Document jmwXeD1K7Vz72BZ23Re1Oav5N

E s ta c e n ny f i r s t v i s i t t o tout p l a n t cq k a v S . 1919. a n d, c y second v i s i t on A u g u st 5 , 19: t h e r e o c c u r re d 52 ne.T c a s e s o f c h lc r a c n e . Scan c f t h e s e r e r k e r s o re ne,* e r r l e y e as a n d e t h e r s a r e c n ir.te n u n c c t e n , b u t a l l o f th e n had v.orked i n B u ild in g 11 o r had h a n d led equipm ent t h a t h id been i n B u ild in g 11 a t t h e t i n e o f t h e a c c i d e n t , Kone c f th e ne-.: c a s e s a r e a s s e v e r e a s those f i r s t seen in Hay. In a d d itio n tvo cases of chloracne occurred in a fa th e r and h i c h ild vhc had purchased /' rid d e n i n a t r u c k r h i c h t.t s n e a r B u ild in g 11 a t th e t i n e o f th e a c c id e n t an d h a d b e e n cor- nated u ith th e c h ericg ts escaping fre n the re a ctio n k e ttle . The c e v e lc p n e n t o f ner; c a s e s s in c e n y l a s t v i s i t i n d i c a t e s t h a t th e B u ild in g U , a n d i t Tj im e d ia te s u rr cun dings a re s t i l l c c n ta n in a te d r i t h th e d isch arg es iro n th e k e ttle a t th e t i n s c f th e a c c id e n t, The in d ie a tic n i s stre n g th en e d by th e f a c t th a t w rk e rs in th e o th e r b u ild ings have not been a ffe c te d . V h ile m a t o f t h e 26 c a s e s se e n a t ny f i r s t v i s i t cn l a y , 1919* ah err i n p r o v e n e n t, e s p c d a l l y th e s e T.ho h av e been t r a n s f e r r e d t o o t h e r b u ild in g s , sen e o f th o s e *.iio a r e s t i l l e n a lo y e in B u ild in g 11 have d e v e lo p e d nee: a r e a s o f c a l c r a c n e . 17n i s a ls o i n d i c a r e s t h a t B u ild in g 11 i Tac fc llo v .ia g th ir ty - o n e e a rlc y e e s a e re p re se n te d fo r c r.u rin n tic a , 1 . J o n a th a n V.ziTlejm E n te re d b u ild in g t h e day c f a c c id e n t. H a r t days l a t e r he n o t i c e d .u. e ra .aair. ca .sac ; . . ce - c c c u : .n ie d by n .r .ie d caen--. Tac l.a .a s :_ z c : ; . c : : c a f f c o i r s . a. c y ra s or. a n c f_ c o an d l u c r e i s na n c l a n c a i s . T reats:cat as described. Cn c / 5/l ? > s t i l l shov.n c - " ta c n a a n a eden^ sbou isas jinny c o n d o n e s and a fee. sc le e r e d `u s tu le s ca t c : i s c l e _ r . I n a d d i t i o n , tacrc- a rc a fe*., t r a l c a au ecs cl t:.c t.- i; k s. T ais r . l i c i t c o r a l sin s cf eucclc a -ir.r i . t.v. 1 . J -a .c s f . H ose. y.rca s u v . r v i i c r . l a t e r c c a.:; _s.- - e. r a n an f<-ce <--m a c c s --*^--r I.o a --s >. .. s : r c:. t > : l e f t c h e e k . r>_- Prognosis: rood. Z r i .t z c z t fu ;;.::fftrd : 5 c ru b f . cc * u th T e rs u s c r 5? s o lu tio n o f S a r .tc a c r r e iz rc o d i: u c ly be f o r e r e t i r i n '. a t r i g h t . F c l l c u t .i s by t h e a p p l i c a t i o n t o the- f - c e o f L o tic .'.Ifca to T h ic k 3fJ . t s u r c i n c l k - s b re r, ad d ed .- a sh f a c e ir . th e m r u i n g uyer. a r i s i n g v i t h T e r .