Document 2jZgY53kz3djGRM1YOp3MR4RR

4 * LEAD INDUSTRIES ASSOCIATION A*3 LKXJMOTOW AVCMUI ! ttcwrome it . h .t . i July 9, 1951 izis HT-izrri jjo simr j.2S Subject i T:irSF. TUX XTACT A3T1CIZ3 To M*ab*r* of the Lead Industries Association f Herewith are reprlnt* of three recent article* of which the first too will be of Interest to those of oar archer* concerned with the discos!* and treatment of load pc lasting, while Uve third tells of the lnatltutloe and maintenance of f t i workable Industrial hygiene program. I j 1 limited eu -ply of additional copies of these pipers Is available. 1 brief i stone ry eech follow*! A Critical ippnleel of Correct Practices la the Clinical Disgnceia of Lead Intoxi cation*, Kehoe, R. Ind. Med. end Surg., 20t6, June, 1951* Dr. Kthoe discuss** very adequately the acre troublesome aspects of the <&*$noalt of losi poisoning, .'.ttsrtlcn Is focused on principles which should apply la errirlr.; at a diagnosis, and on major sources of error and confusion resulting frees unsound clinical thought .and practice. "Treatment of Lead Poisoning with Sodltn Citrate*, Hardy, H. L,, Blehop, K, C. and Haloof, C. C. ^rch, Ind. Hyg. and Oocup. Med., Vol. 3, March 1951* four cases of lead poisoning in which treitment of the patients consisted primarily of sodium citrate therapy ere presented. Evidence nccxaulabod In this study points to effective relief of aywptooa coincident with oral adniniotrotion of odius citrate, Studies of urinary lead aeration and urinary coproporphyria are also presented. f ! i Industrial Hygiene at American Smelting and He fining Cos-,winy", ,' bersold, J, f, and Me la on, X, w., Jour, of Met ala, 7ol, 18?, [Jo. 1, January 195L TMe rwirw of a well organised, successful Industrial hygiene program should be of great Interest to all of our awnber companies. The author* discus* the Mdlcal services, tha method* used for s'.ul/lng the working envl rurswnt and the plant lm- I proara.nte which, with Ui* interest and cooperation of employes* at all level*, have t resulted in grrstly luprcred voriing condition*. rit i \ QUn Cc.trf O) { \ Manfred Hcwdltoh Dlreotor of Health and Safety wrw iwyBBP<ppjrHwrii',j mb nmmmm< >pw1- w '"'awy'iwi^Lmii^'PigiimiaawBWBWB^pwy L IA 10838 i t tf J A A Critic*! Appraisal of Cimant Practices in tha Clinical Diagnosis of Ladd Intoxication ROUST A. KEHOE, MA CudiMti, 0kJ* 3 llffdolrd fri<n ItMlllllL Ruill INS AND Ml 70 . ZWJAD. JoM, I*M N 305.01 PMMiuiO*wnMiW|wp*l!^^ p^WPip! 1 lj!tuv 1111)1 LI A 10839 i i f i A Critical Appraital of Currant Practical in tha Clinical Diagnotii of Load Intoxication ItOMftT A. ICtMOC, MA G~ci~v.fi. OU* i Till dlAfnoiU at toad inloik*(i Itoo )m| Un ih b)rt ot Ia Ia m intmtt ud at fr#du#tt cntroTrrar imof| clinician a, #* p#>cially among them* nhoao pradKf ciw#mi H*#if with (Ma of artoai of aW#fd orco pat inaval fdumbiaoi nr 1lk VtM>dKtiiffkJ rtwktKf or |nti(rw^ t roonortin *ilh aurh paw Morr forrrtly, nu* i<W-raL*a cumbers of eoo-mmliraj frv*i Karo comr to Wr tunmMd with thia pndiWm. through th#r rr*pen*ibilitM til loduairy for thr ap> ^riiuJ or ccjotrrd of pmifotMAiJ lead huirda, od through lb#r artiiU#o in wvirkm#* rtn- IMMutton prttfdim, la gmmmfalii h#oltb utd labor dfpaitiMntA la Ub< orfiAiuiiciu lad la trad* aaaonaticoia. Nor dm prrf#*>rvol aod Ujr tiarfri rod ferrr. oa# mry pHulriit, family pO>a>rai and pormt iful pay attmtum |o thr u*agr of Wad and Wad (nmiv^nda la thr WuMhffd audar (uad.l*u^ h*h n*av (Lraalat thr brohh of infanta aod amall rhiMrm To a mwh W* aigniVaM eitml. a<oi-nrrupotinnai bad poionfung errurv in thr adult pfulalina m th rmwH of a Oetnlvf of highly anuual ntulH, among rbab th* moot frvqu^nt. 11 Mima. Intfdtr thr # trad papa and brad* linrd tanka for Mipfdyig and rtonnf watrr fof thr buofx4d from a apnng *r rail (lmnl?, Ihla haiard la litnilrd aimnot mtirrly to rurai arm*. Wut mcmWri uf far familira *r> man? <f our ot;#* hatr al*o I-## jarjunod hr thr u*r tf hatlrry Uno a ittnfd fr*<m rift <!.m^a aa furl f'>f tww and frrpiorf. Thia di*#*#, tKrrrforr. may la found amaf (gram wf alt ifo and In all ' ) and rc*v/**ur InrU of <>rty, and it i* fc thu rra>o, piS` mart)*. that it la aurb a trou>W-*m# HiarrwMtu pfifl.Wm in thr fWld of grnrroJ rn*duinr > icrut*tif>r.ai Wad f arm i n g ttrurt lnfrr*|u#*lly, and tbrrrft rr frar phvairiana in grnrral prartti# Har bad rnough n|*nrn* r*r hry/wWirr |/> *. aid# I horn tu prtaba primfd u m of ff wti> ritag- tut> rwaaiim hkh mar I# aai*a*U r<r tn iw iur'ii taw-*^- * o*. i' ( *r r * a**ia W^w *m W-#oa ~<->a J *4 Tvi'W~**a t Hiaiiio i 4 11 in 4 MM f\ H. I*M ~4 <* *f P* ifu. aHi a mi taka thr itrpo I bat *l Mtart thr frtarr d* Wring and aa/rty of roltmta who arr. or vW ikiak th*ma#Nr*, aJT.x-trd wttb thU iHra--. <Vru(at<iaJ trad pmaumac. tba otbar baad. ! n^ rarr tn Ha orrurm* amm| tb# p*ti#U of pfcyvirtaa* rcniH La pnratr prartc*. bat tb*-*# riH arrvr larrrtr amcrf prraona la tb W^arr tts-iai arvd #roo<<rr.x irpixtiti of tba popa Utua and la I hr or baa irrai la bkb aurb pnooa Inr and wort Tb#y arr ot diitnbfKd rvmly of *k 3Wt anwwff pk^airiaaa raf&fad la pnratr prartr, and axain. Utarrfoff, faauli* my mtb tLa dlar&nr u abarfdy limitad to a crfiaia group f ladurtrul pby**oaA. to pbp* wtana *Ko aprriahir tn tbr rtwdy at orraf** lK#ial dtaraarr, to tbroo | rrrtaia rmnmualtim + pfttalr pfoclK-t d#la Urrrty with tbo iiir.***#* <d laborrr and tbrlr fam>U. and tr {Km# Lu *#* |t#aU ia grnrral Wnpilala la mda*irtaJ twlm It la M aarpriainf. th#rn- f'frr. that crrla.a aaprrta of thr dtaga^tlr prnfr- l#m arr nWn, and that dlaftoatk rrrnr art aumrmua. It La i\*A Uilbia tb# amp# nf tbit paprf to dral ottb all lypr* of |#od pnuwiai, of oilb thr tn*** of rtfuavr* to Wad that giro rito to tbrm. or *ith ail or ram many nf tNr factor* wblrfti r root# rlmkral and fftrdk -*-4<gml diAruHtr* la roa 1 ftnli. with IL.rm In*'.#*4. thr dir**m wig I# f><v#d on orrupotici*i prawning fmm tbr ff Wad. th# >mpio pnn'i|4#a objfh aK^uld ajply la amnag at thr diagwoia of tba di*#aa# for Mb rliaWai and rrvUWfai and > a frw r-f tb# 1#*iafi-a frtm ar^md cllnka) thought and poor* tor whicb a##m to to ma>nr Moar* of rrmr and at thr prr*#ot tilM. OUf#a*o #T*MI diafni^ia at Wad IntntWatkwi. Aa ahail <W*J oMh It h#rr I* loud b(*w a talid h*- try nf .fnr**At f r <. >nnaJ npr^orr to Wod. ^# |h |>r*#fw* ft atrnnfly aagfrotivo *1 |hr rdrtla nf a'**->fjKi'Oi nf Wod, and upoo irfi*.a p*r*J fna ohwb rKarorIrriro M of W*4 tr i^lotkalino tb#rrfrma It IU Wo Mot that (hi* ial#m#it puli lb# m MMWW muv 'g.wnwtfHSjiciw> LI A 10 8^0 phaeie on Dm actual nitlence of aa fotci xatioo property appralaed orpoeur* ta Wad 1ft ladaa* which 1 to bo Idee lifted by ordinary <hmcl trial piaflt*. asd. therefore, the dtafiwetk prwW- )I moon*, and make* t h rtfirtw* to any laboratory Wni i* aiwaya an latrirvlnf one fmm the a*pact AndJef* That each a atatement fail* to rw of the cufitratlun and appiKatloa of aewad riiaW f the entire 4ikrrwmu< f>Jd. both from the upvrt f *J nvelbod and Jodfmmt Erory ra*e of lAsnoa of the mor* cr laae chrxjk clinical tnanifretn- hkb cecwra amunf workmm np*wi to Wad Uorv* of the 4loooo and aleo from that of the hnuld be wtxked ep t^y the r*opon*iLJe cllnkdaa tor hole ml armamoc.iarI am that rail bo brtxyM In *wch mas nor a* to aobeiaatlato the dia^boaia. to boar M) tu rtody, mu*t bo admitted. It U If the diersooii U that of load ffiUs*x*tJo*v tho don* deliberately to place the emphnaw where revord* ahowkl proetde tho rrldence that trill U bvionr* amtmf cttoicinna The fart* irt that lift# cuntretor*? and prwride for proper and m mark ho* bee* raid and vntUa, on tho c m adequate oedKai care and for pram?* rtenpmhood. aU^t tho oiMk and unueual rlir.WaJ autre uti< for di*ol><lily If It W aecse dk*r IReeoa. that cofx*i*aUy may reeuit frets tho nbeorpti'jO the rrrnrd be ovjuaJ/ apt and marirxinf. of Wad. and. on the tAbee, about tho UnfrunUc meoewro* and rnlmi of tho UUnlory, that If thi* drhnitlw d.ffrrmlialkaR ranaot be made to every raw, there are bet few nrrpica*. and moat of oar cboxian* haw toot eight of tho dtam** a* it coenmunly proecr.t* itonf. and of there i*. at Wart, do jaotilWauos for not maklof an h*e*el a^d ropeMe attempt to do m* More* the baa* conditio*.* without which it teem* wrf. to the performance of thi* pndmuaal an*#. Th# chnxei diegnowie of Wad *M*<*wAf. whoa It orrur*. a* It drew io tho exry Urge <4 iH n*n. la a morr nr Wo* *ute ry*i*-LW f lllnoaa foitowing bnrf of prvA<-red duty, the pkyaxma ha* a f\W that W perutiarty hi* pe , jot 4v irf only the tnlent* and tkiBo aKuh. rei the Um of hi* tnialAf. may jtlf be *iperiod of him. rrfardWa* of hi* eipertosre M|xvrr to dacfom*** KTup*tuf.*J r<M)i)o. of lortponmct nth the mere modem toch- i* not diAiuH. Tho wo create fur rur- iMjtm of ladoatnal kyfieno. **frm in nee.#* t x* with it inw f n Inctywri- nr* to to wfo. tot mainly fries tho The Occ*p*hl HW*wry tie* of kix/sWdge which wo do md y **# ** and IT KiTT be riCDfalud that tho taeopaUeoaf frees ahrer r*reir**o*n* la tho performance of ht*tury, a* it perlaia* to the Wad trades, to i-tc iwipie clinvaJ procedures. A ary of tho lubetaatiaiW h m4*m, earept 1* a flee which meet rfcordt i f ri*ra of actual and ilWfnl Wad pne le *ut*tant>atr4 or dlwardod. anWw it l oWofiinf that h*i boon la r*oitrnr*y and hrnre tained and rwrorded and intrrpcriod by *ae who hart rum* up foO owr mirw oi*f a |ofil of t* wh-Jly familiar With the oporetxoi* to the*e yenfs ha* forraWd cove t HanuUntt X ) tr*A>e* and the *fw*ihr plant in whuh the In nww< -f t(**m tho {*> !.**.? w.J c.-l tun th* UmT.! if cartful Itnu-ai ttuJr A h i 1 n of <yef*U'-fi% *ro leinf tarTiod cut The *tate> imk Ii uf 4 p*t, nt - <* tbe*e me::***, aloxel without farorex4i. are irwrepCeK* * rlnxaJ tUfval W*4 tt(karf. utwrilxaHy and y*t ihf ni4<tx*. and are warrl>*t4o la lh>e features m*tira!fy *uted, a frarmmtary rental of la- hxh rrtato t* the ^aantitaliie apprai*nl rf the iWAr.it* toftrwvj whuh wore out inoeetlyatod. Mjofidi*. r*C t!*rr<i*fjlt, cr rvofi fteiwaiy. W and a phvvxal riamir.atjnw that y iridod inly i*uw of IW MiOiu rx d*h4Vkrty, M dubtow* inf.irmatKoi. Uifother with w*v>*. cfWn txr*u*e of hi* inability to diffofmt>*to the *4f a multitude, of usually IrroUrnnL. urw-ritxally tiifxant fMoa tho in*4fWV*at fieta, mt * If latrrpfoted lWr#t/*ry reeulta, nmy-Wtoe a d*v- the phy*wtaji i* capable -f iixh different i*i*'Wi m*rt whMh |k-ftrr no* a patient'* iTne** Ik iI a phr*xi*n'* iM<nprtf*ic. and of ModetiBr bio Irxjwiry We# l.ftre that will faril/taie wrh diffcrewttatxei There are. (l.