Document 0qxzkXGgMDoDp3x7ZEL0XKnqM

_ f " " n. i rurrnm uir ...... i............ v^aaa^Lkr. PL'LMOXAY ARBV.STOSJS 57 PULMONAKY ASBESTOSIS HT; CAIitUNO.MA OF HUNO IN . ASBKSYU-SJLIOOST8 - , emaciatinl. His ehiuf complninU wcrc pains in tbo rijrhi eide of tbe " sto m ach ,'' gbt siclc of Oie bm'k nwl sbonblor and sbovtncss of brenfh. lhitorif; Prior io 1H33 ilio patent's laudih mus jrtwxl ami irnrOealy no limo wns lowt frena wovk ns n resali of illnoss, ultimagli for fivo vean KENSETO liebaJ notim i some sliorfnexK of Imuilfc. le limi limi mWnvy in'iniS. - ----- nnw- u^. w* ibroe day <Veia file /fcjwrtntfm j,ta 1(,,,A remest ISTERLIBRARY LOA REOUEST r p TM ^ __ __/ , P r im a ry cinfm M M m teret in nutlbpm si i m m * ' rco g n itio n , i f jto t JBlijjg** f** ondp w S AdminHtmtioB Likew ise isbextosis u huinsii-ial m edicine. R1* fcodeviffe, Maryfond 20852 W tirker# in Oie r p 5 r ^ an d IboSaxo ides, E88SW *0* sssf RirseBstein STATUS im m uiy diseuse w Ih#? a n d J A e b y m o r . - ... ... AUTOUR{Modici SK*1, stigmi Amer. J , Cancer, vol. kt 1935 SEPT. I*jrehira am i ik l tb a t `O b e ro w ero on i f FOUIS: checheoar ***w IBtttfly BATt *KS 5._______ (USURESFORS BAT5SENT: " eue- BESTflKTIQJf: DCSWW6 MPFR(WnEB n*0* UBRAflYUSEOKCf `rlhor vmppain iavove samo ido. rty iiimiios. also homme eli'd fo qit *mbor, mdor lyspm vi WBR I de- oraJod frofdi w m H m ed in Oiw D fM O O moms'imiosK a *****. m ny bo sornowbat i *** snlw bine dposH ec * UFIDU i* ureeo(nrieteeeei cu ses r o v e n ti **&t rides and p l ^ J ^ g j g j im m inm w a s f e W l " * " radium erm uintlon t HW-WK1UTB6, MASEW W Q (MMUIU O HARDF IFCOSI OMS F BCE., IHDUISLI8BAS? (!*!!> ,,U II Oie J^m cofoerg and Ifcudoski H iutt i Seheeb m iner KLM tribut fit ejiagati - - ROTSERTSECASSE: D * c o w n B 5 O rotovuheddiiibsi an i o ]d im * *i,*Mi io w o rk STKAIig COSTOF:CR0FJU-. RARecmr^. BOfmOWlPG U8SARY BECOioT BATEREEEIVES______________ ^__ BATERETORNES_____________ _ SY UBRARRATEH POSTACEINCUBES > w ifh opon -- insallw l; be -- Jf<*'foilimiod < lio (lilainod __ til jtiRj p r io r . ore* 'as untmnirri. KoJion*, u ^p^te {3> s ta te s r iJ m f j & South A fricani waiu monoetmUsHs s m o n W5.`TaftCfiMmfit*# ywj."tw otpgmsikr w MWteaMH<rfnoiHa({X in a rs e n te m n o rs . % ma** ttpFcnt.0 wnwmao BY,full TttlE-- nirrciicc ili iirIwI minera or mili nirkora, ulllimiHii llm m 'oril of onToj}' oxnBiitmfoftH o( caws nt ikM ! . i not liiifro. A s w o rd iy o f m - o l i 11 i lllc r w t o f Imlli .Tbobscb, n s w rtl is llm ir jMKSill*! iy t.itareiiip, Uto fo llo w io g rim o o f tm lm o im rv iwlw ,,i ,, il i . iBBoriutod o a ra in o m a o f Ilio lim g i , ro p o rto d . RENEWALS: (ReqoestorompunTo, sheetc. Ve'co.^It.raU e Z ^ o ir j u ^ ^ -. JfflHWfBTS- -- - ^ nowmt. In d rv lo nllow .. _ .......... KBlOSOfSENWAl ro kepi opon, ah* f m m tbo fo n W T d rn ff fro m filo'" p rq v irfltto ti ro n m , o m p tjin <ml- sid o |I m* pliial. o lito m i ilio ro an i n whtoli tito p a llo n i wovkod. Tio limi fivo o r six iium llis f liN i`inplfynioiil lu* w ns al " \vi>( w ork " in siem i u t d r y i m n i n g , ro d u o in g Ilio oxpoKim lo d o s i. Un w ns uo<*hk- I htwy lo w o rk o ro rfim o , sfiieo bo w as p a id b y Ilio jn r d . ... Cor K rpoiit fFds sia Ihi'ii, w o rk i'd :t a oofloit m il! w'o a ro r fo r np]> ra\inm tely twi*fiiy-twci yoai-s m l x a n sb o slo s mlH wonvor f r smno tw on(v-ouo A Wllito man, fttty-BWOJi venni of rigo l Im timo of iiis donth, llrst emae under Ae ^in -u s IH^x-nsury f Uu* Itojmr Ho- puai on dcm. IV, litJi, a t wftttii tune feo a llearm i very oM, weak, nnd M yoiu*, wiH'li m a y m