-tug c r C a n to z e rs o . la c :: d ry a f e d c f t.ie c y s t s s h o u ld be- e z p ti e d o f t h e i r c o n te n ts by e ir p r e s r ic n . C ozedcae fo rc e p s m y be u sed f o r t h i s purpose end th e c y s ts m y bo s u p e r f ic ia lly in c is e d tc p e r z i t th e c o n ten ts tc be core e a s ily ex p ressed . The p a tie n t should avoid exposure to stro n g s u n lig h t. O n .2 /> /l9 s t i l l h a s d i d c h lo r z c n e c f l i c e , T h ere a r e o n ly a v e r y f e :. l e s i o n s no*.:, T h e r i s a d i d degree o f m e la n o s is b o u t t h e e y e s , Ko a p p a r e n t change i n p a t i e n t * s c z n 'd i t i i n , 3 H r, L- 1!. H u r l e r . E n te r e d t h e b u i l d i n g a b o u t 2 `.reeks a f t e r a c c i d e n t . B ash a p p e a re d cn fa ce ""rceus I n t e r , li cv e!;o;.s cone d en es a ro u n d e x t e r n a l o r b i t a l re g io n and acn e--l i k e l e s i o n s cz e x te n s o r surface of forearm s and knees. Treatm ent: ns fo r case 2 , On C /5 /1 9 s t i l l h a s m n y comedones and l e s i o n s . The back c f t h e nock and a x i l l a e n o r shots m n y le s io n s as r e 11 an th e f c re a m s and k n ees. T his v o rk er co n tin u e d v orking in th e p 't i d i n g a f t e r t h e e x p lo s i o n . H r. H u rle y a l s o c e x p la in s o f s e re n e p a in i n th e l e g s . T h is m r i *ov: o u t o f B u ild in g 1.1, 1 , I v a l H cC lanihan. E n tere d b u ild in g 1 hour a f t e r a c c id e n t. F e l t no 1m e d ia te e f f e c t s , b u t had a headache th e n e x t day and 6 days l a t e r th e face be cane s ro lle n and an e ru p tio n appeared, I'or. p r e s e n ts a n a r k e d m e la n o s is , an d z a n y s n a i l c y s ts on f a c e r i v i n g t h e a p p e a ra n c e :x d f e e l o f ground g la s s . Has numerous s tr z v co lo red a c n e -lik e c y s ts cz th e upper e y e lid s . A lso shous the sca rs of o ld acne v u lg a ris , T reatzen t: sam e.as case 2 , On 2 /5 /1 9 s t i l l s h e a s n a rk e d in v o lv e z e n t p o s t e r i o r s u r f a c e o f n e c k and b e h in d t h e ea: I n a d d itio n n r:.' p r e s e n t s p u s t u l a r l e s i o n s on Ir a n i: and b u tto c k s . L 's la n o s is s u b s id in g ( c o l o r ^ ,,.wrC, \/ /,A ^s.,--t,r5/"C*\!l^w r>O^^,^. i.w*/ 4X.1 ^ * t* c*wu--^51 ^ ** 5. i oodre?: i r o v x E n te re d t u i - d i n g t h e day a f t e r a c c id e n t. F.ash cz f~ c e appe ..red : \ eel: l a t e r . F o r p r e s e n t s n a l z n o s i s and num erous acnc--l i k e c y s ts and p u s t u l e s on th e f a c e . Treatm ent: as o u tlin e d fo r case 2. _____ _ k.yU trr W,, _ / . V , .. * X V C .CW . i C -------- - J w ic i c r i e r - r - c c t c r r.cc;: - - c c c r c - c: . _______ l a t e r he t s e i z e s l c u an a vi u a ite d b lo o d fc : m f r o z th e b u lld in g . Three- c_v a p p e a re d or. hie e :.r s . s iz e d none--l i k e c y s ts ca th e f .. ' - H e r c y s ts cr. th e a n t e r i o r s u rf.-c s c f th e l e s s and tr .ig h s . Treatm ent: as fo r case 2. / c cci c r r t i l l f.-.rk. Face ir. r. rl:odl~ in -ro v e a t p o s te r io r a s p 'c t of r.rck , ho*- -v . a r c - r c . l e s i o n s cr. lo g s :r v c a l s o i z t r c v e d . ?_ai:n*. c o a v .l.ir.s : f ** ir. i . i < ` r n : 1: c : ty e s r o a s . Or. c:: z n . . i i c z c u o c r s u r i a c .A'. Lf *rww, w..*.e c.