Document RJk4ML9gnDE9V6MBXB8E7NmOk

LEAD INDUSTRIES ASSOCIATION **0 LXX1NOTOM AVCMUI ttcwrome IT,Rt July 9, 19SI izm a j o ximr . 9 subjooti r-c-sr. ntiCRTUT unizizs To Mwbar* of th# Lead Induatrlea Association Herewith are reprint* of threo recent articlaa of which th first too will bo of Lsterest to thosa of oar ambers concerned with th# di*_no*l* and treatment of load polaonlr^, *Mlo tha third toll* of tha institution and aaintenanoa of worxabl# industrial hygiene projraa. X Halted supply of additional copies of thos* papers 1* a railable. 1 brltf fimnary of o*oh folloeai A Critical appraisal of Current Practices in tho Clinical Di 1571cais of Load Intoxi cation*, Kehoe, R. A., Ind. Med. and Surf., 20t6, Juno, 19Si. Dr. Kthoc discussaa vovj adequately the aero troublesome aspects of the diag nosis of loal polsonlnf, .'.ttenticn ia focused on principle* which should apply la arrlwlnj at a diagnosis, and on major source* of error and confusion result Inf frees unsound clinical thought .and practice. Treatoent of Lead Poisoning with Soditn Citrate*, Hardy, H. L., Blahop, R. C. and Haloof, C. C. Arch, Ind. Hyj. and Oocup, Med., Vol. ), March 1951, four cases of lead poisoning In which trcitnent of tho patients consisted primarily of aodiua citrate therapy are presented. iMdence nccxiulatod in this atudy point* to effectlra rellsf of ayaptooa coincident with oral adsinletretion of aodiua citrate, Itudioa of urinary lead sac ration and urinary coproporphyria are alto presented. Industrial Hyjisn* at Aaerlean See Hint and Refining Cos;Any", ,'bersold, J, I, and Melaan, K. Jour, of Metals, 7ol, 18?, !Jo. 1, January 195L TMa rwirw of a well organised, aurceeaful Industrial hygiene program should be of treat interest to all of cur swober ccAp.onies, The author* discus* the jeedical aenrlees, th* method* used for studying the wc-rkirg envl rurswnt and the plant imprcrrertenta which, with th* interest an 1 cooperation of s.-iployeas at all levels, haro resulted in gristly i-prersd working condition*. '^tnc*. (J) Manfred [cwditoh Director of Hsalth and Safsty wrw iwyBBP<ppjrHwrii', j mb n mmmm< >pw1-;'^Bwwwr")WP>w^wyiywi^ w '"'a wy'iwi^Lmii^'PigiimiaawBWBWB^pwy ^ - - LIA10838 j A A Critic*! Appraisal of Cimant Practical in tha Clinical Diagnosis of Laad Intoxication ROUST A. KEHOt MA CudiMti, 0kJ* fc t t f 3 llffdolrd fr<n ItMlllllL Mu>l< INI AND Ml 70 . ZWJAD. JoM, I*M N 305.01 m-wanway wm uriwii wjun LI A 10839 "IWgBl A CriHc*l Appraitrl of Current Practical in tha Clinical Diagnotii of Load Intoxication c *OlW A. KtHOC, Mix. Od~*. OW ill dlifiMMU of trod inloik*(i kM Im| T ban ih b)rt ot lotnM mt#mt ud o4 talf tb# ilrpp |k*t vtfl aarart Om ftft Wring and aafet; of fotteata % ho art. or frequmt rflnTtrT among clibKiMt, f*pori*Iiytkiak t hr*rx nlf.xled otth thU illn kiBOfl Lboar nhoao praclKf mixrmt itreif with OrrvpatMdAJ trad pc* aunt a f, cm the other band, (Ma of artonl of alergod orru pat inevnl fdumbiaoi t* M rare in Ha orrurrnx* anvwif (hr potieeU of Hk mfdioiiffkj nwkMf or |nti(TW7 ta of pt.;iriaa rcnfd La prtrat# pmrttre. Wot roe nee turn *ith aurh flaw. Mnr rorrrtl;, nu> three ri*e arrvr Urrelr amccf perron* la the id*-faL<e cumbers of atm-mediral frvi havo W^arr a<wial and rrofx<r.x irfmenti of tKr pap#- com* to Wr lucwrrned with thi* pndirm. through Utum and la I hr arbaa arena la bkb aurb thetr r**po*taibilitM to loduatr; for thr ap prnaona tit* and wr-rt Tbr; ar* ftot diiinbaUd ^rtiuJ of coctrrd of pmifotMAil lead hajarda. rvmljr of w k JWt atrwmg pkf%ciaaa raftfed ta and tkmfii tbrir artiaiUro in wnrkiamp ff- prtratr prartacr, and araia. Lbrrrfnr*. fasill* li>i>t>o<> prrordaroa, ta |reenimealai health ant; an lb th^ dlaran# la abarfd; tiaitrd to a utd labor dfpaitiMntA la Ubf orfaikiuiioAi crrlaia group of ladurtrul pfe;**oaA. to pkf* asd ta trad* aaroriaUceia. Nor dm profewaMwiol Miana *Ko apnialu* in tbr ftod; c4 orraf** aad la; tarni rod her?, oa# mry peduimt, tMmaJ diaraara, to tSrwo la rrrtaia reanmuaitira fasti; pA>*>ran and pormt ruit pa; attmUoa fMM- pm air pratlx-t drla Urrrl; vitb (he to the u<ff of Wad and Irod (not|v>inda la I hr liir.rwrr* of laborrra and tbrlr famiUeo. and to kou*<h^d auder cweuLleot^ h w h n<i tLrealea (Kmt Lo mw ((eate ia grnrral Wopilnla to (hr bruit h of infanta and amall ehiklrro To a indv*inaJ em(rr h i* m aurprltinf. th-rro. mwh W^ aigniVaot ritrat, arwi-orrupoltonal that crrla.a aaprrta of thr diagewtir prob trad poioomnf crrurv in (he adult pfvialiM lem ar* nWur*. and that dlagnootk *rn*f are a lh# mult of a ttomlrr of hrH; unuual aumrmua. iitulHO*, among ohich th* moat frmjuent. 11 It La r**A uitbia thr amp# nf tbia poprf to do^ emu, Intrdtf (be a*# *4 trad p*pr and trad* ailtl all t;pra of trod (irwpfl of vtlb tb# tn1** lined tank* for Mipfdyi*g and rtonng water fof of rafuiurr to trad that ft** riw to them, or thr bu*ehi4d firm a apring or ll (lnnul?, with ail or r*m maa; of tKr fartnra wblcfti Ihla haurd la limited aimnet rMirrl; to rural r fwate rliatral and rtxrdxdegal diArultlra la rro area*, but mrmtwre uf fr ffile in frair? ret<n w(h them In*'.e*4. thr diw* mw i wig .f or rit;e* hate al*o leen pimeied l/t thr u*r tw f*<vrd no orr upot i< wial fulworfig f fnOi 1 ho 14 hrtfrr; truer aratenred fr-aa rift <!nmf ai ir.'.rfaetM- #r. f n-i* e*f kad. no thr a>mpto furl i`>t atorra and ftrrpiarr*. prtrv'if4a wh>rh rh^ld and; In armiag at tho Thia dieeaee, tKrrrforr. ma; lr found asai e-mail of thr diararr fnf Mb rtialraJ and prr**va of alt ifo and In all * ) and mewea'c rrw*tw4rfal pifprea, and S a taw e-f the Irtria of **!;, and it i f*r lhi fe*ue, pet* 1riafi-wia frnm ar^ind cliAkal lK>ufbt and pfar- twartlr, that it la a*rb a tnmliieoiose A\mtra\U to* whwb arcs to to ma)nf aourrrw of *fwr ppd.lem m Iht feld of general molk m Nf>- and iirt'oM at thr prearot titw. <rrutrad f aem i r g itrun infrequent!;, and thrrrf* rr few phfairiana in general praetor CKr praM . Have bad enough e* (er tr tu e of hrv*w|**l;r to e< #T*M dlaf*Moia at trad tatnatrattoo. aa eo ahaJI aid# then* lu pnaka pr<mfd uao of effwiu# d.ag- <W*J pith It brer I* lmrd U(rui tahd b- meaeurra whkh mar I# itauMe r>r to t< e; t'f **ft* ant t <|oi>nnaJ rpprour* to trad. fM iW liturti i t, v* h 1 < 't f >e*ie Mi t*~4'>*4 -*> J !'>-*** e I *4 >m Tk>'Wtk I>1 ' 4n iO' >-->1 |*IH Mf i,p, a**a pa iaai *n th* pre*rwr 14 itmiLou atrnogl; tugfaalivo *1 thr rife* It e>f a'>*>r|Ki'Oi nf Uod, and wpom frri>a pAf^) t.fn# whlrb eharoflrelra of lead t.t htniWplim tWerfeewO It wifi Wo MH that (hi* iialrneiit pula thr m 6 nii.Miywiimn1 i v* 'ig.wwmun LIA 108*0 m0 phaaia Of) Dm actual eiitlenc* of aa totci*ation property appraUnd rrpooor* ta Wad In fadaa* } which U to be ideotift#d by ordinary <hnicol trial pianta, and. therefor*, th* dt*#TM*tW prob ) mean*, and make* r>u nrferetv* to aa/ laboratory Um ia aiwa/i an iatrirvlfif on* fmm th* aoport ! Andieya That auch a alatetnent faila to coeef nf the cuiliration and appirratlc* of aouad fliaW th* entire diayncwtic field, both from th* uprrt f*J iT/elbod and Jodfmmt Erery raa* of Ulnowa - f of th* mor* or late chronic clinicaJ tnanlfreta* whkh occurs amuny workmen np#*d la Wad tJon* of th* dlm and aleo from that of th* ahoy Id L* wtvrkad a p try Ua* raapoauibW rJInlrfaJl UrhaWaJ armamentarium that can b# brcntyhl in au<h manner aa ta aubwtantlat* th* diafbowia. to boar mi It* Mod/, rauet b admitted. It W If th* <Larno*ia io that af land IfttoaKatimv tha dona deliberately to pine* th* etr.phaJiJ where rteorda ahould pro*td* tha rrtdeore thal will It bdorn amonf rlifiinan* Th* fact* irv that tirte centret*r*r and pftmd* for proper and ao mark baa bam *id and vntUa, on the on# hand. about th* eiotic and unuauaJ clinical autc* ade>{u*t* DkedKaJ car* and far premfd rvwnpwa* u*t*.i for disability If It ia r<M r*hr IRerwa. that rowMUr may reeuit frees the nbnorpti'ja th* record *W*uld L* ccjuai]/ ap< and rmtinrinf. of Wad. and. ca the tdber, about th* diaynoetir If thia drdnrtlv* d.ffmatiatkn raamd b* Mf> meteurea and rnlmi of th* laboratory, that U oery rkw, there ar* bat frw eacepiicna. and mat of oar rlifitriAM have Wat aiyht of tha there i*. at Waat. &o jtutiiWauoa for not makinf diaeaee a* it commonly {rt*rtt Itanf. and of an h*>*l at*d rapahW attempt ta do an More* tha baa* conditio*.* without which it <a&ao( wrr. ta th* performance of tlua pmfnauad ana*. Tha chnwal di*yao*i* of Wad pM***way. duty, th* ph>a*riaa ha* a rtd* that u pwruhaHy whan It occur*, aa it dti io tha ?cry Uryw hi* ewa. laruWirf only th* tnWwt* and tkiB* pnntKfi of aQ f**m. la a mor* or tea* mot* wKwh. cn th* hw*i* of hi* traJnlnr. may }o*tiy q*adf of lilnaaa fotWwiay Lnrf or pr^^yed Le c<ported of him. rrfardWaa of hi* experience fipovrt to dear*row* orrupettucaj r*vdit**. or iDftpenmc* wnth th* more modem trch* i* noC diffWuit. Tha prvddem* a* create for our- n^i*r* of laduatnal hyrieo*. *Wt t * io (ic &a ti<n with it ana* fr Inetymme* to W awr*. Lot mainly fr*w th* tMump- Th* OccwytWeei HWhwry ticn of knt/el#dy* which w* do not f ** ** and from *Wr rmlfoorw la lha performance of vr k it t b* rfcofli4 that th* <rep*Uoeal 1 h*tory, a* it perlaioa ta the Wad trade*, k t aioipi# rJiewaJ peeredurea. A *r%ey of tha *utwtaatiai!r b **W*, racefd a* a le* which meal c fftord* i f r**M of actual and aJWyed Wad pn lw utaclaatiated or dlvarded, bn We* it li de \ miir | that h*t bran la ctwitrtn*ry and hr nr* tained and recorded and iatrrpreied by cm* who har* com* up foe our mir* nf a of t wWJly famdiar %tth th* op*ratx** ta tkew t*re ha* nrreoWd c*v# rharacirntn* wr*h la tragic* and witn th* *fwei?*r plant in whuh th* In mn#{ of thr# (**n the |<a- i-peratn-n* ar* te-mf earned cut Th* elate* !.(.! w.J i-.-i luif th* Ui.tT.I *t iL.ttd i rt fw) iMi.li %.( m |*U at -o tbew aloKwl rlinual tujr A i*id*h h i 1 r? of Kiufu- without ea<-ct*K>n. are ir wrepci-l * rt n^aJ tbwiaj Wad eij*nur*. wnrrilKafly and y*t hy* matiralfy tatad. a frarmentary recital of la* f>t-}tx*. aod ar* uarTi>*t4* ia lb** fratwrew whw-h rrtat* to th* (juantitaUT* appraj*J of tha <WAmt* *mptfitM wh*h wrr* out infeetlyatrd. njiwiif*. fx/t rerrewrilf. cr r**fi rtananaly W and a ph*aJ riemir.Atjn that yielded i-c.!r lime nf |J* |wte*it'* IRiWii n d*h4'w%ty. t*t dubtow* laf.irmatKai. tyether with arm*. often tweau** <`f hi* ir^Lilitr to differential* th* aty a multitude, of ueuafiy irreWeant. urw-ritoaHr Oifcant fr**w th* in^yaiVabt fart*. n*a If latrrpfrted l*U>r*t/>fy r**ulta. fc'fnpWtee a d*v- th# jAy*Ktan i* rapabW d iwh different lati'D m*nt which j^'rtrara M a patient'* iI'.w c m tot aed of coeiduetiOf hi* ln*r*iry aWey I.new that a (kroruR'i iMifiiprtmr*. will facilitate *wrh diffeeentiati*-a There are. <1.acaJ UiiCwa and Inept I tod* ar* alrrw^t Woke-ie?, (*rtain fart* ili rar *!