Document 7RVv1jvqxxq1Kabba56grxvKB

THOS. H . GREGORY CHAIRM AN L. E. NYSEWANDER J . W . BEALL. A . D. CA DOE^:r ary W o r k m e n 's C o m p e n s a t i o n T h e In d u s t r ia l Co m m is s io n o f O h io me dic a l se c t io n COLUMBUS H. H. DORR. M. D. C h ie f m e d ic a l Ex a m in e r ' Oct. 22, 1935, Dr. R. A. Kehoe, ; University of Cinn.Colle geo f Medicine, Cincinnati, 0. \ Claim No. NAME. ADDRESS 27 Wuest St.? Cincinnati, 0. Dear Doctor:-- We are referring the above claimant to you for.... s^ s _ report, and,o p t i o n ,,a s,,to whether or ,ript_ claimant i s noy?,.suffering from the effect of lead poisoning. You may notify the claimant at the address given above when to appear at your office for this purpose. , We are enclosing, herewith__.............................. .... . which will give you a history of the case, as shown by our files. Kindly send your report in TRIPLICATE, together with your fee bill, direct to the Medical Section, as soon as possible. The extra form enclosed is for your files. In preparing your report, please use the following subheadings in the order given:-- (1.) HISTORY-- of injury and treatment, past medical history, pre vious injuries, family history (if applicable). (2.) PATIENTS COMPLAINTS--- describe in detail even if they have no apparent connection with the injury. (3.) EXAMINATION-- include all objective findings, clinical, lab oratory and X-ray. (4.) DISCUSSION--- -summary and treatment indicated. (5.) OPINION-- -extent of disability (total or partial). If total how soon will he be able to work. If partial, estimate ` degree on percentage basis if possible. ..... ,, Use the form(C-111)enclosed and continue your report on the reverse if necessary. Very truly yours/ MED. 11---5M-- 2-35. H. H. D:6r R,^M.V D., Chief Medical Examiner. WEE/ eh ' IN REPLYING. ALWAYS GIVE CLAIM NUMBER. NOTIFY TH E C H IEF IF YOUR INQUIRIES ARE NOT ANSWERED W ITHIN TEN DAYS. OD u s e s Cineinn-sti , "hio. obt>* horsey w>. t ^inoixmiiti Qliio. tmi 7/ 20/35 7/lS/h5 44 '10/4. "flead m or i. i>Ufi-Sit* Tty ;.k.oe;.ia ana a. iOr -10 am; #5 i s til uXooc ?-*v*H- -.<w!*f*t.#G -vh &w* ** *..?OHiiSv*X1ilti1iJi-L ^ .-:.i_,5* GS; ! '; S' ;/I4v u.<j t'.f 'airly 'ell developed and rs,tner poorly ncutished it male. ais akin is of a si-1low cm ate m d his Lins are moderately pale. fhe mucous .mbrans of tp? south irnd throat are rale and tile hj p f ; h j y *o . -> - i1G 1Cil*- art sounds are of rather oc r uali'ty t.ad. r s d i e i rterios are thickened. blood pressure is 134/*5 Tenderness is complained f<.i h;,,. i- X v* ?rSf*- upp-sr quadrant, as well as the left lower j.:d ant of the abdomen. There is no musou1 X' -: idity. ...bdominsl raf 1exes are present. All tendon ref lexe: /hulls repot t< t ;n.-.-e <of she S' Claimant relates symptoms of the onset nearly on year ago, which consisted of stiffness of the knees pad a "ight feeling about the chest. 1 diagnosis has been made of lead poi.toning. Claimant at first attributed rhese symptoms to. extreme .heat, until this cisynosis was made. In th pest three or four weeks he has noted some discomfort and fee-lino of heaviness after eating. Ibis is particularly true following ingestion of fats or greasy foods He denies dysp'sia erior to the onset of lead poison ing. In June of this year, a nssal operation was done bclause cf furunculosis of the nores. This has relievod. the local,oyuptews aut he does not udpit any Improvement in general health. The time olesent in the onset of his difestive symptoms is v.... not in favor, of a causal i-alationpto,.tlie..^ead pod- N19508.01 '-""ISIS *:-"-&.,Zrf-s`'*<friV.T''T;;' " 'S*. ifIj J- sr* Ei*| it Pi.. niiwd'i tl `t s * ; le BfSl028S _. gsi^msht irolerao &***-,* - s y m w tke .Osgt; gtiffagfs-^. -, ..*|-^e.isii .... . I:a 'tofty'ao o f 3 / ' ` #j >h$*:?af i?wag; aotb. i:-dISrprtl'.&ai.-ff^ %t .S .gesti' kil fiaiBll io .--ti S mfiil *i ;.|J >ai* ''` i i m t< . -geae 1M m Ai -r > \ - * / .. . itt# pt#: febll ;,|ylsi s&tJ IH L f? mi Z\i'\ . '* -. - /* 'r.-:` ; ,.~ ,*** ceft-.tkl . ' y . vv rA* V 1-A $M m v-. V-' SijK:,?wf3l sS. f.'mfe&^. A- mr-W:M :3 t... .