- 042221 Trrndy L m i s r s . I r . t e r e d th e b u ild in g i m c e d i i t c l y a f t e r th e a c c id e n t. He f e l t no lume l i t e e f f e c t , t u t th e n e h any r.i h id th e h e a d a c h e , e le v a tio n c f te e n e r .tu r e , g e n e ra liz e d e i y - . Ilo;; shov.s e n a rk e d t u r c o l e r m e la n o s is c f f a c e end many s n a i l acne--l i k e c y s t s . The j. c ~c an a ^ nr r '**i e a l s o a f f e c t e d . T re a tm e n t a d v is e d : same i s f o r p re v io u s e s s e . I n a d d itio n l i v e r f u n c tio n t e s t s shcru be done, 6 /5 /4 9 - V ery much b e t t e r , m e la n o sis n e a r ly one. S t i l l p re s e n ts non e - l i k e le s i o n s c arm s and l e g s , . Bock of neck c le a r . T h is p a tie n t a ls o com plains of p a in in th e le g s a t tiro e s, 8 , H arold Young. E n tere d b u ild in g th e cay a f te r th e a c c id e n t. Rash appeared cn fa c e 6 days l a t e r and face beeune sv.ollea, U elanosic appeared sev e ra l days la t e r a f te r I - r s y t r e a t ment vas hryen. Ko?; p r e s e n ts e x tre m e d e g re e c f m e la n o s is end many a c n e - lik e c y s t s on th e f a c e . .T he hands and am s to ju s t above th e T /rists a re a ls o m elan o tic. The unenposed p o rtio n s c f th e boc a re no m a l a h it . Treatm ent: as o u tlin e d fo r case 2. 6 /5 /4 9 - S t i l l a e la n o t i c b u t l e s s so th a n vken f i r s t s e e n . F ace i s much sm o o th er nerv j t e r i o r s u r f a c e o f neck n e t a f f e c t e d ; th e a rm s, h o w ev er, shovr ferr come don e - l i k e s c a t t e r e d V n s . T h is p a t i e n t a l s o co m p la in s o f p a in s i n l e g m u s c le s . 9* R alph iiarkham . P i p o - f i t t e r v e n t i n t o t h e b u ild in g th e day a f t e r th e a c c id e n t end h a n d le d can Rami m ated a p p a r a t u s . T h ree d ay s l a t e r t h e f a c e became edem atous and a r a s h a p p ea r* cn the face and th ig h s. lion: sho?:s m e la n o s is o f f a c e and s c a t t e r e d acne--l i k e c y s t s . The a n t e r i o r s u r f a c e c f th e th ic k s i s erythem atous and desquam ating. T re a tm e n t: a s o u t l i n e d f o r c a s e 2* 8 /5 /4 9 - F a c e m a rk e d ly im proved t u t b a c k , t h i g h s , b u tto c k s , and p e n is shorn c a n y l e s i c no;:. K uncrm s comedones cn le g s , p r a c tic a lly every f o l l i c l e sh ew le s io n s . p a t i e n t s t a t e d * .ife s h e a s s i m i l a r l e s i o n s . A c v ise d t o b r ia r inlil a foe ai n to se c L r . hclson 10. John H ein. In tc r c d b u ild in g th e day o f a c c id e n t. Hash appeared cn fa c e 9 ays lu te i; c. p r e s e n t s m arked m a lm os i s and r.umarou: t i n y c y s t : 0:: c h e c k s , g iv in g th e f a c e th e T re a tm e n t: as c --a ~. n c a a.. c..sc *_ 8 /5 /1 9 . Ifuch b e t t e r th an Then f i r s t see n , k e lm o s is has a ls o ly p rcv ed . -------l e r s e au s c a l a r l e s i o n s cn c h eck s an a u n d e r c h in (s c c c n z a rv i n f e c tic n W * * - j Hot* h a s 1 1 . J a n e s 11a rk :; a n . p i n e - f i t t e r . E n te re d b a il aim g 11 days a f t e r t're_ a c c id e n t an a a b o u t 11 d'.ys 1: t e r n o tic e d e d e m a ,-p r u ritu s ana e r u p tio n on th e . f . c c . go-.: p r e a m t s a _ a :c : m e la n o sis c f f a c e and s c a t t e r e d a on c--l i k e c y s ts cn tn e I x e and *scr surface cf the lo v er th ird cf tk irh e . ira -tn c n c as cue lin e a ic r c..s: 1. /.