&xal Uiir-ew# and ineptitude aro alrrwwt h'onvr, lorlain fart* tK < ar *! *>* tw i^u Mfuiily- fnWi1 eJr**x>g the jhiKi*n* >n tho t*ine*f and *r* kiyrlr lfcf*ctait in *he tn*#f. load uuig 11.' } , *tr>e*. r>./ --> ftlr l-rctati n */ otker ct.nxal laf-cm*ixei ,*ince wi*e r'ov Kifhlr unlW and M)B>*vife to *|preri*i4 qoentitte* of Wad it a laW'/atofr pr.^ntufr* to mako d-fTormti*f d-*r- r'fular and eit**M`lat4e oi(wtow* *< nil man* rvw.* of itlnoowr* whkk raa only W mndo l.r kind.*'* the f***li'Nr n*p*w1 f *wch rt* raroful tbaual t*4/ It I* c-no thine In at>piy fvrv netitbl the (sent. urWiilr the *n4e th* pr*fok|Wffa of tho chemkal **t Ini*- uf tho i*rv|aUof>t} hWtncr The ijfnifb (fatnoy In a fr*wt*aa mann*f. and, )<r t*iw* ./ iKinet.of.*! t***f* <a Ua4 t*n tx ta tho *;t*f*<#ai of the <Wetw cf h*iard uf an vittlr ia tfrm* of it* and Ho trrwjaUi n It l* ijii<i# *n-t/th#r to irnto at *}* AM *'* *!l-e,* ta Ik# pal>**I la diar***!* h*fi lllntwa iuri (a an |t%dm*.*i `.all w in *|wv>ro are f<-c the fwryrM# of ap> nviman In tho Wad trodoe *r *rrueif tkeee |o limp the ii'tidu of fMtrir md dv<oJ**oJ wh *r, of ill*, nf ana of nw**v*F*-u Th* ^xo*.^ *f f*p*ouon i.th*r *( rweoit*rW, a* w(l a* rour<*i-foi J j .* U| kM the patWwt worked U the >oh if>*e**e )fi<ruTor. raeoo nf Wad p*^>*<eiirif mar * at kwk he a w-nrkiaf when t car M the roaalt of *nreror*i*ed and im Hi* lliw !-( ha* he wrxked al tk> *aj w * )nh  dpywffw1 1 ntupwi *mf^mmgmr LI A 108A1 rl*awh#m? What chn&ivu of orrupaUan Kara urrgrrrd ot*f the ;nn, at what (Uln have they occurred. and what Internal# h#vt to- * On# attrfn;*# h#r# to find out the dura/m of uninterrupted r*pu#ur to toe*i;Uo** quantitatively tompumble to thoae in rutlrart at the lima erf ocieet of the iUne*a. It lnief- rvpllima occurred. what *u thatr duration? Abm ail, what waa lha Uat day m the petJeet worked under rcmdiliocw which la* vtdvad #ipo*ur** Tb# tim# factor. in rrtatioa (a et{jiur(, in lie nary a*part. la td lha yrmt- rat Importance Without tiwtMff of (bi mo Mibneqomt informatiew ran ha adr^uat# The W4eaw>y f byiaat U7B*T waa tha c-fwratUAi (or operatic*#) la which lh# patient *u ftifirfd* M hat part did tha patient taka la carryiny out tfut elxai * What othrr operative u earned out near him and Nj w near? What npaurv utbai ty occurred d>**t. vap# *f nwltm mrtai 'at hat Irmtwcataf# > >7 VI hat prrcaalicoa^ if any < vrrtil#t*'#. WaJ or ymerai. s*# of rraptralnra, car# ar.J y jw r iof mm ar,J c-jui promt. h>'UAekcrpr.f ar-d nat*'.*cn >. **r# L#my taken to owitrW tha eipn*ur# * What tryw. if anr. were iwir.g takm to m#wur# th# Ttjmwur# and to U*#ne th# clinical Latu* of tba awiimra? What do tha putimt knew about ra##e of pn4*rauay that batv Ttirt*d rr- cattily, tjf at aay r<h#r time, amowy r>m m* fdoyrd in tha aaio# kind id wofk and at lha UAr fcb ha Ku bam prrfnrmmf? Th#*a and other qv*##ii>#ia will ntur ta the )h#r irinanr* |* iw4 affortnt to tfca rttc, La need on11 rw^faii' ti.arab) that b# i a hmw#. and that ha ha* tntM h tn Warn Nan# d-ffi# of humility t*aad t*u orh c*n*idaft*-<i ' 4kd r*"prr-**T\t ral poyr#* b oard tha eL mi r\* tuai if tha frvd* uleyai .<aitrmarir# that now aria# Th# Hwtary of fh# Bn* THI nwwt iyniVant rlini.aj characteristic of bad intoxwatM^, f*tvrr*Urk U tha prrjw^uWr- anc# of funrtMmaJ mar anatom* at^o-fcaraLt. *. ttalrd i4h#rw>*a. I ha greeter weight of *_.> ;ct|l* (rttf ohjevtike n..iaf<aa of ill'a** Th* Ttv^t imi rtant aj*ttr*<a t, th# diarr.'<-i*, thara- f.'f*. .*). in tha rar>fj| al.. itat. -o >'t !h# in f>-rmatM#i alaait (m<( ar.d pramt <frf4aot*. thatf ooaat. thaif da*S(#f>mt in f^ati*^ t- a|p* jfa r#f diac-otm^arw# of t(Kar* od thaif awt'irwa, intmaitf a*d validity With ! > tha lat of tha*a fa^l/ fa. t ns fn )( <| | n>ia a l<tT)V a *'l a* a A * rA '* huh roar ha*a fa**n baro#*4 r(^r t*n at jiaMan'td In wh.ia or *n tn part T^r t* t-. ryV# fif tki* pr<<r*d*f l,f tha Utta k<r: ?rfp ( r " : f f T f a f f f -rf i al lh<|4irp Into tha r>^>nf<*%ia faaat* r.f fajtro- rntartr a mptofn**i. gi and driiuMi; a , ao4 f>f i4()arti>a } )<*.*} of tfa tp.i)t* >( tiarh Inquiry. Htranyrty rtHKiyh. Ibo B#r* mmlioai oi an opportunity for orcupatkociAl orpoaur# to load "tni frwpueclJy to lw th# airaaJ for difprnaia^ with lh# rarrfui inquiry that U ao rti rvroffnit#d at birf nrcniury for tha dla^ncwia of Mhrr abdumiuaj rcrnitdainu. and tha flib dh* riakm li mad# that tha patiaot la aotfariitf fpaai load (die. Thar# la a hlyhly uncritical attitada of mlad to tha rffrrt that aay ikrtur kaovi afi abuat Wad r*4* and raa rwtfaitr lha rharairrlttk pat# tarn of lha ayndrcaa# without diArwity. Tha farU ar nv^a nearly tha raart oppmila. fa tkd thu. amanf tha many ard tnort ttmomm abdomi nal diu4w, u cma of which dortora, iwurtfly, ara aalikHy to Lava knowWdra and rtparVmca. Th# nyw<a2 FMWft 1M TUI moat fravjoant typa of Wad peUtniat, rpwriaJlr ia tha And rpi*oda of Intoatcmtloa rtfrmnerd by lh# individual briny raaminad. th# phtAical hndinyi will br canty. Tha awidrvt f*(ur*J and aulceoauc n#tvou* alyna of aW doa&inaj pain rahiLit thrm#al*aa la raryinp da> yrr#a of wnenty. irxludiny thru# which rharar- trtM# wruoaliny ay(<or. yL*jdicy otnr-whni *nd t>-m rrrumny in a*ciatK4i with aMocai- nai nyidity or intmtinaJ *paaaa Tha alwaarw of fr*#r. th# aranty mdmea of abdominal dia- raw la th# (nUndv l#tws boula cf wvtn rtd*c, and th# lark of rrl*mi >d fp#rttrv#a)l pain. frt funrtiiaial diw>rdrf rath## thaa oryuk diwtw, and if lh#ra la IS# blu# or black punc tate her vf t ,;Jf:dc drpn*;t in a g.zg-.i al tnanfta. in aJMBr>atHrfi with a <hrart#n*t>r h*tory o4 frfnt v#-*rh*t rwr>rnmy arw>r#*>a and rru- t>|wtitr. th# can tvamnaki; W BUkdo. |.r**-'iyl L*.* I#tti auud ri***h#rw abrut tha harnrlrntw of th# M.wall#d Wad tio# to la* *|Mr# tA^tv.wi in il* r#r-rnti*4i. 5ufRcw it h#rw t" mi that rai# khouid know wh#rwof h# a##a and iapft.r# arr#ptiry any no# of a#r#ral ab#ormlitir of th# tr#ib and yum* a# b#iny a **Vnd Un# " T.\perimcw U r#qwlrwd ta had and Intarpfrt thi* IraioA. and error# of o*ut* u# and rotruniMii# in thla rrUtkwiahrp ara all t#> fr#*)u#nt I"P#ri*i!r in t*o iavolviny probwiyrd rcra- I#t)#ial MpAiirv att#n#5*d br prior r#rtirr#wt mu-) *r #v#r# *i mjfti.rr.v. ev>tt#nr# of n#vro* muwuUr dtMtfilrM ar# likely tn I* found. *f ahih wrii-def rrd wraknr*# of th# ntcawf of th# Anyvr#, vmt and foraarra aa 1 h# rr**>*t u*#d *i<l#. *<r <#v Wdh d#. *oh th# r-4t f'#nw#i Trank pair. with wrUt drop, W rv-i rr#. if it rafir* at in an Initial bout ' Wad intnw-i..o, |Ma l^iny an pr#o- m-o of pfvdnc yod irtn (*?*? to Wud. la th# i 'u iw of which <^h#f rnanif#tatlnoa af iAtiKiti" ha# uvuailr nrrurr#d frt#u tlm# ( `..r.r Tiilirf aiyr.i r.f r.r^r^re-o-wUf Ir.v.dra- rrvrnt. that mar yo hand in band with aatmaor Mraknea# ia th# upfwr itrvmitJm, ara *br-#a- rrul.lln of huali t4#v#, a#*oriat#d With krpaf. C 0 " IIP1  ^WWW.WWr**gWffWgJ LIA1084? --y 1 } 2 f o rvAexia. hyperaeneiliidty of rauariee ta cal vtimuUUoA. and maintained mueruLar roe* traction*. Thee* may involve the lower nlrtmJtia* and. when they do. there are complaint*, rvmmoniy, of myalgia and arthralgia. The interpretation of the rarer clinical ti'pee of Wad planning U more difficult and nqulrra careful and critical atody of Uj * patient and kit etpuaure. Full coverage of the** ptvLifWia > beyond the wop# of t>.la dleruaatan. Perhap* the mmt taiual.i# ad rice that coo id be g;*en ta cocnariiod with thrtn la that one shoald pcecewt alowiy. fathering all of the fart a, before rnrV Inf or eipree*ivf a ctmcluekm from which ft i difcruh and often etBbarraeaJag to Ornate later. Modem me^iirilejraJ procedure l* eurfc that tw mmU* {in*4 cf the mitfTvf* of orrwpoliooaj (Iterate ta or afeovld be required. ThU include* proof that Wad hna actually been iWrtH la qua*(Lite* ever,p*title with aennaM mam fret a* tlon* of the diaenao. a aeriona diaeaae Our contrary clinical attilnd* toward thla diaeaae atetna larfelj from earlier clittkal deacriptiona of a neftarUd diaeaae, which, when it finally came to the attention of a con* petent clinician, eu the gapre--ion cf an *puaure to larre quantltiee cf lead ever a loaf t*rtod durinf which there knee been recurrent rsiid or moderately never* epUodeu of Intonien* Uca with brief period* of partial dlaabUit/. Thu remrrnit. oetenaiUy aaild. but pfogrreeire ly diaabiiftf. fora of the diienae, nuUnt over a period of yeart of continued eaprwure ta land, ia the ao-ralWd "chronic Wad polaonlnv,'* >rene time* U tta Milder form* MiaWndingty called "Wad abworpclcev." which U m contmonly do rnbed in r&edtcal Literature. It U not altogecber gun# from the American tree**, bet certainly it ia Wee frequent than it wee formerly, beinf the pr&durl, at prreent. of obeicoaJf backward hr und^r t^erp-ai`rT|t irduetnaj policy, or of poor industrial medical and hyfienic portico. The CVicai Cnew rVSl of (he ccer-awmeet of rh&ical mittaAr* to the d.if&uKi of tcfwi*'j raJ Wad pc>**ce- inf ilrfni freen the te-fief of laetpenertred ciia;* c itai that cry frcea Wad pcaacning t* b * ally alow, and often, if bed rrralaHr. incoaaydete The facta are prwruwty opposite Lend intoti* calun. except ia ita more anrr and unrrenaaon fwraJytic and encephahpelhW maa*fritKav* i* an i earc-t tally neif-Jimtted diaenae. of reeapara* tiiefy h*.rt duration 1 day to week* . from tth-lt, ta the i#r*U*ir..nf of r--e*. there ia Cvnpiete recovery when the i jewa* re ha* I* i tree**jf.atrd The je-r*i'*^*re rf ab ducm&aj tnp<i<ni tut many nveuth# or f*a Tf irnr* afur the (r*ation of rip-*rr. a* Kaa been the raae not infrrq^mJr ia rreitm- \er*ial *;tua!u*. fey-re*entJ practically indubtt* aide that the rig** of the ailmrnt wa* not Wad at*wrpn>n Kvrn an anemia, on finally ronaidered to W an etpreaaion of the tmw ef- feci* of Wd absorption. i to Ue retarded with the greatest *br|diciam. if it prr*i*t* IrwWfi.fti'.ely after the termination *f rtp*eure to lead 5** far a* can be by the *todr i f earner* ** ra*e nf Wad ir.fi *k alio*. no trrevvrailU* In )4-if< imif.g ti**ue* i nawciated with p*uirkU>m Indeed anemia i* rwd a rave** ory ac'iveynniment of Wad lntmetK. and l*ee whn Wyal prycedurra and current me**, urve of tndeatnal ht|im are the *ee. tty of *< u at r.al Uad po>*r.sr.f ari t^e of ar^d rT^e1(i<-.