Document YDBDRyqkBNxynyLxvmY50NOr8

January 31, 1940 COPY !irs. Dominie Bertagliat Xeewatin, Uinnesota Dear lira. Bertagliat: Both Doctor Johnsrud and uyaelf were ver/ unhappy about the outcome of the illneaa of lir. Bertagliat. During the short tins that we laser him in the hospital, he was moat courageous in spite of the extreme severity of hia illness. On admission to the hospital, the history was obtained that he had worked for many years in a plant that used powdered silicon and asbestos. Host of this time he worked as a foreman, but was periodically exposed to the dust in the main factory. About four or five years ago he began to have trouble with a cough and diffi culty in getting his breath in and out of his chest. He consulted numerous doctors but the condition gradually became so severe that on the 15th of Hovenber, 1947, it was necessary that he leave his position and seek other employment. About two or three weeks prior to his admission to the hospital, he noted some swelling of his ankles for the first time in his life. On admission to the hospital, Hr. Bertalgiat was dvspneic on both inspiration and expiration, orthopneie, and had some tachypnea. There were many expiratory rales and wheezes over both bases. The heart tones were normal except for some accentuation of the P2 sound. The liver seemed enlarged and-extended three centime ters below the right costal margin. There was pitting edema of both ankles. Blood pressure was 116/74. An x-ray of his chest, taken at six-foot distance, showed a TT34.5 cm; HR 5.0, HL7.7 total 12.7. The bronohoveaicular were markedly accentuated in both lung fields. In both bases thereiere lineal areas of increased density. The diaphragms were low and there appeared to be tome decrease in the density of the lungs. Fluoroscopy of the heart revealed the heart shadow to move in a normal manner. There was very little movement of the diaphragm. An SCO showed a right axis deviation with a flat T1 and 2. 1 PLAINTIFF'S i EXHIBIT > lir. Bertagliat -was treated with adrenalin, digitoxin, aninop'nylin, penicillin, salt-free diet and salvrgen. He died quite suddenly on the fourth hospital day. Autopsy by Dr. George Berdes of Duluth revealed the lungs to be ersphyseaatic. The bronchial ttree was dilated throughout the lungs without containing a large amount of purulent exudate. There were no areas that appeared to be typical of bronchiectasis. The heart weighed 450 gp and showed a very definite hypertrophy of the right ventricle. The liver showed a fine noduliag which was due to dark areas in the center cf the lobules. Diagnosis: 1. Chrcnic bronchitis with emphysema; 2. Right heart failure secondary to Ko* 1. It is my opinion that Ur. Bertagliat developed a sensitivity to one of the substances in the dust to which he was exposed during his work. From this he developed a chronic bronchitis which finally led to his death from frailure of the right side of his heart. !fe were unable during his brief hospitalisation to test him for skin sensitivities. The microscopic sections have not as yet been reported. TOien they are available, I will write you concerning them. dincerely. V