w m n l f o r ro v in ili font a r e s o f kHh-oxis in ilio Imtp, in ndiHiion fa tlnwo oF fisbostosis. Covrxf': Tlmniidawt b slay in 11* Iiospllal lb< ysilionl conlimied io oompbiiu f |KirMKtviil inhi nlmijc tlm riisbf rosta! Inmor um ri^bt \+K VVUtfXSlxm ASBESTOSlS i n : c a r c in o m a o p l u n g in ASkBSTO -SlU COSIS jB S N K Jm i S L h V S tm i, . a , ax0 w . a t m a r s m it h , m jj. (From tfe / Ptttiteiogg a n d 3lf<he{*e, Medieai Cottrge o f th e 8ta te o f Mtwh Corutiea) Prim arycarcinom a of the lung lias attained a pitfdlton of m ajor in terest in aalignim tsoeplasticdisease, through at least a more common reeegniiten, M i&b Sfttifce frequent occurre*we, within recent years. Likewise iisbestesai has assumed a rank of considerable importance in rodustritfl modteme. ? - Workers in the rothcs of tin? E w Mountains, on both the Bohemian ail the Saxon sides, lw*ve niTered heavily for sumo centuries from pul monary disease How reeognwed as carcinoma ami well known as fSchuee- berg mal Jaekyroov {JoucbiroKpil) lung cancer. lhrchnn imtl Hlfel (1), in a report upon a series of these eases, slate Hint " there were only nrnderatc degree# of nntlmwosis," and they are not inclined to attach any parUeuhu* importance to the degrco of pwm- nn3oet>mosis as a eauso of the cancer, hut tnntKidcr that " the question may be ManewJwil different with regard 1 the qualify of the foreign substonce deposited In the lung." ( 'hemicnl analysis in one of their eases revealed " only calcium, magnesium, aluminum, silicic acid, chlo rides, mid phosphates * no trace of arsenic, bismuth, cobalt, nickel, or uranium was found.*' lim y lay suspicion, as others have done, upon radium emanation and iqxm arsenic, Iwrth factors Iwtug encomdered in the Schnceberg ttd Lichymov mines. Rostowki, tsaape and Mrhmorl (2} found severo *`allthracoKis', in Sclmeeborg miners (ho subjects of lung cancer and are hiclhicd to a t tribute the causation o f the cancer to tho anihracoris, while Simpson (3) stales Umt jndjmnwry cancer is a rare complication of silicosis in South African taiim*. Schulte (4) has reported lung cancer in pjiea- immoeoiuoak nmoug coat miners, and Smqm (5) has recorded two cases in arsenic milters. iHiove appears to lio no previous rejmrt of its oc currence la bestos miners or mill workers, althongh the record of autopsy exnroinatiojjs of eases of asbestos*# is not largo. As worthy of record in ih ein terest of both diseases, as well a# their possible relationship, the following case of pulmonary asbestos** with associated carcinoma of the lung is reported. Gas* R kpout A white man, fifty-seven years of ago at Hie time of his death, first came under observation a t the Shirra# Dispensary of the Jtopur Hos pital on J ab, 10,1934, t which Umo he appeared very old, weak, and i M iS A S U M iiL E -C S E BY T H E NATIONAL LIBRARY OF lyii-Ull'jY-. Ir u i" ' rULXtOXAIIY ASBESTOSIS 57 oraneiiitcd. His eltief complaints wevc pains in the right side of ihe "sfonkach" right Bide of the back and shoulder, and shortness of breath. Ilisivry: P rior to 1931 tlw>patient's health wns good awl practically no time'wns lost from work ns a resolt of illness, although for fire years tie had noticed seme shortness of breath. He had had influenza in 1918, hut except for that hod always been well. In 1931 he lost three days from work on account of sharp pains In Ids hack, cxtewdhig down over the three lower ribas, Nine month later intermittent sharp slwoting iw'ms occurred ittvoh`JHg Ins right boulder. These lasted aboat ten day*. Bxyept for the shortness of breath, there were no fnrtlier symptonw nnlilNov. 