*4 Wad in the urn* i r. i, * nlual, ar>*mia la a m * h Wa* llR(>r>rtanl a*f the ^liM^al ayndc-*ee than It u formerly lead a* >**a ia th fra W oht^h are rufrn^l e>*a (oa|44i.4 .f WaJ, bn rmru tni pr'Oai-Clr Ai -4 *>11* iu.itlHA.if \:J tag \ K* io JiiiOj*) frm ii[uri and jerm.Mlrf b.# re- t-n I* hi* > .b te.lf when the Mpeart haa teen U'"*|bi endef 4e*joate fimtrrf, ii *)r reretr The C^WnbwtW* W tSe LaboraHry pncaiyf hu been made prrrlcwaly on mm of ' the diairr.ietic d;Ouh.r of the phyairiaa e^ raged ia rcr.craJ practice Prom the a*pert of the UUratory procedure* ehlch hare oaf In be aimeat indiapenaable fmturee of the diafrmeie <>f Wwd potftf for medsndeynj perpneea. th* pndjira U cefwnaDy dxflVruh. Pew diAfoaetit Ubnratorie* aiaiUhie to eorb pfcrairiAAA. Iti fue that matter, for of tWee available la bn t* tW and me<l>cal center*, gererallr, are equip* d muk fcii.nr* ft f the yvrf<emance of the net #> ary tret*, or ith the knuwWdf* and rtprW rwc mj.irni f> r c.v;^c ad^iuai# advice oa Ibe tete that ehnuM le perf>-rmed, or on the metb* `W required fe -bte*mrir material* to be es* emined TW mill I* that the teeta made tn many UW*r*tr,re* are more likely to be Mia- leading than heipfel Therefore the phymiciaa will be well adned to di*pm*e with them and to lave hi* Judgment entirely on the hitory of the i"ne-- and on the phi*^*! *>m* ahich he ram unW*e he he* the knowWdge and *tprrien<e that er.aMe him to appeal** the lal^ 'fi'i'fr and it* reeuita. Vr* rum:MVn in relation ta orcupn- Wad p<eiiOf. *uep< ia the differential d`rr*i* of a f*t>-*fitrfK dieorder. May be wfh *ummarilrt l>y printing oet that they haie no value a* diAgr*<ttc precederee la the a1Jt One l* rrwf-erra*^-d acd infrequently |g nrflrt, by the aere**ity of pointing i vt thel th# line ( eieu,rm*;5r den*e bnce which i* fr*/em time to t.me et the margin* of rp*4 growth tn th* vf infant* and *maJt ik4!i, u a (eeifie mult of Uad ftUcrp it.e <n (he ie^ Wi.4 a phenonwnrei of *<U!l life, na the o4hr vt may *i*o iWal oely with rerlaia of the fru.t* r mnwei UW f*torr j r<ee*lufe* Tb* hewia- J.Argrf rhang** aae> taled with Wad pnueini |4*r *a imp*>dat r*de la rllaWal iwnwwue i i njuumupn yigwj wmi--'i.mmj.n^r -'*pqwqwwew*'U>'!y**iW*T*"U}|,^MwwawwEt4^ L 1410843 w j iw u i" \\ Mi . ifc-- - '----- -* - --*- - kiuu. m' " ' w e H M - 4 J H H H M " w i i w w >w # W W S W 'II|W > > i i i ' m n ijw iD i m w ............ .m mt , diagnosis. Tto UterpretaUoa of ths entire blood IcfW and pattodogW ptoaomeaoa of rataldar* picture. bowmr, niut be made in tto full rerog- a tie canability, the catant of whkh hae not p nit** of tto fort that *11 of H 1* important been eataUiehed rofsprehenalvrelg la nrytaf Ct tot that no feature of it give* specific rvidcwce of Wad absorption Ths commonest fallacy to state* of health and di*n*a*, or la reUtloa ta age and aex. Certain It la, that this ptooceneMB this rcaaevrion is the persistent belief that baso is n<X peri ally relattd to Wad abaorptioa. phil* stippling la indicative of abnormal ato Mm Inftomrrd markedly by Uref damage or sorption of Im4 or of actual lend Intoxication. disease, by tatoiWetiofti of other type* thaa Wad, Much cooId to ftud cf tto method* of examine- by a aonaW of Infartioca disease*, by certain Uco of the blood ia this connection. tot, with- deVimcy diteases, and by certala tomatopoWtle cwl entering upon such a diecuaaiorv. Wt it iwrt- uleoedrr*1 t T That there U aa eWrstioa of tto ijr to recorded tore, rrfirdl* of method, that rate of urinary txtrriUm of copropcrphyrina. la tto wfurrw* of bnsopbiUc rilmil In the try- aaeortatlcA, more or Wa regeUrly, with highly '.hrocyle*. per *+, has no diagnostic significance, abnormal abeorptioo of Wad, U aa totereetiag **d that there nuit to jam* quantitative ' prmjun of (to extrot of this ptooomenow in aad Important physiologic fact and that this phenomenon may wed to aa highly significant i tto Ltori to five It isrntfirtot*. First. on* mu*t aspect of the mechanism of Wad Intoxication, ewtaU.eh whether or cot thr phcrwcRenan or* goes without argument. But that this noo-*p^ cum beyond tto physiologic ranre. and them <i V phenomenon can contribute aa aaeseer ta tto determine, if pcwsiUe. tto m*-t probable Iio m primary diagnostic question with which tto phy* uf thr abnormality, if such U found. 1,-rad nb- sician is faced ees-ma most (mpn>tobW. W*hat puqtica 14 only ceve. and not lhr moot fmjwrtt, Is th qur*tr*i* If we raa make this ^ffrieotly of tto ynuubie factors. Tto greatest vnJor of clear for both rhnical and medicolegal purposes, thi* UU-eatory tr*t, w hm pruprrly performed, we shall by that means define the l**oe sharply. be* is the fwt that failure to detect any ab Mrdu-tl, legal and economic cocridereUoca re* normality <{ tto b*d in thi re*j*t argue* quire and )o*tjfy a <Wcmv* axuwer to tto qwaa- tndfly, indeed, against tto likelihood that tto Xton: has thi* paumt atooftwd a quantity td iUa**s under consideration ii tto result of tto Wwd aufflriei to r*u*e Intoxication? If to haa atooept>Ld of inorganic mmpound* of Wad absorbed such quantities of Wad. tto diagnosis Another procedure of tto labur*lory, around uf Wad lataAkcaticsx. arrived at by sound clinical which an run* of eethuaiarm has gathered re* mean*, msv to regarded as adequately substan cewtly. it that of the determination of rupee- tiated. If to has not. tto diagnosis Is untenable, tBiephynna in the urine. *j a means tf detnre* itfit.i.g tto orT-urrmre of hxtardcvi a^-rp'.i'^ / W*J ('srrfu! InretigstKn of the rndalF-b-w and further study of the case Is required to arrive at tto ccrrrr! d;Sgno*i*. Tto Lrin/* us raturalJr 1t> the r*Bidcratloa #mj ri r fr* -- .f |He jn-e-yherine u*der *netv f ftetrf <r.. including lho*e ****n*trd with ,.f tto jrT^erf'ires *<f the Ul-rf-at*(rr wtorrbe tto rttrot and signlAraoce of tto Wad atoortdloa of r iryrg Wsn* *.' Usd mb** .' prion. may prmide {to fwf.en! cA to apprai*ed. Tto ph*m'igic a mean* f*r tto early detection of actual or rvidmre <* which tto choice and iaterprrtatksi tmyeodrrff Wad int(>tirati*r\, and thur add IM- uf these prteedurr* are baaed I* awulaUe1** tenallr to (to armamentarium of industrial and r.red iw4 to brought Into (hi* di*rtji'ei. medionr in thr lead trader. Moreover, If the al1f--Aigh aiw h rvwWfxc mu*t to ynder*!'*^ fuDr r*creturn of porphyrin*, in the cv-urae nf a reeog- hr Iher who would apply It. The method* uf Died (4u of Wad p*ijw*ning. an re>eaj thr rampbrg and nai>*is'*" also have toe* de- %e\enlr of the Intoxication and give aid in prog- wnl^d in uitrient detail and wlQ M to mew- it iU (tm to arree a useful purp*e tkonJ. to*<evd a further warning that there T>*err can to little d^bt. h*or, that tto are atojuatr tnd ir*<tojuate meih*t and that rurreot pt^niartty of thr i*rwe*liire t*m large* *a high degree f knowledge and skill, far to- ly frm tto desire uf clinical aid UU^atory y n.l (tot >f the uual trpw of Wbwat>>y tech* <>rk#r t>< sutotitutr mc m aimpie 'Jt*grusU< nWJan. i rnvirH for the performance of tto te*t for tto m-r* precise and therefore mure wnrh. diPrult analytical method* that r*l*u steefW*llr Tto rucmlrstifo of Wad In the IJwl sf tto W tto rev<mtratoei* of Wad in thr unae. bV*d prrws wto> i filtering from symptom* believed t,r tl*sue nf persons *u*twcted of teing Ktim* tn to th<>^ t f intotication by tto Inorganic root* t>{ lead ml'iiHsiHe I^t u*f*'OsMler hrisflr eh*l of Wad i* the rv<et im|*>rtant *inffle bit is l.krir t<> to 1<*1 hr a too rnthui*<u )iMn g ,.f >i<Vfw# r,M,frd to p*<rtfsy the tigwlhcaoce It. tht iio4eralan<it>l# de*irr tyuitr apart fr*m of hi* ai'--rt'tion i t- bad Since the coneevitra* {he yneth'eU i-f analisit of the | r j-ht )*. who h Hnn of tn the Uf-d varies only within SX* hile urn;.* are far fpm fo.lpri.f, ao*l w.th narrow limi'i fr^m hour t* hour and all |*MiA| regard f<>r tto n*w**ttT i f fnm day lo da. unde# conditions la* ,i.g (?. wrj .i agab.st *igr.;*car.t ar 1 tdrieg (<<c^H/rent a^4 highly isrUt.'# stpcaor* derrrasa* la It* coproporphyrlA r<e>lent on stand* Ing ardey varying rtmdition* of l>#ht. temper* at are and react ie. w are dealing aifh a pAys^ T\* i ........... U M i* * Mn*u >! ><>* W mu m< i * iiww **e > 111m. Wa Mm i |imut ami* 6 w y f Wt m nm !***!* 1 LIA10844 (4 of (a r*wpon*# to th# admjnWIratJoa of dithioprop*/K44,t only on# determination would b# required far dlarncMtk purpo***. war* It &/* for th# po*#ibilily if th# e-mlamir-alion of a oatnpi# of U*d with mlr-ul# quaatitlr* of Wad In th# ptXKf+r* of Ha withdrawal and Bnaiyaia Borb u m of lh#a# ponaiUliliea It Ic adttaabU. mn voder tb# b#*t of reeiditluno, to obtala Bull 2 pi# aOJOpWo, at Wn*< ift duplKaU, and t# vbmtt them to frrpont* onalytU. Th# rtwuHa houid ch#<k wtlhio th# or> narrow limit* of b few micro* rama. wk#a r*prew*#d ia l#raw of 100 *rmau of wfccW Uorid, if they *r# to t* arrrpted u rrliabW. T"b# determination of th# rot# of tb# Armory ncretlta of IrW. ohm pftifwfly <am*d out, provide* apwrifc and inaiuaii# information mi th# ritmt and *J*n;ftcanc# >t th# Wad ilw*w"p- tioe of an iBdmduol. and therefore th# choice of material# f<t aoaiy*. la ie#dK-t4#*al <a>#* eapertally. lociwdru auitoLi# **rr.plr of urine Th# aimpie*l if mater tala f<*r du*nuatc *.-.4 oc# which will i/n to dim:utr moat of th# error* of umplm| ud !trrpfrtatujft, roatiti.t# duj^Kale **mj4r of Mond taken la afwvioi r*.j u i;cru-r.t by an instructed per**#!. and c#w of ftx>r# aam of unne, **ch vended dimrtlr toto th# container aprcifScoJ- tjr ^nmdfd for IK# po rp>* under th# critical #y* of on inatrwtrd prroo*. Analytic and pkjai<*> Wic atwyrrw# tm tb# port of thro# retail* will tamp them a* taltd. while ta/iatH** is k | them beyond th# known rangr* of analytic pm- riion or phT*W>cc limit*!*#) errale* th# de mand for further i-.yr+Mt\r + Any atandard* ad- pted or rmp4-**d fir th# interpretation of th# analytic r**uH* mu*t h# b**#d v>n the known fmloA **f th# analytic method of mriS-wi* rmt-^yrd )friWW of analy* #4* b o w available will yield result* that rrr m either aid# within th# ran** of *rrale-t jdir*m- lctfW- oirnifcanr# by b o floor# thaa 10% ordi* oarUf and by ft# mar# thaa JS' at th# mail- mum. 5o k#i# aa rrprodwriU# r#*wlta of known arrurwy tan b# f4#air#d br th# method no* pb'yrd, a *<#n#what Urr#r tnarym rti+* run t# tnl#rntM. ht it 1 nearT tn r-ffuu that th# rvtrn! nf th# ;it#n!iai rrvf >/ th# method will itrtrrmir# th# pr##*H^ f th# thfe*h^-i.