Document YrYevgDqrQ8KzQrZLDZYb7zpK

D A N IEL M. MURPHY, M. D. IN D U S T R IA L M ED IC IN E ft SURGERY 3 9 9 EAST CHURCH STREET MARION, OHIO OU 3-7182 A p r i l 3 0 , I 903 HAR O LD R. IM BUS, M. D. O CCUPATIONAL M EDICINE Mr. John S o fia B. F . G oo d rich Company I k r io n , Ohio Doer Mr. S o f ia : As you know i t v.t . s recommended t h e -*-, t h a le a d s t r i p p a r s , r s v i e i l a s t h e t h r e e man who hod b een removed from le a d s t r i p p i n g , have a r o u t i n e p h y s i c a l exam ina t i o n v.hich would in c lu d e a system ic review , h i s t o r y of any symptoms r e l a t i v e to p o to n tisl le d poj.soring, complete blood count, stip p lin g exam ination fo r b a s o p h ilic s tip p lin g , u rin a ry coproporphyrn, and a blood and u rin e lead exam inations to be d u p lic a te d and s e n t to Akron and K e tte rin g L ab o ra to ry . Follow ing is a re p o rt of the p h y sical and la b o ra to ry exam inations w ith the ex cep tio n of the blood and u rin e exam inations. P hy sical exam ination and h is to r y n e g a tiv e . Blood c o u rt ^eveaied a Hb. of 86$, 133 Gms., w h ite blood c o u n t, h e m a to c r it, and d i f f e r e n t i a l n o r m a l. Wo b a s o p h i l i c s t i p p l i n g s n o te d and h i s u r i n a r y c o p r o p o r phyrn was n e g a tiv e . Physical exam ination revei led a sm all ganglion in the dorsum of ie r i g h t hand, otherw ise h is p h y s ic a l and h i s t o r y was n e g a tiv e . Hb. was 86$, 13*3 Gms. w i t h a n o rm al h e m a t o c r i t , w h i t e b lo o d c o u r t , and d i f f e r e n t i a l . There was no b a s o p h ilic s t i p p l i n g noted and h is u r in a r y coproporphyrn was n e ra tiv o . This man had j u s t r e c e n t l y re c o v e re d from th e f l u and complained of mild tire d n e ss of the legs over the p ast fiv e months, otherw ise h is p h y s ic a l exam ination and h i s to r y was co m p letely w ith in normal l i m i t s . His Hb. was 88$, 13.5 Gms., w h ite blood c o u n t, and d i f f e r e n t i a l were w i t h i n n o rm al l i m i t s . He had no b a s o p h i l i c s t i p p l i n g and h i s u r i n a r y c o p r o p o r p h y r n was n e g a tiv e . Viho had gone on a s a le a d s t r i p p e r i n J a n u a r y . P h y s i c a l E xam ination and h is to ry were com pletely negative except fo r a moderate o b e s it y , he had a normal H b., w h ite blood c o u n t, and d i f f e r e n t i a l , th e r e was no u rin a ry coproporphyrn and no b aso p h ilic s tip p lin g noted. Who had b e a n removed fro m t h e l e a d s t r i p p i n g o p e r a t i o n f o r "m onths. Ho had a h i s t o r y o f n o c t u r i a , tw o t o t h r o e t i m e s d a i l y , and a m ild b a c k ache f o r a p p r o x i m a t e l y f o u r m o n th s . He- had b e e n . t r e a t e d r e c e n t l y by h i s f a m i l y d o c to r who made a d i a g n o s i s o f p r o s t i t i s and t h e con d i t i o n was under c o n tro l acco rd in g to him. A ll phjrsical fin d in g s were w ith in n o rm al l i m i t s . He had a Hb. o f 1 5 .5 Gms., 101$. Vihito b lo o d c o u n t n o r m a l, th e re was no b a s o p h ilic s tip p l in g and h is u r in a r y coproporphyrn was n e g a tiv e , h e m a to c rit 49$, and d i f f e r e n t i a l was norm al. Feyo 2 Hr. John Sofia H istory revealed a chronic c o n stip atio n which had not changed f o r a p e r i o d of y e a r s . H is gums w ere i n poor c o n d i t i o n b u t t h e r e was no lead l i n e n o te d . O th erw ise, ho had no s u b j e c t i v e c o m p la in ts , and a l l p h y s i c s ! f i n d in g s w ere w i t h i n n o rm al l i m i t s , lie hod a BOfi H b ., 1 2 .3 Gms. Ko had a 13 , 600 w h i t e b lo o d c o u n t , he had a d i f f e r e n t i a l w hich showed 2 3 % Lyme. , 2 Eos . , 4 Mono., 70 S e g . , 1 S ta b . There was no b a s o p h il ic s t i p p l i n g p r e s e n t and h is u r i n a r y coproporphyrn was n e g a t iv e . Because of h is e le v a te d w hite blood co u n t, i t is being recommended to him t h a t he have h is w hite blood count and d i f f e r e n t i a l rep ea ted in two weeks. N e g a tiv e h i s t o r y , p h y s i c a l r e v e a l e d t e e t h i n f a i r r e p a i r . He s ta te d he was under tre a tm e n t by a d e n t i s t a t t h i s time.. Otherwise e l l p h y sic a l and h i s t o r y e x a m in a t io n was n e g a t i v e . Hb. 88?o, 13*? Gms., w h i t e b lo o d c o u n t , h e m a to c rit and d i f f e r e n t i a l w i t h i n normal l i m i t s . There was no b a s o p h il ic s t ip p l in g p re se n t and u rin a ry coproporphyrn was negative.- H is to r y and p h y s ic a l exam in atio n was co m p le te ly w ith i n normal l i m i t s . Blood c o u n t r e v e a l e d a 9 4 r :Tb . , 1 4 .$ Gms., h e m a t o c r i t 477, w h ite b lo o d c o u n t and d i f f e r e n t i a l w i t h i n -normal l i m i t s , There was no b a s o p h i l i c s tip p l in g noted and h is u r in a r y coproporphyrn was n e g a tiv e . H is to ry n e g a tiv e , p h y sic a l exam ination rev ealed one d e n ta l c a v ity , otherw ise a l l p h y sical f in d in s were w ith in normal lim its . Blood count re v e a le d 84^ H b., 12.8 Gms., w hite blood co u n t, h e m a to c rit, and d i f f e r e n t i a l wore w ith in normal l i m i t s , no b a s o p h ilic s t i p p l i n g noted and h is u r in a r y coproporphyrn was n e g a tiv e . H is h i s t o r y o f some ab d o m in a l d i s c o m f o r t s i m i l a r t o h e a r t "burn o f '/ t o IU days d u r a t i o n . I t was n o t r e l i e v e d by fo o d s or a n t i a c i d s . He had no o t h e r c o m p la in t i n h i s h i s t o r y , and i t was recommended t h a t t h i s d i f f i c u l t y be rech eck ed . His p h y s ic a l exam ination was e s s e n t i a l l y n eg ativ e o th e r th a n m oderate pyorrhea of h is gums. There was no evidence of le e d l i n e . He had a Hb. o f 1 7 .8 Gms., 110 % w i t h a h em ato crit. His w hite blood count was 1 0 ,0 ^0 , h is d i f f e r e n t i a l was w ith in norm al l i m i t s , th e r e was no baso p h i l i c s t ip p l in g and h is u r in a r y coproporphyrn was n e g a tiv e . N ith the e l e v a tio n of h is Hb. and h e m a to c rit, i t is recommended t h a t h is blood count be re p e a te d in 2 to 3 weeks and i f no change, be re f e r r e d to h is fem ily doctor for evaluation. ' A nother man who had been removed from th e lead s t r i p p i n g o p e ra tio n ap p ro x im ately fo u r months ago. H is to ry was n e g a tiv e , p h y s ic a l exam inatio n was n eg ativ e o th er th a n poor d e n ta l hygiene w ith moderate c a r ie s . His blood count rev ealed a H b., 1 4 . Gms., w h ite b lo o d c o u n t, h em ato crit and d i f f e r e n t i a l w ith in normal l i m i t s , th e re was no b a s o p h ilic s t ip p l in g noted and h is u r in a r y coproporphyrn was n e g a tiv e . In summary, th e h i s to r y and p h y s ic a l exam inations of th e se elev en in d iv id u a ls f a ile d to r.;v eal any evidence of s ig n if ic a n t pathology which would have any b e a r i n g on t h e i r b lo o d and u r i n e l e a d d e t e r m i n a t i o n s . One man had e l e v a t e d KE" 0005606 Page 3 Mr. John S o fia white b lo o d c o u n t and a n o t h e r an e l e v a t e d ro d b lo o d c o u n t w h ic h was f e l t s h o u ld bo r o p e c t e d . One man had some h i s t o r y of some a b d o m in al d i s t r e s s , p o s s ib ly a g a s t r i t i s which w i l l be reev a lu ate d in approxim ately two weeks following th is examination. Hoping th is is complete' and s a tis f a c to r y , I rem ain, S in c e re ly , cc D r. Rex V.ilson 0005607