Allen

CHEST

Chest

Suppuration of the lungs,

The condition of the left side was involved in great obscurity. To the touch that part extending from the false ribs to the crista ilii, and from the dorsal vertebrae to the left rectus muscle, presented a hard and indurated feel. The hardened mass lay immediately beneath the skin, and could be traced only to the muscular system,

Weak action of the lungs, especially the left; distinct shade of dulness in the right apex (the left being the first affected),

Labored movement of chest and diaphragm,

Two out of one hundred and eighty-four died of gangrene of the lungs; two of tubercles of the lungs,

At one time the friction of the muscles of the chest was so loud, that combined with other symptoms, I had great difficulty in satisfying myself that she had not pleurisy,

Accumulation of phlegm on chest,

Rush of blood to the chest, when walking rapidly (fifth day),

Symptoms resembling angina pectoris,

Tightness of the chest (fifth and sixth days),

Great oppression of the chest, and anxiety,

Oppression of the chest,

Sudden oppression of the chest, returning at intervals, and constantly increasing in violence,

Some oppression of the chest, in the morning (second day),

Tightness of the chest,

Sense of constriction in the chest; the pains prevent him from fully dilating it,

Feeling of constriction at the base of, and all around the chest,

Oppressive cramp in the lower portion of the chest, with unusual fatigue, after physical exertion,

Anxiety about the chest,

Pressure upon the chest (after half an hour),

A pressure similar to a sticking in the right and left pectoralis major muscles,

About three weeks ago, had cutting pains in chest and throat, "as if scraped by a shell;" has the scraping feeling in throat now, "as if a shell were scraping it;" the pain comes and goes, lasting only about a minute; it makes him feel quite exhausted,

Dared not dilate his chest, lest he should increase the pains,

A young man complained of very great pain in the anterior parietes of the thorax, which was greatly increased by the slightest touch, and even by the respiratory motions. It was more severe above the costal cartilages,

Dragging pain from the chest, as if a string were stretched from it to the groin,

Pains in the chest, etc.

Paroxysmal pricking pain in the external subclavicular region, near the brachial plexus, diminished by pressure,

Great sensitiveness of the anterior wall of the chest and in the cartilages of the ribs,

Stitches in various parts of the chest and shoulders,

Stitches in the left upper pectoral region; on rubbing it extended into the mamma, then backward and upward along the shoulder, in the afternoon,

Sticking in the right costal region after sitting down, disappearing on walking about,

Front and Sides.

Pain behind the sternum (second and tenth days),

Pressure externally on the lower portion of the sternum (after one hour),

Pressure upon the lower portion of the sternum (after two hours and three-quarters),

Applied perpendicularly over the sternum, the instrument showed .75 mm.,

Lancinations becoming worse, at intervals, in the front and sides of the chest,

Sticking in the upper part of the sternum during inspiration, in the afternoon,

A stitch in the middle of the sternum (after six hours and a half),

Dull pressure upon the left chest, always quite independent of inspiration or expiration,

A dull sensation and pressive pain within the left chest, anteriorly and posteriorly, intermitting and returning,

Severe pain in the lower part of the left side of the chest, apparently seated in the intercostal muscles,

Tearing beneath the right arm (second day),

Fine sticking in the left side of the chest near the sternum, disappearing on rubbing (after three-quarters of an hour),

Sticking, now in the right, now in the left side of the chest (second afternoon and evening),

Sticking in the left side of the chest (second afternoon),

Sticking in the left side of the chest, extending through the scapula, in the afternoon (second day),

Stitches in the region of the right lower ribs on turning the body to the right, and still worse on turning it backward; relieved by rubbing, in the afternoon,

Stitches in the right side of the chest, becoming a twinging (second day),

Violent fine stitches in the left side of the chest (after a quarter of an hour),

Stitches in the left side of the chest, aggravated by inspiration, followed by tearing; not relieved after rubbing (after two hours),

Transient stitches in the left side of the chest (after two hours and a half),

Mammae.