* / ' r r r . . ---- -. - *T * ^ ^ r * ' ' C-Y f..cc ana t 'd anr- a u aclo g a in s . A ll j o i n t s su g g ested a rc s i t e s c f ;v in . 04 2 2 2 2 I c ~ I 1 1 . A. H. l : n c . F ilte r e d o u t!d in g 6 u .y s u f a c t uhc a c c i a c n t . K o tic e d a b u r r in g c f th e face 2 days la te r . !!c crow s a fe*,. i cne--l i k e c y s ts ar.d s l i g h t m e la n o s is . *- ----u--_ av f*c--cc% w. L^kiC 4C* * .8 /5 /1 9 l'.e la n c s is much im proved* Shows many b la c k h e a d s on f o r e h e a d . B c sic n c cn f :. - r e much mere n um erous. JLlro c e x p la in s o f p a i n , v*ich a f f e c t s n eck and a m , no le g p a i n s . 1 3 . K n eel T u c k e r. E n te r e d b u ild in g .bout 1 month n i t e r th e a c c id e n t* Two civ s l a t e r an e ru p tio n appeared on th e f a c e . Kca ..p re s e n ts s l i g h t m e la n o sis o n ly , no c y s t s . Treatm ent: i s p ra c tic a lly te ll* . f / f / l ? * Shows m arked i mp r ovem ent. Si i n a lm o s t e n t i r e l y c l e a r , p r e s e n t s few le s ic n u l e f t s e lle r reg io n * CosauLains o f p ain in l e f t h ip and le g . T his nun has te e n w orking i n B uilc in r 11 a ll the tin s . H . Eugene Cunningh-~-r.. E n te re d b u ild in g cn e month a f t e r th e a c c id e n t and a f t e r v e n d in g 12 days noticed eruption around th e ears* how p r e s e n ts m ild d eg ree o f m e la n o s is , some grouped a c n e - lik e c y s ts around c h in and m outh. Acne le s io n s a ls o co a n t e r i o r low er t i iir d o f th ig h s* ( Treatm ent: as in case 2. 8 / 1 /1 9 . H e la a c s is im proved* FTcm p r e s e n t s u n d e r lo w e r j a r c y s t i c l e s i o n s w ith seen: a r y p y o g en ic in f e c t i o n ; i n a d d i t i o n , p r e s e n ts a few le s i o n s on th e back c f th e neck* 15* C-ene Thom as. E n te r e d b u ild in g a b o u t one month a f t e r th e a c c id e n t an d e r u p tio n a p p e a re d on th e fa c e 3 d sy s l a t e r * How p r e s e n ts ' 1d ery th em a o f fa c e b u t num erous acme--l i k e l e s i o n s cm th e c h ee k s and c h in . Treatm ent as in case 2 . 8 /5 /1 9 . Has more le s io n s on fa c e , c h in , and fo reh ead th an v/ere p re s e n t vhen f i r s t seen . In ad d ia l on, p re s e n ts le s io n s ca had: o f neck now. Has m ild f o l l i c u l i t i s of le g s (her/ T h is ra n '_lco com plains o f j o i n t p a in s ; th e s e n o t p r e s e n t no*.. K eccm m onnations: rem ove w o rk er from B u ild in g 11* a. E n te re d b u ild in g cne month a f t e r th e a c c id e n t and re u p tio n app eared 1 ----o c c n ts a ***e". ac"'cx--l i k e c**~ th a n o se an: unc f o r e a rm s . . He. . . . i m r.v la r g e .cat.-L_l.c 1 - a io n : ova: :--ck c f n e c k . 1 o n io n s ca : cro _ m _ l e t u c r . r. co nmm.cnTorii o n s : I f g a ts *. o r sc remove from B u ild in g 1 1 . X t c._a r u C: c i l Cunninghrua* E n tere d b u ild in g iru .e d i.-t.c l7 a f t e r th e a c c id e n t, 1 cays la o er. I; o r pro r e n t s a f e ; a c r e - l i k e c y s ts cn l e g s n e a r `r.i fa c e i s n r .