| whirh *af# fr#n danf#r*wa *>f kad <nw#titra^MWi, r#p#r*af?y jn th# ImwwS Tnt etamp>. th# r*#w#ntralk# of Wad rarrty # r##t* f/> mwr*>frm* p#f 1^ pram* in th# wh*4# linrd t>f p#rw>rvj who h># auiTrr#d flo f# #rt unuwa! #ipaMr# to Wad. tnit p*r-ni wW ha** flO mkr**rran># trt nv-r# of Wad p#r yrama Kill t#Q *lp>a*d to Wad to wh an M(miI that thr may ha* mld ynH`#n of lrto*j. ration Th# a.yoiK arw# f an aoalrlo #ffor of * I*', In draliAtf with a aamyl# of 10 frama of hhaat lm rathir Wry*, therefor# It ! in th# wf vh |j't#aU*J #rrT>ra. that dMfdkrala aftlr*ea ai* hflffwl, and that th# fr*nt aifnitWanf# nf th# rat# of (h# wrlnacy #<rr1<w of Wwd, da#pit# Ha fraatar phyaiolofic varW aUlJty. romai Lata piay On th# other hind, t la bocauoa of th# f rmt phyaitdofle ranatiUtp la th# uriaary rwp##wa to Wad abaorpejoa, pfa th# fact that th# rmal rxcretioa of Wad la a#rW ogoly ImpaifH orcaaivAoily, tha* th# aivaljraia of th# tdoad l# M Mnmfy, Th# toacfpt that th# fl#r#nitlaa of dUrnooli Ckil fnt th# uolytli of a aampt# of aria# of Urr# acdum*. auch a# that obtained over tha prrvd cf 24 howm or kmfrr, ha# b##w dia* Wdr*d by tb# amilatdlitjr of aaalytk method# whw-h prmid# for th# aero rat# anoJyaia of laofl ampWw of Ud. and aUo by th# dctrnmaaiioa of ih# riayt of * inability of th# cocMwntnitloa nf Wad la moll aampW# of aria# Bd*r virytir r*#Mitin#u i< human Wad atmorptioa. Thi# 1# not !o *ay that th# anaiyiia nf Mirpi## nf grin# mt Urf# !t 4u iw # la wndrwlraht#. hut rather that tfl i*#*# (ttatw*. and in many m#1>ci4*fai ait- uaUon*. it l diffkwh or Impnaatbi# to arrrwnptlah. Th# djfVuJly of iddaminf uoconlaminated uf>- r*#a v( urine of Urge *4um# for a&alyaW ran \m < Wi i*trd throufti th# u%# of amall oampUa ia th# j r*w#*x# of th* rxamir.rr. and at th* om# t:me. th# mi*Wadin( rfffrtj of th# ;*!fkdoc*c and pathoW'#^ itriatWma ia th# urirary r^urrtow of lead ran Lr a!mWd by ol^ tamirf and analytic.* aampW# of bdnod. It Or#M#jm* happen# that Ih# diafWnai# ct Wwd pTHoainf la in <W-utd at th# tim# of th# death of th# paU#nl. Th# problem of diajuoai# pimr-rtrm it im< may, #xrrpt at it may b# mad# in th# n*ratii* Analyst of auilabW tiaow## wil art* to dHrrmto# whether c# rw# th#r# haa twrw | e*t rat tally daRym'ua abw>#pti'#i of Wad, and. if b o aorb atm-rptirni omtrrrd. th# dia#- nM t f fatal n# f<-rtriKuf. ry plvn>Wt*fll *t h# diarartVd On tb# uth*r hand, if th# rlinWal tud* nf th* Imrf patiral haa not ywddrd III- f'>rmati<#i r whuk to ha# a dia*yw*oio. it I# unlikely that rridenr# of Wad abaorptiea ok* taia#d pralBort#fl raa ju*tify lh# diarnooi* of fatal Wad IntotKation. on Wot further invmti- riiif divliwti prmowoiy varmiird or rat#inlrrpf*t*d fo^ta brann* <# th# MnitwIWaaf and rlmwal h*t rt of th* Wra*ed. Thia fob W- frem th# fort that there no atwrlftc *w rr>!it* fharartrrWtK nf Wad pnM>#t* ic* and that lh# dtarrv#M* nf W*d pauMwitn* ranfK# m*<W # #*idmr# of Wad al^r|dlofl th#alon* but f th# flink*) <h*r*r1*r*tK* wf di#a*#. For th# of th# ritrat of th# ah- oi>ip<i'4i of Wad r th* fM of a (!*raaed prfvrwk. -tv hould nM h# |.^*#ot with the ana!**** wf wr -r |wo tiMim It i a'41*IJ# (a hod rwl lh# pwtirrn nf Ih# d*triI<w IUh i **f Wad i" th# organa and ti*.ea. > k a th# ll*#r, k.doef*, i(4oa, atriatrd icif #d ak#l#trui IlLid tfi4 wnn# from th# blaster. iKauM I# (W t*tn#d for aaalyaia wh*a lh*# ar# arallatd# 7h# retenti'w of Wad In th# Unfa I# Important ia relation t a rwrra! klHory of o k u p w Uw b bI - I-1-f^WPWil" 'r HM-M LIA108A5 !7fp*l *tll ' xpuurvt and th# cummirAlUjO of l**4 ia th* brain u a matWr of gr+*t imprt*or* In th# diffrm(iAl dtAfS(*i of a fUJ dl*+AA iavoJf Inf th# brm ll U di^rutt In nvt ir,lAnreA to obtain A iparimm of km# Urn# fur a a a Jj a U Fortonxtcljr, ihi analf*!* of rib A#rve* th# pur* pno# Adrquntrty, And t#onr from thia n-*ufc# in ilwi^t pnruraU#. MrtKolooa rirv In Ih# rtd UriUm of Mapb of (iMur for tiuiffli h ^Irvf. nu( orljr Vo awnd tbwir malAml notion but to rftAtff# thrir Trpfr*+*lMti%r th* CokulnUod. Uwd (At th# diotftbolM* of l#*4 in (hr (,nar)p*J Um( of th# Udy, lU fid4 IftfuirrutUA. wbuh ohtfl rutnpArrd with normal nii>n nnd |>/n found And mofiW. In i m tMlkA with known lyj* and ifltmulira of n pn*wrw. wlU portrm? 11m farU as In ompunnrv in a drAnllirf conn**#. IMitncw I tiMA A A. ! < r. *( (*. 4 (A A i i 11 w k iw i A A. CMUA 4. **4 Aw A V tMM < ~ t_4 i-i^ i m<m* r>hi e-v ini 4 A A TW tMw>T I i-- m w-_ r <**. i * c / TW rrn M M *** tou a -w * mi i 4n4 IW VM A 0~*# .#. I nt IMA tw A A. ( 4. R'w A L A. *# A A m( *<*. A IM > **! w U4 imA 4 /M IM A IU1 I 0 UPFw jMjfpy LIA10846 Ml* k/f9**i*4 /* *44k,'MM <' fA/ .4 W .1 . 4r lure# rf Hjftra* 0*4 U***\m*, l'*'A 1**1 t .-1 J, ff *< n C^yryW /!/, ^ ,*H'rwa .(i muH TtlATMlHT O# LIAO POISONING WITH SODIUM CITRATt bW< W lw Gw HAUin L KAIOY, H& MfTOM ftOMMA c tv*or. M* NkMf, MU m CU*t*Cl C MAtOO*. IO. MTO* TMK |*ROf*hK KiimfiwK U Irt4 |ii(Mimn| cnuman to be (Weird. The *Uitdm( <)ar*4)uo (4 whrtbr-f uf r*4 tJjr jalirtit thuuM hr U Oat wt>u*rcirJY eitWL It u fmrraJl* a*rdrd that tie `W lre*inf "* %huuM M l< dune tn i/tt ae until Alter the inamM-Uaikeit <4 ecwir jdumUun here |wd. The cflrrti <4 the urvni Ucnn <4 tfmjijr rrmetn ulft dMtiituiift, rxcr^t lot (hr (rfltiQ letelt i4 (tkium in rrlex *| Minji|<tM <4 kutr Wed Whether tirviui ilnt(x oue teed xl ri^r *<* iotfaed Mcfflmn 4 thr Ind 4 (til lnn( (WatitL Nuh, Kairtnll Mttv* and Kem*kfl,' tn I'OV frj*ield A inrrrawr tn Wed certrt* wlwn wlj*n citrate u ebnimtirml. The mtrr*e an nt ixtHt M peril ** that |#'tiKT*i bt the u* <4 anwikemun chk**k end >uUr medsCAteuM, rhk h rreiknl Ml % rnturun <4 itfM f. Thrr Mtnlmlni the inrrnjtd Wed nrrt* l*t |eihed W w4ium tmafUe^alr ar*t 1* wlnim otratr to the Alkaljrartnf rdfeel 4 thrw wlu end U* thr Ucl that the wduUlrtr t4 tfi-Wad |4vf4\al* n tncmnd to Ueh Alkaline And Af*d mednim*. kni tnl I/Vn >(| * hjie len in kiceAlinf the |te> *4 walntm nirMf in tW tfratmen* <* Ilev lair m<unrtwWI (Val 40 tn 50 fim. <4 ndv.;rn ertfetr te l'irrtrtxtrrrd t:nr% da?h ; m -orfe c.iw"v. thrr idrt^e that V) or 4 l 25 |rfifi'l alnjn fiintr le mjertN nlfiVfniwdT Their ninrviV l<e thi* treatment in lae>t ><i the okrj< Out W*d (ru*d a n*rr wJuUe, difluadde oentire with the otretr ton TV* mr*e Wed i made ay aiUMt I hM H iHiwn tJ lVnr<i>*al Mtfvfv Mh h Iimw Hi lv^t*rtwW 4 Iak m! twW lnn ilk UiVtJ Ik Her*? * lr*w rV* (WrMOml Mehil 4 1*w W MnwHuafli Ger*aJ If * **! ilk Mr4rl w*4 *** |*e \ iwtim M V eel W *u ilk t>J*-*i P* vrwfc V M Ik OktMtW Vlrk*l t <4 Ikr UnmkiMlIl I m r^rt k frr*|t rme* lr>n it* 4 M#*M l He#** FvM knn |m r.< rrvWN m tmri|> m f t'^nl ^*i Im V*iftu h ||>*((|], U ra n.TMt--M- (k yk4 h tatMiw *4 (k 1'imi'* *4 (Vrf^!<w] llrfwr*. UiHkkwkk Ik^w/t* i #W *4 ] *Ua ami Itiiiw a Ik )lr<tv 0 Wwt<4 *4 the Ono1n*l MeWl (W |4iw(kant Geneve) Mufkil. e4 Iu mWiiH k lk tkrv *4 rW(iei>etl lltiw Ui*kw<ti iVortiwW >4 I eWe i4 liAniie*. I \4v J C . I T ; Mki A A. 4 Wi mI 4, F . I*4 Fi**wc wok a f k|4i '* ik hniWi 4 IcwtwiruJ 1 1" m fke l`ivk4 'uw* Lf 4ln y-W~ wVV iHw i A v.,%,^ |9X tU 7 f0 2 K**r A ' vl ) rve*4. T V T fw*wk >4 t r*4 rwn % A<!< A nrtt A ) V V || er. 414. IY4J f- ij ^j l mJitggp" g ijiyiiw i j awwwwwBiyh v*m'*m&?o&n&9mamm LIA108A7 2 (f*r fmJ rmrtrtvo rvd in ft ta* tout hwm. Tlwr %)u, |>o*tiiWid (hat Ifw rkratr might W tnrUhohrcd hy (hr hrrr. taring ih* tad tr%*iuc m t rarfrlrd m the UW and thu* ut (hr (nn. Pho drm"*fitrd ft tathrr tharp iVrliiw in i>w blood tad Lrvrlt with tint trrttmmt in wnrt id 15 c a m** In n'^lirr puUkstiow, Kny and l^rtonodf * ihrmrd that in a rtv td |tniii trratrd mlt vtdtn oUik (here a rw in tad tMrro*m * hm (hr (t j u ! td (hr unr-ary and (hr (fti) tad waa c*m**kfd Th* wrM marVrd n*r **j m (hr irad tad Tbr lungnt pr/lod during whteh thr tad nrrrtkm was kJVMrrd in (hn# raara %% It dayv Smith.* m hi* dicu**>m <d (hr Irrmtmrrvt <4 tad potaumr^. httrd andnm otraftf at a auwsge a*TM*. taw w**4 tlwt rt had only a tro*ofy rtfrrt in {hr our oit rtjiofled. With (fir {U/rf ctM>*drra(am to mind, we that h would hr worth w+ulr (n r(*n <Air r\\mrrxr m Mealing four |MtMi4a iof tad with andmre ruraftr u thr ma o|wN cd dmpy. i aamrr or rates Ca m J 'J S. * 4 >*/ cM katwr? Uwy nay h jar. w m ahatwd la tfv'Vl'nl Inlay Vnma <1 lawiinnii Hiyo) l\t 17. !W( (sma ni iSAisal "4 two day** iWm rhrr< tV (Srwr |n yartw l * 1in o hr Kt4 brew m Ow Iawry Tuu t-(Wi frW u w taw IH atw v a* I. rtw*i / J, Wff Ca w *: l w t* aw aw aw aw ImI ^rlW4 OI mw iM i* O M IW an aaa aw aw ia hWy * a fta^ aed cd thr b-ioi <* rt~* J-ft., U Mm %wt *fc --fraa Wat *m4 **b lrt M*a paOc Ow tWr tw fra/ frmuw in lw SU >hm Waw* *W *rftak al#` >iwfA( i*w i*i !''* * rwt and tartmf t**> lrai ft tht wrr Tm .Un Wtwa Ww Nr h*J ttw r-.wi <4 * <S7! *<l* U/ |Mm# fM*y arf t'w I wa I y>*m * (!w '' , * Mi m (Kt/Mbf to a kSv| roltcfc? paw fwwr| rwrry In Vi IS aw>4n l* tbr (wLwr hr M dr tw** <d toMaf llKwi <W>ln and '**rti4 t'.jurw'j l>.* t1-*! lr ft* i w c4 wWnnw I'rwiay Uwl iaafw'*i*w K*-t Wr* ir^r'wwd 4ww< W* ftrwM d Wfrr at thr lolWry tarbor? 7)w art )> n LUr |. lVn*! tnanta rrH a rH*wv (1m lat V(*awlr a w >M U aw a aw 4arn ark mm lUawul [ IU mrmtwt u *71 F . yW raw. h; Wood yrrwwi CV'T'O TWrr wm > wferai twm TVr wrtk wtrr m law Trp*. aa4 ihtra waa a* Irwd >mr |lrrl hjnc* *m T*W a*Vnrw a* <f.*iiar1y Ww iVt kW |?*ia Thr u*V*tw w* anemia w t*w r**4 v>f ul thr afc&jwum 7>r *n rartina aWr nt *, w 4*t *w tr^rd (V# Wit gtraVaM <4 for itka*a 1 jvrr, I itnrji aarf *?W* r r*4 WH F*rr -mW m fVmml t* fW<* ait m, waarW w*wArv* a*1 r>^ rt* a***r? iWan f K# alkArm*J rrdrsra am drrrra*rd / *b*0r+i*+y /W -rW *knr blt^ tad fw4 aw f M, atl ynJjwaryfaajaWat |i mW rym 71 P*t rear. llrawf'.^Ka l! S f'w y*r I71 < Mad Md ul't >ajord J[ Kaif. t 5. ad Iriwd, T \* Ttrmm 4 trwd f 4ng arl Vtrwa CrraW. Iv r(f r-4 A ut M <7^. 477, |MI 4 1 (. f4rt i4 fl#t;*t Vfrr4 m |W | irttaanr t4 |ra( (wv*ftMmw 4 1 *^r *-( M*rr4<mt |*a. } <** 1^41 17 fr wy. .......... a'-iay.w. * UPWMVP .<MWi!W<P--'f WJH.I i UWPWWWP LIA 10 8 rf Tr-~ -- -'`^11- vVt-- * i - V i-i *~in intwMhirtrrifMti nfiiiri' traofftwitf ftftivnw l ). <t U fount. 0 5 p*t iratl IV wf w ki4 t ijvriV r*Hf ui ( 6A a*4 30 tu 0 tu* .' # prf htfc VM OMmkiJ turn rat nr J tfc* fcfc*4 *Vtrv*4 wnn Wtrafera. 0 J my pr Jj O k , tkrai iravyroMiv rutr*-***, J] mft prr 1! cr., k 'w i cbk>oir. I GO mi-4 /l - P^rr* r*rS*W*n rifttin* <6 n>f givrv u /O pe itti m two kr JtwJ Wv4 fw Am mg ISr fcjt 34 Iron rW ka^ul vo* 0 41 v| per lift 4 ww.1 Comm m ik# //uftij{)vir^ tKt kf*t two timnul 4ifi tW j o o mI h i f^vrv Iu4i kt/li'twly Vb vtfifMnt Ml erfti ivukt ft*i * f*rv mrp*f4m kr4rmkk<n4i U. K (kvmi* Vr'towkWwi*) k* Milftvt. IV ropwti 90 ef tonmiiw Mioliionk nw; itra i# (v hon kf rlid <4 pun dvnr* rt-u u m. ! cm ctbv* kr) onA Ovk vt |t*n v* tokfMai !l iIm jitr* ^#vl*rtrt*J xiiu l' l f iul M4i*ra ta)lj( to^ mvuiiy^ Qm Du urmj 4*7. vrfiv Obm^y wm mm*y**A, wit ft kutf o4 1 0 ijv t.