The milk was very scanty,

Sticking below the right breast (after five hours),

Sticking in the left mamma on inspiration, in the afternoon,

Sticking in the left mamma (second day),

Sticking beneath the mammae (after five hours),

Sticking beneath the left mamma, near the sternum, in the afternoon,

Two stitches in and beneath the mammae, lasting an hour, in the morning in bed, disappearing after rising (third day),

Stitches deep in the right mamma, not disappearing after rubbing (second day),

A fine stitch in the left mamma, afterwards in the right (after six hours),

Somewhat violent stitches below the right breast, extending into the right scapula (after one hour and a half),

Stitches deep in the female breast,

Pulse

Sudden attack of severe pain in the left mammary region. It was constant, boring, and extended into the back. Pressure aggravated it to an intolerable degree. It was accompanied by fever and very severe dyspnoea, as if suffocation was imminent, obliging her to keep sitting up in bed. The beats of the heart were tumultuous, rapid, and resonant,

Respiration

At the apex of the lungs bronchial respiration was heard,

Constant pressure across the chest, especially behind the sternum, causing anxiety and making respiration difficult; movement or pressure of the hand upon the left side of the chest aggravated the anxiety,

Dull pressive stitches in the left side of the chest, not affected by respiration, intermittent,

Sticking beneath the right arm, that takes away her breath, while standing,

Some râles, on auscultation, at the apices of both lungs, perhaps merely from bronchitis. Says he has no habitual cough, does not sweat, and is not emaciated,

During the paroxysms the inspiratory movements become hurried, incomplete, and noisy, as if held in check by the pain,

Real asthma at times,

Asthma,

Respiration easy and regular,

Respiration in short, rapid jerks (first day),

Rapid, painful respiration,

Respiration rapid and anxious,

The breathing was intermittent. The average time of the intermissions was about forty-five seconds. I never counted less than thirty seconds. Forty-five to fifty-five seconds were common, and in the latter part of his illness I often counted seventy seconds. To be perspicuous, there were two periods, one the respiratory, and the other the non-respiratory period. The number of respirations ranged from nine to sixteen, not per minute, but per respiratory period. The longest respiratory periods marked the shortest non-respiratory periods, and vice versâ. In his best condition the time consumed in the two periods was about one minute. Then he had a comparatively refreshing sleep, and his respirations resumed without so much panting, and he would not generally be awakened,

Respiration very quick, especially during the paroxysms of colic or arthralgia, when it is 68, and accompanied by a sort of noise at the entrances of the nose and mouth,

During the paroxysms respiration considerably accelerated, sometimes it was suddenly arrested by a violent attack of colic, when it would become interrupted and choking,

Breathing short and rapid,

Respiration, 120,

Respiration extremely rapid, 55 per minute,

Respiration during the paroxysms, 65 per minute; between them 35 per minute,

Respiration 48; quite incomplete, short, suffocating; a kind of jactitation was also observed; during the intermissions, respiration was more regular and less frequent, but the utterance was always panting,

Respiration 35; anxious, difficult, irregular, especially during the paroxysms of colic,

Respiration 30 to 40,

Respiration 30; short and rather quick (during the paroxysms); 25 (between the paroxysms),

Respiration 30 to 35, interrupted, panting, hurried,

Respiration 30 (during the paroxysms); 24 (between the paroxysms),

Respiration 30; irregular,

Respiration 30,

Respiration 28,

Respiration 26,

Respiration 25; quite regular,

Respiration 25,

Respiration rapid, 22,

Respiration 20, ,

The air of a room filled with people is extremely oppressive; he feels as though he would faint; followed by darkness before the eyes (first day),

Impeded respiration,

Difficult respiration, that compelled him to jump out of bed at night, open the window, and gasp for fresh air,

Respiration difficult, superficial, and accelerated, especially during the colicky paroxysms,

Respiration embarrassed, accelerated,

Difficult respiration (fourth day), ,

Difficult respiration, with anxiety,

Such a distressing craving for air, especially at night, that during warm weather she was obliged to keep both the door and window of her bed-room open, becoming in consequence deaf from getting a cold in her ears,

Oppressed respiration,

Her breath was arrested, with sticking in the sternum, when standing or sitting, or on moving the right arm toward the left side, in the afternoon,

Respiration painful,

Loud groaning and sighing, at times, with excessive weeping; the patient seemed affected by a violent hysterical attack,

Respiration frequently interrupted by sighing,

Frequent sighing,

Anxious sighing respiration,

Anxious respiration,

Respiring heavily (after five hours),

Respiration slow and indolent; expiration stertorous, on account of weakened power of the buccinators,

Easily gets out of breath,

The respiration suddenly cut short,

Great shortness of breath on walking, especially on ascending a height, with hoarseness and oppression in the region of the heart, aggravated by pressure with the hand,

Shortness of breath, with somewhat dry cough (fourth day),

Shortness of breath,

Sense of suffocation on drinking,

Feeling of suffocative oppression during the colicky paroxysms,

Very feeble respiration (30),

Respiration slow and sighing,

Dyspnoea, attributed to convulsion of diaphragm,

Dyspnoea,

Dyspnoea,

Spasm of the respiratory organs,

Constriction of the larynx,

Dry mucus in the upper part of the trachea, that he could loosen only with difficulty, and not without some pain in the chest, with whistling in the upper part of the chest on inspiration (second day),

Intense general bronchitis,

Voice.