- o tic . l l y c l e a r , f l i .g n t m s lm ;o a is . r.ash on f a c e : / ; / . . V. I n - - 1 : im proved. i.a i c rr.b ir v j:: : : r . a / u l l a i more l e s i o n s ( c y s t s ) cn fc.ee; o o s u c r ic r a s m c t c f r - c.. snows a m-T/iec p y o g en ic ro s-.cii . f a i r is.kleo and ta ig a s im proving. 042223 c 1C, C a rl lc n in r. jr.tc rc d o u i din.- th e c /s u in g cf th e a c c id e n t ar.d re m is e d f o r 2 hour. Or. k a r e n 50, th e e r u r ta c n a p p e a re d cr. th e f a c e . her. p r e s e n ts a f e v a c r e - l ik c - c y s ts an th e f :r.L on t h e - t i r e , Tr.cre i s czi;-* a a l i g h t n e l a n o r i s / T re _ ts .e n t us a h a v e . 2/5/49* .2cler.o s is su b sid e d . Face le s io n s no v.crsc, her..ever, does p re se n t cone le sio n s cr. th e b .c l c f th e n e c k . In a d d i t i o n , p r e s e n ts s i r . - f o l l i c u l a r l e s i c n s o v e r th e tr u n k esp ec i a l l y about th e v r d iiic u s and over th e b u tto c k s . T h is n r . a ls o hoc c o n tin u e d to r o r k in i>ui in g 41 n il the tin e . 19 F-* h a r . B u ild in g f o r e n i n . E n te r e d b u ild in g i r s r e d i a t e l y a f t e r a c c i d e n t . Bob ap p eared 3 -- i days I n t e r . Hus been in b u ild in g every day s in c e . Has s lig h t n e la n o s is of f I c n e - l i k e le s io n s on b u tto c k s and s i d e s . Trootner.t: ic p ra c tic a l! y v e il. 9 /5 /4 9* F t i l l shcT's s l i g h t ic c la n c c is cn f r e e . L e s io n s cn f a c e rrcre rrunorrun end . p re s e n ts s .n y la rg e c y s ts and p u s tu le s cn th e b^ck of th e Deck. P a tie n t has s c a tte r e d le s ic . o v er th e tru n k . T his ro r k e r h as contin u ed vorking i r B u ilding 41 a l l th e t i n e . H r. Shank a com plains of severe pain in th e le g s . P a tie n ts enzrined fo r f i r s t tim e S /5/49. 2 0 . Ja n e s.F * S h e e ts , age 6 . E ru p tio n began in l a r c h 1949> f e r day? a f t e r p la y in g in t . uck prurchased by h is f a t h e r iro n , th e lira sun to C hem ical C cnpm y. The tr u c k r a s c o n tam in ate a t th e t in s cf th e e x p lo sio n . Both th e boy and h is f a th e r developed se v e re ch lo racn e free, contacting the trucks T his p a tie n t p re s e n ts th e ty p ic a l coned one acne syndrome on b o th ch eek s, b rid g e o f nose, forehead, chin, neck and about the a x illa . I s under the ap p ro p riate treatm ent as advi fe r the ether p atien ts a t the tin e of the f i r s t v is it. .21 C. S t e e l e , k u in te n c n c e This vorker entered the Ling f o r th e f i r s t t i s e v e ra l n in th s .'I t e r th e a c c id e n t. At p re s e n t com plains of an e ru p tio n on h ie fa c e c f 3 v t d u r a t i o n , t h i s e r u p tio n b a g . r 1 v.eek a f t e r e r.