Excerpt from The Glasgow Medical Journal, Vol. 66: For the Glasgow and West of Scotland Medical Association, July to December, 1906
The latter has been the main symptom, and has been increasing over past four months. At first it was only a sensation of tightness in chest, but soon developed into a definite pain, localising itself more and more to the right chest, round and to the inside of the right nipple, and equally acutely felt over the shoulder blade. The pain is usually worse during the night, and, while it is not felt auring ordinary light exercise, any effort to return to his work has at once to be given up. Too long remaining in any posture, whether up or in bed, induces the pain, and it is usually relieved by any simple alteration in decubitus; for instance, at first he could not lie on his left side at all, but can do so easily now, but not for any length of time. A little exercise is antagonistic to the pain. The character of the pain has varied from a dull ache at start to a sharp acute pain coming on gradually, increasing to an unbearable degree unless relieved as above, and then dying away gradually. There are no shooting or lancinating pains, and no boring pain associated.
Shortness of breath became evident about twelve months ago, and interfered with every heavy work, but never incapacitated him at his work, even lately.
Palpitation was noticed about same time and under same conditions, but was not thought worthy of any attention. In fact, he feels he could have continued work easily but for the pain.
Weakness was slight, but he noticed a failure of strength some time before he left off work, and he is conscious of a very appreciable loss of vigour since lying down. He has been in bed for six weeks in all, and lately only partially for six weeks, and has felt much improved, although the pain has not much abated.
For twelve to fifteen years he has had a chronic cough and spit, rather recurrent than constant, and usually present in winter time. No asthmatic or paroxysmal attacks, and no dyspnoea or well-marked breathlessness up till eighteen months ago, and even then, and since, the cough has been rather less in evidence than usual. There has been no swelling of feet; no alteration in voice noticed by patient or friends; no haemoptysis other than mentioned.
Works as a lorryman twenty years with Caledonian Company. Work is very heavy and requires great physical strength, and offers constant inducement for over-exertion.
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