Document M4wdVnpbvEybdx8Y803QNOmaz

MEDICAL DEPARTMENT M E R C K & CO. INC. R A H W A Y , N. J. June' 10, 194-3 Robert A. Kehoe, M.D. University of Cincinnati College of Medicine . . Kettering Laboratory of Applied Physiology Eden Avenue Cincinnati, Ohio Dear Doctor Kehoe: Dr. Carlisle has requested that I give you the clinical data which we have on the case of lead poisoning which Mr. Crutchfield mentioned to you. ' This man, 60 years of age and has worked for Merck & Co., Inc. for the past 4-3 years. He is a lead burner, but I am unable to determine from his record how long he has been occupied in this way. He has been doing it for at least the past nine years and perhaps very much longer. On his first routine examination in April, 1934- his blood pressure was 150/lQOj he was edentulous, but there were no significant abnormalities. In February 1936 his blood pressure was 138/96. The first blood count we have on record was February 12, 1937. The Smear was normal. Hemoglobin and red blood cells are not noted* At that time his blood pressure had risen to 14-6/SO. In February, 1938, he was again examined. At this time the optic fundi showed a small area of retinitis and diagnosis of bilateral optic neuritis was also made. The blood pressure had risen to 174/110. Blood count showed: hemoglobin 95%t BBC 5,100,000, white cells 7,000 and a normal smear and differential. Urine showed a one plus albumin. Laboratory studies were again done in October, 1941* The hemoglobin was 68$>, RBC 4>018,000, white cells 7,000 with a normal smear and differential count. The urine again showed one plus albumin. A 24 hour specimen contained 0.0276 mg. of lead per 1,000 cc. Our latest examination was made on May 26 of this year. At this time he was complaining of daily cramp-like pains in his lower abdomen but otherwise felt quite well, He was questioned about precautions and it was found that While he observed meti-' cUlous personal cleanliness, he did not employ any measures to 0. 0001417 (over) 2- - prevent inhaling lead fumes while at work. Blood pressure 180/118. His urine showed a trace of albumin. No lead line was noted in , the gums. Reflexes were normal end there was no sign of neuritis. Blood count.was as follows: ' Hemoglobin Red blood cells .White cells Polys Lymphocyte s Monocytes Eosinophiles 15%> 3,790,000 6,100 55% 3 %% 6% 1% " '\ ' Occasional stippled red blood cells were seen. We felt that this man showed definite evidence of toxicity from exposure to lead and, accordingly, have removed him from this exposure. . We thought that perhaps you could assist us in the fol lowing manner: First, if there are any laboratory tests such as analysis.of blood, urine, or feces for lead which would aid us in establishing a diagnosis and prognosis in this case, we should like to have them performed. The charge, of'course, for such an analysis would be borne by Merck & Co.,,Inc. . . Also, we are interested in knowing whether you feel there are any really worthwhile therapeutic measures to take, aside from preventing.further exposure. " ' .. If there is any other information which we can give you which would be of interest, we shall try to secure it for you. We appreciate your interest in this case. , Very truly yours, ' AG:MGD:d / 00.0l4|g