Document 10r2zerEVRmXdbmKEMzB4pzbX

C,C* P.I. I. h. Pb* H, F. K. Lead Poisoning February 1932 started work on molten lead spraying operation which consisted of sty-acetylene torch through which wan fed a lead wire under pressure so that the torch would project a spray of finely divided molten lead on objects to be coated. Work was done In booth and patient wore a cons respirator the sponge of which was changed twine daily* Great care wao exorcised in point of cleanliness changec clothes and washed before eating or leaving work - did not cat or chew tobacco while at work. The booth 13x2x5 ft) was equipped with a fan which was In constant operation during tho working hours and was considered adequate for! air changing in booth. Such amounts of SOg# NK3, and IECL( solderInrj as escaped Into the air of the-' main room would be sucked out throu/j the main ventilating apparatus as well as through the patient's hood and 3 others which Were in operatinn in this area. Enclosed area (main room) lo situated in the corner of tho building and comprises an area of approximately 5$ ^ 50 foot* On an average, once per week, escaping r-i3 wan muff'clenfly concentrated to drive a 11 12 nen out of the area. Patient worked under these conditions for about 3 months till May 3-932. Miring which tir.10 hie health gradually became poor. A sweetish metallic taste was constant after tho first week of work and has persisted to date - somewhat hotter lest "-tonfcher two. After 3-^weeks there began nervousness with restless sleep - frequent waking following involuntary jerking movements of arms and legs during sleep no bad dreams - po insomnia* At tir.es ditrlng &ky crould *yve to stop operation because of framers and shaking involving entire muscular apparatus - no chill ~ May I952 * after bad spoil of trembling - wont to hoag! t;*l where he was told ho had a foyer and. was sent heps where ho remained in bed for 4 days - returned to,work - worked l/2 day - went home, ntoyed one week. Taken off operation and pu\; on tooting operation 'no exposure) About 2 weeks work Sin 2 months', Han had ho work since July 1932. Since July has had no improvement - taste in mouth persists - has periods of lassitude end nervousness - has generalized tremors* Appetite has been good - eats little lunch - no constipation at any time. - occasional headaches. Ho unusual indigestion - no cramps or colic* Weakness and taste in mouth have been principal annoyances to, date. Mouth felt very dry far first few .months at. present has salivation especially noticeable on going cut Into air. Ko cough no chills - no fever- (usual Tj.98.5-6). Weight loss 8-9 lbs last 9 months. School till 21, Salesman 18 years (oxy-acetylene wel.ding apparatus) Frigidaire past 5 years. Welder 9 months - foreman welder 3 years Silver soldered 2 months - thep on present operation. Only on present spray operation. No Kg exposure. Born Philadelphia - 2 years - Eupope till 1908 - U. S. A. slnceTraveled considerably as salesmen - never in Tropics. ' V- i- . a**--.-- Fi. II. Father died at 58 - d'p.betes* Mother died 80 years - 2 sinters living end well* V.'ii'e livihg and well* .2 children living and well* . Ko miscarriages. E. X, Influenza. 1951 ** 2 weeks quest!enable illness 1922 - bed X month* C. B, Dyspnoea, on exert?on past ') months* 2 Attacks severe asthma at night April 1952* tJheosed most of nirht - whitish sputum. Si*. I. aeittorrhaids - syr^tosiless* 0*1. Negative E, K* Occasional headaches ~ after nervous spells has cold sensation' in hands no nurabnecs * tingling or formication. Best weight I65 (19ll|.) ** lowest 158 (195*) - present ikt. Habits Averages' 8*9 hours sleep ~ no alcohol pact ? years Little tobacco. Cental Increased irritability - memory recent events somewhat poor* Koticeable Impairment eyesight post ye&rv wr.zm, ' Dark ccssplanioned - spare built whi to mar, about ho yoar-~ old - not acutely 111* Anxious expression - alert - cooperative - judgment good. Tt 98*2 ?: 72 Hi 20 B.P. 121/80 Head negative Ears negat!ve Eyes R~L med. regular-, Reflexes D.O.h, 0?.. convergence good. iose Staal' amount mucoid discharge on left. tioufch 8 snags 3 bad. - 1 crown Gums good - no line. Tongue coated* Mucous membrane clear Tonsils very small - scarred - reddened - anterior pillars Injected, Keck negative Ches t Is- J, . tit* O 4 0 Lt.9.0 -*h* Hi, ^y|nQr!r,a2. oositlon Lt. ;j*p} a , i > * i. * 7 * 0 F.C.b. 2,9 x 11.5 [: Some Increased normal difference in percuss? or note two .sides especially right apex anteriorly. Expansion not greatly impaired. Tactile fremitus normal - whispered vole and breath aouns normal Spoken t*oice increased right apex - Chest essentially negative. Heart tones clear regular - apex rate 70, Reaction rood. 0016930 Skin 1 Belly thin - pale. Slight cutaneous edema healthy otherwise. :ral palmareezemle ocp.phold - reap, excursions free, ioascle lax* t'here in an indefinite mass in h.L* Q. It ; area of diagram tender on deep palpation or forceful percussion, Ucdes at Ponpnrt leg ore large as are inguinal nodes most narked cn right who re they arc- tender, \ Liver and spleen not palpable. Left Kidney not palpable, itodes Other tii&n inguinal una iliac arc not palpable Reflexes borsa&l +* i.I*. -**"* . superficial normal - rsoderuto inyotuctic irj*lfcablXlby. .'iensorlvca norms! acute* Pelvis Large sae with impulse op. right - rings la:: Bectal Several tags external temorrholds - also fov? internal - Prostate largo ** firr; - especially left lobe which vA th the median is cu* fce tender* LABORATORY Y13C - 6*530 KB0 ~ 5*290,000 Diff, Poly 62.t 8 tip cling - 0 Eb- ~ 15 H.H. " I*. Jl.J S and Tr 1 Hr 5 Urine ~ Acid ti.E. - Alb negafciv 0 Sugar iiogn sivc Stool IMPFEdfxoy 1. Ho evidence Plurs'cism 2. Dental car5.es and Infection 3. Chronic tonsillitis h Prostatitis 5* Unexplained tumor in abdominal cavity. Hk 0016931  Sample urlr*o unci faeces for lead Suprlonl consultation on abdomen after Br. L'enfenl x-ray certain extraction snags* G examlnafcl on " and r.; consult at ion* Willard P* .fcaehle. K 0016932 .L-___________________________________________________________,,,,