> t# r>i*. MfuaHy rti'Wnl jrwnr th* {-hi*x<ana the f*in#*t and ar* WyHr lrrfw*rtait m # ts'.ef* )rwt Wiiif M-'t .*trr**. rh/ --> ff?T jrctti n *f ot>-#r cf.nw-aJ laf-rNwr wtM<e. n'v h;yhJr iin*i/W and i'Utmr^W.I rit'wuf* to *ipr*eitl4 quantttte* / Wad it a ^r.^ntyfru t<* mak* d-ffr rrti 11 * I d'*f* reyular and eiia*'i>iat4* #?fwr**w# <4 all A*a rv. of itJnrwar* whkh raa only W m*rW hr kirvd.*'* th* fwtw/i'ehr* f *wrh ra* rar*fu1 cliaUai #tud/ II la mw thin# to at>pir pr? na*iitbt the (mM, iri*rfr th* *nf* th* pr*v^lbr* nf the fhcmoaJ *>f (lmral Uh |#-4c. 1if th* wry|wUne>al M*1nf? Th* alynllt- iratnry In a fr*ut<n* manner, and, )ff ./ rerutmt.rvA*} ep>wr* t Wad ran tw to the a;v-f*<**j of tho (Wyrr* cf haiard uf an I rlr ia trrm* nf it* and It* a*rwfw!l< n It W ijii<t# an-t/ih#p to irmr at ^ # -*'#**(/? AM w'eestl'-ei* |#| t IK# patea| I* ifiarn*wia whn ll'.nawo fun la an lndii**'.a< !*ti to **|wt,r# are f*.e th* p^ryvM* <>f p, nrarr.an In tha Wad trad#* ar* I ho twtiRi* of fatrk and du<#t*aal yh*r, of ilia, nf ii*. an* *f |fiiR| theee (we Item* Th* D^ai^a W fay loam i.thr a a*i rw ontarW, ao wall aa n*wri^f>rai Jt*#a*a kfi,ruT*r. ran#* nf Wad pw**iirir mar J | w ie| ha* th* potWnt wnk*d U th* >nh * at whwh he waa wnrkiay when t tram* >ruf M tS r*aH nf ynraroywiaod anj in ,n* Ifn? t-*f ha* he worked al thi **jne >nh  apmmJM I ! nm fff ia IWD>II jpyjiri< vgfP LIA10841 ,.:* r * . r ( i. i *L ` - " , --.............-M i.. a t**~ *m *~ .** - i j eiarwher#? What < hangs* of occupation have occurred otr the ;nn, t vtut *t<e#tAc (Uin hav# they occurred, and what lot#r*als have in tervened ? On# a item;** her# to find mit th# inquiry. .Stranfely roovyh, the mere m#wtio of an opportunity for ercupationAl erpooure te leed aeeena frwfueelJy to lw the aifwwl for difprnalnB with the careful inquiry that U ao wed rirof- t c furefiea uf uninterrupted eipLeure to ctmddiao* ni#d aa briny nce*aary for the dlaywcwij of quantitatively tompersLle to lHew# in eaislrwre Mher abdc4niuaj comiTiainta, &ad the flib da- at the Urn# at oosei of th# iUn#*e. It lniefrvpticaia occurred. what wm their durelkm! ciakei i made that the patieet la aeff+rlAf freai lead colic. Above ait, what was the Uet day on which There ia a hlyhly uncritical attitude of mlad the patient worked under remditkx* which la* to the effect that any dnrlvr known afl abuet lead vcirrd tipraurv4 Th# time factor. la relation crl< ac*d raa mcocwice the charwtrriatk pad* to eifuurt, in its nery expert. Is of the yrrat- tern of the eyndroene vithonl diiSrwlty. The M importance Without kwrvMir of thi* im farla are more nearly the raarl eppoaita. in that subsequent informatics ran fce nd#%uat# thin, ama*g th# many ax*d more tceunua abdomi The Me*w+y ^ Eiytawa nal dluam, iM d m of which dortenk (eeerwfly, are unlikely to hare knowtedye am4 ctperteera. ^V7B4T wae the cperatimi (or operative*) la whl<h the fa!*#ct *u enraard* What part Th# fVyvkal RwAiy dd th# patient take ia carryicy out this cph |M TWI meet fmjwiit type of Wed peieoniny; fcliflO* What other fwrati^o u earned out rspertallr ia th# flnrt #pi*ode of intoaicatioe near him and h7sr pear? What rip^ur# art bai rtpenmerd Ly Lh# individual belay examined, ty occurred fume. du*t. %mp-e < f aw^tea metal ih# phtatcai flndinyi anil be aranty. The mdewt 'at what Irmtecatufv* >? \k hat prrcaalicea, if any vrrtiiat-i. WaJ re ymcrai. s*e of u ral and autneceau* nervooa eiyna of a^ docainaj pajn rahiLit them#el*ee la rwryiny de respirator*, care ar.J y je rv 1 of mm ar>d grees i f aeventy. inciuding then# which rharwr- equipment. hou*eaevtr.f ar.d saAitsUcei *. *#re (eru# arruciatiny ayir. njLwdicy otnewhal Le<ny taken to cretrW th# #ipnerr* What and t>-a-n nrrumey in a*ciatKni with aMocni- *tejw. if any. were twiny taken to weamre the naJ rigidity of mtestmaJ spaaaL. The alwetwe rtjewure and to Un* th# fhnMaJ *Lstu* of of fever, the aranty mdeoce of abdominal dia- the woekmm? What d-ea the patient kac# raw ia th# interval* tartwwen bowta of aeeere about mere of ptiawi*| that hate recurred re rtdic, and the lark of rebnu >d f peni/evcnJ) pela, cently. uy at any r<h#r time, amoey mew m* ugrest furctuoai di**>rder rather then orgaak fdoyed in the same kind t>f work wad at the di*ra*e. and if there U the blue or black pone- 1 tame job kt has teen perf-rm^y? ta?r !;cr cf ;!?:dc drpn*;! in a = al marytfi. e. The*# and *4h#r q*#e*ii>*i* will urur to th# in a***e!*--* with a (h*rart*n*t>c b*tory of flprrwtv r*i If ?h#f frieiinre U *>4 r**-*t weight la* rwr.rtiiny aiwvreva and res- a|*fwrt!| to th# not**#, be need on 11 r^-^ynu* the dura<sii ran reasonably be made. ti.#reh) that be i* a htwe. and that he ha* touch tn learn None decree of hum* 111 r l*aed on urh (*n*deratMe w.-nki r*-present fe*J prw- Ir-.gh !.*. letti leal ri** when* abr^t th# < harartrr>tw of the wwilinj lead line to le jHrr rs^ti.ei in it* rwr>-rruiifS * 5A(* it h#re fre* l.wsrd the d the pwiiiMiVftl 1 ii that reie *hc.okl know whereof he sees eitrm#Mi*s that now art*# The Hetary f the >>e and *rewk* Iwfore arrepcipy any r# of several abnormalities of the t*vr*.h aad gum ae belay a "Wad line " r.tpcrimcw i required te Bad j*Mf moat *irniiVat ftm.nl rbaraeteridic **f lead intotwatM^, y*e#TaJ)r. U the prey#nW- inrr of funrlMO'aJ <n#r #hetewiw al<o**fyraltr. and interpret thi* IrsioA. and errors of emta*m#i and rommiHiia in thle relationship are all \tm* fre*ru#nt *. stated tdberwtte. (he greater weight of *_.tf**#f oh;e*tie r-i ,<`.m es of i)',<.#- TH* 1 f*eri*Ur in (a*es inroluog probwiyed reewistxeial e*t*-*yfe at!mdd br yrior rerarreel ftval imi-rlaHt aj-gfr^a 1* tH# digr.<-i, there fore, (*)>' ir the rartful el itat. -o >'t the o- mii.i or *rer *im|dorr.. t^itferwew of HeufOmuwular di***flrr are Sikety to ie fewod. ef fi-rmatMei al**it p**t ar d pre*ent r rrf4aote, their oe*ef. their de*!^jenen* in t> whuh weii-defnrd weakness of the ntrawf rr^stL of ih# Rnyvrs, wn*t and forearm ee e|p* jfe r-f di*r*-otn carw-e of (<**'* ar-d (Heir aej'<v, inter***tr and tah*!ity Vkith u*je*i th# most ued !<)#. or <#t U'th des. i* low h the o-4t fmirvei Trank f#!*r. with wri*t drwp. le t th-e Iftat (<f theee faster*, t o# fn )( j| | riii* rre, if it at ail. in an initial hoet a (atieot. a* we'i a a d *** t-\ '' f Li {Motirat*..*, this i#*i(>o l*einy aa stprea- whoh m*r ha*e i^en Larr.ed rl^r i*n et l^i termed In wh>i# t.f ten in part Thf I* -.n of fifolorgsd itt*n# Mpsurr te lead, la th# i 'u iu of ehifh ^h#r mamfestatioaa ef It. ruk (if thi* p(ie(<l4f* but, by the *Ow t ker ?rfr i f- f f t Art* tv'. fM*k ition have u*ua)r nrrurred from time te `..r.c f'ir!irr aiyr.a r.f r.r^r^re-wwUr ifti.ire- i ai ih<|4iry into the facet* t.f fnate*^ rfient. thsl mar yo haod in hand with ntreset# enterk * mptom**.i.g and n. ao4 wrasuraa in th upper eitremitlee, are abr-e#- t'.t (>4.;rti*a a(.|(a.*al < ( th* frn)t* >-t turh roaMise of mu*)# too#, asecelsted With hyper* 6 CTWWWlyi 1-1A 10842 raw 3 3 i <3 rvAexia. hyperaeoailietty of rooariee to cal vtimuUUon. and maintained mwaroLar con traction*. These may involve the lower ratremi- tmm and. whm they du, there ere compleiata, rvenmoniy, of rrreJrl* and arthralgia. The interpretation of the rarer clinical fypm of lead planning It more difficult aad requires careful and critical tied? of the pa'itot and bit etpusurs. Full coverage of these problems it beyond the wnpe of thia diaru**use. Frrfcapa the mmt valuable advice that coaid be y;en la cociterlioo with thrtn it that one (decreed alotriy, gathering all of the facta. before reach ing or etpTe*i*g a conclusion from which it l* difficult afid fie* embarrassing to dmate later. Modern medinlejraJ procedure La awrh that rva- pn**f cf the existence of orrtUMul disease is or should be required. ThU Includes proof that Wad has actually test lUrriH la quantities ever, pa title with wnffiM manifesta tion* of the disease. a aeciowa dlaeaee. Our contrary cliaWal attltwda toward this diaeaaa atema Urytlf from rartitf' diftkaJ dewcriptlc-ns of a aegdnrUd dlaewae, which, when it finally came lo the atlentWm of com* petewt clmiciaa, waa the gapramlow cf aa gpuaurw to la rye qoantltiee of load frttf a kmff period dunnf which there have bee* rsuiml mild cr moderately eeverw epiaode* of IntoxWa* tiem with brief period* of partial dlmbilit/. This recurrrot. oetemsiUy aaild. but profteaaivt1/ diaaUicr. forzB of the disease, distent over a period of years of cootioaed eaprwure to Wi is the so-railed "chronic Wad poiaoninff,'* scene* times ia Its milder forme auaWwdinytjr riflnf "Wad abworpticev." which U a* cornmoniy de scribed to medial Lteratyfe. Jt U pot alloyecher ffuae from the America* areoe, bwt certainly it U Wsa frequent than it waa formerly, belay the predict, at present, of oWksUf lerktud *r aid-N oinpocirt Industrial policy, or of poor industrial tcedicaJ aad hyyieoic pmetioa. The Ctswc J Csmt f\Xt of the rtcuBOOMt of clinical mi*tah ia the <2.*rou*is of rcYwiatioeeJ Wad penn.e- lAff stems freffl the belief of Inexperienced ciia;* ctaas that rwitry frr<a Wad posse* lag is usu ally slow, and of lew. if pot rvraUrtv. inrcaapMe The facta are precisely opposite Lead Ifcloxi* rtlue, eacept lo I Is more arvrre aad unrreiace ywralytse and mcrphai<palhW maaifestatKeis Is aa rweewtiallf self-limited disease, of compara tively ah- rt duration i day to weeks . from which, is the ii#rwUfm.Af pcvt*tj<* of rues, there is CvC^piete recovery whm the npesrs ha* Keei termtr.stod The p-ni*ert rf ab dsem&aj nptisni for many tvwthi or t<f irars aftr the <r station of np<re. * has been the rase not tnfreqicetJe iq crat rotersial ;!uluc. req-rrsent* practical)# irdubit* aide evidence that IK# rays# of the ailment was M Wad at*>rp4i<>) Krn an anemia. onrnaaUr considered to t# an expression of the tot h effedt of Wad absorption, it to be regarded with the greatest skepticism. If it persists Indef.iuteiy after the termination of r*f<*urv to lead JW* far as ran (o' detrrrmn#*! hr the stud? i f earner* r a see nf Wad ir.tiiKation. no irressrailU# lisiMf* In the t4 -d-f< rmir-f tissues is *. i*ir\| with psumUism Indeed anemia i* rH a rave** *srt *#*-mparimewt of Wad lntrrxc*tKw. and now whan Wf*J prrvedurr* and current mew*. ur* of Ia4stn*l hygiene art rH-jnsf the *#-** ity of isr u; *t. r.al Wad pn*s<r.ir.f *-4 t*e !