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118
Case No. 48.
F. 12. Schoolgirl. Onset April, 1925.
This patient's first symptoms of illness commenced in Easter
week 1925. She got wet on Easter Monday, 13th April. A few
days later she was taken queer with pains in the arms and elbows
to the wrist, and in the middle of the back. Slight headache. No
pain in legs. She was sent to the doctor on the 16th April, who
thought she had fallen off her bicycle, but was not examined by
the doctor at this interview. As there was no improvement, on the
18th April she was taken to another doctor, still complaining of
backache and pain in arms. She was carefully examined and told
to go home to bed at once, she was not fit to be about, and the
doctor said that she was so bad that he should have been sent for
and the child not brought out to the surgery. Hot soda fomentations
were ordered for the arms. The pain was so bad that the child
was screaming at times. The elbow was said to be slightly swollen.
Two days later the doctor called. The child was still in pain, and
treatment was continued as before. Two days later the condition
was much about the same. On the 23rd April she began to ramble
in the night. She said she saw a monkey on the clock, and a man
coming into the room, and a finger on the curtains. She jumped
out of bed frequently during the night. No drowsiness during the
day, but could not sleep at night. The following day and all night
she was delirious, jumping out of bed. The next day she did not
sleep all day and all night. The doctor saw her and diagnosed
acute chorea. The child was still rambling that night. The
following day she seemed much quieter, sleeping quietly on the
night of the 26th April, so much so that the mother who had been
advised the previous day to send her to the Infirmary, refused.
On the 27th April the doctor called and as there was no real improvement
in the child's condition, advised her immediate admission
to the West Middlesex Hospital. The child was eventually
removed to the West Middlesex Hospital on May 12th, the Hospital
notes being as follows:—