Rough voice, with hacking cough,

Rough, hoarse voice,

Voice hoarse, almost toneless,

Voice hoarse,

Voice nasal,

Voice toneless, hollow,

Voice loud,

Voice a good deal altered, and the tones of the voice much impaired,

The voice has lost much of its resonance, and is weak, like a woman's; articulation is impeded and sometimes even incomplete,

Voice panting, stifled; he can scarcely make himself heard,

His voice is weaker than usual,

Voice very weak,

His voice (which had been a little weak for some days previously) began to fail him one evening while he was reading aloud,

Voice weak and dull,

The voice is weak and husky,

Voice became very weak, talking very difficult,

Voice very weak, with imperfect utterance (tenth day),

The voice had partly lost its strength and resonance,

Voice feeble,

Voice weak,

Voice almost extinct,

She lost her voice for about eight weeks, at the end of which time it returned,

Violent cramp, at night, in the left leg; it ascended up the entire body, and affected the throat, so that for a moment he could not utter a word. The difficulty of speaking lasted fifteen days, but gradually diminished, until he could speak as well as before,

Aphonia, ,

Aphonia permanent,

Cough and Expectoration.

Cough, ,

Cough at first dry, afterwards moist, with expectoration of mucus, finally accompanied by fever,

Cough in two paroxysms (third day),

Cough, with purulent expectoration,

Convulsive cough,

Hacking cough,

Frequent cough, with bloody expectoration,

Dry cough,

Dry cough, with frequent vomiting,

Dry cough on deep inspiration,

Short, dry, nervous, fatiguing cough,

Coughed up blood for three days, having lost altogether about half a pint; afterwards an attack of spitting of blood, without cough,

Haemoptysis with fatal suppuration of the lungs,

Cough, with bloody expectoration,

Slight cough, caused by dry mucus in the upper part of the chest, in the morning (first and second day),

Heart and pulse

Prominence of the praecordial region; it gives a dull sound on percussion, over the space of three inches square,

The praecordial region is shaken by the hurried and irregular beats of the heart; they seem as if stifled, on auscultation, but there is no abnormal sound,

Pressure in the praecordial region,

Jerking in the praecordial region (after half an hour),

A stitch in the praecordial region on inspiration, then anxiety, with mounting of heat and redness into the face, soon disappearing (after six hours),

Heart dilated 12 by 14 centimeters; four beats are heard instead of two; associated with a pulse of 84, vibrating as in insufficiency of the aorta; moderate beating in the carotids,

The heart measures 10 centimeters in length, 15 in breadth; the heart-sounds noticed over a larger surface than normal; the valvular sounds are wanting; instead there is a double bruit, very rough, rasping, which is transmitted along the carotids,

Heart very much enlarged, the apex in the sixth space; the murmur at the apex diminishing in intensity along the aorta,

The heart measures 11 by 12 centimeters; chlorotic sounds very marked, pulse 80 and feeble,

The heart measures 9 by 14 centimeters; the heart-sounds are redoubled; the second sound rude, changed in character; it resembled a pericardiac sound. The chlorotic murmurs are considerable,

Heart measures 11 by 16 centimeters; the sounds are sonorous; at one point, however, there can be recognized a little murmur in the second sound of the heart,

Heart measures 11 by 12 centimeters; there is double rough blowing sound, which is transmitted along the carotids, associated with swelling of the limbs and albuminuria,

The heart measures 11 by 12 centimeters, the apex is in the fifth intercostal space; the sounds seem altered; the chlorotic murmur can be heard in the vessels of the neck,

Heart enlarged,

Organic disease of the heart occurred in seventeen out of one hundred and eighty-four cases; two workers died of parenchymatous nephritis,

Anxiety at the heart and cold sweat,

Anxiety at the heart and anxious perspiration,

Nausea, with anxiety at the heart (second day),

Anxious, apprehensive about the heart (after half an hour),

General oppression about the heart,

He complained of sudden and unusual pain in the region of the heart, third day after his entrance, and expired in a few minutes,