> *. ho*d of rw^rrent and frjelitlous lead p'.seior in the sme i r. i> * idusl, anefnia Is a m ** h less |fR(ir>rtaril f. en t i,f the fliM^aJ syndf- sne than It was forrnertf lead ps^wei^f. as seen in |K tra les *Kwh are foo/sm**) w<'K in*eysf'*! i*en(a-Mi,.!* i.f WaJ. s).n rr<'fh i'<l Ai-4 ibell vilh ri4<i4l.i| \ij fiSn^idg \Ke io difidisi fr<m sif-*eyfs and h.* r- t#n |a h>s > .! ie<l| when the f**vre has tee* buffet under *4e*jual# (unifri, ia naif rarefy The Cff+rtbvt''0 W f^e Lahorafery f'oMKKVT has been made pmlwuly o* some tf ' the di*jrr.(*t*c (J;Ouft.n of the physirta* e*' yayrd ia yrneraJ practice Prom the aspect of the UU ratorr procedures which have own# t* be aimejst lodisprasatde fswtures of the dlaynoaia of Wwd posacminy for medsesdeyw) pnrpcwea. thtf prtddrm U especially diffWuH. Few diAftootir Uivwatociew aiaiUbie to asach phrsiciana, a#^ foe that matter, few of th** avaiUble ia boa h tab and mesWcal centers, ferersilr. are equip- M mtxk fani;ties f*r the |wrf<*manre of the per > ary testa, of with the ha*wWdye aad rtprh cner mj-irrd f> f yni^y aJojuate adiWe o* the testa that shnu^l tc prrftciwsd. or o* the ineth* 'it requited f,e itvta.oirjr materials to be ea- tirnnsd The rush is that the test* made t* many UW`f*tr,rtes are more likely to be aie !e*dmy tha* helpful Therefore the physicia* Will he well *diied to dispense with them and to lw*e his judgment entirely on the history ed the itlnesa and on (he p*t*iraj aiyna which he ran unless he has the knowledge and iperierwe that er.sMe him to appraise the lalw fr and its result*. \ rs lum^sVfn i* relation to nrrupw Wad p<euny, swept la the differential disyocuis of ya*trecenterK disorder, may be *rh summarily, by pruotiag Out that they haie no **Jue a* diayrestic prvcedsrwa la the a'tuit One Is smt*srraawd Infrequently |* rnd^rtrrfes. hr the aevesiitr of pointing rvl Osl the bn# * f ai*r'rm;}y dense bn*e whWb i fi-wi.4 tf'*n lime to t.me *t the margins of raj^d yrr'wth In IK# Uu> vf Infants and sraaJI |t rw4 a (#nb result of lead sUerp ii<e <n the tr*e ksi.d r.**# a phewowwfwet of *(!!! )ifs, rm the her may also firai i.rve^r with rsrtaia of the rrv.rs ii ffiisa latvrstory | rtvelures Ths hWia> j.A^yu- rhonges c*sem.^!r aas> ial#d with Wad { sMAiny |4ar a* Impudael r*de la rllaWal iUPPffWM U*wuaWUIU| w.wwg u. un> up Mgr ui **W UUL j L IA 10843 MV* ' i i S. * ! > 5 diagnosis. The Interpretation of ths entire blood picture. however, niut be made in the full rerog* nltioe of the f*rt t>4t all of It is important but that no feature of it gives specific evidence of lewd absorption The commonest fallacy in this roensetion is the persistent belief that bwso* phtlx stippling is indicative of abnormal ab* sorption of Im4 or of actual lewd Intoxication. Much (inM be awid of the methods of examine* Won of the binod in thit connection. but, with* Mt ewtenng upon such n discusston. Ut it mere* Ijr be recorded here, regard!*** of method, that the MfufTtw* of basophilic material in the try* '.hrorytea. per **, has no diagn^tic significance, and that there must bo name quantitative ex* pmsia of the extent of this phenomenon in the Lo*jd to five It significance. First, one must estaU.sh whether or cot the pherxenmon oc curs beyond the physiologic range, and then determine, if possible. the m**t probable fawse uf the abnormal*!7. if such is found. Lrad ab* surpticw is only cne. and cot the most frequent, uf the possible factors. The grestret value of this UU>catory test, a hen pruperiy performed. !<- in the fset that failure to detect any ab normality of the L<*d in this re*p**t sryur* tncifly, indeed. against the likelihood that the illness under consideration is the result of the abeoeptuea of inorganic compounds of lead. Another procedure of the Isburslory, s round which aa excess of enthusiasm has gsthefed re* really, is that of the determination of (tyro( rphyrir.a in the urine, as a means tf demon* i!rst.:-g the oreurrctft of harardcvi al**rpti*e* 4 led t'srrfut lnvetigstKA of the fnri*l*Ji*fw *m] ftrrHu-i .f iHe jnwph x 11 n* u*def s tifirtf f roetiti.e-.*. Including tho*e a***-*!rd with isryirg levns f l sd il* pUon. msj prtnidr s means f*r the eeriy detect!**! of actual or tmpeodrr-f lead inloticstim. and thus add ms tenallr to the armamentarium of industrial eedM'ite in the lead trades. Moreover, if the rccreturn of porphyrins, in the course nf a rwngr.Jir^J ca*e of lead poisoning. in roeaj the wtrnly of the intoxication end give ltd in prog* r*-, it will none tu serve a useful porpwe There nA te little d***bt. hsmf, that the rqrrefit pp*iiartty of the prurecjure (*ms large* 1^ fnm the desire of clinical and Ub*fatory <>rk#rs t>< su!*titute scene simple J*sgrx/*U< 1e*t fur the nv-rv precise and therrf'*re more difTrult analytical methods that relate *teefw*lif |i the f.yxmtrstoeis of lead in the unoe, l>Vd or ti*ue* nf persons suspected of teing victim* of lead tnt'iixstiuei |.#t us consider l>n*Ay ht is J.krif t<. 1* h*1 l.y a too enthwi**i/ nW*r g <<> this ureterIa o -Is M* desire tVuit# spsrt fr-m the meth.*U i-f ansi 1 < of the i* iph n**. who h ahtle simj-e are far fp*n fi*4pr>*`f, sod w.t)< tl| |<SMin| regard f<>r lhe nMe^eitf rf prtrv. ,i.j th wf.M sglii.st lgT.;f.* si.I l; .'ffa*rt arl dseressss in its cwvn^psrthyrtft (el#r>t on stand* log ur-ler varying renditions of |.#ht. tem^r* aturs and reaction, we are dealing with a p*sl<^ logic and pnihcdogic pbeoomeao* of trm*i 4er able variability, the extant of which has nog been eoUUiahsd comprehensively la nryixi statee of health and disease, of la reUtkm te age and sex. Certain It la, that this phvncneMB Is n<X specifically relsted to lead abeorptioa. Mn Inrtueftcrd markedly by Uref damage Of disease, by Intoxications of other typ** lhaa lead, by a number of lafertloca dlssesee, by certain deficiency ditseses. and by certain hematopoietic ^is^rder*14 T That there Is an eWratien of the rate of urinary excretion of coproporphyrins, in assorlstlcev. more or leas regularly, with highly abnormal absorptioo of lend, la an toteresUag and Important phyaiotogtc fact, and that thie pbenooroon may wed be an highly algnlficant asp*et of the mechanism of lend Intoxication, goeu without argomenL But that this w*epe <1V phencenen00 can contribute aa answer to the primary diagnostic question with which the pky* *lcian is faced seems most ImpnbsbU. h*kal Is this questirsi * If we ran make this suiVlewtly clenr for both rhnieai and medicolegal purposes, we shall by that means define the issue sharply. Mrdu-al. legal and economic consideration# re* quire and justify a d**tive answer to the quentin: has this patient absorbed a quantity ad Wwd sufficiewi to cause intoxication? If he hae absorbed such quantities of lead, the diagnosis uf lead iatoxteatieex. arrived at by sound clinical mean*, mar be regarded as adequately substan* listed. If he has not. the diagnosis la untenable, and further study of the raw is required to arrive *l the ccrrrr* d;ir^it T>.* bring* us rsturallr tu the r*ideratlun ,.f |h# jrTr*d>iw* *<f the Utrat*rv wherebv the rxtrot and signiArnare of the lewd itsorytiMi of the Ts!.er! tan be apprai*ed. The ph**io'igic r% tdenes < which the choice and interpretation uf these prteedurru are based I* aiAilsUr1*1 and r.erd rv4 Iw brought Into thW dirvj**hei. slth-*AJgh siw h rviderxr mut be under*t*d fuHv br Ihsr who would apply it. The methods uf rsmpbng and #nsl> sis'* M also have t*een dowrite*] in sufficient detail and wlQ M le mmiHoed. brv<*vd a further warning that there are s b-juste srvd ir*<lf*justr methyls and that *a b)gk degree f knowledge and skill, far bn* y n.l that >f the v*usl type of tsborshwy tech* aician. i rv-juirrd fur the performance of the wt*rh. The re*centrm*cAv of lead in the 14<4 sf the I*im who i* s'ltfrring from symptoms believed tM W ! >** t.f knt<<tication by the Inorganic com* *`f Wad i* the moot important sirgle bit i f rr- M.frd to jrtfay ths *ignificaore his at<*--c{'tK>w t t Uad 5ince Ihe cooc#ntra* luet ( f )c#4 in Ihs I4f-d <i*flea oolv within ex* 11(rv!f osrr>w bmi's fr^m hour ta hour and fnm day to day. csrept node# conditions In* and highly yariaU's stpewarr p c r 0 mJ9 HWKWWUU-P ,|..WIH|I||U. I I in HD Iiwuy, in imn I.W WPUBtP , L IA10844 > i <1 3 Id 1m4 or la ruapon*# th# admirUtratit*# of dithlopropA/toO* only one determination would b# required far dUgncwtlc purpowra. war* It not for lh ficMMtbiiity vf the f.jntnmir.aliua of a aatnpl# of ti*J with mlnut# quafitstlea of lead ta th# jwwfwi of It* withdrawal and analyaia Bflraua# of th#a# poaaiUliuea It Ic adrtaabU, mn under tb# b**t of rcnditluna. to obtain muit.'pU aamplea, at l#a*l la duH**U, and to ubmtt them to epart* anolyaU. Th# nooha ahouid check wtihio tb# very narrow limit* of a frw mkregram*. when rtprc**ed la term* of 100 fraxni of whtie bland. If they ar# to be orrvpted o j rriiabio. Tb# d#t#rmin*Uua of lb# rate of tb# armory ficrotlta of Wad. whew pf*pectr carried out, provide* apwrifc aod tn*lu*bl# information o lb# eatent and *lgn;ftr*nce { lh# lead ahoorp- tiae of an lodmdg*!. and Iherrfcfe th# choir# of material* f<r *a*Jy*. la ffedK-tW#*] <*>#* eapeeiah'y. Ifwdwdr# *uit*Ue **mp>* of urine Th# cr<nhintiije <t material* for dUfnuitK pufpn*#*. and oc# which wiU ^n to eliminate moat of the error* of umplmi and latrrprrtatHiA. fOB*Ui.t du^Kale a*wj4rt of Mnnd taken la (Hv>ai r.j u i;crvrT.t hy an in*truc1"d p#rw#v. and cor or more tam;*** of unne, well vpvded directly iota th# <ar)t**ner *prcfScaJ- tjr prvn ided for th# purf-*e under th# rntka] eye of an mlrwlrd prro*. Anal) t*c and phywlo* logic aocvrrmc# tm tb# part of the*# retail* will atamp them a* valid. while variation imnar them beyond th# kiw'n ruin of aa*Jrtk pro- riiaa or phr**tr'C*' limit*!