<m d*j!f Hr i u rruwd on W At lUt u m 0ft *u % tt^rf ikmv m Km fuv<rtnrp| cd amfrut Hu WotpHAJmtrjM (ram flu* ant v wrtrarivt If# *< frrm mliv* <rrM. 1-0 Cm kvr (Mm <ki/. tar c m raiu Dvnvf 1$ sf i ; OmI ! (c a m !. pMrr< ) > l -TV fciJ lira rtyrfiU mwf W4. Um kc4 l vrai 1W *trip*4 bkk* fiyrtwra wi bA-- <w /*m Uteri?? wit % 1 djri m4 in tiikral v Cho Igmtm 6m Imm tkrrf w m ft iVr| U7f in Mrary k*4- ! ft kM dif pvrvjd, dnrvttf *Vck iaAy fjtrvM m vwi. tV 4r*4 n(mf nra v* ft (wtk WOM m for kwi ok mm. So *1h mv rttiM iVt mj *ti rcNv(H it 40 ( kor ih m 4ft*V. tM u*o IV M runt dn4fv4 4 yrvipt v *>t A fVtifT tu ctmimrad. Ik* Vv4 (rife*;!? nu to OJM fm Uv c4 mw Kn* iKi Ira ISr W*-J (umm rt<rp< tor era fftort r ruttu v 1 K<k fcr ft ju? *>l ai iiv> ` -* *m*krlp X kri *rt On (*(1 ftw'kjwii? v+t ft fr*4 of k*ft l1) Wftfkft MVft. tm F.k IX 11V) D* W*4 ftrrint * Oil V4 prt l#rf i4 mw . TV otfi< u fitra M (S# JhftSrr kf i M*J <M Jt A*/* TV pvtuvV t >* iw ftnlunrm( tSeTftp? Mm VvftkV fivM r*A Wrw. V M IV Vv4 iHMirft IffM Vo Uil. thf kcMfUai V|M ft* HurmV ftfttl Imk 1 fra# fW vrira ft#ftm#H f>4Wl4 tm fn| mm^W. ftfl itlvt *rr* 4jra4 tv ft mm gfftKy ok 10J4 (tf*vf. U Md Ii V, ) P,. frtlHOv o4 I'riMrr tn4 Z2X JVM. I TV S>fw*Anr V IV 5|mi4c (frar. f. fV4 Mtl- A To**ft(. tfitt?* ) f pimpij 'tMnwujy ms iw w jPOUtofW* mf LIA10849 as i 4 Tto** u * aJtfto rw H <*rt*4i )Wf |N4I 15 I In 4j MfMM m tfLtmm tm* iWspr T*m**mt*. TSh rimri to K K*lwar* y* cat* iW <Urt totor j TV* I***'7 W*4 an4 motr? <c4*t>^ofcrr Vrrato t*4 tto* rrUika to (tor**? mi toss* (*#* *11? to <Wl 1. Ca m l ~C A. a ^ 7*st did to***7 ^Um %a toMtto4 la Dm WfK IMwy Vftwir** AdmirfrttkJi Hc-paul a* Oct It. 1** tor*w* *4 *ss**U/ scfes **4 fi 4 Us <Sn' **4 stokm**) iri*H u4 Ira 4*y` 4wr<*-* Tto isnit Had toi taktof is dn M*r lartury U Itw* Mtfkt II* ***% maaU l laUlai da M fUa i Km day TT* n-a*^*4 l/'rfu s Is t mt c *d psckwf tL>rm Wf0 stwto kUt *4toMtoB to imH (hi cfMd M ia >(i a . Sec 6yt U4urr Ui iimo to (to 'am 4 otto* Ml ton * to* am *t4 toil. n4 totor to o t am! fw*t is tot fai **d itoto Fn* ton htor Ummb s to tod tto (M<( U crss&t* to* kbVxnM IVts cm tto frfVS cl (to --Islrst Ttoj xrr*#4 fv mrr Mr*U (tor **t Tto cnstoiy Uf*1* ash s 4m|m U to*i ** **(. s4 to v ifWto to tto tofSil la Aerify. j r z ; C o i < 4 to a to o u T;Ut * OATS Own 1 kis . f*lm< C A < - Tto % M lev tncMrMt arMy WU. (to W4f to*. Ois*r f Tto *fpM*4 i**l *ni***m tntwu ttorsl* *r4l S tow c*lts del tto rr** tontovj to*k U*rtMS *! % tow rsicMVS tod Tsrrtof nHontrs t p*r tto Mat PV**I mwwiM rrrrsird * r*** *-Vr S>* **m* *to> si m *b dums M fto (Mf y*' >4 tort e (totrtyirt *m Kt**** ibVssil ttajpf 1 tto u ei^Wy ywto L sn4 ytfVw i(frKMWi Mm MncentMf *m * F . ful* r* 7*. Uto ftrmmrr. IIR./7V Tto trail *m >*> i** rtoei**, ton m *> | )TM I>ra t ss /at at* awl fviitod fto#wtv.* ,,+rt tto Wt\ It*'* f**arv<a Ttofa * a (*sV 5 ayn-to iwarnav mr ito fMre*dwM * it 4 yto*c *** r*i **w*t Tto *^*w4 iwi4Wf fMWfstoaU roto t/r n**l`ir uk*4i fc*Urt tawtofArta 11*rr k'Wt * *! >f*e*s sera M toll Ttoff ssi ycrUfi aJ^fto v*toii t4 toutoms <4 took *r**4, to* |to* sari tm> rtoy wsovdeftoil rCM. //>#-Tto stov <*a tt**4 Ml +,rn || |UfsirfUa*lto grirrsla tytaa fA tot tats HfstUw V> I) Cai fat r* Tto Mw| total ia,U ttoiwl \ M-totod r rl* *#*. II fa( ft**' Tto s mm ***4 a *^< kto ft stilt 4 T 015, po il>*a>an to **fw, 4 > 1 stow W-*d laOa par took fr/wr to<4 wU to4 laaoal W itoWSa UMOUWP1 IJIjUiMlJlIWijfl LIA10850 ' Mwpunwp! 5 0 46 ** Strum Ulirdbb 'i me t*r Kj O ee. A* o*n*^r fr4r tM tMHKiftM Hi W * OH Jr tort 114imm iHlcwidt ft*4 lo b* cow?irtft M O-V ft (flN. TM| tft bmpritod to onrraal JUvn naeuiu> ci fW thm ftfc*wt4 M n^Wor* of ft* pvlmratorr diM|t TW wawry U*d rtn*T7 <T4*'***Tfcjrn Wvrift ftnd thrtr friattoM to 0 tffymk program vi *** fr*t*sv*nr H fbrl i Ctmrm m lU -S^n fthrr iknw (W ** to H 4U|rrft Hi MMt fim awtrrvdwv HrO***^**^ L*. 5. P,, 1 M i w m44 ka p*m )( wa* He* ftm ftU<*w* **!*. 64 m* MAr*U*rr>^r t+**T h* tm/t. **4 fan Attftd w*to wu Nf MM* IKHIHMI 4*U ft*4 ftftitf* frJU*ft. U-latH <4 U>WHB v# gtrr tfjf t 4i* + S*i.wm otfV i*rtr4 mi 4*i|t (4 1 0 O*. Ur ftmc* daily CM IW wrtarl to^yaal OftF M* ft tow rftknwa Ort Aft fedrffttod. TU plw* Hm4 ....} M U te t*v (ni* 'Tia. ww*ft k^ftarM r* Mmftif a\ lUM | ft--ft ml M mMi M H pa VTft. r*^4 ft* *n.fcfc Iiftifft mmm. ftbiUiw. in w#aWi*Jbb w mW >*J ft* *nd in4 raqatfW wr?ar!aw Hydra WWwIt let f** rtn *-* lh ifik day Mr p Im <4 lyppi.w urn lb* Milk to ^wal 4| m4 rnaaMl U tHr rl c4 da prtU <4 Umt t Mk m. thaw* iHr ftrf**i 4 It* Hr n |-vr ft Vrm (|W*WB tfn for win di;v (kr* ft f*Twi*r d*rt i.# tram A*w k itow ft k-a <uui 4w< ka 19 d*r* Af*rt Ha Ka4 mnn4 nUft <***. 49 <.. fa* day la rrr* davv tHaTftra M r*n*v*4 ka wm day* TWw Ha VN !* l--*r^n*ir 4 9 t .m f w Imvi k* *trw <tor It it 4.*v(l to trie** ffca i* k Wad rtrra*a to Ha lKrpao>r yr-am Wi'Hj * tro mramha t5w ir4 rtrrftKfti raa^a l> >> nrnl and '* 1W W I'/'O tW etirm/y Wa4 a U"7 p^. ^ar L*ar. AWv drrf ikn lanr |( krmftkWa r^aa tft !J Cftk Cm* J -S O m fnr oW| >Wi map vW> daa| 0a Ur mracka fa*a to iOmmim *aW4 ft * (rpkr to* m wft>aiaW nawOli ^!m4 a War* Wad ftXW M aa4 I (>Mik maa iWftfta 4 (A twrna W ft m maha-.ft ftnrti ft ru(ft/f 4ik r4 f^aaflf Mwtar<! i{ p4 TU frWiad Ml haw Mlrr# hnsjr* r4 Mra-lr ayhftlft^ft (4 W*4 dwi Pma to 1*^1 awn 4Wa* ftaw*rrirt r*j*f-rw*a K*4 Ua iapt^al Irjt toUaq^taJy fH# %ak Wftft twi#4 m Wrw<h m4 wtiMk nr fr nvV4 to ihr rrn, So farnrH to i*r r**t*rftWt I iPtJUB I'WPJ .. UHHIltJtUWI.'WBWf* m^u^^nMU'ji.i'i1 gyp1 wwpp< r*wmef LIA 108 5 1 WMi >. -LPUOA&-*t+ X3 *>*. 5- 0- % ftdftwtitd v* toapttftl ier r*/i b*ca*M U jiwditi m4 ftWfeM*) fte ti m "aft't dartt*. hradarto and dniinm carurra* MUmtartwniy f<* tW taftifur, vri^rM, fcmtfttoSrtj r>4 di*i urtoJtrr ol btfaaJ totou 4rw| it* ^t t v j i Ai ito tmmi <W Km K pal*** ib *jfV* iK* tftH ^ to tut acrli m rvafMMdW*. H* tod 1*4 ***b toIf to*U tot UIWv trortort teftd toai K* toukad jifto* Hn imUJ tottery vat **>m* xkt*. *ad ymw waniwt |ww4 him t M bi>* tour iwrrab. fVifcfti oa *4k w mm rrrtaW v>n*trMrd juanto*. rxiarufly frrr~-t hi (b rKm i*d m ito lUawt. Tto ?* *m o4rw**dy ouaitfuWf bi *c* h nip A, Tbrrt *u Wad la* i**4 t* Mn*f tMffie ei t** Uoayidt Ttort m m utorhiai trtMf of tb toto1 Otar am * rr* no ru*afti fawdayv Tto L*V**fcay <Uu tctotd m tfthl* 2, S*rnftl m*rr' ft CTrVal aryl^-rowl r*toa erf I I 1| ftWadMft IWiUm ftflrf WanftAihc ai attotvw crttft. mdafttv* totoipanto: mmrrom fta W to mi antoft rf r*4 rrfU r*d by WJ Htotftirftttaw. 5$#rtft! Irft#)l4f UwSat don* a On potwaft tb*d o i o a io n m 40 4i w TtMt *0*T CWt i (t A fvfaa* S O l -- Tto *r^4 rrrrrtmri avu/jr Wad. (to W4ft fetoc. w*mrr Tto w* tfl bVrft* rrpfr+ern i *>Uft citvfttft ttora#f w*Ul ft krm tM*~-4tn <W#i ard r etytoaarf to tto text. by l*r ) W Hft/n*. at tto TtonaLto b!rr*tol taWprfttary, rr*%l#rf to.*atol mMk W Utf&'tj I (Kl^f Haty by t H i! rf It ttor* rA 1'* l. unU * If* lu to ftrfttm ; Mto* ti tcArf '*T ftCflofai >. t I. (to aV*rv ttoNrJjr Wyf*xh/'*THr Tr*t al fK Mnod a tall iditA 4m ai tS* UtMftrh*ttt (>nrfti |{o^ui tht r4 Wad ctHi to U 4 ftnaai taau*ft> (rft^pMy t V'a l*rrw Nttod. k^atnt** **r!v fta K**>f r(Mf** and r> A*rtv>n at Wm at tyfiaft TK* * f>nt fcJ'jnt by ftkJwtb m ^>tr >4 $ Cm. ViwM ft 4j/ Mhi ft W rhra <Wrt 1(>* v+r+ttr* r**y*M* u rtwtrltliW, wd (fan 3 blrttn iKr nmi (wrNMi <d U4 ad (tpr'ty^ryj-.rr* ^-K ftrruwtyaaMd IKm A.N* Oh * tK**yy W4 W* *rr*#d f b* **%. d *t *M 4 baa* U*r (la paim* r tUad n| At >a*tor to a*d fttobaH^ai pa atocK h* Ka4 r*tat*d <* *4<r*Ha If t* fVal #**# fa (rW I ll A ; Umitoi. A K. Vat W V b#d r#<>> H>* M*rawW?(tr (Hw***, ItHirf | > >4 L. K. ati A'^, y M. )t UdfJ (V-f't** KK ft4 (Wto* J W*d HI b-J C) < (tor I) ftd OTj ? 4)4 (l>*r || tr/ U-Vir* Iwantortf* af ff** ZJ) )toA Dxa*'*aW Ofayi.K*ftr laftod C waiqr !i wm. i mi, n.tf' 'Irmm Bsawwy LIA 10852 mm o 7 rim nfd t*r*A ftorv W4 *m4 Wm c*n<<M*i4i r ti r*rr4. Altof At ntirtunif tot**** tft* ***** (W tru *S km (Uwrt dm --U iW torrto <W f1--1| |*m! mU Cr>tarr^M^rna r*b <<>T>(i*er<>>l *M.*wr\*j p*m *M t*4 twwa 4rax*t#r*li. rtw {*<*** vtt 4>*Hfc<r*'4 * crtf*< l(*"T *$7 Ihr *t*rvirf# *4 the U*4 Unr |r4w*lty 1nt|>n`r< I) m ftrrrHU-j to Irrfiiw iWUu > 4m 4 ft> Cat. Urtv Urn $jj ta rt*M Om kmtk4 to m to<p*t W*ii 7>* f%irr< Mitw^ la irt M >>Wi to4 nifma* m4 (*J frwMoato rMirWy ttll TW fr4mJ b-* 4 to*4 (* ttor towJy by nttrtHm U M tW (Wn <4 WJ Wrrit (fh*/1 Jl ! * <%*. *t*t*v*f !* -- ckfcWMh 0* aim *.*;>!** <4 cnrato actumi--yaf t km w**W# apf**rd to fat 4 t*l Ciii 4--C 5. t 4S fr*t <44 aW ton <4 f*4**h 4w h i, w^ifd u i y>wmr raa M *#wt fJaat V* t* tiyto *f*r> }* to* hi* vet \ fwri >4 K* ^4. hr --t*rvtw4 Wt> id |**M*M| to*4 fhrooffk w(-*S *t*w *rf p*r4 U wm-ti*-.* from (W KM m* M to*4 a (W w itwan frm* OJ to 2J f 4 k*4 yrr 10 n4r mrtm m4 dav anM mi M Har ma W C V **4 k*a MW *^W lOUto Oil * <4 W*4 p*t Urn) to crrttoi t^M o 1 At* tmtfwt k<W4 U4 4r< Om r* tiprtoi CM tto irv# to <4wj || mm fr~rg *<< V C. S WM th <#4y o< %to 4m^fH >? Ht r**to torkW rn*iW4 hklh*4 w*rWl In-rr wit^to Irv-ww M^wrta la |944 (t*4 k*4*t fctowi <'. ^ i trr#4 t*4 to*r*^** ak **w*t%l Mton 4 a*4fe- 4uw H M 4*4 4f** Itm* * 4 k* n cw iSa kto ibrtH l( n--o'iotot td lew (4 i* **> 4o*ira r4ww (to to*i |*nilto bm m) }-*m y n Hto ItrwWU UW( war I 05 M* (n wwtfn Sr h watt Tr fttoi hrW* t4m*4* C V !#in V* **4rf lf'* yA to (to twfr (<to ftokttl 4 (to kM**A MVM*a rlrt IS* fT'Mrt (hr (^-rtart* h*^l(4 ||',tibriA. tot >fto* 4aea * rw* jark-fMMt Tk* jwwf< * w>*.t'r4 , mas*! */i*-r a p*r*4 *4 MTcv^i a!*k #wjl y%* * ? c 'r m yn .( ^ A-*f*%** 4 trto) tMaaj VM rwk r*w1 fNr (wfr(<w*tot) rh W> ^4weqn>frrv4 tor rw *w( by Mtoto llowm, S* ***>wr4 t* ifrryU* 4 artkiTM <4 | 4*4 at (Haft la w*i m>K* Km 44miJ fmm *n*4 yto* torlrto t r<i frr*r( rakr*H h (4toto4 10 l*tof tor th !** lr^i) k* f*to ^-rtV 4*iif to to *M |rr*#*4 aid 4ar<*>yi4 l* '> I* ( ft M. N* '(.>**f*-J >< *; iii itJMbrtok tT*f*i*(* fftoi ktoa to irtarto to**, to* tok *|*wr*| Va 44 M fw (mb Ur *k w tta nnt **U !to Unwty (AfUM mm (' 5 ito*m by i ia 4 W t*ak 4a kar twaito iUf to toll (to to*y*i Ato a* <4 h***W| r*4 to*HV (to y*i*r* >|M ii{towi4 <4 re* inu^ iL11 mif " wr LIA 1085 3 W*4ftrW tfkhr ft**4 ttiV--k I <f>ft S ttlngi m Ui|f Aw <**> iilDittt frtiM |4 t 6 tm ) <i**>r *l>r ft*# JO cr mi 10 j mt *m < *- ** gl*..