Violent palpitation, with pain in the heart,

Very violent palpitation,

Rather strong palpitation of the heart, slight bruit de souffle at the apex,

Palpitation increased during the violent attacks,

Excessive palpitation,

Palpitation of the heart; the first sound is short, defective; the second sound unusually distinct; the impulse received in two intercostal spaces is jerky, but not forcible; there is no murmur,

Palpitation of the heart, with slight bruit de souffle at its base,

Suffered a good deal from palpitation,

Palpitation of the heart, worse on going upstairs, or running too long,

He feels the pulsation in the head, hands, and feet more distinctly after dinner,

Palpitation at times,

Palpitation; beats of the heart irregular, like those of the pulse,

Palpitation, ; (after one hour),

The beats of the heart are very perceptible,

He felt the beat of the arteries distinctly in the feet, hands, and head, after dinner,

Heart's action feeble,

Impulse of heart feeble, and second sound indistinct,

Contractions of the heart feeble, beating only 44,

Beating of the heart strong and irregular,

Bruit de souffle, humeral only; none at the carotid artery of heart,

Double murmur in the crural artery,

Cardiac impulse very strong,

Anaemic bruit de souffle at the base of the heart and along the large vessels,

"Bruit de souffle" during the first action of the heart, more distinct at the apex than at the base,

Bruit de souffle in the cervical vessels, ,

"Humeral" bruit de souffle,

Anaemic blowing-sounds in the vessels of the neck,

Carotid "bruit de souffle" in both sides,

"Bruit de souffle," at the apex of the heart,

Cat's fremitus at the apex of the heart,

Tremor of the jugular veins, on auscultation,

The first sound of the heart is remarkably ringing, the second sound dull; the impulse of the heart strong, whirring; associated with dull pain under the sternum,

Chlorotic sound of the heart,

Soft systolic souffle at the base of the heart,

First sound of the heart at the apex sharp and metallic,

The sounds of the heart are modified; a double souffle is heard in the subclavicular region, but there exists none in the crural artery,

At the apex of the heart is heard a bruit, sonorous, transmitted along the carotids; the second beat of the heart is heard under the sternum,

A double friction sound at the heart, without enlargement,

Heart-sounds were accompanied by metallic tinkling,

Pulse.

Pulse rhythmical, but the heart impulse violent,

Forcible and visible beating of the aorta, which shakes the whole abdomen,

Rapid pulse,

Pulse usually very quick and weak,

Pulse frequent, hardly to be felt,

A small quick pulse,

Pulse very small and rapid, regular (after four hours),

Pulse rapid and hard,

Pulse small, rapid,

Pulse rapid, weak, small, intermittent,

Pulse very small, irregular and rapid,

Pulse quick,

Pulse very small and rapid,

Pulse hard, full, feverish, rapid,

Pulse feverish, with most violent colic,

Pulse full and rather turgid,

Pulse rapid, small and weak,

Pulse hard, small, and quick (after five hours),

Pulse soft and quick,

Pulse quick and somewhat tense, in one paroxysm,

Pulse usually full and hard,

Pulse very small, a little frequent, regular (after four hours),

Pulse weak and but little quickened,

Pulse very feeble and more frequent than usual,

Pulse 140, and hard (fourth day),

Pulse 140, rather full,

Pulse 130 to 140,

Pulse 126 and small,

Pulse 130, feeble,

Pulse 120 (after one year),

Pulse tense, 112,

Pulse 110, hard and full,

Pulse full, tense, 110, with considerable fever,

Pulse 100,

Pulse 100, slightly intermittent and of great tension under the sphygmograph,

Pulse 100; regular very weak, hardly perceptible,

Pulse 95; strong and cordy,

Pulse 88, soft,

Pulse 85, frequent and strong,

Pulse 84, attended with a jerk,

Pulse 84, radial artery rigid,

Pulse 80; quite strong and regular,

Pulse 80, full, but soft,

Pulse 80, compressible,

Pulse 76, small,

Pulse 72, tense and hard,

Pulse 65-70; soft,

Pulse 65, soft and regular,

Pulse 65, rather hard,

Pulse 65, vibrating,

Pulse 60 to 65, not remarkably hard, dicrotic (observed several times), not constantly, but after every five or six normal beats,

