326 STRONG AND CROWELL. 



again. On the sixty-sixth day he complained of feehng cold; 

 pulse 84; no fever and no pain. There was a slight cough, but 

 apparently no disturbance of the lungs; the right knee jerk 

 seemed more active than the left. His food was left with him 

 as he did not care to eat. On the sixty-seventh day he ate bread 

 and bacon, but no rice for dinner ; however, he ate rice for supper. 

 On the seventieth day he complained of general pain throughout 

 the body. His pulse was 84. The first sound of the heart was 

 distinctly prolonged, suggesting a very soft systolic murmur. 

 The knee jerks were not obtained. On the seventy-first day the 

 note states: Point of maximum impulse not distinctly visible; 

 impulse of heart near apex visible between respirations; point 

 of maximum impulse on palpation somewhat diffuse and may be 

 felt as far out as the nipple line; slight visible pulsation in the 

 vessels of the neck ; the first heart sound is somewhat prolonged 

 at the apex ; there is no distinct murmur ; the second sounds are 

 not markedly accentuated ; there is no abnormal spacing between 

 the heart sounds. The cardiac dulness extends to the left, 3 cen- 

 timeters outside of the nipple line; it is not increased to the 

 right of the sternum; the pulse is 88 before and 94 after slight 

 exertion; he complains of soreness over the chest and abdomen, 

 and says that at night the skin feels as though being stretched. 

 He also complains of soreness in the calves of the legs and pain 

 on pressure over the calves of the legs. He winces slightly on 

 pressure in this region. He says he has a sensation as if winds 

 were blowing over the pores of the skin, especially over those of 

 the chest and abdomen. There is apparently no marked loss of 

 tactile or pain sense. The right knee jerk can not be elicited; 

 the left jerk is very weak. On the seventy-fourth day the note 

 reads: The patient has lost 3.6 kilograms (8 pounds) since the 

 beginning of the experiment. He is in bed, and complains of 

 pain over the abdomen, chest, and legs. The calves are tender on 

 pressure. He states that he feels feverish. The pulse is 100. 

 There is no rise in temperature. He ate no dinner nor supper. 

 On the seventy-fifth day the note reads : Pulse 100 ; point of maxi- 

 mum impulse easily visible, rather diffuse ; can be seen and felt as 

 far out as the nipple line ; no change in the heart sounds since the 

 seventy-first day; heaving over heart more marked; knee jerks 

 can not be elicited. On the seventy-seventh day the note states 

 that he vomited his dinner. He is very weak ; there is marked 

 lameness and dyspnoea; the respirations are 40, and pulse 88. 

 On the seventy-eighth day the note reads : Up at breakfast, in bed 

 at dinner time ; he complains chiefly of pain in the legs ; there is 