--,. .. , , _ -. t*. . .- - - .- 1 - .: 3:1-5?1 *; t r3 lv.r'-*V ;. ,-:^ ?: .'. .- '-i. :'t:'Vi 1 Tii'S f &^r':'rSvr:y ^Vrjv. -.T-.V/ij - '-v-'.;';.Vv. : -' .:." .* r-; - ...... .. U. # # f .' "" " ; ' WORKMEN'S COMPENSATION Th e in d u s t r ia l Co m m is s io n o f Oh io Address ..27_-.IiUSS.fc..-.S-fc-Cet...................... . Date of Examination... SPECIALIST'S REPORT ' ........- - .........ILAge..... M* .......... .....................;........ NOTE: Submit report under following headings: (1) History. (2) Complaints. (3) Examination, including X-ray and laboratory work. (4) Discussion. (5) Opinion. Mail THREE copies to the MEDICAL SECTION--Retain one for your file. HISTORY ' 0*0 wsicts8:8 and logy feeling**. ' . ' ' . P.I, Has boon painter, for 2$ years. Was In good health till June 1 when there gradually began weakness and stiffness in legs and arms., , 1 Xb became difficult to rise frota stooping position.or to negotiate j efeairs, fas: Working usual 8 hour day but condition bsdam ore - . --J with pronounced malaise# sense of constriction in chest cud gastric ^ diucomfort particularly after eating. Appetite was poor for breakfast as hay been true for years. About August 0# 1 93& stopped nark because of symptoms particularly the stiffness In the arms end .legs*.Con* suited physician and has been under treatment for lead poisoning since then, Mad, little progress till August 1935 hen k@ bagan -to.-improve somewhat. At preoent tiiaeehas some weakness# aching and itching in with general m a l a s Gastric, symptoms-..hare disappeared,. Appetite good Cxdepfi. for breakfast. Ho history of colic# wrist drop etc,.. Hcsdaehea have been frequent and annoying particularly at time of onset Insomnia was annoying - no terrifying drees. Constipation has been . sever in recent years - takes saline cathartic, regularly. Ho numb- - ' n#s# or 'tingling# no- chills# fever or metallic taste* . '. - X#H. School till 13* Woodworker months,Icafcher and hair worker on - carriage scats month. Paint shop worker# paint and puttyMixing#," >; cleaning# glazing fee# 2 months. Carriage painter 2 months, -tipholstsrst 1 'year>, fainter since, ' " Pb.H, Has boon working with lead, paints almost continuously since age of 18# all types of work# sanding# mixing-# glazing# interior and exterior painting. Averaged usually-,,8 hra.dolly. %tt 1920 and 1929 worked os' :: long as XH-li* hours doily, - Sine 1950 has worked 8 hour days for -; about 7 months of the year, -."-.Prior to onset P.X. had six months ;' - - steady employment, Ho unusual exposure * no dry Xeed compounds# etc, P.1I. Father died g2 - C*H#R, 1 brother living and well, Mother died 82 - senility, 3 sisters living and well. 1 slater died 22 tuberculosis, - H.X. Kasai ppsrtifc?on Juno 1935, Frequent cold lasting 2-3 days, . .. C,R, Ilegftfciv -5f * . ' - ... G.X, Appetite ....usually goocL-except.for breakfast. Constipated - catharsis 1 x 2 weeks. -- - - - . -- G.U, nycturia 1 - 2 i: before and during early part of P.x. Ho vonrsal - > .-disease,., . .-.1 _gi ;.* . -. r~ -;p; NOTE: Submit report under following headings: (1) History. (2) Complaints. (3) Examination. including X-ray and laboratory work. (4) Discussion. (5) Opinion. Mail THREE copies to the MEDICAL SECTION--Retain one for your file. ;, HISTORY ; ." ' v,';" " v ' ":8# P*I. H"tatsew btbeeenaeeusnw.p-aai.nndt,.leorgyf-or 2,*j ' _years# .'$as In _goo'd 1' health till JttB l$__3.k. ' < when there gradually began weakness and stiffness In legs and anas. . constrict i.* '' ' 'IhiiifTf rt# . ni'ri -fcii'iri im : V' O D ^ 8 I .B . School till 15# Woodworker 2 mem theLeather and hair worker on . carriage seats 2 months# Paint shop worker* paint and putty mixing* cleaning* glcsing fee# 2 mouths# Carriage painter 2 mouths# Upholster 1 year* painter since# Ph.K# Has been working with lead, paints almost continuously since age of 18, all type of work* sanding* mixing* gisslng* interior and exterior painting# Averaged usually.8 hr.daily# In 1928 and 1929 worked as long as 12-11*. hours daily# Since 1930 has worked 8 hour clays for about 7 months of the year# Prior to onset P*X# had six months steady employment# !io unusual exposure < no dry lead'compounds* etc# F#H# Father died 2 - C#U#R# 1 brother living and well# Mother died 82 - senility# 5 slaters living and'well# 1 sister died 22 'tubcrulSlS#- '' ' ....... . . , - . , * ' I1.