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(COPY) WALTER B. MARTIN, M. D. 339 Boush Street, Norfolk, Va. October I4, 1940 Messrs. Hughes, Little & Seawell, Attorneys at Law, Wainwright Building, Norfolk, Virginia. Dear Sirs: I am enclosing herewith a copy of my findings on His history indicates that this patient was one of a group of men who on Tuesday, January 30* 1940, helped clean out a gasoline tank which had previously been filled with gasoline containing tetraethyl lead. The patientrs memory is very poor and he is unable to relate how long he worked in the tank. The records at St. Vincent's Hospital show that he was brought into the hospital in a state of confusion and was in the hospital for several weeks. He states that he does not remember going into the hospital. He is now complaining of pain in his head which Is present when he is hot or when he walks. He apparently has an extreme compulsion to v*alk a great deal. His sister states that when he does sit down he often dozes off and goes to sleep. Ha also complains of having a pain in his chest and being restless at night. An accurate history is difficult to obtain on account of the patient's inability to remember or to answer clearly. On examination his nutrition is fairly good. He shows extensive scarring from an old smallpox eruption. The optio discs appear pale but the retinal vessels.show no particular changes. There is marked infection about his teeth and gums. There is a moderate degree of hypertension. There Is afairly severe secondary anaemia. His kidneys are clear and the kidney function is good. Of course, at this date it is impossible to prove or disprove presence of lead by any analytical method. His history, however, seems to be conclusive that he suffered from rather severe acute lead poisoning, with def inite evidence of cerebral involvement. His symptomology now is compatible with a late lead encephalopathy. To vhat extent this patient's impairment is due to lead is somewhat difficult to assess, since I do not know his mental state, etc., prior to the onset of the acute lead poisoning. Very truly yours, (sgd) Walter B. Martin, M. D. COPY Wa l t e r B. Ma r t in , M. D. 339 Bo u s h St r e e t No r f o l k . Vir g in ia No. 11,123 October 7, 1940. Physical Examination Patient is a fairly well-developed, moderately well-nourished colored man who does not appear acutely ill. His height is 66J- inches and his weight is 133J- pounds. SKIN - Is pock-marked, particularly over the face and back. There is no eruption. KEPT) - Is negative. EYES - The sclerae have a muddy appearance. There is a lateral nystagmus, particularly marked on looking to the right. The pupils are equal and regular and react to light. The eye grounds show rather pale discs but the blood vessels do not appear abnormal. Thera are no hemorrhages and no areas of exudate. NOSE - There is no obstruction and no discharge. The frontal sinuses and the antra transilluminate clearly. YOUTH - The mucous membranes are of good color. The teeth are in very bad condition. There is marked pyorrhoea and many cavities and caries. The throat is not inflamed. The tonsils are not enlarged. GLANDS enlargement. - There is no cervical, axillary, or inguinal CHEST - Is well developed. The expansion is good. The lungs are clear throughout. HEART - Is not enlarged, on percussion. The apex is felt at the nipple line. The sounds are of good quality. There are no murmurs. PULSE Is regular in force and rhythm; rate 60. BLOOD PRESSTJRI 180 115 ABDOMEN - Is soft and easily palpable. There are no masses and there is no tenderness. The liver and the spleen are not felt. GENIT.ALIA The external genitalia are normal in appearance. RECTAL EXAI'AINATIOi'T - The sphincter is of good tone. The prostate is not enlarged and is not tender. EXTR-LilTI* There is no oedema. JOINTS Are normal. REELEYES Are present and equal and normally active. 0021019 N 24456.01 Colored) copy Wa l t e r B. Ma r t in , M. D. 339 BOU5H STREET No r f o l k , Vir g in ia Laboratory Findings 10-7-40 Blood Hgb. 56';i P3C 3,410,000 NBC 6,800 Differential - 200 cells PNN 73.0 4,526 HIE 0.0 00 PKB 0.0 00 lymph. 27.0 1,674 Nono. 0.0 00 6,200 Urine Volume - Specimen Appearance - Slightly cloudy Reaction - Acid Sr C-r - 1019 Sugar - Negative Acetone - Negative Albumin - Negative ^icro. - Negative Non-protein nitrogen - 30.0 mg. per 100 ce. urea nitrogen IS.5 mg. per 100 cc. Urea ratio 41.7% Sugar 100 mg. per 100 cc. '.vassermann - Negative Kahn - Negative KB 0021020