# (Wa* tftWM *M> U*M v> W* tr|4>M, W toft# tflwnxd lu iiw UkMW^Wli lltufatil tur awd**! w miiiiw i<- Phrk-l 0*4 ihA inial fw ( wckv Iftw* torfr ft* oa frml4 % bvtkj ** fxwcAwMP^ *4 Wfttrtw U* tiwArwtn ftJfttw <4 tW >Uwwi ufti |MMnar Mrt W.*|1 IVt Ih I ruftMiM twuft* Ml m TW pmtrmrn %M *m#*4 W <*H M M t***T **-- m prriocm ncjJt )<4*. *fc * Wwmntf m4 TW*a on wn h*/4 * mlMH, ftiar* C. v K*4 Wvft wr% V* tv* fr#* 1*4 h*4 ftwf W(tk frtrfMM ft* (mI mi tfwUMf ts r^rrt iu*fkt rt |( *%i w*| (jkyoMtM, rt* wW.t4>y cnft^mH Ow ti tmt-iiiHw* ron^Jj#4i Of frrt rWrfr^ M (h* 4><mrt l*4l tS# ftfMt't 4rftiir ** U Ufft i>*uiwl mw * ftp#* , Mto W**l tid* nit rW ft* Iv o 10 0 ftftfc I f W*4 0* jvfUMMfcltf Wvrf (flA 1*4 * ** wrr tTn>| tJI tarf 0IJ ft^ *4 Wt4 ff l*wv *4 . ftfjuiftf niifanliW vute U* In .5s I2 f i o 9i id n )o u o ti m Tac - OATf Oftrt 1 'it* 4 C S i -- 7W U* rtt*** vMfi lr*J. f>* U*4m l. *r'4j'T TW *ifr^ Uk rry<m wi miu* <mtMe %) A--* ttirnn m*4 tn 4f4*<A*4 M tW WtL 0n\ ft, 600 ang of lr*l p* *** TW Oft* mn i r*# *4 Hm Into* I* *1*9 tHJ *>tn rmt >*r# tr^mm k- r m mm m**i tWfiyf **4v > ttUiftf %tf k* <>#*<rAj <4 V*4 to* ##** >K* tv to*4 >ft ft-tot W*ft imI too* fOftArl*!* tmfrtni A*~* h> ir*4 *#M tftm* |W yljal. |iir< >lvn r*rt* Aw *4 4 (i^ l>v t*i K* *br h a**lK 0* *ffagftn*ft* *m >4 I u >t*i i4 / (* tVtt* ti* f A*# ti ftr* >A* *v| fti-fM WUl#. )*s!Xirtr* n4 *tr* otln* **4<*4# K*4 W to *#4 ft* W**ft Ito *wA>*1A4f (>*^4 ito >M*i nt'M tWnf i, C S ft *4 l<4 ft % lr* fV*wft <4*1 \\W* tl* ftafta** f<tt* Itofftkf * |fa|4M M|^(r4 fr*'*T'l W M Mr* >4 lift ftM't r**ri ft> ka knf t.'***4 II to* 4**-*ntl I '** !^>*r fttf -* AHff K*4 r1*rll Waftft, to f*i<m *u pr'i-wi**! ft* (Km** l># tymfm* rV '>i*<* -`j -j a t **#r If'** lu **1) ft* I W*4 Hi* ItMU j> f k -*>* rl* *4^* *ft**#ft iStotof W '4 *4ft Kmw ) V4 *** *- t *i '-* Ut!i i>>^ r* t*+#t 4 C- i *<*ltf*>aM( to* <**iAft*ft <4 to<fttM|r ft* vfc ft<*4 *4 M4>* A*rf^| / *to ft***<. ftl f* ft* kftfft VHM I' U'Willin'1^? 9 had or U<ww*l p. U*f *d h4 ^<ua<y< tuM****** iupUM fUU7 rwwwj (nm* the *<'Wre*1 ii^Hi >4 th* UK, whxb had i*< t*e trfbad. CtJ*4rr*lj*r UImiw j i vr% h in and ih 4u in \u*t4 m tM* J. Tht vuMfr Hwki 4m ut ifvn la iWt 4, %h*h firra <i*u am lead. pytforyiyi^ mi t^ifr tl Wf * Md \hr C 5 m iWW4 ann and ricma* adtmal bed ubiUMim da li-iin d finaa had MnvtAM TW amUaia al tfc* fMdMq*. 1l* and dw trial--d a aul tWa*. COUMINT la three rd (hr am (eramtotj hrfr there m a rather unVinf nrbed at t^i|4Tam tumrwWnl wh tulnjm citrvle (Jirrmpr. In thr cw of J. S jax 1) it *rrtn that renal Wad eu'rrtwwt wwa Mi|>pre*aed bf todmm curatr thmfo iVftof* lh** n (he tformce effect <4 todnicn citntf uc*e*ted Hjr Smith.* iVfhajo this effect i* f**hired l charge* m acid-haae pattrrn 11 n rWnrrd by l!< tcm^evry nc u\ carte** dm\Kir--enrolamryf potTf mhirh <*rtirrrd wbm th* citrate thcT*|y ui C'<irhMOtM mar r*4 Im draan fruro (he ilata at hand, 1m nr thmk (hat tbc*e apcewcwu*4 mrrvt further It intrfrMinc to rxr t)at urinary lrd irxTOMcd during *he m Hh ttwhurrt otmir ifa-raf** mi nmute-il l/rimry Irad a)u tmrra*rd after (Jr mittal UC (rrumng at the time therajry * rrinatrtutrd- Thrrr i* n> rrum rv*Wnrr in tie ilata l>rfr j<r>mtH lhit thr rurdue c4 Wad * l.*urnrd in oin I, J ami 4 In it*- citrate fbmfo- Hcdh the atawnuJ oruvar* Wad o*rmtr*lk*i and ftie *hw ne cd the hrnayh-daq to mWjoate Wnrf* nr take n e**Jmrr that thrrr *u jermimcr id alemetmj muum* id Wad w tSnr ]anmK ttt c *k 3 thr >Uta |er*cfiird and i)e chntcal hiMufy fi*e raweiahW ndmct that (he mlniM otrilf (Irfi^ u tt>dd m hiUminf lrit excreta** am) |eiw|< rr|d id AltUs^h th** iin' r%p~ure mmvWj .hir!. it w%4 intrude, an*I it t <rm<n that iia>**rf*lwe Irvl u *4rfr^l m h *rvi alnneW^ ffuaji tlatr Mlii Ut he *tv tmr litre hu tn*fd. The fet4o*vcin< ci edran ofntr t'^Ti(*> i<4 a mattrf id nrrk* after t) i uiani initial acute In*] |Mem| nai |<rrtu(M nuIJrl tie rrmatnm^ Ira*] In he harwfle^l m a nu**frt to jerrn( riKrftaiMi d Mn|di>m* Sniff S O | n*4 ilhrH (it muni tn ai^ek im*J*n4p ]r**1 ef<Mife, hi* lra] irrfmiraikCi niifld wtfl hare Inlkmnr] a tm-fti clitsiml etirrte ^rthnut DmliraCiuci. Thr |eJ4ffn d ( . S. fcar 4 | it etoijdKatnl m( to hi* hmc*cnrtf*mird intake rd Jra*l at ht* ;4, { at h*rr \* h i (j *t J. ih>* if free tnuen lea*] fifemify, niiflt hiir rufrtH *m>uiiti id trail wiihiut lie ue of vdiom crtrate. Iloanrf ttvre ran f?o *V uld tlut tic fi<ntrd id hi* Mmjdmn*--aiw] in the ra*e of C S (In* **a CTtfate. - u whined l>t auftctrirtly Ur ft oral V>r id mlm Tie u*e d J*nefT*je>4 (It M.) in ihr ca*e of C. S li Hard to mhate. Imatf (V jiatienl (**e*fu>wnl to take m uivall rV**r* of Wad from hi* dnnkinf water after Wam< |t Umful Wt were led to me the a*stUI4e htmtiarr an4 jermiri tie fidVmtr^ nrmnarinnf remark* MtUxi^h dnfa(ei.l n m*i*( eflr*tne m the treatmrtii of fau*e*l hy certain len? imh a* ar*rr*c, fok| ml irituo^ji, (hrte it, with <nr ctrrp> W||IIIHIjlFF nil !. ,]> IMWMMU IJIAIMIIf mm LI A 10855 P aw- 10 tkm, no courinemf rridrfKT that rt it c4 ealur in thr tmtmrat of tad poitootaf.* TrMrf 1 rreeled one rue of tad potKeiinf treated wrth HAL. Ahhoufb the vurVrT u rtrrrlmg normal amount* of lead after reemmf rntnemoo* m/ertocti ad ok rum flufonaic (or three da) i. thr urinary trad roar to hfh WeU shrf a aerie* of dimrrtsjrfof injection*. We have Urn much intcmitd m the Mnntioa that ortnary raproporpfcyruM te uard at an mdr* t4 trad uitaxicaixxi. Increased cwfeufaeyb)hfmna vat found during acute iHnna m all four of thr am persrnied m thh paper and veil hrfuer lie etutr rjsaodr in at tail two of tie oev In aQ cates thr urinary Wad and cr^iCoiwirjhjTm tallies showed rrUtirrW puid correlate dl. It should a'aO l* oytflwini that m ail cam the *;fn of c o j w t j *.c j Ji. nnufia waa tern much rwdtrf than thr Wtj-pitnf i4 thr red Utxd celli. lo thr cue of S. O. thrrv waa a fTvJ tcrrae m cnfenporjdnTm rxcrrtmn. acxtwnfmmrd by an absence of nippird red hkrwf cells in the pmjhrral On thr fourth hosfstal day. tfiffJrd rrd Mood frill rrr harod tn thr Uwv marrvw tnrir l*rt not m the jvophrral liood On thr tiath W*}tal ihi, itij'jWi red Uoaat frfU i^raml Ua the &nt time ia thr prnphrral F rren then tei there u a frs^iuaj merrate tn thr stippled crQ ciont wh>W Lrdh urmiry trad and urinary <vfe^<}4,*riA talue* shoved a iknrmsard trend la the fairs of C. A. and J. S. the CLprupgejftywm racer* tiros rrr rlr'Strd well !eWr thr *} m^Cren* devrit^jed. and thrt tune itijpWd cell irnmt* a err normal. In thr cate of C S. who had trwd pesaoumf oef a k.c{ Lcdh thr ncTrtiro <4 rt o and the lippfcn( of fed Crfla were mcrraied la [oMuUitn| tie nvhimwa of thu incrrawd 015*1*5* ejfnnouria m |4unbuat, it IJ5WI from attwhmc thrsr (our am that it h entirety fwwstfcir iwf th* mhinum to iin u different am. it u brlred at lh tj t v that ta ihute acute pononnfi wfarfa dnelrp enrf thr relatival) shnrl |rrwi if irml mouth* and which a/e arr<MTtinard by inrma and tr<rrard wWTui, the mechanism ts due to thr (IrtinKiirw c4 thr frvl Inrad trill. whh Wads t> a trine <4 (et"(i<r}i)TTtiti, which thm converted W*?n ci^'enpnrj^vrm in thr Inet a- t rsiteled a* such in thr urmr Auli1 and In aci*trs have alreade dr*r\hrd thr tnrehanuot cd \ iiftiPK, r n. Jr. aw* faW, H: FJCevr rf HU. ('. Dmmte*a^rfVoO W Trrvrwrwf .4 F YC 4K V^A ical (rad N<ir< a k(i>K J nanewi % Fj*rt TWftfi >|> W T. wad larltrWr. ) A, Jr V* 4 F \L m > TmHwl <d lueioM 1 *ti i4 tfawr. Hmwf and Otwt M<wTe rnai Am lal Mr! tl:Ul 7)4 <frtl 14* ffMM. M A . tnkr. L W- and M D 1 Arscy td UDmr- cafarsm^Md (flM.) m Pew rd rw*ufe Wy Ot ^i id Kmhm*wtf, IttawK Ore w mipp Uinei wd \rWl J P>nn*cd A I ij-rf T~S*r> <> tTiI I adf. I. M . F-fiac M A. ad I a^u. Y. P 1 fart 't P U Pfprrear^aal loi Tnu* Tm.,4 It, ^ l'r*eww. (' ferr i<d \r^ f-***<*. J. ltww Hit k yu tet, I14S Kt<Wt. H W fc-4 aA of (MW < j! U ) m I < iM 1 (U JhO.nr*!**, ) I tii h f' Hf4 I1.I4ZX 1*4? lt/dV M VV . iVik. J. m1 It \ Ulow# vf iPAl.) t* Hires* lead V^arfl IM) i*~ rc iX IM7. 7 Tilt*#. } r. d P M m 1 rod i A. M A |M>Lt$*J7 (X-. At 1*4?. ffrrw^ai M,V> flaw )) J>4 4 {) \ r. T^ (*'>}>* t rte is t'rewcy htpi4i ia TWw 1 imi I'lU'V t iM W#nra. l`. J (-nr*** lV# Sumtf Or4-wr^t (V I'l-Slf roj^fia m 1 rad 1' ^Mn| a* CaMl4pf tut Thai rm*d N rjir rd a fulw hMim. J Oa la*aHt*2*i l|iV?. ItH L IA 10856 .Afmi >1 ififlnii rn phsot4L His n|>isMtion of thr Mshrtmnf" of the red bUd ecfls Ms in wrii with thr ihnv theory. Mowmr, thrfr sre many mar* in which thr exposure hu continued ottr many )mr, and (hrrr h urjy sltUt anemia and tto icterus present. It is Uikttd dm tfl Mich csvi Ktnvofini'i * (hrary (bl Wad may hr acting u Mock Mnc protoporphyrin and iron to pr> cni thrir normal ctmiUnaimn m thr formatma of hfmufWjfl rmgta be (iautiW espfanatiofi o/ this incrttird toprmwqib)tMBirii. Ko IVj i| (hi tine <4 pustuUtkm, we brlWre that in thr case* of 5 O. mod C A. o^rujwctiiyfuwm mctnud Unac red liord ceil* *m tnn{ destroyed by Wad with muhant rrioir of jeutu*xrj<fnnn. which sat cututtW into corrupt*y4iyTia and everted la ti>r utc of t_. S. who had chrutuc Wad poisoning and wWo had bm taking W/ge ismoti of trad Mr many yean. h U Wlirnd that (hr iocmir of cnjrt>f*rfhirm look jlacr in thr tmne marrow uui might pnaaihfv hair brm due to a by Wad dunny thr aytithrsi* of hrtnugioMa. Thr our tf J, 5. abo mn* to hs>r a wwnrwhsi sanda/ awchsmsm m thr cur of C S. } lornnrr, a* wea stated ('fninoilv. although many throne* hsvr !<rm set bxtK thr Actual ntluftiMa t-f fhxa tnrrrwti oipfnjioq^i rmuni ii not cWarty under* stood. It rhea if^r-ar. however. in mmn| these four ca*rv that mthrr than insisting tlut three r>ni*t le oro one mechanism ct*nn**i to ail am of plumbtsjn. k i* ttcr to mr.tsWf thr posulalrty that two mechanisms may t< prnerrt. este-c-aCy in im of thr tan that U*h thr clmical and thr Ui*rtnry findings do rary from o m ta cajr. UWW thr mfdttmm of thr cn|mfiir)fi)rinum of (fumhian is sot dHuutrfy know*. a t know* that an wirrr*rd rscrrtiun it srrtt m Wad worVm absorbing Urge imwirtt of W*4 and al% m c a s t * of acute and chronic Wad faasomr^.