71933, wlien there were renewed attacks of para involv ing the right Ironhkr, axilla, and the three lower vTl on the same side. The pain omnTcd bmit oven- limn* and hiHted about thirty minutes. It seemed to be more severe (haring tlie night. Tin? patient Also became quite weak nmt seemed to lose weight lie was now compelled to quit work and seek medical aid. During NovcmW and December, raider medical care, ho grew weaker and lost more weight, liis dyspnea was aggravated, and a cough, productive of wiry, white mucoid sputum de veloped. On Jan. 8, during n spell of coughing, he expectorated fresh blood mixed with mucoid material. The. family history was not significant. Orvuimtimui! Ifhlnrtj; The first exposure to a dusty atmosphere occurred when the patient was about sixteen, when lie began to work in a cotton anil as a weaver. He first worked in a place with open doors and window*, and later a humidifying system was installed; ho did not consider the atmosphere excessively dust laden. lie continued work a a weaver in various ration mills until 1913, when lie obtained a jab as a weaver at an asbestos factory, which he held until ynat prior to hospital admission. During times when his work there was sus pended he did odd jobs, with npjMirenlly no occupational hnjcnids. Be ginning in 3913he worked in an extremely dusty ntmosphrie, in spite of the fact that, windows and doors were kept opew as much as pawdhle. About lfti3 n humidifying s\stim was installed, but this he considered very ineflieionb though it improved the atmosphere somewhat. In winter the heating system kept the a ir in the plant too dry to allow settling of dusty particles. In summer, vliea all dom-s were kept open, air from the forced draft from the " preparation room," emptying out side the plant, entered the room in which the patient worked. Tim last five or six mouths of his employment he was at " wet work " in stead of dry warning, redw ing the exposure to dust. lie was accus tomed to work overtime, since ho was paid by the yard. This man, then, worked us a cotton mill weaver for approximately twenty-two years mid as an nsl>estos mill weaver for somo twenty-one venrs, which may account for certain features of silicosis in the lungs, ra addition to those of aslwstosm. Omtrsi': Throughout Ins slay in the hospital the patient continued to complain of persistent pain along the right costal border .and right 1 .; r > * i ..VRi* . .! f t f ' f- wJr-.L iH i U -' ;,.!i 1 i i T: 1r 45 '1 f '\ I' .; ''f - J U ' it ' , Q' m *b vHuUHHwpnn*^rr<c*; O F CijT-ntlmOVv (OR R fS F & q C H IN Il IFf U OF LENDING T H f O ftu .tk r 58 K R S X E T II AT. W J? C J A3? W. ATMAB fiMTTJT wdtHjf the abdomen. The cough* with expcetoiation of large quantity of muetjpjirulont sputum, continued mid Irenme more aggravated. There was anorexia, with progruKKive lows of weight and .strength. For the first three weeks after admission there was im irregular afternoon clovatiaa of tempuratftTc. l a ttm latter weeks of the ill# fever of remittent type was constantly present (QD'-lO P ), rising on the day of iteath io lOf''. The pulse rate ranged between i>0 and 100- The res piratory rat waseonsfnnily above normal amt mi the slightest exertion there was dyspnea- , RsmmhfaiUm; Tn generet appearance the patient hmkrd much older than fifty-seven. He appeared exhausted and was extremely weak and im tM O X A IIY AOJESrOSS 59 tem presented no idniormalitios except for the (dubbing of tin? fingers previously noted. X-ray exnmhmtimi of the chest was made bv Hr. Hiilver Hudisill, who rejMivfcd as follows; " F irst