Document 99YKZzadQx6e86BazNwaB3RQp

NOV-06-2002 WED 04 ' 26 PM SHEPARD HOFFMAN ESQ FAX NO. 2145220420 P. 18 58 KENNETH M. LYNCH AND W. ATMAR SMITH sido of the abdomen. The cough, with expectoration of a large quantity | of mucopurulent sputum, continued and became more aggravated. There was anorexia, with progressive loss of weight and strength. For tho first three weeks after admission there was an irregular afternoon elevation of temperature. In the latter weeks of the illness fever of remittent type was constantly present (99-101), rising on the day of death to 104. The pulse rate ranged between 90 and 100. The res piratory rate was constantly above normal and on the slightest exortion there was dyspnea. Examination: In genoral appearance the patient looked much older than fifty-seven. He appeared exhausted and was extremely weak and Yio. 1. RoENTOENouaxM Showing Pni.noNAa.Y Asbesto-biucosjs and Oaboikoma of Lowia Rioiit Lobs emaciated. The finger nails and toe nails were clubbed and somewhat cyanotic. The bony thorax wus of the emphysematous typo. Expansion was equal but poor. Dullnoss was present over the bases of both lungs, be ing more marked on the right. The upper levels- were resonant. Breath sounds were suppressed over the right base. Rfiles of all varie ties were present in the lower posterior and axillary aspect of the chest, though less numerous over the right base than the loft. They were in creased by cough. There were numerous coarse, dry, "squeaking" sounds over the upper lobes as well. The heart was normal in sizo and position; the sounds were good, There were no imirmurs. The pulmonic second sound was accentuated. Tho systolic blood pressure was 100, diastolic 60. The superficial ves sels were thickened and tortuous. Tho abdomen, muscles, bones, joints, extremities and nervous sys-