** It has rremth brew suggested that thr hndmg of ctiprotie)diyrwttm* mar hr a vtW aMe a*d sn thr ffnmxtfi if early d>A(fiiui of ifumloun" Kluvef 11 has loosd t>w ri'f'ruya4]*h<trm to tr rrmuQi jmmt in tW white nutter rf thr crctrtl nef>**i* iviinn of animal inr fading tuan. Thi* has Wd to speeulatiiwi that thr tarunt* |>n. 1w -**Vk )tr. mrrf<haV'fwlhy and aWker.mal col* ftfnrnt to plumbum may rx^famrd ly thr c*pr'Yfwjejtoyhn* dqvmted in thr insure W't should like to rf4>ee the r fleet of citric and. a* to that of sodmm otnir, on Wad rjufrtv'n to acute |fumisni. We shmtlH bkr to Aamwr thr effect of thr citrate ten a* oj^osrd to thr alVaJmteinf rfTrct rf sodrvea citrate. CotiJ such (JjsrrrMmn* are crmpVfr. freedom from Wad e*ro*ure. if aruiaahW* and calcium thrrsffy where n*rWd. are drprodaMr meawers. Smcr it is vm4 always t P --^ ( C^l I r*f d ln >h Uh Cs#l*Arrf, eeW (W tJ'AM. I'M*; Tto *4 l*rw*/r m*. **1. ) A U IMfU7 iTtk |VM 10 <t W*A-4 ( C K4f rA n iMwttn 1 St Vms at rrws m Inf W<rWv Arth Ufcul H;f k Om* M4 ItWrdsl ItlWMM* tt dm | l sad w* hf|. ) A G ha ih* t'Hns a IVs j)*W at I m%A K U mmL V Itta*. IMt Wt^| K. S^Umi tlf' -A fW Ttmt A-r I e*4 AkwyOrw. Ani lw4wt lira k kt*4 Ii/SM (V*nhi Wfinal1* 11 Ktv** If Oa N**csi>r fw*r*nf ri^ytrrrWa Aval Hi AAl |Hi tto C#a*rsf Kffwai Ay*ma { f. y*' wm LI A 10 8 57 4 i.............. . . ........................................................ _ .. 12 pOM(4e to achieve the ntol of no tod rxjoure, a U pfflinnK to continue to explore BartfexJi by which to form cr*nj*nr>d of tod in the body which art to* toxic thnn the lend ton and which hittrn tod excretion. tCMMAiy Funr run of tod poisoning, acute in three and chronic In one. bi which the pxtimi* bare here trreied trrth ftcxtriitn citrate. art pnmto W lx here die evfetoce accumulated lead* tn the (csknrwf opifiau: 1. Adequate oral doare c1 todtum cxrate will a*nred t)w aytnpuxnt of tod ftttftoninf. 2 Stndire of the tod excreted in the nrmc in three to cure ti Ucic etndare o( tod excreted m the tore--do not warrant the (ooduto that >< citrate merman tod excretion. X Studin of unnary coprtiporphynp are pnwrtti 31 Cdemi Street. Thr antrn err frt4f U lira C. H. tb* *1 B F Vi f-'rmm i%m ^ ilr *^ Uf fvitMt. S O Mrf C 5. rm>ui<t> T>* vuerr ar* iW h R f W ftwtio wJ f*. tV |V^W <4 fS rSwwrii iul W (W VlaMadMwfU UhuM d (knre**l Hjfvfir, iut ^rrijrmi ib* M ewil|ei o r '- ..............- , ***- ** fiM l >4 ** *W I IMW *  IILWkiinglWHiJ XJ|ji WWWJJ Wim i' iiiu.nryi|iiii|jimmM L14 10858 i i ! I i I ! 1 5 i . .. . , * * *| - I. f\Z American Smelting and Refining Company by Jom N Abefvjij o/xl K '.V N* vr> NDUSTRIAL hygiene has teca dkffned by Ptty` I a* "the sewnr* and art uf recuCiilrmg. evaluating, and curiiroiiifig puientialiy harmful fecvora in the industrial nvjfmir^'nt " This deffmtsurt implie* lhoft><*gn itud> <f oper*Uun*. evaluation of potcn- lull/ harmful factors through **r sampling. ttKfo* im;>tra and other meat'*, ar.d. finaiit. appropriate med.rsi and rr.g.nrvTir.g cont/- 1 *iwrrvtf indicated. The prmnUtA of thduti/ial health injur*** u a vital pari of operaUnro of American Industry today Prorgre-s* *r.d interest in 'hu field ha* increased steadily U* many yean, Lhe moat rapid progress having twm attained, perha pa. during the last three decade* It u significant to note that there ate now official agencies m 46 ilJ'.ri activrly concerned with induslrv*i te*Hh problem* and that a western ftrld talari ha* been evtaulished recently in Salt Lake City by the L* S Public Health Service to augment Ha irw5w>trvai hvg-.ene k *mc m directed from head- quarter* t-f '.he National Institute of Health. Belhewia. Md Many of the larger industries have found it advantage^M* to establish thrir own industrial hy giene department* The American Smelling and Refining Co k a world-aide erganualKA engaged tn the mining, melting, and reftrung of lead, copper, u a c , silver, gold. Xy -prix 1 *c1 metals. including cadmium, arsenic, nd other* In the L r.i*ed h'a'.cs there are i j smeiiera and irAnerie*. II secondary smelters t* ftnjndfie*. *jtd a f.^oUi of tt.~t.rt. Ap^is.mutf 1/ work* m ire rv^TTv*:.j employed It ha* -r-t be--n lhe eslabi.ined c^cr.panv policy to ieek out urrupaUonal hazards and provide aafe- guard* for rrrpiojee health Protect;** equipment has been 'upplied to individual w>rhm and nhauat ventilati/ei irt*ilat*on* have been m ue in scene operation* for more than 40 year* All of the major unit* ha>e Ihetr own medical department* which provide employer* with excellent medical and hoe* ptlal care In 1>J? full scale industrial hygiene studies were undertaken *t the ,S*-ibv llant *rvJ *e attended to m/t of the other vmelt^r* d ifing thr neat three year* In ill) the Department uf Hygiene wa* organu**! with Trofeaaor Itulip Drinker of Harvard University at D.rteir* and with Dr S S Pintn a* Medial Drecti*r The department I* responsible f/f roofdinatsf-g and maintaining * program (,* tt,#* grind health i*f *11 err.j i<>> re* fii*m top man*rn.ent down to the 1m*mI t * *d day worker It frnti*l!jr a efv.c* #*f ( *m <i wui *er*ing ail (/f the frutol State* plants irpiJVii it PcatM-n re size Poll aiwt (*a't* time {.hy** /- ( rtnja..r*l m all tj U* r<enpnr s American p.e/t* ar.-l w^iirg in ct<a# unpef *tuer With ttie V4r*lual Jnrevtw are fe(em*itiie f'*c 4e* ;C*M AIMWA.0 N.Me t w UUW>* n*f--r CW* -I Mrt-w** iae** -* lrleeg t*. W Ui (n t/*ek k o* ! ft Ml 6 mi M m- '/ iei' i *<wt V Wrtl t >nt Mewyi. U trVO He M u*rea. ##vw* iHd terymnlng the stale of health of all thl employee* and giving tfeaur-.-r.i when nece-uary. In general, medicaJ rare U r*c ihed tn acodentt cr Ulnraaea ocru/Ttng while the men are cn the >c.b Among the duties of the dortor* Is the making of careful phys ical examinations of new employee* and routine check-up* of old employ re* In addition to mnd.raJ care a p?tmary resporsai- bdily of the department u the pecrewfum of occu pational UIne*ae* In this the mam comm u with the working environment in relation to It* effect on the worker Environmental factors ovay be dust*, fume*, gate*, terne material*, heat, humidity, radia tion, or none The objectives are (l) Immed-at* control of thew factor* through the e-j;^raUon of the worker, fhrougn providing the wearing of reapsratnr* or other prolect've device*, and through careful medical ekaminatwcvs and regular analysi* of unne s*wcirrver., (2) a Ung range control prc'gram which may be acccmpluhrd by local erh*u*t Vertilation, wetung of irV.mai*, change* in metallurgy, char.gr* in method* of handling, or by use of special drvkq and special equipment. To accomplish these ob)erUv*a a An# Industrial hygiene laboratory wa* built in Salt Lakt City and equipped to do routine and experimental work. Trained and experienced industrial hygienists ob tain the Ik U by making frequent hygiene surrey*. These surveys include lest* of the au. studies of ail processes. a:*d cairful ir.tettigatl^l of VT.l.l*Uca, lighting, and general working rvciditsoei*. Except to rvnergmoci air c<*il*mmant* and often the substance* handled by the w-wkre are sent to the laboratory for analys.* ty chemist* and technician* specially trained in industrial hygiene method* The findings are evaluated tn terms of limit* recom mended by various State and Federal agenewa, and tn light of all available medical data. The method* used I'M studying the working an- vtroruTvent involve il *>f the uual cheenical and phy*Kal proccdu;r employed in industrial hygiene The I/npinger. electric precipitatne. thermal pre* ripitator. and filter Mfvf um; Jrf have been Used U> coiled a'.iTWM|iherc dust and fume sample* Of special Interest here is the filter paper sampler, shown in Fig 1, which was deveb^ed by Or Silver- man at Harvard University The instrument nas been Improved and is uwd very rx'ensivety m held ttuJie* A water manornet#/ < rr r>eeted tehi/sd an onfWe u uird to deterrr.me lha rate i f air fnw Uali- bratuo ii rfTsdni by use of standard gas meirt tn rotameter The d-i-t of fume is rUMl*d e> a filter {taper damped t^eiween two rings, as shown m fig I The Mtat {atwr i m U a* Wl-nman No 12, rolled* both dust and fume wtth a V ety Mgh rffbirruy Th* instrument U very Cwnveruenl arid easily transuded T>ve a..l.ds foJlrdrd <^n tl^ Alter fiapoe are an*, tyred tn the lst-*rat*#y us^slly l<r *e tf a |*>iar i (iipur {nerlure Uy Iho it is {-w*ible !/> ir.rsiwir quad - *i.ty in a * /(! analyst* Uie k-w 'SOOfcNkl Of MgfMV IH. He I, Wt l1l, p >V **4 Au*4. V4 1*4. P >k i t i N 305.03 **r LIA10859 :v*ir u ' ..a ; 4 Jr* j *.- f ad*. ijri the t.*u s i t,,w:e*e s\; ...-er m-v". j i, ..iff,, th* ^.r**`-e tr g / rruie r** - " moatloot for l/wmeo te pr> tecticn of tl. 0 rv*i.4%twn of ait ia an important fuiuu n i t i)a Hv(im# Dcp#^* cot T>aa involve* in part an appiaual of air stw<i^ and (h# rorrvia* 1 Uo a of th** studies with r.rt.x i daU. When all the far-ts are bmvght Uvfe-ther, ut\ <#v*>all avaiuaUon of U e rnvtroTi.ment is male. tr< nw*j for coittrof measviree determined, and a c>ufU./^ated control f* program outlined flec.c*mmdator.s for conl/of are cor-wr, feed. cid.-nium, and rinc in each rr.a.ir iu the plant frianager and pa^ed on U> f' larc-grs;h;c mevn:is are alsu u>*\i for th# drterm- m(iwn eapenaii/ travnrd M /,duetr^al hyflen# of * number of other iitnnU. vamiUifcon. Tlte paat manager and the superm* i Du*u of v*rx>u* type* are th# moat common trndent with his operating staff decide what method r*vitarr. mar: U found in th* atmuaphere of th# various of control should be ra/ned out Thla la loftcai pi*nts r^nn oont*.n;n| lead ovui# may b# found because control. may be accomplished by change* i u erruuo wnelter and rr^nery wurk *rr*i and are fivn special attention s;nc )**d otvd# is more read.ly absorbed than ether leu anlubi# Irad com- j>ur,dt such as ih# sulphide Other contaminant* < luch a* o*rbon rrMnoiiJr, n^drofra sulphide. sul phur d*oida, kirrium, tellurium, cadmium, and aenc me t* fv-und ahd require study Certain cJ the {s>et mmt*or*d mir be task or untanl 1a order to he cr m taniJ y on the alert and to be w arced in advance. rapid Arid testa hare been deveioprd for hyd/ngen aulpfude. chlorine, and anine from baaac British method. In thla method a cmaii hand pump U ued to drew air through Alter paper dtaka unprefnated with various reagent* *hrh produce i tt4in if tram of fa# are prevent, aee fig ), Three stain* are compared with standard* to estimate the fa* corwentr*tK>fu Dy use of this method chemist* and J.