# -R a s a i '"operation Fune 1933 Frequent colds lasting 2-3 days# C #H # Negative" -.T- * . .. , .' .. C#I#._ APl>tlt0iaually.good,,xcopt.for breakfast. Constipated - catharsis : 1 ' 1 x 2 weeks# ' ' . " -- ' ,- - ' GU* Kyoturla 1 2 X before and during early part of P.I. Ho von; real "" ' -- **-*:dis*., - * * ! . . ... -': . *M* Frequent hoaclacbos prior'Sr during v had-tired -fewlit%-lti\C^;- _ * 'feet* for 5 months prior to onset' P*.X* *gradually* spreading up lags* Hallfe Averages 8 hours sleep nightly - not restful during P.I. Ho fees or ....... ooffe - no spirits. Weight U.w. 18o r B*w. 200 (1910) L.w# 159 {193U p.tf. 169 5Examination *, ** - ' General Fairly wall developed and* nourished whit wan about IjB years of age prematurely gray# Hot ecutely ill but with pasty pallor and unhealthy (S ig n atu re o E x a m in e r) M. D. (CONTINUE REPORT ON REVERSE OF SHEET--NOTE INSTRUCTIONS) \ (CONTINUE REPORT DOWN FROM HERE) _ appearance. Aloft arid cooperative* . .. .... , ,, Temps $Bm2. "" Pulses "69 Ri 2 Weight! l6l" R*P. X^O/86 Hoed Hot remarkable - V.'ei .. .;.... .` v Ear m i m e whitened ~ otherwise ok . , . Sfs: H Qual L mod, reg* ' react well. * E.G.M. Ok* ' ' * hep turn deflected to i*ighfc * is., ducky red both sides * left turbilifees shied evidence of ehrenie nM*l disease. I m.m. good color feedsile very teall submerged glossa inlocted V ; . . . ... ... , . -.. . . dry P'':rli.O.E.:2.9 X-ia.Q'-E*|W Rfe. 8 B.E. k .... -. .. , ....,.- ..k *i . &t. - Lungs are normal - Hoarfe tones soft, leer* Reaction good. In 2 minutes -- 'adoalertifees'l'5/*atln*'.after'2$ hope *" * ' ' " ` 1- Abdcsaen lax slight tenderness over cecum on deep pressure - sl^aold full and ' 'palpable -belly is negative _ * - -. v Pelvis normal -\ ' ' . : . -' ' Eat. skin pale and dry. Scattered superficial abrasions fro serafeeding pulse poor in dorsalis pedis 2nd degree pronafelon both fee6. 'Syndactylism 3 and if fingersi left. . - ' , - ,' ` .Reflexes feiiddn reflexes hyperactive `*++* Superficial nomai. s Sensorlum - nomai* Tpefell,disc. expepfeionally good. ; .Muscular eysfceni n o m a i well developed - coordination .good - gaife and speech good - Cranial nerves Ok. Hb 82^ : M sbssse; BBC $,050,000 WBC 8,920 Poly*. 66$ Lymph 30/ Bos. 2* Bus* 2$ Stippling 3 per 50 fields M im : 0.02 mg/Lifeer .. ' . : .... _ ___ ______ alb. negative Sugar negative Microscopic negative IfeMiSSSEgJ^a : : -- - . The patient la nes definitely convalescent: and in a fairly good state of health. There Is no evidence of any permanent Injury or residual effects of the.episode.of-lead intoxication. The urinary lead which is within normal limits, indicatesthat be has eliminated such abnormal Q u a n t it ie s : of lead as may have been absorbed. While the present state of health is ~ below the nozt^l, it is believed that the symptoms now in evidence are .. ... associated with other onuses. She nasal disease is the probable cause of u . the few general symptoms remaining, while exist of the difficulty referred by the patient to the legs is associated with prenation of the feet and should.b improved by corrective measures. disability may be considered to b of the order of 501of total for the next 30 days at the end f uh* ch tip it appears that it will be proper for him to return to his occupation. We have roeosammded car of the nos and correction for the feet* Robert A. Echo, MI). June 1934 10-24-1935 Complete clinical examination (consisting of physical examination, microscopic blood examint ion (Red count, white count, differential count, haemoglobin determination, count of stippled erythrocytes), urinalysis, lead analysis on urine. j^g o o # 4o 00 Dr. Machie Urina: Received IO-2I4.-I935 Mgs Pb/liter - 0.02 Reported: 10-26-35 Specfcrogrsaphlc