*t'e-'**r g th e b o i l c i n r. ? re? ends a f cr.; i r p c t i y i r . o u s l e s i o n s cr. th e c .iin m i l e o v e r t h e n o s e , b e n in o c a r s , ; h cl: c f nr.ns: th e r e -re p r e s e n t a f e r s t r u t c o lo r e d c y s ts t y p i c a l c f c h lo r a c n e . I n a d d i t i o n , tr.c a ra r ana cuttocks p re se n t a m ild f o l l i c u l i t i s . T his p a tie n t a lso c o rn i-in s c f p _ins in I t y c and unci:. S u g g e st % n o m in a ted ra rre u ry ci n truer,t f o r i r p e i p t i n o u n l e s i o n s o f tn e c h in : d .ia io r. zo treatm en t os p re v io u sly o u tlin ed fo r th e c..lor-.one. 042224. \ ( 2 - . Renard Icney. lnintennnce nan. F rcrei'.ts : fe. scatn cred crgdncm .to-f oliiculwa* and p u s t u l - r l e s i o n s e v e r t h e *.r a r i : , e s p e c i a l l y a t i e n e n . f one c : th e l e s i o n e r c r .e r b le eyed s . 1 h - r e ir. osuda io n s c .tt c r e c l ic z i c m o v e r th e cull ocho and abouu ehe a i d l l a r y f o l d s . Ih p rcseicn : ra id ckloracns. I t ic I d i Vraa heat aisc ic a fa c to r ir; tr i e case. 25* Frank L e s t. Heir,te n cnee c m . R ent in b u ild in g i l d o r th e d i r c i t i r e 5 -.reeks ag o . P r e s e n t s ic*,? l e s i o n s on t h e f i c e v h ic h r e s e n i l e a d c l l i c n l i t i s . JU t y p i c a l l e s i o n s cd c h ic : ^cne. A lso p re se n ts a dei; f o l l i c u la r, p e s iv i nr le s ie n s ev er th e upper th ig h s end b u tto c k s. 1 aubtdul cese, 26. John E iad rrrell. Forked in B uilding 11 b efo re and a f te r th e e rp io d a n in k src h , Thi: r s r k c r h:.d no clsin l e s i o n s i n i d y a t th e t i n e t h e p l a n t v a s f i r s t v i s i t e d , D ev elo p ed r.k-- r Iccicn s curing the p est 6 reek s. P rese n ts e?.rly le c ic n s of ciiloracce ov er th e fa c e , fo reh ead , p o s te rio r a sp e c t cd ne: c h e s t, a jd lls e , and ever th e tru n k . Is under regular treatm ent. 27. P au l T .illa rd . Ran alv.ays t:orked in B u ild in g 11 b e fo re ana sin c e th e e x p lo sio n in l a r c h . *" ~ - P re se n ts a fe n c h i o r acne le s io n s cn s id e s o f f - c e , behind e a r s , and back of n e c k . : '.tic n , p re s e n ts cany le s i o n s erver th e p e n is , b u tto c k s and about th e u d b ilic u s . 7 h i s p a t i e n t c o n p la in s cd s e v e re j o i n t p a in s i n t h e l e e s and- b a c k . I 2 3 . F o rtn e r* Bo ra n tr e n d n c i n B u ild in g 1 1 , Li&y 2 , 1919* B id n o t vrork i n t h i s b u i l d i n r p r e v io u s ly and h a s c o n tin u e d t o nork i n t h i s b u i Ltding s in c e t h e above d a t e . S k in c r t is n be ran about th e n ib b le of Hay. Shot's a s l i g h t n e la n o s is e s p e c ia lly n a rk e d about th e l e f t ey e. P r e s e n ts a m ild ch i. a cue in v o lv in g tr.e f a c e , e a r s , f o r e a m s , f r o n t c f l e g s and b u tto c k s . Ko l e s i e n s cn th e n e c k . 29, R ap ar r d f f i e . Has al*-ays *,.e rk e s in B u ild in g 1 1 . Has not, *.or.<ed c u r in g o a s t 1 vet.;:; ? r a s e r a s uur.y c h lc r -c n c le s i e n s o f tnc- f a c e , c ;d n , n-ac;:, u n a c r ja v , f c r e a m s , lu g s , t T .dr te m e r aaso ccnclains cl l e t tudr.s. r i g h t c - r -n o s a y 1 -rg e l e s i e n s over a re p o s t e r i o r -ep o ca c l aac n .c k . l a c f c r e a m i shot* i n v o lv e aer but i..: t . ark i s cana..r-ala*civ fre e . I r i s *. o rk .tr w ise c o r..lw ii:s c f p .d n s i n g,c i a s ( r e e l .:*;. -uude-) . 1 J l . C-eorge I d . r a r e . Ei-g..n . s r.iin g i n b u i l d i n g i l ; r e n t e s age ard_ h s c c n a in u c d ac re : a.