Document N21a0aJK87g6G71xZeZKk36zE

Tlovember 12,1926* Dr* John a* Johnston, Citizens Bank Bldg#, Canncnsburg, Pa# Li? doar Doctor Johnson: Pur1suant r conversation concerning a patient, Hr a few days ago, I am very anxious co:ns importance of this case to keep in tuuch with him and with you in order that v/e may ar rive at some certain conclusions about the cause of his illness* It is my feeling that the exposure which this man *aa had, is so absolutely insignificant as to cast very serious question upon any etiology or relation* sk p of lead to it, and I should be inclined to doubt ohe correctness of the diagnosis of lead poisoning, unless indeed, the clinical picture were so typical as to be conclusive* in the ease of this man there are certain atypical and very unusual findings# I examined hi blood carefully and found no evidence of any stlp- pi ng or anemia* lie lias no lead line* His nervous 3y?iptoms different from the usual course of lead poison ing are almost completely cleared up in a very few weeks, and there are -uthgi^uervous system symptoms such as a tingling in the legs and the hyper-aesthesia of the skin in the- back which are by no means characteristic of lead vi soning In view of the doubt, therefore, I felt thatwe should proceed with all care in ruling out certain other possi bilities* xor this reason I should strongly advise a spinal fluid Wasserman in spite of an aparently negative history-#' The possibility of an infectious pdy-neuriti^. , and of a subacute infectious process as tuberculosis, S i d h might bring about such indefinite nervous symptoms asfPl; this man has presented, must be considered* Hysteria must certainly be thought of, and even a slow moving spinal cord lesion must be considered* I should be very glad, therefore, if Xray examinations of the chest and of the ce4,,Jt~spinal column were made and I shall greatly appreciate reving the samples of urine and faeces of which I spoke to you* I wish to thank you for your courtesy and cooperation on the occasion of my recent visit to your city. I do not wiaih to appear to be arbitrary or to try to influence tod ouch your opinion as to v?hat is the matter with this J.A,Johnson Page 2 tioember 12s1926 roan, but my clinical and experimental experiences with this type of exposure to lead appears ' . 't ; . Pr,, A*. Johnston XIovesber 12,1026*. man, bub ray clinical and experimental experiences with this type of exposure to lead compels me to conclude that the diagnosis of lead poisoning Is not a justifiShlS one in this case, and X feel that we must, therefore, rule out all other possibilities before deciding this unlike ly thing as tlio cause of his sickness*. I shall be very grateful to you if you will notify me from time to time of the progress of this raan* y<:QJ