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THE KETTERING LABORATORY COLLEGE OF MEDICINE, UNIVERSITY CP CINCINNATI EDEN AND BETHESDA AVENUES CINCINNATI 19, OHIO INSTRUCTIONS : BEFORE PROCEEDING PLEASE READ THE REVERSE SIDE OF THIS FORM Tne information required below is of major importance' for the performance of the service that you have requested. FAILURE TO COMPLETE THIS SECTION OF THE FORM FULLY will result in delay in carrying' out both the analysis and the subsequent interpretation (where applicable) of the results. Please PRINT or TYPE. Patient: Name Address North Charleston, S. C. cYty Zone State Race y Sex m Agez+s Indigent_____ Private x Other Hospital: Name Address City ' Zone State" Requested by* Dr . C . H. Baylor_____Texaco Co. Name Address ______New York,_____ 17 City "Zone N. Y. State" Bill : Doctor_____ HospitalOther Texaco Co. ____ Send Report To : Doctor x HospitalOther Investigation Desired: History : Include nature of exposure, actual time of exposure if known or surmised, and especially the last day or hour of exposure; character and time of onset of illness; course of illness and present status; previous pertinent medical history. Time and nature of exposure not known. Developed weakness )f grip and of extensor muscles of right wrist in November 1962. No definite reflex changes. Physi cal Findings : Weakness of flexor and extensor muscles of right hand. BP 140/100. Pertinent Laboratory Findings : 24 samples of urine reported as showing lead - 1 - 3.6 mg. # 2 - negative. #3-1.6 mg. # 4 - negative. # 5 - negative. # 6 - negative, lo stippling of red cells.seen. Impression: Probable lead poisoning with peripheral neuropathy. Treatment: Specify medications and dates of institution and completion of therapy. 500 mg. Versenate given I-V twice a day for 5 days - Dec. 8-12,1962. N13175 The Kettering Laboratory is a totally self-supported research unit the University of Cincinnati engaged, in research in the f i elds of industrial hygiene and medicine. The Laboratory is not a medical service laboratory, and clinical diagnostic services, as such, are not performed. We do undertake to assist physicians with toxicologic problems or other special problems in this and related fields, as a courtesy, when adequate facilities are not available locally. We shall make every effort to be of assistance provided that we can obtain the information we require, and if the work that is to be done will yield, in our opinion, information that will be helpful in establishing a diagnosis, in the management of a case, in teaching, or In contributing to a better understanding of physiologic or pathologic mechanisms. HO SPECIMEN Wlli BE ACCS.PTE.D_FOR ANALYSIS UNLESS PRIOR ARRANGEMENTS A FfftsiSlAI* IN'THfc`^ff_E__OT&"OTT5__M__f_IS_ T:1 TEIs Is necessary for a number of'"reasons Firs~t, unless proper specimens are collected with specified care, in specially processed containers, and in adequate amounts, they are likely tc he contaminated or unsuitable for analysis. Second, we must be sure that we are aware of pertinent historical facts and clinical findings since we provide frequently interpretations of the results. Third, ou.r staff members must frequently revise work schedules on sponsored research in order to carry out the analysis . The Laboratory makes a charge for re'mbursement of the actual cost of the service performed, since otherwise funds earmarked for research will be expended for medical .erviee Levi at., on from thru 50. TS made when pat:' ents are indi gent or vhei the cost of the service would cause undue economic hardship Therefore, it is requested that the attending physician assist us by marking the appropriate line on the reverse side of this form.. KE- 00] 23d 7 j o e: \c o f-orm G-44 j Date. //// >^r ase: Attend to Note and return cCH: `C.