Document 5kD07ddgKOneaXgQwMJOZbL0N

k. 12th March, 18. te*. 8. E. SXpbiefc* Medical Superlntendant, State Sanatoria*, JESE&Sfr J>eax So*, -------------------- Z ** ao* intaxeated 2*1^ pattest has so diMBwnA Iwt aiiht* X km 1 oafcsa p mr tstu at BktitMla t thi Mt f ft* latftr will mUr eofreirt of mrwta fm tt*M ft tti* partuning _______________ bmtft ft. ta4bt ft A4.L inkift* of ZSGSSnGI Sealift* W5,TM11, 7.t8S. - Jwthnltgy of Aabaeteais* describes 4 y tlaa. 3ft tte firt^aaa iiftftr* of uftettal* ftdla am AkbI la ftt ^mU*. this, he eeye, 4a an iacUlaatal finding, Z later aabestoaie Min aa* found with definite changes la the lang tliina, laical Aabestotta - la the A.ft,A, Archivss of Zndaatarial 1955, toi.11,1^204* Pan! Cartier sake* a ssJ'voj ^ 4COO asbestos worker* la <ftebee. Between 1945 and 1953. 12$ cases of asbestosls sera discovered, 40 of whew died* Of the 12S, 121 were diagnosed by x-ray and ifte ether 7 ea patho logies! stody ca3jt l.a. diagnosis aaa not Bade a& ft* fllaw, where changes, If present at all, acre Of the 40 deaths, 6 were due to fertraefeogeale carcinoma. It is of lawrest, that la the other J,0C0 odd.swployeea, only 7 died of broncho genic eareiaoea# Of the 68 aurvieors with asbestos**, 5$ acre able to eerie withmt dioeoBfort. Of the remaining 29, bo good correlation between the dee** of asbestos!* e&4 tta clinical, sfttas was found. Roweear, la sa article In the Feat-Graftaate Journal of Beaicine by B. y*re, 1949, Id.35, P.635, la a ssrvey of cases of asbaetoeia, dyspnoea is quoted as a universal 00*- Baint. The author also aeatloas that spates aay be occasionally cod-specked (this is the only aontian of hemoptysis that I hare oae across}, Za this sorvejytlfe average erpeenre to asbestos was* - i6.2 females 7-3 * ) All oases 10,4 years. la a survey of 53 eases. 29 ware found to have finger clubbing. (Also 33 of the 53 had an acceatasted pninonary 2a3 sound. Co the other hand, ftenaeth V, Snith, la the A.*-A. Archives of Industrial Health, 1955, 1ol.12, P.1?6, states tn? there are do typical clialaal feature of asbestosls end clubbing of the fingers la a rare finding. Re sft,tea that as bentos workers esc net predisposed to fttercorrvM peSaonasy infections. 'Howrer, when an scute pneumonitis develops in *re presocce of an established aebestotic fibrosis, tie izf&etion is clow to Heal, relapwcs are frequent end be r:i(*n: cay be core susceptible to subaoi<uent pulnoenry irfeetiana.- In mn article --Silicosis '>nd Asbestosls* - Anerle*D PLAINTIFF'S EXHIBIT WV-04061 PLAINTIFFS EXHIBIT K'-v^ .0-- WVW14064 2 Journal of Surgery. 1955. Vd-39* t ltn, Tiimims, niCw log to ssbsetosle. states teat mdldigicdly it needs V> bo dlstisBlsb*d fro* chronic passive boagsstlCB. bronchiectasis* polycytbaeaia and Infiltrating mllggtaat nataatlele treet tfas nsdlaatliTM. Cm tMf 4al7tt tf x-myw ttat X ira m4. m yet, 1* V X*- g. Bristol, A.K.A. Archives of Industrial Health, 1955, MS3, to wHich fas designates 2 ata<M# Ha desorictlen infer* totee? tesct slates Hurt tee disease tend* to folio* a bilateral sy-Limd eaflintita. tfte_^l*tiqcohiB-OX caaoogjrf tee too Editorials-a--rlera /ml of an<--s Ted1^2th5e.reP.a13pSpCe.a- r* *> C^SESS^^SliiMtel^aoX Cs.- Atfbestesi* cancer of tfc* lag to eeapeBaslO* sssuaMul dlMMf la feziur. It t-cancer of th* long basTijdted tto giwseaoa of asbestoaia of th* lmg end doa not &** to exposar* to asbestos without the odatsBM of a paeuseconidsis restating thsxsfrgs. X& the British ^oonol of Industrial Kbaids*, 1955, Yd.12, B.B1, by Slckard Boll, gives various percentages of yjmg eases* la esse* of nabeatoelst 1949 - Kerwwctbcr 31 out of 235 - 13*. 19?1 - (ZLfOBO 1? * til m 14*. In Kenmttsr'B figure*, 17* of sea and is Gyrae* figures, 19.5* of *en with asbetools had oarelaoua of the long. All of tie snbjeote is whoa two disease# *er* associated, had at least 9 years la conditions is which control of fast did not here to be undertaken, i.e. prior to 1931 la Bsglted. He states that the snaodatlew of the 2 conditions has net been farad da say person taken late enjoyment elaoe that Ante. SHe point is sere aldnlfloo&t when It is realised test between 1933 sod 1953, incidences of lung cancer sacng sea in the coostry At large, increased sin fold. Apart fron tbe clinical urgency# it is Important to establish whether or not this patient has a carciAoiia of the long. By this 2 assn that tee shadow-la She Jef^-nld tone, l.e. a slowly resolving infection. could bo dsa* to cnroisona of tee ismg nad be b&s got the slabbing of the fingers* Share scene to be evidence that the later le of fairly recoat origin and probably of fairly rapid progress. I rather tend to tbs opinion test this vapidity weald be sore 1b keeping with dubbing due to a carcinoas of tee long *>" that due to etlieowta.- US tele patient h#s cardaons of tes long* we are Xsft with the ashestoe bodies and the iaeonoluaive shadow at the right base, to establish a chain for sebestosie. It certainly night be well worthwhile going ahead with tbe dale under these clrennatancee but If we are certain that there is no carcino&a, then "e have a cuch sounder ease for asbesteals. 2 wander If it would be of help if you could get a *peeia*n of oyntun -td if yyu eould send it down to Professor sansti-Jen -ite a view to h-avlnc a search for earcinoss cells.. to you r-t 2 . alien*. y.M for Sr Z do hope that l would ilk* tn these notes will be of assistance henr the outcone of your Inweet~ >=' *^dcV,^ciier2 ^SD ?*** Then* Tours elncerwly.