Document Jvx3ROLY6Qjg5wy7y08Q2XpGB

October 19, 1939 Dr. W. 0. Ramey Carew Tower Cincinnati, Ohio Dear Bill: am enclosing herewith our report on While the analytical findings are higher than the mean for normal individuals, they are not within the ranges that we would anticipate were plumbism actually responsible for the production of this m an's illness. On the basis of the clinical exam ination, it is our impression that this m a n 's disability is due to a radiculitis of the cervical . nerves involving mainly the fifth and sixth cervical segments. The fact that the motor phenomena predominate suggests the possibility of an intrinsic- lesion within the spinal cord and further clinical studies wrould be indicated if one wished to establish a more precise diagnosis. Thank you for referring this case to us Cordially, vTK:vr Ward Machie, I.'.D. K oo u*i) October 1? 1939 19 ' Room. - Christ Hospital Consultation requested by Dr. W. 0. Harney History " I.B. Patient is a deaf suite 79 years of age suffering from wrist drop and paresis or paralysis of both of soapulo-humeral muscle groups, .'rental changes of senility limited history to that of P.I. Has worked most of the time as painter, Ik- years in a carriage manufacturing company - the past 13 years for a sheet metal specialities company. Date of last employment os a painter, November, 193&* v/hile at carriage plant used considerable amounts of naphtha as a turpentine substitute and throughout the period as a painter used lead paints and did paint mixing with dry pigments as required. II. Incomplete. Hines 1^90 there has been stiffness of the neck. In past 5 bo 10 years there has apparently been complete fusion of cervical vertebra as no great change in degree of ' Immobility has been noted in that time. r.I. Beginning in 1937 after some *10 years of spinal arthritis, . there began weakness in hands and arms accompanied by severe, shooting, knife-like pains running from the neck into the arras and f creams. Those last have become increasingly worse as has the weakness, the pains being much more sever this year and seemingly of .increasing frequency, though due to the limitations of the recording, quantitative infor ration could not be obtained, aince onset, weakness, numbness, Itching and fornication of the skin of the arias and forearms has been frequent, especially in the past year. Local Examination Pronounced atrophy with extreme paresis or motor paralysis of scapulo-huseral muscle groups, the forearm muscles and the intrinsic muscles of the hand. Kotor paralysis of the extensors of both wrists and fingers and complete failure pronation right arm which is otherwise also most affected. Trapeaii are extremely -weak, and deltoids, especially right, seem paralyzed. All affected muscles are tender to pressure, vermicular and fibrillary tremors are occasionally in evidence, specially in adductors of thumb where they are almost constant. Adduction of thumb is poor, abduction slightly impaired. Flexion of fingers variable and weak in all. Right fourth finger stronger while index finger exhibits best flexion in left hand. Interoasei are wasted, finer movements of the hand absent. Kf 001.4531) 2 Senaorium is act greatly disturbed except for areas of byperaesthesia on both arms over 5-6 cervical segments. There Is static and locomotor ataxia, but walking Is possible with assistance. Muscular apparatus, trunk and lower extremities ere not remarkable. Laboratory 3ee attached record Impression Cl} Kypertropic spinal arthritis with fusion of cervical vertebrae. (2) Traumatic cervical and brachial radiculitis with muscle atrophy chiefly of radicular distribution. C3) The course of the illness, the absence of history or clinical evidence of lead intoxication and the laboratory findings led us to believe that plumbism ployed no role in the production of this man's illness. ViHard M&cfcle, M. D. K 0014597 patient at Obrlst Hospital xmxe uy Dr* billard Mncsl on October 1?# 1959* MM& Analysis Ho* 59~5?$5 Voloes 65*0 Kl H PtyLiber 0*10 iJlood A n a ly sis !?o* 59&*5?56 Orsais <* 2*8 Kg Pfcs/lQO g?s 0 .1 1 5 * Beoausa of the amallncse oi* s&mple any possible sllghfc contamination introduoes lar&o errors ben the rsulta are calculated ou a basl of a 100 a sas pie* Roportedj 10-19-59 00 4 3 8