exmmnathm, Jan, 12, 1934; There is u geuernfired fihvosis tUrunghoitf both lungs, jrorticwlurly m 11 tase*. There is gewvaFtwd increased density in the righPtase jirotabty caused by pUnmd thickening. In addition I believe (lure are ImmehketMic reus through (he lower halves of both Inugs. ``Impresslmu l^ahmamry fibnwis. pleura) thickening (particularly right base), and bruneliu'ctusU, probably the results of mhnlntion of stHne irritant material," >*, -%; .. f c ,fl tm * F ta. 1- H e ra tiB q n m th v a w n * I'P t,vN A St A finarlo u c m t a a s o a k 's o u a o r -Uhm, Snmv Xou emarft!, Tfie finger nafs mi tw nails were dubbed ml somewhat cyanotic. - ' - s . ' Tile bmiy Dmu w as o f (lm emphysematous type, Fxjymsion was hot jftmri nHntvss Was present over the lawcs of Imb lungs, ta in# more UHirkwl W ith e ri|ht. The vqvpev level* were resonmit. Hreftth somids wero supprtwsml over 11 right base, tifile* of 11 varie ties were piw euf in f he hvtrer postprior and axillary aspre* of the rtaxt, ttwmgb l*m uumvnm o m frim rig h t ta w than the loft. T1my were in creased b y egji, Oliere were iwnwrmm coarse, drv, ^squeaking" sounds ovorfhe upper lobe as well. ta a r i was j h i m ! hi sijt and position; the sounds were good. There were wo murmurs. ThcqtuUnmc mvuiuI sound was awentnated. 'Tb systolic Wood iW e^hrew as 100, ilmsiolto 00. The superficial vos I# were ihickoifed aiwltortnow*. ,> w . . C ` nv ,~".WETS. Pmi, 2 . AsnRrfTO KK.niMx m jtji ( \ m h<m o r h o w t* ?*ows . The Iwtamdm (Mautoux), mid Wussvrumuu tests were negative. No nherob taciTti were fottuti in tiic sputum < numerous oxnjmuaJ ions. Ashesfosis tadies were present in une<treni ruted viscid, tough jnuco- jwx. Tests for fungi were negative. The urinary findings were nor mal. Hloocl counts were as follows: -Ian. 11, 1934: hcnmgiobin 80 jmt cent (Have}, ieuktspytes smalt utul large lymphocytes I t, huge monomu'h'rtrs 3, neutrophils 8f; Feb. 20, 1934; IwmogUdn 72 per cent (Dan*), leufeoeytcs 13^50, small lymphmwfes 18, large mononuclears 4, nentrojdiils 70, eosintqjbl 2. The admfoswm diagnosis was pulovonary fibrosi mal pleurisy with effusion. The (find diagnosis was Hritestosi* ml cUvmde hulnmtivc i h it's fin ' * e x TM T ,! * > < * * w . ,, m a s S M m . --t 0plmtmiges o aa m u r r io ,! < ^, r.t'i?,TM'1,"' V*' T,t*1 /! WU proinhipiit S S '" ld nnd ro,,ni1^ . Hie dient f" ' te w u tf th e sk iie , ' rS * * * * * t e pur- ""** th e tm n liv ain n m u vf*--r . f tf re- S i S '. K %* * * * * S^ 'S sS f r^ L M O JA Jir SDR8 T0 8 8 j te l inile i of ,,,,diter, teird, S i-! h op n " lnw r tl>W Of tlie t e e r nired, a t tire ptoe, | W a r n t e , ! r ^ f S E ^ ' 10 TM M w , ruptured in remavi,,s Ole ? r B^ ns8,," a *'= X ` c S ^ 'S c " J ' t i " = = " = ; m o d e 'I f S S r ^ te ite o a e , a ta * . V *; f^' :p .l * ' V ^ t r. *. ""- " ' "* .e e^ T `x m !'- " hma- - * * - HMmtmrt ,,ero IrIih-,Wj!mlt,'a^,*n,t`eiww^1SSrS f f i S 'f r m";'*"*,vlwh'!'!"lm"*l'**r*f*<,`1"1'- TM iiitTM teit nn,] fu rm ,* * \ r ? t l n L , l f . i i ` P " r f !<i i l in rotigli, H * upes ,,r H A ' S * 0,,?fc* is ,bB * > W ' mimi of ,mi|'tepieSS S <*. m i<l|.rlw" r f i m fn ,1SS l 2r * " 11' (iimT tra,">fMte Mn,J '`'"Oli t e l i wtU*l & S r ^ k #**>sy. * y , a m i o f Mio miei foliar pie,ini, 11, telti ,, ,, . ( ' r o j'''.""'11*; 1,1 11,11 PPuaillnn of Klin niimm liv b iv n h ilm irL h i " ,1,,1," ",f <'*eti, ivith .Z&wWi W S '" 1 " " d m Pdi'l'<lh'ul ~3 * Z S t e librtm a ,,,,d 1^ ** * -* ^ s s s r & ^ p it ^ M a n d i d a o u ^ i , ! Hai Kim-i I |',C*|),; :f il'S&ufe*** 1 MmW > Al l"- o^'f - ssi | l i ;z . ( ^ '< fm | mm