(p*u*t ar* *Ue U check the working environment fr* tupectd danger* Tor one plant where hydrogen sulphide U beir.g used in one of its oper*n<>ns. a machine is being developed to aound I a h*4 ** hmt it*e W bed * *w ee#teei e Sf#s*e ssf ctbes automatically an alarm before any escaping fa* in met all ur rr or method* id handling rather than reache* dar.grrou* corKentraUceu. by local eihaust vmtiiaton or other engineering or from time to time certain analyse* requiring cheentcai means Occasionally control ia not poeaibld highly specialised training or very eiperuive equip- by engineering mean* and il la necessary to rely on ment are performed by the research laboratory or respiratory protective device* and medial control og'txJe Ubr>rtor>e*; tor eaampie, spectrograph* procedure* Sometime* the reeommevviatKma far and petrora;>hic anaiyse* Certain type# uf re plant impfryvements are based on comfort alone search work involving animal e p*-rim#ntaton have lather than a health haiard. fc-'-en performed through (rants to Harvard The ven'ilat**) enginrers frem a unit or a dirisk* Uni verity. i4 the Western Tng.neef ir.g Departmmt but work As a pert of the fect-Andlrg functwet of the Hy. in the <ka*tt corpefaU*o with the Hygiene Dtyarl- fierce [leparlment. urine specimen* and frequently 1 ment In carrying out the detailed rec'enmendattoft*. blued tperirr.m* are obtained from all worker* frequent ctmfrrecHe* are held with throe engineer* et*-**d to lead and other rr-etals and eiamtned at and general plana are approved h**f l-mpvoa*<ao*f| f^mir>atPm nr rieitrnl nf all |otentlally herm/ul i fai'lnrs in Ue *nvnn/f-nt IS the mar^f tong-fang# 1 obrertive H.rvre 111* and i^rtM-ilai ly during thy i past f'-wr years rn<rh (wr-f'eas haa I<*-*'0 mad# Uu *41 fh* In raw* **rh *a I* (K# tha rul has Uen very high frren teo la tamty iV'-'ars l-er worker f,'U.wir\g a?# *- it * <4 tha high! *>.ts <4 c *riif-l nf dujta. fumea. a;, i gave* in tha iifH vi ( *ni* a^hicvad through the (>/.Mncd ntcrrl a*J efl rt rf nvaragert. aujwf- 0 iM*nd*r>l* m#la<io( g.*la f .remr-rv, lha spaetally trained staff o4 irriinl.w vnguvrwrs *J llv# Waoteva I I LIA108 60 kf'g. '.-'Ht,; tr. r.& >'. U - , . ^ * : i - -.4 : ,,*e 1 '. ,i; -J, j ,:U :> . * *f,>] I'll-' -i I I". 'i . { v * * a k- > a-'.- ! r J- s*rt c.e*r.r/3 '! rc-u-pn-.r -1 twtae^nor* iv'j, ' :> tr rrean* 4 l^a*e r a : lw b* u>rJ ai* ts>>rfiy local nl.a ii dual * ty wn*.i bag- ivuae ^r.ila ard 1 ri.'ugai i/tp.ngrrr'nt % Doc4 .e* cf the very ? ,gh cal, taper irr.wtal work Km U-*-n conducted lo find other tprart pMduc*d by *'c<r.;x.n4 water with cwripftM^ arxr have been l.rd T\e mirrule droplet* of water preduced by three actually wet dual perttciet* and brio to reduce <r-e nacape of duel* at the aourre, yet they avoid ob>ect.or.*bi# wetting of the flowing With thi* rtM-i/wjd of ciantrol a 0 pet re- durii<jr | dual <onrrnUfUorti Ui bMft achieved ill on# mill. 1a certain toatanrr* protorlloe of the workor hge boon enmmpltahed by ventilating and air condition* u\g amaJ arts* where mro murk, tuefa a* crane cab* when the general rrn'Juatioci of the room would bo dJVvul ii not impoaeipie. *re Stevenson.' La other m-ortl* tho man ha* been "venUlaLed" instead of the cT?vri*oo Cabs cf c t *r>-i Land-kCg ore*, tarnring hot fr.etaie over furnace*, cVf, art example*. Thto approach U bemg Irted now in (mils by buvid;r\g booth* kept under pw-ntive pre*#ure m>th f-llered sir for woe am whose <4ule* can bo rtmrd out Crura auefc aa enckaura, Samtpumf ftoemu Loral exhaust ventilation and food housekeeping have bran used exclusively to control dutti in sampling room*, xv fig 4 Modem fnndiAf and sampling equipment are email j enckwed and the duat roe bo coctrolWd al a rrry modrrato coat Bed* and CXo'pe Bima Wet tint mcloeure and e&ha^al irr.U^Atoa a/e uad f--r c^r.tiu! of duet* in *u* h e^; i:promt LKut rantrol in theme department* U one of the meal di^ult prt>bim. Wetting ran only bo uaed to a limited degree bo* Cau*e etre* mouturv may a/7rrt the rooatmg cf cer tain type* of ctia/gta. The unloading cf trurkloode rf ore* and corrm* tea let for w>ragr or making up cfvargea waa a dif ficult prtrfclem to control in one plant The float aolu* Oon w h found in a emi-enrlnaur* and hood mrtlh high ettiumr ai/ intake V .\ fa - *> *1 * H * l<UH in>m0 he* ifW Hi - --> . Wa at i fa 5--"*KWi *h *W *a< Se *.< tow l * Inf HW i'f-jW lar* W*w m<i *( Dvitfof-LLcrpd 5imler />lamu Wetting, erwkia'ira and k<ai exhauat eenUlelK<o hart been tho r-ttn* cipai method* of contfolUr.g dull and f-^ire .n t/a Owight-LLord unlor plant* Water may t* a ii*i tn both flrat and arrend-q^ rr charge* at the boit tr.ppwr, at (ha mating lab^e* and acanrtime* *r;ih u> cf pugnuila. Water u ueed te e.wrch the m;rr aHer u ta frailed and Lhe d-chan^ end* of tho rr ortine* are kept tightly enclcofd. The centred cf duat* from crushing ftrat-orer winter haa been r^actw# with local aihautl vtrij!|. t*on and cc4;m*un / duata with cemnfugai wmpthgrrarnt waabert. Tha diiitmt DwtgM-LLoyd operation la the re* moral of drpoajta from wind boars Control of Oveea dual* haa been eftretrd by U) uo of encVwed pan or *crrw conveyor along wind bor with draft maintained on tho boars, (2) wetting by Inarming Into the dual pile* a water pipe wtth fkrwtng water and (2) m-a^ntefvanr* of a water aeal in the tacAbm <A the wind boie* which cvmplrt'ly Hi the ecru- muiivr-.g Cat'.* In I ?g 5 ie *h*.wn the teenrv of t .i.! duiti after wetting with injected water ptpea The water seal haa been applied only to aeoevd-wrw machlnea. Good hfuaekeeping with frequent wadi down of Boor* te very important in control of dual* Thermal air current* plus nbraUckl caQ redtaper*e aetUed duiti Coraxlerable bnprovemeot In dual and fume ennr*n!r*ixe>* woa edreted la one Owrlght-I-Loyd plan! by a change in rrvetallu/cy. that u, a lowering of (ha percentage of r*k* in the cha/g* ticetai* real ha* teen onl/c-llcd by Inaulallng wtrvd b w orvd a/ duct* and by ue t~4 U/gr Ic m1* fTHJunted errer the pallet Immediately bedirKl ; -./ivr* and ronnerted to a ttark for grarity venttlalKei. Lead ktoit fae***** Tie maka up wf b *e< fur nace rhargr* may Inmlve d-^ity 0(wratan* If aerrmd'wer amler la fv4 lenlly wrtted Tha *M#r la p/ed In h >{^er* *n4 It haa l*ei) f *iiuj f^nufy to provide ethauat vtclllji^a when the .nter u withdrawn The orit/ij of #| it arid fume at th* feed to tha bleat fyiaea la arrompliahed chiefly by pad draft te the f'irnere The Ud I laat furnace rannot be ta|fg^<i f e alag. or f,je |*ed rf th# temirature la h *h aMtr^^t live generate*' t-4 mih )ad f^n-.e fume fc^n thea I* f<*11i i.**d >th |<<ral eahauat at a*l fv-rt'^r* ll i* ne-e-aary to ratae irn. !? *- haet j reaaurv<lr and wwtera have neutiraw neglected IMi duty tvsuae of tha little etlta week  V mmm LIA10861 t <! W'm a jm, rtoAvf)*4M' upsraixv TtiT*h- *'r?i tl f- i'.m'.j '.; " .t *..-n. rr/'.rvrr*r arid t <**4 f ,<; !r 1*^ fr>'ii ) U*",!' tiie Inm-'V'i*' l>it*e ufvrr u'. wn !? f f i T.*u* dr>'>Ce trt v h *a art frd c Humber rtrm- ! t^nod A arrular w*.ar iway Uirotrd near lha top partially wrti Uir *t.i*la a* they p*M from 0ua to tar TK* wetimj of the duu u continued in the car and Durumitri diuunj in later handling, t L . k.| u** W *< ***** W^-i '**| 4 M 4 <*rm4 wt<iM kwd CofirtUi The control of atmosphere deata result* Ihg from the cleaning of rrrttreU hoppera hai been dtAruil. Enclosed and ventilated convey<* along hofTpera have not been adequate ftpUU which create airborne du*U dj terur m spile of the beat care. The problem has Anally been solved bjr repUnng the w-orkm with autumatic equipment. Electric vibrating hammers have now been tftataUed on moat of the cottrrll uxuta. 1 rtgmfr^i Tu ci*fcrji>v (hu end provhi* (on* ttrur'.n to res**t the heal. * hnud Km brew wy rwrr.!.y which (ifl be rikkH lwir4 by *n t-rri.* motor merely by pressing a Wttow a* iJvnn in ft| I Stand*by empty or Ailed lead pete sarrvctimes cause r**\sidrr able fume Tg notitd ihM a vt'.auit ient.istrd V*xi with a flexible fireproof dud Km t*'C*n developed. Rt: r+i-e^Mto+y f * rwt Corsl/ul of dust and fomr from ottiU>n if le*4 (lrtu fr^ftbritlory furr*e* has turn effected tj a^irquata draft 04 fidr^n t i yurevent rvii< of 1 *^4 *| (h# ctiargv 4c k .v and bt oval eihaukl veeiii.stKgi *1 the lap Kcu<* and launders U* iprus and matte Uy-fVodsru Metals The mntml of duvta and gates la the refining and packaging of by-product f r Kfltk* One of the mod diAnJI prattfim hit been cvrfUroi of d^u and fume from refining opera tion* tn kettle* Complete or partial hoods with cihjuM vmtiUtiui hare born effective wkfft mH>U ore transferred to kettles or whew stirring u dime to r(Mrl drueae* Kif 7 khowt o h<od wilb a l.-il. *,>:n.e an ir.uhe u cur.Lr;J the fume c t v t ih# ixiftrr / a l/id lirHlf Ai i/wArut i^ptorrk to rodK'lrj duitinru du/iAf 4r*r *kj/r>mmg. ripeniwiiil work it r-ow under wy to (1) change the elements* such as selenium, tellurium, and cedmiusn. metallurgy. (3) rfmovf drosses with Kfcw-type cet'ryc h with torsi exhaust rmtilalKn at ptunt of di*rf*rgr into ikip and tJ) u*e of a high veUeily has been accumphihed by use of heal eahaust ventilatKm almost radusively The hygiene program and aume of the work that i *iwt type exhaust around Hfr *f kettle A fair dr* has been done to improve working conditions m the i %t-r* <>f turn*** ha* brew achieved with ua# of the Ajnerkran 5mrJting and Kk-Aning Co have been re* ! aerrw-type cuarryor shewed briefly In presenting this information there is no wudi to convey the impfes**<ei all objective# / Jar* Tt-* removal of setllrd dutls from flues has have been reached There are problems yet le sofve, and changes in r^wfatmn* and hew processes con* tmusily arue shuh require stud/ #rd o-nl/ol la <wit smelter recently the minutest details of corrtmf m a new prices* were worked </ut before the plant was built in order that no chances would be taken. Top marveiement end o;>eratihg staffs displayed keen interest and c<*i'ef*trd to the fullest estehl. The same mterret and r*-psratfcin from manage* i iI 4. mrnti of all plan's have r^-t'rri in all other phasea f l?> ndu*tral hrgirn* (f'-sfam and are largely rv(^)*ioie f<< what meaurr of mrm* has tern achieved. IHw mn \ * * * il ii fee V r a t* tt* Am', m 1*.-f jstftil Itygirne Assoc Qusitmy I *wpt )>I V No 1 a | W M /**.*]!. with surq.;*n-*ni i f C. A fttarvnataa Air C<<dit!<<r>*wJ t'rs>* ( *) (Serwa pub* or |ixtutrtsi y--'.rv>iiMai ig An<*>e%. Ifsl)-*' Jnsliiut# |`itiatiign }' tMf e I bd m* w m m rnb nr # M fsderal runt A^u aa fW*^aHing ang AeAasag C4S, l**W 4w *'* e* bad ha* A)P<^. IU , lujthef J ftuik. Manager ( i4 !