*#! irrwle* th# dr* mand for further Imrwttfat^n Any atandard* *4- pted or rtnpWved f<r th# interpretation of tb# analytic rr*utt mut Ht b**ed th# known of th# anolrtk metbod oc m#ih*<J* emt-^yrd >frth'J of analy* *4* now available will yield result* that rrr m either aid# within th# ranf# of yrrale-t t^irun lock airnifcanr# by no floor# than 10% oedi nanly and by no more than 15% at lb# mail* mum. 5o keg a* rrpewiuriU# r#*u<t* of known Occurwry can b# fd*air,ed br th# method em ployed, a wmrvhat Urr#r maryin ! m**r ran t# tokratrd. hot 1! ! tn r^*e#ut# that th# eatrnt nf the {witentiii erroe >/ th# method will iktermire th# pr##i**f *( th# threhe>i| which *#f# ff`#n danfrr*-u* kwN <>f lead forwent rat mw i, epwr*ally In the Iwmd To# rtamfue. the f**wertra!kw of lead farrty # C###l# f/> mirnfrum* per 1^) pram* la the whole |4m| t>f t#rw>ai who ha%# ulTrtt*l no f*fn| unu*ual #ipure to lead. tut p*r*-n who hate flO mkrorranv# or n*-f# of l#*d p#r lf*^ yram* hate l#a *ip>a*d to trad to h an Mlml that lher fna) h**e i#*U| yn|ii<#n of Iriotj. ratio*) Th# a.CTiiK arw# tf an aoalrl* trfot of |*% In draliA# with ft aampW nf |0 framt of bbwd hame rather Urye. Ihurrf'## It 1* In th# of av*h |->t#wtia] errora. that dwpltrale ana>r*# ai* helfful, and that th# fr*wt aifnihcance of the rate of the urinary eacreltnn of lewd, deepeu |u greater phyaiologic vnri* abdlty, roawi Lata piay. On th# other hand, ft la bocaua* of tb# great phyeiotogle rartatilitg ta th# urinary reepeva# to lead abeorptioa, p)n th# fact that tb# renal excretioo of lead U nert* ooaly Impaired ocraaniAaily, tha* tb# nivaljralft of tb# tdood la m iwaary, Tb# concept that tb# pereweitift# of dtacboaia call f<k tb# analjaU of a aampl# of nrinfl of Urge icdume, eurfc na that obtained over tb# period cf 24 bourn or kmger. ho* been dim Wdr#0 by tb# availability of analytic method# which pem to# foe tb# accurate aoolyala of amoA *apUw of Lind, and *Uo by th# determination of (be rmAgt of variability of tb# ctaxentniUoa of lead 1# *m*H aampiee of nrin# under varying ct4idiUfwwi u< human lead aimorptioa. Tbit it not to **r that the aft*ly>a r>f Mirpiee nf grin# of Urge vtdum# ia und#lraUe. hut father that in i*4r tuMatwee. and in many mevticvdegal ait* uationa. it i diffkwh or lmpn*#tbl# to aerventdiab. Tb# diifwully of obtaining uncootammated usplea of urine of Urge *<4um# for *aalyaU con Iw b^iated through tb# u%# of amoU oompUa iMjnl in the j-rewetwe of the examiner, and ad !Se uint time, the mnWadinf effreta of the ;>y#kdnc>c and pathokcc variatkma in tb# urtrary rx/r#1toa of lead can be avoided by cd^ tatairg and analyring aamplea of Unrd It #>M-timr* happen* that th# diagnoai# flf lead prwMWviag U In d**wt4 at th# time of tb# death of tb# patient. Tb# problem of diagonal* palmnftm it net ea#y, exrepd aa it may be mad# la tb# r>#r*tivr Analvaia of amiable tiow#a wil wn* to determine whether c# rw4 there baa ter* i^tetitially daRfroui ibaorytii# of I rad, and. if no aorb ab#*epKtc recurred, tb# diagn<*i i t fatal nf c<e.*nK(it< rv plgml>i*m fnt b# diacariVd t>n the other hand, if th# cllokol tudv of the livirg patient hoa r*d yielded In* f'*rfT*tia r which to Ka# a diagvwwi*. It U unlikely that rvidenc# of lead aboorptlea olo tallied prwtmortem ran juelify lb# diagunai# of fatal lead IntrraKation. pnleoa further invewti* rilif Htr|www prmoualy warevraied or ml#* inlerpfetcd f#^t bearing rev the rwrupathmal and flmuol hi*tfT of the deveaM'd. Tbi* fol h-w * ffcrn the fart that there i no {WClV j*ajhi4- gw rrtitv fhafactcriit* nf lead pncaoev* irg and that lh# dtagr^wia ef lead p>xMWitng farm'd le m*k if) evnlror# of lead al^.*rptloa ahiei# but f* tb# ftmkal tharorleriatka of tb# diaea*#. Tnf th# tprrt*J of th# eiteat of th# nb* rd U*d rm th# fart of a dweo*ed pefacwi. tluMild n<<4 h# e -e**ee*t with the analwta of W'C .f |u |iMi* J( It *'4l*l4e la hod out lh# pattern of lh# d*lil<wlbHi */ Irad In th# r>rrna and tl**`ew. > h a th# llv#f, k>doef, i(4oa, trlatrd iritlr **d akeiotrui t:U,l ad urm# from the blester. iKauM I# fd>* tamed for ***!)! wha th**# *r# available 7h* reteoti'w of Wad In lh# Unffa I# Important in rwUlioa | a r*rnt ktHocy of oifupaUonal } * ; i * r : i k ` ; * . a*mw LIA108A5 J?"4p>W Pin ' axptwurw, And th# cum mi ration of lend in th* braia u a m*twr of grrmt impn*or* In th# diffarmllaJ dlafatMiv of a fr Ia J (IIo t a*# Involv* Inf thv brain, ll U HifVuU is frv*t Ir.alAnrea to obtain A iparimM of lot.# Uw># fur AnnlyxU Fortonatrijr, lho nnaJri* of rib oorvr* lb# jnir* pON AdrquBtriy, And bof>f fruftl this %**uffO U alwaya pncuraldo. Mctuulouv nrr in Iho rtd* Urtkrti of MApin of Umu for uuifda tv rw- qiilrvd. nu( orljr Vo awnf tbwif ton laml nation but to rftvwro their repreoenlvtite chararlof. CalrulaU<L, baaed ( tho divtribwtM* of tend In the prtoripal tiaaoo* of th# will yield IftfumutUA. obkch nhtfl tuotparrd with normal raloea and tb'MO found and mofiW, in u eAlK<A w ith known lyj* and intrtv^ur* of rx* ppaarw. wiU portrmr lb* farU a a tm wnptmmn in a definitive manner. IUf A A. Taa<i f. OT (w a J A A '*4M *M OT LOT I L^OT m l *i lawitoi t fAMM LOT Mm Xm. i* Dl. *A A Um A A. Cmu A 1. o t 4 MOT. A V .HOT OT R~a~ m I n-- AA M ** t m t >*. Ui o t m Co o t > Mw'to* > M AA a i u o t (to*# w o t . IM. 1MT OT < M1 iM.wto rOT Aa A Am OT Aa T-*V ih L AOT !.* A A TW t'i M Kiai n*OT JOT. ft Tw Oy rt --|ii fa JM M Vo A On*# w o t . i n*. ImA A A . # . r. >*. . - #< a a *o t >wt. a v m <m ItoMM w LOT (< MaA IOT. * n i i* ai . o t a "< * **4 c. IM A t|. |Mt tt ti*<A A A A II H WMM V to I ** A M( lw 4 ( IM A |T! w I l e 0 , LIA10846 ..... : Q i I ktp**tf4 WA I'*** Ik* .i >4 .1 .i'.hnrf rf /J*4rW Hyjtrm* 0*4 I >,m0*.~*. U~>* Mr. 1/^.4 /! I -I I, ft ."A.' .71 /**/. 41 .*am<4a Ur4u'W .(iMufwa TtlATMlHT Of LlAD POISONING WITH SODIUM CITftATt bw< d Im Cm HAUJfT L KAIOY, H& MfTOM . ftONM* C ItlNO*. MA . OAtlXI C ma iOOT. IO. HK |*KOf*KR MAftfrmrwt 4 M |nitunn{ cwnmon to be drhutd Tbt T *Uitdm( <)ar*4)uo (4 *hrtbr-f * r*< ||jr jalimt ihniiil hr U not fc*lu*rtcjrJt trilled. It u fmrrkJl* omirdrd that tlir xtSr Imdinf"* %huuM M l* dunr in ini nr until Altrr thr inAmM-Ukikj-it <4 Arwtr |4umUun hirt [utd. Thr cflrrti d thr iifmm U*mn <4 Omjijr rrttutn umirf dmiituiift, rvery4 (of (hr crrum Irtrd d (ikiura in trlr^ nm{i|<m d kulr Wtd |nmnM|. WhrlhrT tirwiui ilnifi our Ind <>f lotfmd ncfflmn 4 thr IrM M tiU lnn( drlatni Nuh, K*<rtnlL Mrawf and Krrmk'>fl,* in frjrjrlod a inrrr*r tn trad rirtnin nhm nlj*n otratr u abruni*irfrd. "I hr tmrmc an nt oftHv M prril * that |rtUnl bt thr ur d lAmminm (hktuk And iwuUf mnlicatwM, nHk h rmikN in i rnhrun <4 mi m Thrr attnlmini thr iirmwl Irad nrrt* Inn |fihirrd h mk }*u r i UarUmlr iral In w*inm otratr to thr ifiulimmi fleet d (Inr ulu and tu thr Url that thr iduhiilT i4 (ft-lnd |<h>a(^ult ii tncrttnl iq (fth tlUlmr gnd a d d tnrdmm*. ICh amt l/Vatll * hjir Irrn ufn'im in klweAlin^ I hr 'tar d k Ih w i n>n(f in Or trraimmf <4 Ilk* lair mirunmlrl that 40 to 50 (o a . (4 mdr*.;rn ermtr 1* ldrrtrulrrrd T:*nr% ; m -orfr thrr idrtie that 50 or d i 25 irtjfi'l d alwti nintr Ir mjertN urffnrniwalT Thrif nimrviV f<r thia trratnvfil * lard >n thr okcj< Out lead (<ru*d a nrr JuMr, r1itfu04r a*i| Ar* with thr <ttrtr k in TVt* mnfe lr*d i niAdr AVAiUMf tnan H d (Vma<i>aJ lltfvfv Mm*hwiii Ihi^rtnwf 4 !ak m| Idmlnn (Ik UiVd t>4 I** llk^r * lt>* r> (Wm>nil \ldil 4 law d WinkUam CmrfAJ If * *! ilk Mr4rl *d (nr i*r \ (Wtim V-bup^iOkMi H ' \\>U tt^Wry, Wiu 11 if 1 i p* <k <V%m at lKc Ok(Mld UfU (I C ltrwt <4 l*w U*Iw h Ui (. **! I n *act**vd m nart la fr*c%ik Vran lf*n *1 I*ailfi ,4 Mi*'1! I at<( Mm ISM S*nnf Ik r.4>r m ff**WN m mnkn l'*d <*>** V*r*u* Wr*t R<rbry. Mna Ik Mikd h d (M |a*n* *4 (Vra^ifial Mrfwr*. Uiiikkwrti lkyn/1- i 4 1 *Ur vd I id-pi i wa Ik H*Hy k Jifwir *4 thr Ounniifd W^WiI CW )4i**W*nt Cm*| Mnfkal. tr4 (*aduk k <*k tVri* #4 rW(irl>fkl Unkw<tt iVyaftfffd >4 | |Ar m4 lnWarwa, fV -- I \dv f C . I><Va 4 I T : Mk( A A. id k#f*.V'*4. F . lid Pi4a*ni noth A (V]4f ,m ik piMW* f >4 II yW 1 |` *..** ka tW t,*iwA*4 '*** by At^r VV iMw A Vi I Vr* ( , *mv , |9,kv 7. <\| ^ ; Kr A ' */>l I rv#--f. T V Trr*m^ '4 t id Fma**** Wy A rr A ) V V || fr. 41A I Mi ) -r- I s i r ' N 305.02  ij M-uJUI ..................... IH41 w'lPi' Miff JMflgiliCWW-- LI A 10847 m gJa rWm ii <i > . i . ~ ` ,., . .Mm M frM i * * " ~ - `- - ^ ," 1-1 ? ffr rrmj emftrfiei and in * \r%* tm* lim The? *lw> thtl |>w rkrate mtfht be ttvlaSolimi by thr brrr. Wtvtntf fhe Wad rr*Jue In hr fvrrlrH in thr UW iiwi thu* m fhr frvrv Vhey drm<*irted a ruhrr tharp tHin* in Uw blood Hid Lori* wtih Out treatment ui iefir* id 15 c a m** In atvxlirr puidleafion, Krty and Ixtonodf * ihoard tint tn a tmr* id j mIx t h * treated rrth eid*tfW otfslc thrrr a h a ri*e in lead tMfrtxwi ahm (hr touJ id (hr unr_toy nd thr feta) Wad n camudrmt Thr mnto marked nr *u m I hr feta) Wad Tbr luntfrto period during rfedi thr Wad rtcrntm li fufVnred in fhnr nm i II day*. Smith.* m hi* di*cu***m <d thr trrmtmrwt rd Wad potauntnf. iitird HVum ntntf at a itorafr acre*. )** i**d that it bad cxdy a tno*nnry rffrrt in {hr oar or reported With fir |li/rr nwWitiDm in nrd, ire llm>(ht that it hr Midi afulr |n r^iKl our fijrfinKf in treating four for Wad fxrfaomng frith odmm rural* a thr nrnm cumfoomt cd dmpjr, i turner nr rAita Ca m 1 $. * 4 n *M toiwry Unwy w ktf4 to tto U'M >iWy Vnmw AiMtorm Ui 17. Jto* tor*w to *** to twa daya' iWi < ftorm* tto ttoe* ynn i o i h n I* to tot tora *** (to lea^ Tuu l -Cmri / rmd f--.n<au.^w f. /"Hwo / f, U a t <> m i t* >an# *t U*r : ( H III It i^i mx rM U`WW4 la a IM IJB* 9m mi 4m mm |iau i imam e bWr *4 | f te4 yjiift erf thr to-*?cr fto lU to u m fc ato** tot ia 4 b kto otto to^e ^>n tto t yrmr% prrr*x* x ton mi to h*4 than V*M to A Arto* t* tan n mi h h ^t ato t*Het ta* ton vt tbr fc < Tm+ ,Un toter Wwe to kJ tto *wt to 'to.'