Document 6R41xo1zgG043Xr6OBKeyxoNo

201 South. 4 th S tr e e t M adison, -Kansas* January; 17# i 937 Age: 37 c.c. ? .I. ?.H . F'.Ii. idus tr ia ' ''L o ss o f u s e o f my h a n d s a n d my n e r v e s . L a st f e l t w ell a l i t t l e over 2 y e a rs ago. 1 s t symptom n o tic e d was d i f f i c u l t y i n w r i t i n g * T h is a c t i v i t y became i n c r e a s i n g l y d i f f ic u lt the lo n g er the p erio d of w ritin g and aching would develop i n w r i t i n g f o r e a r m . P e l t a s th o ''elbow w ere i n v i s e . N e x t n o t i c e d ''e x tr e m e n e r v o u s n e s s " m a n i f e s t e d p r i n c i p a l l y a s i r r i t a b i l i t y . A p p e tite a t t h i s tim e was a lm o st c o m p le te ly l o s t f o r a l l m e a ls . T h ere was, a t t h i s tim e no o t h e r symptom. T h ere was no i n d i g e s t i o n , insomnia or disturbance of sle ep , pain or n o ticeab le lo ss of s t r e n g t h . Has a lw ay s b e en c h r o n i c a l l y c o n s t i p a t e d b u t t h i s was not worse a t th is tim e. Loss o f weight s ta r te d a t about the o n set o f symptoms and t h e r e Was a l o s s o f a b o u t 50 l b s . i n 4**5 m o n th s . A few months a f t e r the i l l n e s s s t a r t e d due to an advanced p u r u le n t g in g iv itis , a l l te e th were e x tra c te d . - About a year a f t e r onset a p p e tite had re tu rn e d and gain in w eight s ta r te d , and w eight i s back to norm al now. At the p r e s e n t tim e i r r i t a b i l i t y i s no lo n g e r p re s e n t and the only symptom which is com plained of is the i n a b i l i t y to w r i t e an d some a c h in g o f f o r e a r m w h ile a t t e m p t i n g to do s o . M easles and P e r t u s s i s only known c h ild h o o d . Remembers o f no o th e r i l l n e s s u n t i l p r e s e n t . H e m o rrh o id e c to m y November 1954 Ho i n j u r i e s . R ather and mother and 1 s i s t e r liv in g add w e ll. Uncles and aunts t h o u g h t t o h e i n good h e a l t h e x c e p t i n g one who d i e d o f TB. W ife l i v i n g a n d w e l l . No n e r v o u s d i s e a s e s . S ystem s n e g a t i v e e x c e o t i n g f o r c h r o n i c ''c o n s t i p a t i o n and p r e s e n t d ifficu lty . " " S c h o o l u n t i l 1916. F a rm in g 1 9 1 6 - 1 9 2 0 . RR F ire m a n 1 9 2 0 - 2 3 . Since then work w ith g a s o lin e , working a t bulk p la n t and f i l l i n g s t a t i o n s . T h e re h a s b e e n no u n u s u a l e x p o s u r e t o g a s o l i n e s . No known le a d exposure e x c e p tin g le a d e d g a s o l in e . . " .........: n Physical; ' A p p e a ra n c e - L a r g e , w e l l d e v e l o p e d m ale who a p p e a r s t o b e v e r y w e ll. The c o lo r is good. H a ir i s h e a lth y and s k in is c l e a r , not dry, e la stic . H e i g h t : 6* - W e ig h t; 192 - T; 1 0 0 .0 P : 88 B l.P; 12k/ Dynam ometer r e a d i n g - R i g h t ; 120 - L e f t ; 95 No l o s s o f w r i s t o r f i n g e r s t r e n g t h a s j u d g e d by r e s i s t a n c e . P a rtic u la rly w ell developed and nourished. ,-j - - \>'--M . Ears C anals c le a r - drums th ic k e n e d Eye s P .e q u a l] , r e g u l a r , r e a c t t o L a n d A. EOM Ok. Hose Hot rem arkable. . . . . ....... pff';. ^ .. ...... .. . Mouth A l l t e e t h o u t - gums n o t re m a rk a b le - no p ig m e n ta tio n e x c e p ti n g a l i t t l e negroid pigm entation. ,; T hroat . Tonsilsjj s o f t p a la te and pharynx sw ollen and m o d erately in flam ed . Thyroid Che s t - Heart No e n l a Ir g e m e n t'. E q u a l c jo n f o u n ity a n d e x p a n s i o n - n o c h a n g e i n PIT o r BS - no r a l e s i. " . Regular rate and rythm good q u a lity -no murmurs - RSD ROD 5*5 4x 11 . Abd. No t e n d e r n e s s - no m a s s e s - o r p a l p a b l e v i s c e r a - no r i g i d i t y . Ing .K in g s Not e n la rg e d - no h e r n ia , E xtrem , R eflex es N egative - f in g e r s la r g e and w ell developed - no a tro p h y . E q u+ ai lh c 'aplsndf Tnnoe rs m/ n ra l l y + aCrcemt i. v-f-e - no a t a x i a - no t r e m o r e x c e p. t i.n g. i n, t e r m it ta n tj tr e m o r of to n g u e vihen h y p e r e x t e n d e d . There is no change in se n sa tio n - touch - tem perature and muscle sense .-entire3y normal. . - inpress ion T h e re >ip sa n e t e n d e r n e s s o v e r b o t h f o r e a r m s . T h is d o e s n o t f o l l o w the nerVe .tru n k s - i s p r e s e n t on f a i r l y deep p a lp a tio n anywhere on fo re a rm s . ' '! ' T h e r e 'i s no a t a x i a - The g a i t i s n o t rem a rk ab le and th e r e i s d e f i n i t e absence of in te n tio n ,tr e m o r . E x clu siv e of w r itin g , fin e movements of the hand are c a rrie d out in an e n tir e ly normal fa s h io n . Pins can be p ic k e d u p . The f i n g e r s can be m a n ip u la te d n o rm a lly on r e q u e s t and e a sin g and d r in k in g a re done w ith no d is c o m fo rt, d i f f i c u l t y or t r e m o r *j A s a m p le o f w r i t i n g i s a tta c h e d .v V * sp a t r*e-ty a # * / frr<**r*nv />> 4 c-*' &f w n ?*4f. 1 . Earljy in flu e n z a ` 2 . Y T rite rs cramp of* l a r g e l y p s y c h o g e n i c o r i g i n w h ic h may h a v # o r i g i n a t e d 2 y e a r s ago v^hen 3 e x i s t e d . 3 . Low g r a d e to x e m ia a t s t a r t o f P . I . due t o a b s o r b t i o n from gums 0010828