Document 0Me8xNx2DjrjNxVkwnr7LYRm

July 2k* 193k Dr. Graham Edgar Ethyl Gasoline Corporation Chrysler Building Hew York City Hew ^ork Dear Edgars We are enclosing herewith copy of a letter of Dr* Charles W. Stephenson, our previous correspondence with this gentleman having heen forwarded to you. The cllnlcaT^^ture described by Dr* Stephenson for Mr. HHHfis very s i mila^t^th^^^ one which we saw izfflgd^telyroilowing Mr. attack of encephalopathy In September 1932 very difficult for anyone to state that Mr. present symptoms are related to his previous attack On the other hand, in light of our present knowledge of the storage of lead, we could not be positive in our statements that it was not so related. It is our personal opinion that there is some likelihood of direct relation ship from pur experience with previous cases of lead eneephalophthy and other materials effecting the central nervous system* We would appreciate knowing whether or not 5,8 at: Presenfc receiving compensation from the I^Hliarc^il Company, and what opinion of this case Dr. St.John may have given the management of the Hartford Plant where he acts as company physician and has been, I believe, Mr. personal physician. Very truly yours. WFMsIS Willard P. Machie, M.D. 0017201 July 7, 1934 University of Cincinnati College of Medicine Cincinnati, Ohio* My dear Ur. Kehoe: Chiefly for your records and not, I believe, for any help in my particular relationshVB_ta_frhe case, I give you a brief summary of the case of of Hartford. I think when you finish you willprobabT^coroexo the conclusion that I have finally arrived at, that this is not so much a case of lead poison ing as toxic effects from gasoline fumes. t On,September.14, 1932 the patient was cleaning a gas tank be longing to the Standard Oil Company here in Hartford. There was insufficient hose to his gas Bask for, him to reach all parts of the tank. Consequently, he dispensed with the mask for part of his work. Two other men were similarly exposed though for a shorter time. They were each hospitalised but for a day or so only, a fact which is in marked contrast to the patient voider discussion. One statement says that the patient v/as exposed to gasoline vapor and "a considerable amount of dust", though this latter is not definitely established. He was rather suddenly attacked with dizziness, weakness and nausea. The following day he suffered with diarrhea and frequent vomiting. This condition persisted for about a week and then subsided to some extent. There was, however, constant insomnia and restlessness. The headache, nausea and vomiting largely disappeared. On September 2Tst there v/as an acute onset of delirium, hallucinations and delusions accompanied by generalized muscular tremors. He was taken to St. Francis Hospital here in Hartford and treated by magnesium sulphate intravenously which resulted in definite improvement. He became fairly well oriented and showed reasonable judgment. On September 23rd the mental symptoms returned and were controlled-by a second injection of magnesium sulphate. On the 24th there was a further recurrence and St. Francis Hospital declined to keep him because of his disturbance to other patients. He v/as then transferred to the Neuro-psychiatric Institute ana Hospital of The Hartford Retreat for further treatment. Dr. Machle v/as called from New Tork to see the case and"believed it to be an encephalopathy due to lead or possibly gasoline". The patient was in the Retreat until November 18th, 1932 at which time he v/as taken out at the request of his local physician who stated that then his condition represented his ordinary personality before the accident. I first saw the patient at the request of his lawyer bn the.- 20th of April 1934, At this' time he complained of pain in the back of his neck, pain in his ears, and catches in his throat. He said that once in a while his brain "disolved" and later came back into place and K Q 017 22 :-5 N21004.01 3=; complained of a continuous "ccmmotion" in his mind* He has difficulty of concentration and feels dulled. There was some evidence of impairment of memory. For example, he said that he failed to remember appointments unless he jotted them down. This was true in regard to his appointments -with re. Neurological examination on April 23rd was entirely negative. There was no evidence of any cranial nerve involvement. All reflexes were normal, no paresis. Coordination normal. Sensation (vibration, pain, touch, joint) all normal. At this time he told me of certain episodes of a hallucinatory and delusionary nature'which occurred while he wasi in the Hartford Retreat. These he still believed to be real ex periences and not just a dream. He stated that he still had these trances. One change which he has noticed in himself is that there is a greatly increased susceptibility to alcohol, so much so that two glasses of beer made him sufficiently wild to try to smash up a place In NW York. At the present time there was no disorder or alteration of the sexual function. He complained greatly of insomnia. There was a certain paranoid trend ran through his mental functioning. For example, something went wrong with his car and he told his wife that ha thought someone had been monkeying v/ith it, that it;was .some sort of a frame-rup. At the time of his excessive reaction to two glasses of beer he received a black eye and felt that that was all premeditated and planned in advance. On April 30th he told me that he had the feeling of someone following him and telling him he was doing wrong. Walking down the street he thought there might be a mind reader there telling him what to do, and that he was walking with Jesus, the Holy Ghost and "all of them". There is no actual hallucination since he left idle Hartford Retreat. I saw him again today complaining of headache, ' occasionally blue flash before his eyes which he thought might be flashes of light sent by some family living near him to annoy him, but he could not understand how this could be since he also saw them on the street. He has the same head ache as before second onset. Sleeps only about four hours a night, feels weak when walking. Still has the feeling that Jesus or someone is walking along beside him and feels that he has many more religious thoughts than, any normal man should have. Going back;to the time he was in the Retreat laboratory findings were as follows: Sept.24,1932 Wass & Kahn on two occasions, both negative. Blood WBC 8700--*-- -- v- Oct.4,1932 WBC 9,100 T" RBC'4,880000~" ' RBC 5,120,000 Hgb. 14.1 Mg per 100 cc. Hgb 14.6 : Smear normal. * Smear still normal No stippling cells found' . Blood Chemistry - Sugar 88 Sugar li3.6 HPN 35.4 ' - , - KPN 46.1. ---H J Brine showed trace of albumen and a few white epithelial cells. This cleared* however, and all subsequent examinations were essentially normal. / . 3 July 7, 1934. No lead was ever found in the urine that I have been able to chase down. It is my candid opinion that the man has a definite psychosis secondary to his exposure, but I am. not willing to express an opinion as to whether this is directly due to gasoline or to lead. The absence of the finding of any lead out-put or any laboratory evidence of the existence of lead in the body, inclines me toward the gasoline fume theory. If there is in all this, anything which you can point to as evidence one way or the other, I would be glad to know it. Unfortunately he returned to work after he left the Retreat and consequently has jeopardised his compensation to which, I feel, he is fully entitled. I am very doubtful as uo the ultimate outcome, feeling that since the psychosis has persisted for almost two years with very slight improvement, the chances of recovery are not too good. I trust that this account is not too long and rambling and may conceivably be of some help to you as another case for study. Most sincerely yours. 0017204