! ft.v* L/ tto iMrfi# |r1 to (to to* I to | am atoftr't *> (to *'' ia ( m (toitVT *o * toxfy P** fwwr| r**ff bw to >J Miira Ito tto 4i| Wtof to tod lltr <*imI to tMMa| ilkiHi 'to/rt *rH *<uW l^fuia1 > i* rtot |r i> i<mr to >Vinii< iVinvt kto i imir**' * *4 Ktal tor k^r'nnr4 4ifxt kn frvto to mw a the UniT) ItcVitf 7W Ml lk>* n Uk* I. I>r*ir*! tUMBt> rmiW i rHtof ( to rWiatelr a^-iM W*t M* a trtor tom* *<ik mm [a If* x b ik rum v n V71 F , ftoar rtk. h; Uoto ymm CVTo Ttoft *-*4 > mkrti tt#m Tto efk *m a Ur rr^f. uto (tore m a* y W4 !an |frn <to to*r *< Tto )iwi a lra*W cpMOl Tto uV^wti * it m> i j iw * tto r*to ! >* to (to iVi*rn Tto** * *i fwt toil ftkmt XiakTwm *ifJ (to to to Ito *kto--w I im, Intoy* ito if-ki tm f4 k-k >M* t< *rfi r* ftortMtd m y Tto< *i< mt* trnmmeit wAxr*4 m{ ito *#f* ** ymTto i4VrmJ rtlkiti imt 4*reraf4 /k*txy /toM--Tto kn* btoto <* fmrr v m t,*A, %<k ydjayliii*iV*i fraatoto rylM 7) ptt r<m I fHhnf - to irH k l! 5 f'<* M W*to ttfU ttoto 1 Ktoy. t 5. i*4 l a4, T V T>>r*to to l/to f torwf BUk V*tot Carrie. fV* r*|t Km4 4 Uto *4 VK V7, |>4I 4 f |. |tot to 'frHi x tto f nwotn* to Inf ritoamc. hn.iTN-i| (>rf/nwrl 4 I *k< v*l l-a-l.m#?, Mirnito| |*|, )o* Itol 17 f a i k . im > mmsm tmim* i. jsm mm *mr LIA108A9 Tlw? y a tJiftft rw m carto* dm^MxWymn Inaa 15 I ha < cntf M temimtrn cirui iWiff trtt rnmitlrd. Tbt rtlarwd to K ml Wat ftcf twl ftoaft tUn totar Tto nfy toad and Mnnary (?#* all? M (Wi 1. imU mU ttoa* rrUikai M rtwrify *rt aftwcr* Ca m Z -C A. ft 22 t*mt tM \****y ftoat %% *Awn>4 to (to Wm Ixhry Vftifih* AAnmrtritui }(Mful Oct U, |M tom d nwU/ acto Ml f toa l tia 4ftft' duraU* m| iWomnil tram** d fcr# <Un` dvrata-* Tto fMiuto tod hwa vtotoaf b da* toilr Urtury to (to** mk II* *% wawM <4 to4)| (to to! ftiw* altar (toy t t * If*** ft larMa and p*(kr (torn ttyrOnr VwrU %t*to toiorv ftdtaaaaMa to M) (to cnart M *(!*. X* 6m UV#r atoww to (to m d *to and pabft to* am and tok, and lato to oraad (am m tot toyi and Itoto f*nt dan hto i to Wad (to c***i id ra<eft* m tot atoi-an* Itow am kcttH a (to Mt>a cl (to i Tto7 xrr*t*4 m aorrftjr mn U (tor * Tto coatoy yfcjmcttm m*4* ft < d toad and to m* ictoarad to (to to fatal U damff. 5 K 4 0 < duaivJibdiM Tsbt-OAtS CUfl 2 icaw 2. h * C A ) -- Tto * M t#* irtat'i r *** *! Tto ar*H k*t tow catotw* <!*( tto rr tontod to-to *K laito tttk/att* t pt** (to (cat arvatf trad, (to W4aa tow. *rl nd**M carat* (Strap? w*W ft toactaaaata anft ton tkwa 4*1 Pto *'<l onwnm rrr*-lrd a 7***^ ato'l S> nwi a to *at m mb d*ra at (to (tor d *<1mw **** tot *r*m ttoa/'rt aa tor* m*t cratf a IW u ttotot*? p%V and ft?Ww a Mm im ( F . (to rM. 72. tod pm*f. Ilft/TV Tto Inili *m m 6* r'ajiat, and (tote *m *> lr ( )TM ftor* t aa cvvataatai lyk j*t< had rtoavton .^rf (to Wtt Iiato Ttorr * a t*aW 5 mgr*Mto c*t ito (atcitlnt 'W a if '4 ftoaa * to *( Tto (^i --n n6'W fmaaatoad t-ok* t/r autont k*al**rd (ator'tota I MW krb-wyt ta| (firm arrt (aft toll Ttorr ti ptrtop* dik avttoa cd touto*a c< to*W tout ito art m ator wantofktl M(M /'ftt - Tto W*v U>d c*B cr*4 vat V*f) mtft (alyat^aatoi (ftoa tft fj f#t <ri k () Cm far n Tto rn| to*d ca.U tto awl War<f-toto I 015, p rfll II fa* (*Mt Tto mu m *>*d <f*ok f'artff d to May**, 4 (.* 4 atot# W---4 caOa far K*fW fr/ntr toH Mad ft toad (t*t1 d e f v.aiim itfai I iDUupuyf.'M'W' , w iimmiw j b 1IWWJI^^ LIA10850 " ii o 'ifn ` i^*- fi' i~i i*i~*f* ~rn'*~--*** *" *' *' 5 0 46 * Sinw Ulirdbb mmaW 22 c ft 100 ee. Am ootmttr tm iki mi tOTi-jm lo W * OH ft tort 11dr-- ihlandt **d to b* con^ftr M 0-V ft tmu T>4a t* fempmad M onrranl Kumii* <-aeu<K0i cd CW thm *k^-fd M n^Wor* of am pwlmramfr (b|t TW vMry U*d 6*4 anwr <r'r*'**Tfcjrn Wvrb And thrb rvUitq* to ib tffymk pfo|rw> vi hoom fr*t*av*0r O rturt 1 Cmmm m rib - V* hrr itiiiw (W p*tm>4 * U H dU|rr*4 Hi mm fim iMtrrvdwv krO***^*^ L*. 5. P,, ! *. a*diA*nWr, m* iwdri fcrf mn lit mm He# |tm ufw wHa*. 64 m* HdnrtiMt^r t+**T h* Uma . *nd U* Amd tntak* M oofpliniri atfti bitiiHMi OiUwi 4 Miif* *Jum H'dftm h a i <4 bdmrMa v# (>*** W w4itu S>*i.a otrv i*rtrd mi 4>o|t cd 1 0 Ca l Ur flam daily on (fct arrsttl dap M m fit* a rakTUM <Ut Ai fedrwad. TU pAfwrd rwnwU Ta ma M-A^Nkr; Porn--Co m /. fdUf 5. 0. tti r u Ii pla ** * tm m, I M |M M . Ia m . +m lit f kM L m tt V l nAi L *** i l*` ! Ml WM* li Kk i Om NA h*Wi an* WiH | |0 n< <M Ma Am* K MM r|1. i rAk* i* .kn uMm< m, mw mim. in * a m >*** r rwfM wi h 1 0 lit m am MA i c wnUiAb!# ** atV*>*J pom and r<M( ud r*q*>rrd wrrralmi krdmcfcWai* lot rm ia 00 6hW kf>ul da? Mr w Im d yanpA----a urn lb* Milk linfaul 4| am4 nnAanl k* Ikr r^*4 cd lb prtU v4 Umt t Mk m. thnw* hr K* ! >4 4-rttt* hr n g'*r a V*b cak*M tfn for win di;i, (kn fvrnUr 0rt i.# rmi dm |Am* a k-m <*-<>-mm 4m< U 19 d*r* Af*rt hr Kad mnnd riU* rra*r. 49 1 .m fra dtp Ir rrrn davv Ov t a ^t m rnitH U wm day* Tbi br VM g.rm lMrbiAir. 4 9 I,m 1 -<*r Inin Ip* ritnr dirt Ii ia 4<dvii frWia (kr ^iTAri n Wm4 nrfMi* Ihr lhr**$urc fr-am \k'*hjA tro wh tSr >o4 rirfftKa ia *0 <> >" rhw^) and <m hk 1A l'^ tW Mimr? bad 0^7 p^. ft L*r. AWv 4><rrf ikn |wnr lb knwgl'in t**m ta Ii Cat C*t J -- S O a m a 22 ftmt rM h*ir a m ik. 4*t**g fto Ur M*(b >rr to iOh mmm *wW4 A A (rnkr In a* ama*<>4W inndJi yl*ol tkm Wa I a IW M h 4 I * mm lbM 4 am twrriM la frribtm. Or an r*U< Ai!k | did td |imtf Mwr*r<| nrd TU fmM n nww iMimHrvr hnsjr* e4 *rdr mhAU'A* (d knd dval Pm* to 1*^1 nria 4W** a yf"Arrirt h*4 Ur iapt>lml I^j 4 hjUrMTfl!| fh# %*k mm wk^| m a Ww<h and iwiik nr fr nvVd hr lb nn, So fAfarH to i*r frftotott tmmontif ? s hhj wb "in mm mmp LIA10851 i $ 5- 0- arm teMi4 V* lb* kowptai iat ear* bwu at )iifcdi<* tm4 AHmmmJ fata | am *w*r' dwr ?<(*. hr4i*to and duimw ccrutnn# Mm***!*!*! p iat t%tm nwwfct. ati aa^p fatftfw, irrwto****. toT*ab*:*tf M duJutbmct o< K#tu 4ww| rW ptmum lw ante Ai ft* * ** <W Hm ib* p*uni ibMfV* ib m in tut **k %a* nipiiidWi fit <Ud i4 M*k mh WJ hiip 4ti hi WiWv k4d bam Ik kik*4 jilVit |{* mMj c aJ kMtory *w ****** **!**< a*4 yirrwi anpiiMni iipui4 kta* t* m bs tow Mi>fli rbr**l **fcm*n*iju* cm rmW eainn^flp H~t ^t ta d* irWv t*4 * iW iWciH**. Tk* fu**4 *u <*r*aip Mu*Bfa*ukw* but ** m<i>y fl, Tkrrt u i W*4 U* ki*mji it* w*i Mire o< tb* tacoap*Aa. TStrt t m mi iAi*Smm |rHr aI th* 0)*i t*r* knt no nu*iti bwt^gv Tk* UV***fcrf> 4ai* cnlWttH W lt**4 to* t*faU i Storm) m*rrc- %*+r~~4 l errWl r*U at t I **k U6al * IliWi mi kMt**ii #*p*J**4 at Mtn crtH. tow***im* Mwpink *m>* rr*aw m W taminli a4 **4 crfc* n*n4 bp lr*4 irao**rfc*i Serial (rap^f ***Am on Dm f*toM*r fctsH \ A a Ii < t8 I 8 0 I3 0 I0I9M))0IM TMt -OAT* Own i <t* 1 5 O) -- Tb* to^4 )** rr<TkrM **u/f W4. iW W4mi twt raarr *-**<**T*rf* TW tr*:*4 bWfc* rrytmr* c*w n>Lw ctorat* tHvrapp wilk a kr* <m4 r4 art e*pta***l m lb* toil bp l>t J W Hurto at il* TbjnvlVi Unawl (AtorMorp rmM fc*--I MbMni tVl^r rtwfr t*t l>r |{*rr* hpH t`* 1 to Wt * tu b* nr*trrf. MM* <4 ce44 Mii. ( f . (W *Vm. *;.***.> kp*rchr*mr !* at A* fvtxnf't m *Jl id*** 4ww M (S* W*McS*rr( f>n*rkj Ho?*ui toh&n4 lb* rr4 Wc4 c<Hi to U W aoraMl c--*M lr**~:My *| ta l<m* NHf^ *r*9 <kr>*Mrin4 m rh*Af an4 an ta'i/tiax+m at t**t or Th* (*-< tin f<fkw k}'<M c*l'at bp tokjuth m 4>i >4 5 fm. istf toi-- i*f mi A Vj * rtorn 4*< 1(< ni^ttin ntpam u rt*nrk*SL, ml itwrt 5 kkUitn tS* nami Ik iMiw d Wm) tod <Tr'>^krp.` rr*i ^*S tS* pr-^r* \t\+4 Dm <b**pf b*4 U*tt *mH f li* I *k. 4 m m*lr< tr*4 .*4 lt*r lb* p*'irM r> >n*Um*4 n| lb* h*lf t* r>4 pal* ttock b* b*4 < *4*r*n )l m {f*rf*< fbo* 1* (nl I X A ; *. A f. *nH V*.* k V |t *4 r#ll * P)**4 *s H#rPrW* tx***. I *mrt |i^4 W (f t*x t. K. Mi A'l/k, K M. )r U")*i |*r. **** VK ^4 < *s*t |iWr4 ; Urt HI ^ Cl MV* )> mi w? *u UVc. 8) ir> tnw*(Mn*%tk*i | D>wn*--4. Krw la|Aw4 i*n l : # *i. i) h w w .i i w 7T LIA 10852 Q 7 Cfcta mitd mb '* W*4 w w^*M^*t>)rni tfti r*rr#4. Aftof thr wfartiai^ Wtw t># **hr (4 *>* titrate ') A k^* fkwrt d*rt mi lb* torri* <4 MDmry b4 mi C*^XT^**'f+<rT\m **K h.t>{4efrf *hi.*vvv*j p*a aM f.r-fr'Urk* )*4 bvra 4mc*ttoralttl fh* t+\*r* vi 4<MrSff*'4 <> nr*tt ilirrtpy /hr i*>4 Ik* lr*4 Vmt frt4u*I}f TiMQtifrd !l ri mrtnrr lo torn** niUu m 4 ftjr Cat |iw |#i tij ft* rt*Mt Om knn^hta to m AWf*> kni 7>* ia imM w w M to to-vrfc M wn<i w| ImI nipav* it4 f*J tm*at*4 *****Wf *il TW ft4w*J kr 4 l*4 tow* lb* to*4; by r\(fetkm to i the rWl *4 V*J k*U (rWt Ji U tU* <**. toSatrrrr |h# wi-hunii, tfc iiwi iwitofiiri <4 kt^MA rra*r atfu*Hayirf km CAk.mm *Ka W# ap|4*r4 ha hr *4 i*J Ciil 4-4!. S. i 41 fr+f *M a Wi toto <4 JWvth 4ri, ^i*4 m b p>Wto a b b atari fJst* 4r,e O* eic>,f r*r |< to ki k>H<iA.'u4'atfi 4i f**fl >4 H ).4, hr >t*rtiM4 Wtha 4 m>f to*4 !}*>*** a tb *t**4 ** W* timrtiFnm (he mi t4 toiW w I rMfto( b*m (Jto/J v 4 toU ft K) n4* w*n m4 (hr MnM ff lr*4 Ihr WBM 4 C K. b4 W MW *rW fO U V 0 J *# ai to*4 p# Ur > to cwtoto 4, ftorto C. S. fto c+m < tow i Mr* ia m f*Hf IW u * * ac -LwM toto l ti ; I I ") itoMif m nm r y m I* M U L h* N4 *WrW4 b4 ^r#< itoi 04 thr |ra# rM. If m 4wMf *V C S *w lh mm %to 4m4^H IU p4 *l*l h*ry fmiW thklto4 w**toy fr-rt irvw^wltf la |M4 (t0 r*r kto*ti i {. S M Ifftoto Urn Wart>M h irtfrtJ 4 Milt* 4m H( M 4jrh m*/\ <to iram * m4 U nA >ai tSl to4 mUmtri Mr r^MH4 4 (ever >4 <r a #K 4to*tA Anhww m ito k*l br */vl y*f pmm. Km HfwWU t||hlift*ir bto/ AM t IJj \Jto tn i%>n S* u H Tn r/| ki AAmw** C. V !#(iii W> *-r4rf ^a* r |W !,/ ft* toti 4rr VMn IS# ft'MA ^ * j A-t *M* I*t}*< fr-4 (',* UW 4K. tM if TV* % , ifi*t a 4 iMmt'ia a'4*Mri m c'afi ** ^ *4 (r4 }aaW4 *w nwto **! {** *n lo olrart toW**>***4 h r* ml hf Itoijlh. ||[s*m, I* u**4 i* ir*^U *4 r4 a>HfWi *rf <H *4 mwn | #%. Hwia* M M>*w a 1 f**M M***4 ^v * * At *'i At r*r*trf *fkr^< h f FtM~i*4 10 Utof to* t** f * l**r>iW U rtS ibft, *. to V* ** |frtto4 Mto 4^**' Ar**4 ln/*tt* l* ' I* (Ml, to (tl. U fimrmtr '<* 4 it ; < trtli (yiwtbrihl f***4 HTim too lto*t*4 to**. h to>l t*t*v*J Ur 44 t** p Uk to* mmk m rtor t*i u M* i*M!r (*4A i*t* ( 5 W** ft fi a*4 W n**k l* Um p*iftM aA** ho toll Or brfMtl Ahrr a* toto*tv*l <4 H*tW7 f4 Wa HV tto ftmf t|M >q*ntoAw4 <4 i t f y i [ L r- r ' 'WW'BHPWi ^w s w w m-- awimn " - LIA 1085 3 H W*4*rW %M ikVwMMl <fMft Sk * h Vi w m U/ft Aj w i <m*> w 10 to tt ffibi (4 Is 6 (m* | usatty H** *0 rt *4 JO j *t **s **** Mnrtft4; (tow tsssft ft M i Utkd in frlstr Jfi if|4'M, ht ** lu chs Uk*u<Ww4U (jfisfftl IlMfHti fiiMMiM on msir4 ft hstoj **to UMff W k**4ftrb* *4 bbswl |a* I.#**y4 to# wmii *m ^slpstra to tW *fc4amra m4 )ftS>wr Mrfc wrln, itoft m * ftUwsnisi ffeytssJ W.