Document bazEbBkqa01w57Kywwxy81ZR3

o Q O . 9 'Z. K 0'S 6a & &w r- 2o w^ 3 p - * cs I cs P, <* 0o -s H2i < *> s Q P}-< r>r. Russell Alsfelder 123 N. Front Street Hamilton, Ohio Dear Doctor Alsfelder: I am sending you herewith, a copy of part of the medical record of your patient, Mr. Sives the most important information relative to the differential diagnosis. A copy of our earlier record is not available, and I have not thought that it would be especially useful to you at this time. We examined him first in January of 1939, and because of the vagaries of his condition, at that time, we thought it advisable to hospitalize him and to carry out further clinical observations. These are recorded in the appended material. The first record gives the complete clinical history and the results of somewhat detailed physical and laboratory examinations. Our conclusions,at that time, presented in the form of a discussion for the benefit of the Ohio Industrial Commission were as follows; "The generalized muscular weakness and wasting, with inconstant tremors, fleeting "lightning" pains and variable muscle soreness, are believed to be indicative of degenerative lesions in the spinal cord. There is a generalized arteriosclerosis, and incipient cataract, as evidence of chronic degenerative processes, and there are chronic infectious lesions in the mouth and nasopharynx. There is also some enlargement {probably functionally insignificant) of the thyroid gland. The nervous system lesions are not, in my opinion, related to the vascular disease or to the existing nasal and oral infection, but rather to some process that developed out of or coincident with the occupational conditions. The history of exposure to lead, the diagnosis of plumbism as originally made, (which of course connot be confirmed or disproved at this time for lack of specific evidence), and the absence of another definite disease entity in explanation of the present lesions, force the pragmatic conclusion that the cord degeneration is a sequel of lead intoxication." If I were to be critical of these conclusions now, I would say that my experi ence since that time does not lead me to believe that the degenerative process in the spinal cord was the result of lead intoxication. I cannot say that they were not, and I do not regret that we gave him the benefit of the doubt, but Kl? 0-0165 0 6 Dr. Russell Alsfelder - (2) - May 1, 1954 I suspect that we were wrong. Sincerely yours, RAK ex Enc. Robert A. Kehoe, M. D. 0016507