Document jmG6dwpjRGDbNkJaw4d4wZDOy

B a t t le Creek,M ich igan , O ctober 28t h , 1931 IS Dr. R o b t .A . Keh oe, U n iversity of Cin cin n ati College o f Medicine, C in cin n at i, Ohio. Dear d o ct o r Kehoe If I n r e sp o n se t o you r l e t t e r o f O ct .3 6-th. I w i l l t r y t o giv e you -s more d e t a ile d in fo r m at io n in th e c ase I th ou gh t was le ad p o iso n in g. A man age 37 y r s.em p lo y ed a s gas f i l l i n g st a t i o n at t e n d a n t fo r one | and one h a l f y e a r s. Mis f i r s t a t t a c k o f c o l i c occu r ed on Ju n e 2 8 , 1931 and t h i s was r ep eat ed a t in t e r v a l s o f from one day to two w eeks. He h ad t o q u it work ab o u t Ju ly 4 t h . He was seen by fo u r or f i v e ' d o c t o r s who w ere c a ll e d in emergen cy to giv e h ypoderm ics fo r r e l i e f o f t h e c o l i c . He was t o ld t h a t th e t r o u b le w as g a l l st o n e s,u l c e r s o f th e st om ach , n e u r a lg ia o f st om ach ,or acu t e p a n c r e a t i t i s by v a r io u s !:- p h y sic ia n s. The a t t a c k s were alw ay s accom pan ied by n au sea and some- ;= t im es by vom itin g. Th ere was ch ron ic co n st ip at io n and borborygm i. - I f i r s t saw him on Se p t . 19 t h .d u r in g an a t t a c k o fv e o l i c . The p a in was ' in t h e e p i g a s t r i c r e gio n , t h e r e w as no m u scu lar r i g i d i t y and no mus'cle * spasm a t th e tim e n or on t h e fo llo w in g d ay s. He st a t e d t h a t t h e r e had-!; n ever been any t e n d e r n e ss. There was no d y su r ia and th e urin was ' n ea-etive to b lo o d ,p u s,c a st s,a lb u m in an d su ga r . Two o t h e r a t t a c k s o f coliCofoliow ed ,th e l a s t bein g about O ct.1 s t .sin ce then he h as been fr e e from p ain and h as resumed h i s work. I cou ld fin d n oth in g t o p o in t to a d ia gn o sis and so took to th e e xclu sio n method. I cou ld alm ost exclude everyth in g except lead c o lic . He st a t e d t h a t he d id n ot wash h i s h an ds b e fo r e e a t in g,a n d I th ou gh t he m igh t h ave ab so r b e d enough le ad in t h i s manner. Blood exam in at ion on Se p t .3 4 t h . showed H em oglobin 65 D ar e,Bed s 3 ,8 0 0 ,0 0 0 W h ites 6,960 w ith no poiych rom atop h ilia or b a so p h ilic st ip p lin g . I n oted in your l e t t e r t h a t in at t e m p t in g t o make a d ia g n o sis o f le a d p o iso n in g many weeks a ft e r c e c e ssa t io n of exp o su r e ,t h e u r in e t e s t fo r le ad would be w it h ou t v alu e an d t h a t th e same i s t r u e a s r e g a r d s t o st i p p l i n g . I a r r iv e d a t a t e n t a t iv e d ia gn o sis o f lead c o lic becau se n oth in g e lse would e x p la in i t .1 Kow t h a t th e p a t ie n t h as r eco v er ed I do n ot se e how i t is p o ssib le to be ce r t ain . I f in th e fu tu re th ere is a recurrence-'' o f t h e c o lic ,w e may be a b le t o g e t some d e fi n i t e e v id e n ce . I s h a l l be - glad t o w r it e you fu r t h e r i f an y th in g comes u p . . Th an kin g you fo r you r i n t e r e s t in t h e c a se ,I am, Sin c e r e ly Yours F.R.W .--y F. H. W alt e r s, M. D .-