^II Cm**to s*wtLsl msn>i IwiW M M Iitf TW fslasM ft st |4 V4Mf4 W M bfl r ^srione h is W )<4*. Mb to Wssnrrtof ft ***4 TVm n 'ftni h*/4 to mlan, *tar* (". S K*4 tom ari $>* Im yMi hs4 awry twMilr rnrirs* k* 0# bilst *4 tnatwaf to Hwt (uSflrt# rf H ti NvttvWif OAffiMlUk *Wh >^Wi4*f gito*ir*l*4 tiw nlW* ti tnaVTt ron^JjMi <X |rr*l tMrrrft *M (h* S>%rrj ilftl 0s paisa** |rsiiin| sfttrr csi b lifs W4 0s |fBMiAU ImJ |flj$ ppm , sk to*sl ttSMftrtsI Is bs a 10 ftfimi fstta#, Im i m mm *r esnuaf 4JI Ml QIJ l f4 M pit f<wv to w mm. MdxMisff nnWntiW wuto sWnv Us Iml fsnibr>4 1 C 0 9 s 5 S M 5 2 Osrt I ins 4 C S > --TVs *M U* s m/i kJ. fto U*4 las. s*fT TW Uki rr^nnft wii )< <ntMs ftorpy *Sk ft k-I <ftVn** <W4 **to Ms sy4*sw4 M tto |#lL ***!. 0ra> to 6 0S >* to kwl f*f hut TW rto'snrSy to On* rss *to Hm tails** In is* HJ *hs* imimi it s s s ! fMMs ml ***<4 iWttyy tin >n<ns4 Pj Pm cWt-sl nkf `4 W*4 W* ik ** ***** ykn tV k*4 ) tost bs** ***4 **4 Soft fn*4cVl> rwh iniv i *im' M tto M>4 y4asS. fms *]#* a 4>si *4 4 (rn l> Iimi m* 4ir In **sik fb* ifSfMM wtiv ((*>* I `f <i^M <4 / iVfw lm |* <it * ftrS 14 ** ftMrl Sl'fS* !!>* *** **m oirw tto<to* M to b #4 l< P**p lbs pto-sM f*tors1b4* (>*W lb !< (ftfM ttovaf*. C S m r*rvi4 to ft !> nVisa 4r1 \\W* tW * 11ms fitfsft* 0*fiM * s*s< tT<Mftos>M Miiir4 I>m m * >4 0 n mm'i tr> to* b*>c .** * s * | . >*#pr< *to i-s Ah ** Si* rtosrs bss, 0# fftliw MM to (h* |>* {** fV .is*f k' lu *4) to f-*r***4 I *'Wi W*4 Hu Iu mI) j ^ i n <ul 0* t>4<M fSiftft* ibflftf to ft iMlIif >4 S*fc kr<ii] W4 Miff*-* i i< a . to *4 tb l>ttl > i* 4 CJ t'rtimto to fismytoto <4 tosMrty to *- k S*4 to Hu** / * to**1* N to MS IlMS i I i t i ; e . { , '1 mm M Hi! P" MW"*; wjjfuffiww- 'jpwwpf i JMI ------------' LiA10854 1**."** .3 1 1 9 M Iwtfcri# or i UmmmI |a U7 W hit ^fuMnr h 4|w iiv v iumeUm* fn+mUf i)liw<4 In* thr *< ire*l atfnrtt 4 thn c a m, wKxb h*d m< tm tnd4. CunaidrTaUt mxeli * iw anrf (hr 4u in ht*4 m tMe J. T>r wmmty HtWi *r< ut *htmm la chart 4, * U)i firr* <ku on trad, gytfuryiyrta ami I* "f S* *ai iht* C S a* iU<W<. umn| and umn^ ia#r1 tm4 * da Altaian *4 rWvour hrtd iatonwatMi TW cocTettftVT af the Vi Inti, the ww|tiii utd At triaiwe a iu i cWmr. Coll MINT In iHit * tA the a*n jrrmmtnd hrfr there m-a* a rather uriVinf prM of fummlod tnh Ktlium citrate therapy. In (hr cate of J. S {c*>< I) it tretnc that rmal trad eu'rrtioti m-aa w|yfmfd by aodmm ckntr therapy Peftoafm lh*t n (hr Mon^r effect todnun citrate hr Swth.` iVrfujn thit effect ii pfiwhirrd l chanpr* ir* arid-hoar frnttrm n nKienrrd bi t?< tent{*jrar)r nw tn cartrmi dtn\Kir-rtjrtHtnr4f potfT mh*rh <rtiftcd *bm the tedium curate thrra|>y au rnnttulfil (levduMOO* nay rad fv drama triaa (hr data at hand. 1*j 1 r thmV (hat tbr*c laffyrdfcai merit (urihrf It mtrrrMing to txdr Oat urinary Wad mcreaaed during thr jrtvd m mhh luiiura otnir tfr-rafo mi umutext Urinary Irtd al*o tnc rra*rd After tJe miMai UQ (cmmr^ a I (hr time therapy mat rrtnatittftrd- Thrrr r> <<ntrxn< rv*irnce in ffr iUta l>rfr f<r*cntH that thr ncrrlioo <A lr*d m a * l.*urnrd m c I, * and 4 tn It*- kiium citrate thrrapy. tkdh thr |<t4>ncH alvw nuJ urinary lr*d ontrurmai and Ytv *k>w rw cW thr hrotfkitia to mkjtulf IniU me fair n exidmrr that thrrr mm* jrfwiinwr of tknram) acnuunlt ui Wad im thrtr |mltmtv iMfa c a m J ihr U jmentrd tod t)r chntcai biMory jit# rrmacaxaU< ntdruct that thr ftlmm otrilf drti|^ mat tr<ui in hamming Irml firfrlma and [diryt nM *4 Ah!>^;h lh* mmii'i e*|***rm ma* rriativWi .hnei. It mat in!m*e. an*I n it <rm*n that ciiWfa!wr kad mat MofrtJ m hit lun^t and atwnrhrdt ffuci l!<lc M4ii U* uMmiataw? iur t*v tmv ntt hit e\{*Mre traced. Thr fnior^in^ d krliTrm ofratr Uf a nutter (4 rnrrV* after t! i iiun'i miltaf acute lr<l jt-txaim^f mat Vtl |<rrtu|M etuIJrd tKr rrmttnuif W^tf tn hr harvDed m a nunrt to jertrnt eiarrftattn f nniptnon Sniff S O mat fm4 aIVnref to return t*> mi^rV inxJttn^ Irvl etfMife, hit lraI info\iraii>rt mi(l4 wtfl ha^e fuUmrd a dmiml enrrtr mHhnut mrrliratiuai. Thr j<*J4rm 4 ( . S. (car 4 ) it timjJxatrd oim( to hit Wmc<Tr4tm>r<f intake fd W-a*l at hi* ai! 4 U-rnr \ h i ca*r J. lh>* jultetd, tf free tfwn Ir^i fijntatf, n( 14 hate excreted arr>utitt tA Wa I mitUait lie u*r ai veliom CTtritr. M*metrr ita-te ran U fo th<iU Out itir ontrid id hi* nmjdmn*--aiw! in thr cate of C S Ifm mat mi)4<rtmt - tv a* achieved l>v luAcvtilly iirp oral ilntn iA aihttM titrate. Thr u*r *A ilnrr*|ri4 (It \f.) W> (hr ca*r tA ('. S It hard lo r>hiatr. Iremote tlr patirnt (intinunl lo take m utval) fltei rA Wmd from hi* ilnnktnf malet after Wm< tie U**j*tal We mere led to rnr (he axaiUidr literature and JtfKirl tltr t<Aerf mwmixafi/tnf rmtafk* MtUitifh diomtial-ei.l it m*i*I rffrxtnr in thr tfeaimrtit lA J****nn{ fautrd bf (eriam Imi neil tth at iMrtm, fuKl ami intum^i, thrrr it, mrth <nr rxrep* T > j, m IMWMUU lliiaild * wywf" V LI A 10855 10 tion. no cmrinrint cvidrncf ihil it ii iM nine in the tmtnirnt oi bod Jx**omnf. Teller' frj*ned one cut oC trod potttminf treated with HAL. Ahhoufti tfa* trcjrVrr >*> rttrrlipjf normal amount* ol bad iftrr reretvin* mtnvt-noui m/ectan* <4 cak rum fluconaic for three da) t. (hr urinary Wad rxjw to hgh IrvrU ihtf a arrics 0f dCTirrta|>rof injection*. Wt have Urn much interested m the Mf|fi(ioa that urinary mpropor- pfcyrma Fe urd at an mdr of Wsd intoxication. Increased ctfeupmphyfiflona vat kmnd doting acute iUnc*a m all four of thr am jramitd m thh fv^rr and well \*-iu*r il< *utr ejaaodc in at IraM two of the am. In aQ cates thr urinary Wad and a^rrj*iq^jfin talor* showed rrUtirrfr cnrrrtat4i. It should tW l* avtlmnnl thsf m til ca*r% thr ;*n <4 cojmpi<rjJn n.mf-j wat trra much rwdtrr than thr sitting i4 thr rrd Uc k s J crila lo thr air of S. O. thrrv was a gmt tncrrir h i cr^doporidiirm rurrtMi, acexmfmmrd hr an absence of Mifjfdrd rrd bknd (tfl in thr pm^hrral On thr ft*ofih ho^aul day. ttiffdrd rrd Mood frill rrr f*iod tn thr lw*r marrvw tmrar |iut nut ax (hr lioof. On thr uith Mjtai (Ut , tn>jWd rrd llud crflt a^nmi tar the &r4 time hi thr pmfhrrai hJ*wd. Frroi thru cn there was a gradual merratr tn thr ftipydrd crQ ount, ibir Lmh urinary Wad and urinary talues shoved a dcm'trward trend la thr rate* of C. A. and J. 5. thr cufrtjporjdtyftn mere* tiro* urn rlri sted mrll !ef*ee thr *' m^4rm* devrw^jrd. and during thb tune itijyVd cell onmt* a rrr normal. In thr rasr of C S. who had Wwd fcatnumf oier a kr( Lrth thr ruftixn <4 coj.enj*iC]4ri no and the alluding of red Crfla were merrawd la jciMulatmg tlr nmhimwa of thn increased m fjwnhma, it fgw'ari (mn st tailing thr^r kuf am that a n n>urrh [uwUr iat the mrchuntim to un in different nm It u brlmid at lh tunc that ta thuar acute pouocungi whtrfa dnrlrf enrf thr relative!) ahrul (rtwi td mrtil month* and which are amattjwnard W anmua and irvrnml iiimn, thr Bohanum i (hr to thr ilrUnKiire c4 thr frd trill. whh loiii t> a trlrir if whrh thru fnmrrtrd W*o ciT-rnporj^Arm in thr In it a- t rxitned a* *uch in thr urmr * A oh 1 and ln aci*tr hair aJrradr drK-nhrd thr tnrehanum of \ (^tnrK. F G. Jr. 1*1 r*cW, H: FJhirr rf >tl. i1J V*m*mw*wrfqwat I la Trr*<rr *d I v v ih w miJ ( #*4 h^oarr a kH>K j 1^1/11*^ % Fj*rt TWftfi tfi hT rW W T lat Lw Ik St t , | A, Jr f* d FAL b hr Tf**<wW <4 |b !t k m F Fnti <4 trir. Wmarf and Ottwf MiuT.< Frai, Ann. lat Mel tl:U(. 7U <r*ct* 1*4* fiM*. M A , la-kr. U W. and Calt^rv. F! il F Arsry id ZSrhmm- (KIL) tm rVi*f7 rd r<4ua( h O mf ai<i id Aianiy, Fh mK Or* mp b MrrVT rU \-WL J P>i*rubied k F ifrf T~Srr> I *br. U 3d . Pf*^. M A. w4 t *e- P- P F ffrrt '< Ml tr Ftper******! li Tv(U Vwm.i I'fianM t . (*rr k<d ( Hirt V t r ^MC j. lab* Hi* A Tn,.,j It, >) rM kd. ;A* Str-WY |( W *d ft A 'fact* of (MW )r<<l*<rd t F* M ) <v K^ii 1 (*i | I *a 4 n fcf*d ll.MZX 1M7 ft ffc* Ft VV . tVil. ), *wX kd*. It K UIo im td t>tH*pr fw*4 (FAl.) cm Honan trad Undod****. VrKTi IM> t~ ret iX tc. 7 Tiltrr ) . l r <d r M m 1 rod V~**w+. ) A. M A IMtft&ftJff (X-. 1W7 frrrwibn M,V> flaw J) r>*t t f) a r T^o Pra>l>haa t rtu#r i* t'finarr hwn b TWr AIs mi t iwv tifi iH VV(na. t*_ I it VdaiBf IV r>- t'***r m trad J1 a* Cam<id inti Thai T !*! 4 N ad a* (>*t i a mmk . J tla !<mihU(a II>177. Wa . iuaji L IA10856 '~>T*lii.t'<><< *t*U 11 inmii rn phsot^m His explanation of thr "hittrfw|" of the red blood ecfis to* in well with thr abuse throfy, However, there err many raws in uhtch thr exposure has amimopd our txnrry years. and tSrrr h orjy slight anrmia and d o icterus preset*. It is Inhered that m frocb case* Rtmufim'i * theory (bi bad mar hr acting as Modi hfua prut*^oephi nn and iruo to permit thrir normal comUnjuton in thr formation of hmu(Um msght Le pUussbb ri}ianMioa o( this inoYtird eoprmwqjb)fimri>. Polbwtng (hi hoe of [MtuUtkin, we WSrrt that in thr cases of 5 O. and C. A. o^eupucpfiirmuna tnrfrawd because red Uorjd ceils were t*mg destroyed by Wad with resultant rebate of ieuti^xr]fn nn. hirh was cumcned into copeufsjryfiyrin and everted 1q ti>r case of S. ubo had chrutuc bad poisontng and wb bad bm taking m Urge amounts of lead for many yean. h is belirtrd this (hr iocrtM of cn{rt>f*e|>hirm tufc pUcr in thr Inue marrow uul might pnssihfy hate brta due to a liekmg f;y bad during thr synthrus of hrvnugiobta. Thr our tf J, S. abo rears to hsie a sorrlut van>Ur mechanism as thr caar of C S. }losnrf, a* cs stated pmmusly. although many thrones Hair lent set forth, thr actual mluftina f thn tnartml asprnporphy rinuna is not drsrlr under* aloud. It 'in af5<-ar. br>rvrr. in retiming tlirsr four cases, that rather than ttMstirg Out three mu* l< mdi one mechanism commun to all cases uf pfumbiam. it is met to mr.sajrf thr po*uU!rty that (so mechanisms may 1* present. rsjec-aCy in ssm of the tan that L* eh thr clmscal and thr laboratory findings do nry from tue Is (Of. tthtb thr mechanism tf thr cojrr^rf-jfnrimma of plumbum is sot frlsidy - known. 4 ts knr>a that as onrsvd eacrvttun is arm m lead workers absorbing UrgT annum* of lr4 and al*> in casrt of arutr and chnviir bad faasomrtg.** It has recently lets ngyntH that the finding of cuprofKirjfirrunm* mar hr a vthsaMe a*d sn thr penrre-n nr early fl-ac^'u* of |JumU*m.'* Kluvet * has bond thr mpeMfs4]*hirm to b nmuQi jeoeTf in (b tshttr nuttrf cf thr tentnl nervous minn of ammals including itsan. This has bd tn tfrruUtsim that thr nruntc fotn. hr*!