Pulse 60, vibrating and regular,

Pulse 60, developed and hard,

Pulse 60 and small (second day),

Pulse 55 to 60, regular and strong,

Pulse 55-60, hard,

Pulse 56, hard, regular, large,

Pulse 55, rather hard,

Pulse 55, rather hard, vibrating,

Pulse 55, somewhat hard and tense,

Pulse 55, soft,

Pulse 55, slow and strong,

Pulse 55, regular, large, tense,

Pulse 50-54,

Pulse 50-60, slow and weak,

Pulse from 50 to 60,

Pulse 50-55, hard and slow,

Pulse 50 to 52, quite feeble,

Pulse 50, regular, but somewhat hard,

Pulse 46, indistinct, of irregular strength and intermitting beat (tenth day),

Pulse 45 to 50,

Pulse 45, hard vibrating, regular,

Pulse 45, hard,

Pulse 45, hard, vibrating,

Pulse 45, slow and hard,

Pulse 45, hard and regular,

Pulse 45, hard, large, vibrating, regular,

Pulse 40, hard, slow, regular,

Pulse 35, hard, and vibrating,

Pulse 35, hard,

Pulse 24, large and soft,

Pulse full, but not frequent,

Pulse very weak, slow and easily depressed,

Pulse slow, weak, and soft,

Pulse small, weak, and slow,

Pulse slower than natural,

A slow small pulse,

Pulse feeble, slow, and irregular,

Pulse slow,

Pulse slow and weak,

Pulse slow, hard, tense, 50 to 60,

Pulse generally slow and feeble,

Pulse decreased in frequency, and he fell into a comatose state,

Pulse weak, slow, soft, and easily depressed,

Pulse small and slow,

Pulse 112, small and rather weak,

Pulse 50, strong and slow,

Pulse quite slow, and almost imperceptible,

The pulse is weak, slow, rather irregular,

Pulse weak and slow,

Pulse 45, slow, hard, vibrating,

Pulse slow, contracted,

The pulse became slow and very hard,

Pulse small and weak,

Pulse hard, slow,

The first tracing shows the characteristic peculiarities of the pulse of lead colic. The second tracing thirteen minutes after the injection of pilocarpin shows a decided diminution of tension. The third tracing thirty-three minutes after the injection shows still greater diminution of tension. The fourth tracing in the evening, about nine hours after the injection, shows a return of the former condition as in the first figure. I noticed that simultaneous with the diminution of tension, and in exact proportion to it, was the diminution of pain,

The pulse is very evidently dicrotic to a degree inadequately represented by tracing 7. This gives a very good idea of the alteration of pulse which is characteristic of incipient lead poisoning. Renaut, pages 30 and 31,

A very gradual fall at the end of the pulsation; strongly marked elasticity elevation; relatively small recurrent elevation; in some cases a very remarkable bicuspid point at the apex of the first elevation, apparently caused by the increased vascular tone during the colic,

Pulse moderate, soft, and feeble,

Pulse weak, thready, immediately,

Pulse small and frequent,

Pulse weak, soft, easily depressed, and very slow,

Pulse extremely feeble,

Pulse small,

Pulse weak,

Pulse small and soft,

Pulse intermits every third or fourth beat,

Pulse 110 (fifth day); 100 (sixth day); 120 (eighteenth day),

Pulse tremulous,

Pulse 70-80, so feeble, depressed, and irregular, that it can hardly be counted,

Pulse 65-69, soft, quite compressible; irregular, sometimes quick, sometimes slow,

Pulse 65, irregular,

Pulse irregular, from 90 to 115,

Pulse always without power, slow when recumbent, but easily quickened by trifling exertion,

Pulse frequent, depressed and irregular,

Pulse 70 to 85, very irregular; every ten beats or less, followed by equal intervals; soft enough, but very deep, and easily compressed,

Pulse 65 to 70, soft, but irregular,

Pulse 96, slender and irregular,

Pulse 65, very irregular in frequency,

Pulse extremely weak, filiform, and sometimes imperceptible,

Pulse 50, irregular as to force, sometimes weak, sometimes vibrating,

Pulse quite soft, irregular, sometimes very slow, sometimes hurried; the irregularity is noticed five or six times per minute,

Pulse 65, very irregular; in one minute, by turns, slow and hurried, large and small,

Pulse soft, varying constantly in rapidity; it was 65-80 within half an hour,

Pulse 65, pretty soft, very irregular,

Pulse small, contracted, hardish, intermittent, indolent,

Pulse 75 to 80, very irregular; one moment slow and quite large, the next, hurried and scarcely perceptible,

Pulse very irregular, varying every hour in force and frequency; it never exceeded 90,

The pulse is hardly perceptible, owing to extreme debility,