*.:re s i r i a . " ---7 ..c ' no .a n c tic . 7r= sn eer of - ' -- W d * A W w V. aem aa, a a i ^ on*, a.cc-ew - --*--cn^. ; .. / g " w-- 0422^ I t I t i d l l b? noted th _ t many of th e ro rk c rs com plain c f pain in th e le y s . I t at first Ihouaht ih~at th e r e v c r r cf p ry c s o rs n ic o r ig i n ,in so.~e, ana n _ lir .;e r y in e t h e r s , rut. a f t e r l i c t c ymptsms I ;m_ f o r c e d t o r e l i e v e t h . t ' i t i c p e r t c f th e r y n s s o n ccr.p ie;: c f th e ::n e i n d u s t r i a l e x p o su re Y i.ich c a u s e d th e c n lcr.-.c n e. T h is ir. th e f i r s t t i n e ttc zr y inov.lc:dge whet c h lc r u c n e V:ns accom panied ry m u sc u la r p a in s , t h e r e f o r e I c a n n o t s u g g e s t ST.T s p e c>i f i cr To' i cen t. I th ird : however, t h a t m assage and diatherm y ccv bo b e n e fic ia l* I n my c p in ic n t h e s k in c f t h e p a t i e n t s u n d e r t r e i t n e n t have im p ro v ed , e s p e c i a l l y t h e s e *..hc :a v e b een rem oved from B u ild in g Al* The number o f l e s i o n s have c lirin ic rie d an d t h e m e la n o s is Ls f a d in g o u t . th e fo ilo v rin g p ro ced u res a re recommended* 1 . S c ra p in g s froze th e T a i l s , c e i l i n g s , m a c h in e ry , e t c . , be ex--m in e d f o r th e p re s e n c e c f chlorphencls to determ ine p o in ts of g re a te s t contam ination. 2 . B u ild in g i l and e v ery th in g in s id e cf i t , k e t t l e s , m achinery, n a i l s , f lo o r s , windows, c - tc ., be d e c o n ta m in a te d by hand s c ru b b in g -,*ith s tr o n g s o .p and v a t e r a n c u s i n g s t i f f b ra s h e s h r occur* 3* The o u ts id e r a i l s , r o o f and im m ediate v i c i n i t y o f n a i l d in g 1 , b e g iv e n th e cane t r e a meni. I t n .y be n ecessary to clo se o p eratio n s in th e b a il ding fo r s e v e ra l cays in o rd er to accom plish th is* 1 . A fte r th e c le a n sin g , sc ra p in g s should e g -in be examined f o r c h lo rp h e n c ls to determ ine t h e e f f i c a c y o f th e dec c-ntami n a t i o n . 5 5 . V ,orders en g ig ed i n t h i s \.c rk s h o u ld r e a r im p e rv io u s c o v e r a l l s , L e v e r *r.d b o o ts and \*se a r r o t e c t i v e o in tm e n t, (r.'e s t r 55) or. exposed p a r t s such a s th e f a c e an d n e c k . /-T ier th e : iv r * crk th e y should ta k e a d e m is in g s/.ov.er a--we _ com plete cwungu c f c lo th e s * Yorkers in the b u ild in g a fte r the clean u r skcj t-ocr.e:.. . c r k c lo tn e s ana '-.voir d i v e o in tm en t. :e s u o iu ic a a. i -- cue's: u n cer 0 -1 2 2 2 0 7j . C 13* t 'n c r e v e r e c- sz.l c f c..lt;r.cao f:c-uli bt r*xr>ve- re r. j-uil-JLin* i u r . l i l ru cb e \ Lr_c :n *<, _ r e . t i e f i e d i t i r s - f t fo r t;:ee to re tu rn . IL . \ :.c.tever c lo ln ta th e '.verkers in b u llc iir.r l l v-cre e t t."c tin e c i t;:c r.c c i-e n t end t o I n e r i n - 1 e c c n tiin in o tic n rc c o c c c a d e d b e v e , fc c a iid be- *'ot\v d e _nedc c r h i r ^ e , 1 2 , I t .*ouid be - u d r is c - b le f o r c e t o s e e th e p a t i e n t s e t 2 r x n th o i n t e r r e l s C lnecrciy vourc, Lo'jJLr cn**.u r t --) X. !>< vst 04222?