*}*. enrrphalr'f *<hy and aUber.inal ciJsc jeetmt to plumbum may le raffamrd try (hr CTjjr^*jrjft>Tmi deposited in thr tissues, \\> thuwkj !kr to rpt><r (Sr rflnrt of citric and. as to that of sodium otrslr, on bad f *< rrtwfi tn acute jfumhisni. \N> should bke to this mime thr effect f thr citrate ten as opposed to thr aTValmieing effect rf sodrum citrate. l'ot>! such iJnerratmns are cmipbfe. freedom from bad exposure. if artausaMr, and cabitm* thrrsfy whrte rwnbd, arr drpendaMe mram. Smce b is nr4 alaayi t It TC-S, ( Tto U t'rA/i f**d 4 trie *Ss Uh writ (Kis t9r*M !*; ; A U V IMiU7 <Pt J* I Id <*) Wiiri f C K*4# d M I>t*r*r I VcHWanr# of Ciyrim 1 *fi UWWfv Ank Ubit M;f k OrcQ, U4 li(Wnkl tMO Wmm* II 0* I etn> ( f, SMf %-- IU| f A (. he|*;ns h ih t'Hm a IVe ti\m4 Ki m+L IMt^. iUX W.MmsA, I K. s4 <nkss |L W.f >W fW iWf ht^ifis Tn fce leaf AWeyiins. ,Vti tuba lira A r>^ u4 I r-OM <y*eito> ITto Wslnol** If IOv* M <b Nsf^sih Hi 1*4 ks tto CatrW fyasms. pmm !t>s s m i w P s i w i M ii i m p * *? wtws { f. y*' wm LI A 10 8 57 4 i.............. . . ........................................................ _ .. 12 pOM(4e to achieve the ntol of no tod rxjoure, a U pfflinnK to continue to explore BartfexJi by which to form cr*nj*nr>d of tod in the body which art to* toxic thnn the lend ton and which hittrn tod excretion. tCMMAiy Funr run of tod poisoning, acute in three and chronic In one. bi which the pxtimi* bare here trreied trrth ftcxtriitn citrate. art pnmto W lxhere die evfetoce accumulated lead* tn the (csknrwf opifiau: 1. Adequate oral doare c1 todtum cxrate will a*nred t)w aytnpuxnt of tod ftttftoninf. 2 Stndire of the tod excreted in the nrmc in three to cure ti Ucic etndare o( tod excreted m the tore--do not warrant the (ooduto that >< citrate merman tod excretion. X Studin of unnary coprtiporphynp are pnwrtti 31 Cdemi Street. Thr antrn err frt4f U lira C. H. tb* *1 B F Vi f-'rmm i%m ^ ilr *^ Uf fvitMt. S O Mrf C 5. rm>ui<t> T>* vuerr ar* iW h R f W ftwtio wJ f*. tV |V^W <4 fS rSwwrii iul W (W VlaMadMwfU UhuM d (knre**l Hjfvfir, iut ^rrijrmi ib* M ewil|ei o -i'**" - " r........ | i x*" ** fiM l >4 ** *W I IMW * C SMS'.iiljlWji mwenwyi wm.il i' nnj'^yiiiii|jiiii)^LiM 1 " iisur1 L 14 10858 wt w i I * i i i i i 5 i - - . * * *i l. r\z American Smelting and Refining Company by Jom N Abefv^j o/xl It '/> N* vr> .VD!,,\'<TWAL hrfim* Km ln d*-ftnr^ by Pttjr' I t* "Uw rve-rice and art of recoCiil;Hg. evaluating, nd cun trolling puientiatiy harmful factors in the industrial eetvirmrr.mt " This dchnrUon implies lhort>ugft itud> cf operiUona. evaluation uf potcn* lull/ harmful factor* through u sampling. ttkTO* analyse* *.*-<1 other mciri. ar.d. finaiir. appropriate fned.ral anJ rr.g.:^cvTir.g con*./- 1 wh*-rrvvf indicated. The p,*mttiuo of U>du*i/)*1 hea*lh injuries u ft vital pari of ogwraUnm of Amervin fcnduatry today Progress and interest in 'hu field ha* increased iteadily foe many yean, Lhe moat rapid prt>f res* havini bom attained. perha pi. durmg the Ul three decade* It it significant to note that there are now official a^mcjn in 44 ilJ'.ri *e*.i v r 1 y concerned with mdu-ttriai leallh problem* and that a wrextern held italics ha* been rl auhihrd recently in Salt Lake City by the L* S Public Health Service to augment lt industrial hvgicne service* dir reted from head- quartern v{ National Institute of Health. Bclheida. Md Mar.y ef the larger induitnei have 1'jyM it advantageous* to establish thrir own industrial hy giene department*. The American Smelling and Ref rung Co k world-*ie crgahiialKJO engaged tn the mining, melting- and r4kung of lead, copper, xane, silver, gold. Xy -pr\k 1 jet irw-ial*. tncludiftg cadmium, ftr*m*c. nd other* In the L'r.ited *>*atc* there are i j ameivers and crfSnerie*. 11 see-ondary smellers t* TnjndMe*. and a u-U< of B-.**ca. Ap^.'v.a.muU'.jr &CCG work* ffl ire rv-mva;,y cmployred It haa <t tem the e*l*bi.med c^enpanv policy to aeek out occupational bara;.it and provide safe guard* for errpioiee health Prolrrlite equipment has been supplied to individual worker* and rahauat ventilatK.ei installation* have been m u*e in scene operation* ft* more than 40 yc*r All of the major unila have thru own medical department* which provide employee* with excellent medical and boa* ptlal care In 1937 full wale industrial hygiene studies were undertaken at the .Seibv llant and *t* attended to m/t of the other uru!:^ d jnng the nest three years In 14*3 the Department uf Hygiene was organised with Profevaor Philip Drinker of Harvard University as f>/teiof and with Dr S 5 Pinto a* Med w- at Directs The department t* responsible fuf rorifdinatu-i ad maintaining a program fn? tl^* go*d health i*f all err.j ;<>> re* f>*m top mangrf>'.ent down l th* 1mmI j a m! dy worker Jt rrntial!y *erv>c# ru g ant <atwui **-r*ing ail </f the Trotr*! State* plant* ff|fJ> f heatM-n nr i/e f ull arwt (ia'1* time (4>y*r *m rtrjUwreii n, all tj 1J-# r<en|>ny i American p*ar.t ar.J w^airg in tt.*e < unper at uei With tfe Victual i^irertor are (<*r rw* ;0mn h AIMWA.0 m4 I w uuwX lkt*M be* *a Mrgwae < ** s **4 lrleef Ck. W Ui (n p*a N>n m *i * Ie Tf Ml 6 * M m--* 1 / <***> H Anal H iwa I >m *a-- ,-* +* /* Li tno H*m fw4 Uare*. l*vet lermiolftg the state of health of all the employee* and giving tfeaun-r.! when nece-uary. In general, medical care U re ihed to aendentt cr Ulnnaea ocrurrtng while the men are cn the job Among the duties of the donors Is the making of careful phys ical examinations of new employes* and routine check-up* of old employee* In addition to med.caJ care a primary respond- bilily of the department u the pecrewfum of ocru- patxwal Ulnesae* In Uus the mam concern u with the working environment in relation to |U eflecl on the worker Unvirorimenul factors oviy be duata. fumes, gates, toxic materials, heat, humidity, radia tion, or noue The objectives are- (l) Immediate control of thc*e factors through the r-l.^-sUon of the worker, througn providing the wearing of resguratnrs or other prolecPve devices, and through Careful medical exammatkicvi and regular analysis of urine pecimer.i, (2) a long range control p/t'gram which may be acccmpluhrd by local exhaust Vvrulation, writing of cr.atrnal&. changes in metallurgy, changes in methods of handling, or by use of special drvkw and special equipment To accomplish these objectives fin# Industrial hygiene laboratory was built in Salt Lake City and equipped to do routine and experimental work. Trained and experienced industrial hygienists ob tain the facu by making frequent hygiene surreys. These surveys include tesla of the au. studies of all procesws. c-4-'c-'-l lr.irt*.igstu-n of vcni.lsUCh. lighting, and general working cveiditioeia. Csrepg to rvnergmcir* au c<*ilammants and bfUn the utwtanrr* handled by the w-wker are sent to th# laboratory foe analys.s ty chemists and technicians specially trairud in industrial hrgien* methods The hndmg* are evaluated in terms of limits recom mended by various State and Federal age-no**, and tn light of all available medical data. The methods used f'X studying the working en- vUxjnment involve ail *>f the uiual chemical and physical proecdu/r* employed *n industrial hygiene The 1/npinger. elrclrvc i/rmprtslor. thermal pre- npitator. filter paper am; Srf have been used to coiled atmospheric dust and fume sample* Of special Interest here it the filter paper sampler, shown in Fig I, which was deveh/ged by Dr Silver man at Harvard University The Instrument nas teen Imt-rrrrrd and Is used very extensively tn held stu Jies A water msAorretsi < nrr>ectcd tehjjvl an onh^e u uted to ddrirrim# the rate t f air f^-w Tall* bratuei li rfTsrtr<l by use of a standard gas meirr or rtrtamcier The d-**t or fume is r.U*1d e> filter |tpcr rlamied t-eiween two ring*, as shown in Fig 1 The filter i*ajer $ M n as Whatman No 12, rt'IJrct both dust and fu*re Wtth ft 'ery high rfTWrnry Tli* instrument U very Convenient arid easily transported T>ve **/!.,Is roJlrrtrd (^n (!# Alter fapee are ana* tyred in the l*U>rat<>ry usually t<y *e of a |*>laf i grsi-mr | ree*lurv |ly this p s k I*;! it Is t.v tr.raiuir quant! t a t*e y m ft s-rgls analyst* u>* - Isae.nS ^ooknac Of AxgfMV IH, N I, J+m--n 144*, P >V **4 f'--Aim*. Vd ift4. ft >h N 305.03 I.W HlfjlOTI^WB ,W,i.l4p.m T LIA10859 At ... I--t **** MM1 MM>* cor*-*!*, feed. cid-tiium. and rinc in each umpi# f '.in<n;.h;c mevn:i* are a'.*u u>r\i for the drterm- i&aVioa of * number of other elements. Duu of vanc*ua type* are the most commas mn*arr. man t found in trt atmosphere of the various pier.U contk.nini lead ocuie fr,ay be fuund ix> cr-rUiO smeiter and jvAnery wwk *rm and are given special attention since lead otvde U more resd.iy absorbed than other leu aoluble lrad Cten- joyr.dv such a* ihe sulphide Other contaminants inch as csrbon rrMnoiiJr, nydrogra sulphide. sul phur d*oide, selenium. tellurium, odmium, and ar*enc rr.sv be {c-und and require study Certain of the (iKi fttmt*or*d msy be toilc or untarjl 1a order ic be cr e\itanUy on (he alert and to be earned in idrucf, rapid Arid InU here been developed for hydrogen sulphide. chlorine, and anine from ba**c British method. In this method a small hand pump U used to draw air through filter paper disks unprefna'.rd with various reagents which produce i at4in if trace* of fas are prevent, see Fig ), Thee# stains ir* corr.pa/ed with standard* to estimate the gas rnft<enW*l>ons By uae of this method chemiata and t*!*ty J.ftKUrfi art Ua U <Jm* the working envimrvrr>ent fof *upwcted danger* Tor one plant where hydrogen ul}hu!e U being used in one of its operation*, a machine is being developed to sound automatically an alarm before any escaping (U reaches dangerous consentratWu. from time to lime certain arvalyaet requiring highly specialised traininf or eery eiperuive equip ment are performed by the research laboratory or og*xie laboratories; fee eaampie, spectrograph* and peUr*r#;4iic analyse* Certain type# ul re search vnrk tr.volvinf animal e*p-T immolation have fc-'-en performed through grants lo Harvard Uni verity. As a (art of the fact-finding functwet of the Ify- fierce Department. urir>e specimens and frequently blued tperwe.ma are obtained from all worker* et*-**d to lead and other metal* and namtned at i~ i t if V *' fa 1 V-- fph'f-M imimm* I ' ..a ; 4 Jr* J , , *.-* r t>. \Jfi the t.u j i (have *'.; *er >z s tfc* kSed.r'fcj tr g / rr.vaa r*'- ," -ixOalloci# for lmmeo-(e |,f (ecticn of tl. rvai.ittjun of hii ( la an Important furwi. n <f U,e Hvfiene I>rp*- * rot Thia involve# in part an appiaual of air <w -j .