- ^7*/ I r-- ^ Prepare reply for my , L As requested siqnature !i rL--Ii cFor your comment,s Send me Information j and suggestions I I i Note and forward to Files See (phone) me re attached required to answer your information L As per conversation [j Does attached meet i with your approval? For signature, if you' approve Other Remarks CUCsCSCS ;'UO i e . ' .AM-j i f you N13175.01 ^ ^ oo i.p. a 4 ij 165 RUTLEDGE AVEM CHARLESTON. S. C It January 12, I 96 4 Dr. C. H. Baylor Texa co, inc. 135 Ease 42nd Street New York, 17, New York Dear Dr. Baylor: Thank you very much for your letter of January 3, 1963For your further information I am enclosing a cop/ of my ::sshu summary on Mr.fljjjHHHHB following his discharge from the Roper Hospital last Hr itold me that he had also used some materials containing It . work at home. Whether or not he had lead poisoning, and from what source it was derived, it is certainly questionable. Our laboratory here has reported lead in a fairly large number of cases, some questionable, but. with the. typical peripheral neuropathy 1 do not think it can be completely discounted. I shall be glad to have any ideas from you and certainly to send any specimens to Dr. Kehoe if you wish. Sincerely yours, RW: vm CO- 'Ay.s.., Rober t Wilson, M. D . ri N13175.02 He 00 j 9.5 4 j Dr. C. -1 . Saylor T exaco, 135 East c,2nd Street New York , 17, N aw Y0 rk Dear Dr. S a y 10 r : Se . ra ; days ago 1 sent you a copy wnen he Tft the Roper Hospital. One ad a itiona I fact is ;g c during t oast spring he had used some : nd of so ! von" \ ' . ,. h i s heme he was not sure whether or no: the paint cau any on did find out that the solvent did not hav e this. uoso. h h,, Si r e `eavinq the hospital hp has shown Hpf i n; t t saw hi m on December 26th the grip in the right hand was or> u i Le ! y we a k; i Lc this by having the patient squeeze a sphygmomanometer ana che<. r the reading, standardizing it so that my grip equals 2CO mm of mercury pressure. On Decembe 26th the reading of his strength in the right hand measured to is way was SO mm. and when I last saw him on January 12th it was 160 mm. This is a rough >e5t bu it does ve definite evidence of the strength. 1 have samples ot his 1 m iwrit on these .wo occasions and the latter is definitely clearer and he r h i n - 5 more like that of his own usual writing. During this interval he has been on i 00 mq of thiamin chloride a day. I have received the requests to send samples of blood and urine to Dr. R. A. Kehoe, and these were mailed two days ago. Sincerely yours, RW.vm .- - Robert Wilson, M. D. N13175.03 K' 00J355 0 Patloots Admitted* 12-6-62 hf'htH ICSrY/AL r c &:s dt,M::.\rar os-'-ital Number* B37636 Discharged* 12-13-62 fte patient was a !j8 ye nr old chemist who w? examined on November 23, 1962 becaucv &U the recent d,velopneni of pains in both arms, more on the right than on the left, and weakness in the right hand* The blood pressure inns llG/XOG* There wa cerumen in t!* canal of the right ear* lie flexes were olightly increased : n activity, the f,rip jlifl the right hand was much wo nicer than that in the loft hand and so* wasbunas of the 'v^tensor muocles of the rlgbi wrist was present, with a clefini ho oripberni neuropathy. JUi^d poisoning woo suspected and a 2i* hour sample of the urine showed 3r.` ntm of lead .-resent* 0<-> repeating the test no lead was frund but u 3rd specimen 1*6 rogm reporter? and the patient was admitted to the hospi- al for Vovscneie i trapy. hc.rav ;;nu urinalysis war- negative. The blood sugar was 80 mg?n%a A f!JN 17.? #. .>-! 5>;*ny of the ntiro 61 '.met w-r within no mol limits* *o patient was given ?0 - mgm of Yorsonate 27 b.i.d* fox' ; days* Uo lend was found 'in |er specimens of the urlns arid it was not completely deterrci nod that lead poisoning tho cause of the difficulty, but with the findings of lead in some specimens and re typical, -.oriphorel neuropathy the diagnosis of probable load poisoning was ancle. The patient ran discharged as improved on December 13* 1962* Final Diagnosist Probable load poisoning with peripheral, neuropathy* mdb N13175.04 K & 001 ,-5b