~+ and (ha rorreia- Ucaa of thee a'.udje* with r r`m U d*u. Wheat all the far-U are brought together, 4V*all avaJuaUoet of the efjvtf'ori.ment ta made. Vr.< need for eoairoJ meaturve determined, and i r^jfU./^ated control program outlined flec.emmdatur.* for ronirof are rr.a.ir iu (he plant manager and pa^ed on to mciryen eapeeiai^y lr*vr,J Ia /.duatr^al hygiene v#miUtne\. Tit# p^ant manager and th# tuperifp- Imdenl with his operating ila/T deoda ivhal method of rur.troj should be ra/ne1 out ThU U logical becaua# control. may be accorapliahed by change# l : I. \.J f% *4 an tw i W UW M*w in metallurgy or methods of hAndlmg rather than by local eahauat vmtilation or other engineering or chevr.tcal means Occasionally control is no4 pouible by engineering means and It la rwcvuwy to rely on respiratory protertive device# and med>cal control pM<vdure Sometime* the reeommewiatKma far plant improvements are based on comfort alone lather than a health hatard. The vmiifitKO engineers fr*m a unit or a dJviaket rjf the Western rng.neer mg Department but work in the cloaest corperat^o with the Hygiene Depart* men! In carrying out the detailed rmenmendsttsm frequent conferee* * are held with throe engineer# and general plana are approved heat |-mpee##ie#t| f?Jmir>atl<'n or rieiiml nf all jotenttally harmful in U-e envnnrfent I* the pn^4f Umg-fang# ol^ective 5<nca 111! and ly during thy ta*l f-'-ur year* n*h wiH (ha* he* made to- rw >rh aa ill lh# m>IU. the <<*! he* very high frrm tea la t~fkty t*w>u*4>d i-ei worker f'><U<wing ar# e it "t the t>.|M *>t* <4 c nf du*U, fumea. hi, i (>M-e in (he | *nl* sit^rved through ().# (>>/tlt>incd intcreel *'><J eft ft *4 n.eregei* Su^nrr- inlenderil* g>*te f .remen, the specially trained itaff of %*r>.li:el`on engtneers *J live W`ester# 0 0 weaveeri "V WW> .yil LI A108 60 - we V*T > ** -.4 ; ,,*ci '.r. i . .* *f, i":. < * J". t'VT C-C* { \t? v * * a . .; k;, i '* p. j ' t r<>vi.{.T.f *. ; w*. r*-n ort i-.-u, :. ?r it can* 'V A . . ll* 1 t < i u*vJ *** nrA/ \ocm1 re La ij \ v*niti<uuAb>u *Jut ..* 1.4*1 ty bag- Ii'iu m nr.:l* and i/t p ngrrr'-nt % Dec4 .*e cf the very ? ,gh coot, pcr:rr.rr>lal work Km b-*-n conducted to And other tnct/ij.*!*. *pr*vt produced by ocr.iXing water with ewinpfeaaed orxr hove teea tried T\e minute drc^irti < wolor predated by three *prayi octuaily Wei dual perUciea |ri,. t. .... and brio to reduce <y*e r-cope of duel* at the oource. yet they avoid ob>ect.inr.obie wetting of the flowing material. With Un* rt^-hod cf ciontrol a iO pet re* 1% j--- m n lm fn , *t W i.w 1 dv*rt.xjr, | dual (onrrnuttMrii Ui baan Khwv4 U or* mill. Ovipnl-Lloyd wtmlrr /'Uau Wottinf, crvkw'iro la cectola knotorvea proUctioa of tho workor ko* and Wxml cxhauit wnulatic<o hart bean the r*tn bon occ*>mpltohed by vooUiaUAg o a 4 air conduiioft* Cipmi methods of controll^r.f d^at and /-~fr-e .n vro iAg email *rtai Sr men murk, tuefa M crone unlor plant* Water rr-ay t<e a to cab* when the general rentAiatloA of the room would both first and orccnd-o^ rr chare*** at lho boil tr.ppor, bo drfVuil ii not ur.poaaibie. oew Stevenson. * la othef at tho miamf lab>* and aocr.rtuT^r* w;th ue cf puf- vror<U the man hao been "viUJUd" instead of the cuiia Water u used to o,wrch lho inter aHer u la operaix** Cabs of c t on*? ber*i.u\g orea, carrying rrmatfd and Lhe d-achari^ end* erf Ihc macttirva aro hot fr.etai* om furnace*, etc, art mropUi Thto kept tightly encloaad. approach U bevng tried now ui mill* by buud.nf TSo cantrof of dud* from cruahlnf ftrat-orar booth* kept und*r puuilive pressure m>th fi.lervd inter haa been effects, with local oiha>jal vtrU!|. mc fee morim mhoee du'..fi c *a bo earned out friom ton and cd;<t*ua / duU with cminfufoi am* tuefc o a encioeur*. pinerment waahert. auipb*g Boo-** Local rxhauot ventilation and food housekeeping have been uood eacluaively to control duct* la sampling roewna, wv fig 4 Modem frindiAf and amrr.pim^ #qu4pnaont tro email j oncloaod ud lho duat coo bo cwtrolkd at rrry medmta COOL Bed* omd CXoep# fliu Wettlivf. mrlomu/o and f ihi v rrs mra br^.4 uad f-r c^i.U ul Tho duatwt Dwtfht-Lloyd nporauon is tho re moval of drpooiU from wind boar*. Control of then# duata haa been efTretrd by (1) tuo of onckwod pan or arrow conveyer olonf wind bom with draft mom tamed on lho boar*. (2) wetttnf by tnaerlinf Into the duat pUe* a water pipo with Aowtnf watar and ()) rramtenanco of a water teal in the tx*U*n of the wind bom which cumplrt^ly **ti the aceu* muitir.4 du*ta In f ig k m n.wn the acmance erf of dturU In aut h r-7 upmaat t>at control in themo 1 .t! dviti after writing with inaertrd water rtpea drpmrtmonta U ant of (ho meal dimwit probirtnc, Wettinf can only bo uoed to 0 lur.ited defrmo bo* Coua# airru moaaturo may rfeet lho romatmf of cor* The water oral haa boon apphed only to tee*evd-wear machtnea Good hr*aekeeping with frequent wadi does ct Uin typn of cKarfro. Booct ta very important Ln control of dual* Thermal The unlood^nf of trucklomda cf coot and coven* air current* plua vibration ran redtoperae Ml lied Ira lea for iu>ti|t or m*Jur.| up cfvarga* waa a dif duata # ficult problorn to control in ono planL The Ana) aolu* Conaxferablo bnprovemoDl In dual and fumo ran- Uon w h found In a Ktw'nrlo*ur* and hood with cen!r*i><>na tu efTrrted la one Dwtght-l-ioyd plonl hifh rciumo *1/ intake by a change in rrvrtallurcy. that u, a lowering of tho n 1 percentage of c**ke in the charge Lirctaitt feat ha* teen {fnl/r-fled by Inaulaling wind b arvd ar dvwli and by ute <rf ia/gr mounied errer the pallel Immedialety beCii*-**! ; ./rcn and runnerled lo a alack for gravity ventiialKoa Lead fT-erf rvivace* Tf># make up of b:*o< fur nace rhargva fray Involve d^ity 0(wratke*u |f the wring-vttf mlef ia rv4 luT^iently wvtted 1"ho tMer ia ^tuaiir Ured In h >{^>eri and It haa been f <usvd f^ere-**e*y lo provide ethau*t itnllljtue whew V the .Mer u withdrawn The r<eit/id 1rf lint arid fume at the food lo the bloat f^rnaie it ect<*rr>pli*hed chiefly by |<arf d*afl ia the f>ii nave The Ud t iaat fur k m# rannot be tatrywf lr aJag. c* f,e l*ed if the temirat>re it h fh wiif^^l live ganeteU'im t-4 tni-<h itad fun-e fume fi`n theao i ra<ei*t.i<ed with heal aahauat at ail M 1* n**vaary to faae aru If *e r^ a- *> *h *1 ** ---a h i heW j raeourvmiir and worker* have etiiiw heglerled IMi d .ty t-etauae rrf tho little etlra week I 1 u u ij w it * >w m LI A 10861 t s t>rm a dual. amt unhvf >*e*ir aparat''M\. ?eT<h~ r??; :? b " .i -*;'--n. r /-.r.rr*r a.-id t <** a . .; f. t! * I: :r(* r y r V ' J ) 1 a ".t' 'J<*' n< '*a3 Vr*ra- u. l'j^>r ncx-cr t-*.-" n tf. 4 Tnifc da>'lC4 irf v<a u art ffVt'tiA jrt arid cKart>brT nTS ! tMnnd A orcolor wr'.rr ij*isy Uirated near Itva lop partially vrti Uir 'UHi at they p*M from Oua to tar Tr.t wrUirvd of the duatl u corMinuad in Ih# car and mmiffiiiM diuuni in late* handling. I S J. . - w *+-4 u-* fc* *! M 4 -+rr%4 Wm Ua4 4 Ct4ir#Ui The control of almoaphartc da*t reauH^ ing from tha cleaning of roltreU ho^prry hai bean diAruil. Enclosed and ventilated (onvyuit along hoppm have not been adequate ftpUia ehkk create airborne du*U l 3j trrur in fcpile of the beat care. The problem hai Anally been aolvad by rvpUnng the vorhen with aalumaUc equipment- Cectrtc vibrating hammer* have nov been tfutalicd on meat of the cottrell u/uta. i required To overcome thu and provide heavier coo* tUur'n to rea*it tha heal. a hnud haa been wy rwrr.',.y dm|64 h^h (fl bf rtiwd lowered >/y *n e.*v-lfc nvoUv merely by pr eaaing * tottoa a* sJvnvn tn Fif 4 Stand*by empty or Altai lead poU fcarrve*.*me* cause rreiaidec able fume To cimtitd thia an '.fc-ii \Tnt.ifcir<3 fw*3 with flexible fireproof ify*fVodn Metala The mntrol of dutti and pin la the refining and packaging of by-product \ duel hfcfc be*n developed. Trvyi Co a Uu I of duit ind (umr f.'crfrt o^wtiUA i.f le*4 4fti rrmSntlary furr*e* h*j been circled tj adequate draft t*0 furr.Ac* I t prevent rvepe of f ..."n* el the charge 4c k .v and by i^eel rihiutl veeiti.elKm el the Lap Kaid *nd Uai>dm fue ipnu and milU Kfirle* On* of Iht mml diAntll pn>Wftni hM b*n c\*lrol of dual* and fume from refining ppm* Uavu in krtlln Complete of pflul hoodfc with cihfcuM vmnutiui turv bm rflKtiyp vtav MUk r? transferred M krttiev or whew njrnri ti Ant to r(Mrlt drttort Ki( 7 show* 4 pntfcj h<d VIlb A an ir.uke U the fume ever the a;*; fere / a lead kettle A* fcftdVf ipptOfcefl to rrdx^r.l dustinem* du/irt dr<w *kripen* frrr'iil work it now under way to (1) change the elements, iifcch a* aelrruom. tellurium, and cadmium, metallurgy. (1) ttnwt? drone* with *crew*type haa been accumphihed by ux of heal eahauat venti lation klmotl eaciufcively c *j T\ryc h with local ethauit vmiiletk>n at ptunl of The hyftme program and eume of the work that dtarhargr trio iktp fcjvl <31 use of a high veUeily i lot type rihfctid around H(r *f krlllr A fair dr* ha* teen done to improve working condittona tit the i |frt of lurenu Kfci been vhtrrtd with use of the American Smelting and K*-Aning Co have been re ! *rrrw-trp* rvovryor viewed briefly In presenting this information there u no wish to cunvey the impfe*K4t all ob/ectivea five* TT-* femoral of tr'.tUH d-jtli from Aura Kaa have been reached There are problems yrt to aofva. and change* in r^'-ratKm* and hew p*ore**e con- tmuaily ante htih require stud/ *rd ne>lrcd la roe *me!ter recrnily lfe minule*t detail# of corrtrof n a new prices* were wicked out before the plant was built in order that no chances wmjld be taken. T'/p marv*feir>ent and operating itafTi displayed keen mterr-i and co*ivr*trd to the fulleel ectent : The tame intereat and ft^v^rtk*n fruto manage s ment* i*f ail i-lan'* have esrt'rd in aSl other phasea i if !?. *ndu*trial hygime (rr>gfam and are largely ii . 1 -r ~l ......... rr(-x>MOie f<r what me*urr of lurewta ha* been achieved. t#f****<# 1 r l +f* Av si - \r-J f A r*t!i Arrrr * ItygJme Aaaor Qufc'lrily i *Wjrt l>*4l V Nu I p I W M itM>fcU. with ni i f C A ftbrrenatai Air < *(> ( *)* fh|.M#n>| (fc#fw puto* or lixlutrifci f '.rv'tetiun ig Anwfiea. i fee r V g ' ln*tilte l'ilt*t*.i|h J'* tHt i '+ ta Mfc fc^a M ra toad ' federal J*Unl aa fto*^Hing and AeAaiag Ca. w **n * at to*4 tow* Altot^. (U , l^ithef J hu<k. Manager ! i4 ! l