Document kmvErDgr2XE7apyBgZXy9wGXD

The Shell Co. of Singapore Ltd. } Singapore Branch, MacDonald House, Orchard Road, SINGAPORE. 7th October 1950 The Shell Co. of Singapore Ltd., Shell House, Collyer Quay, SINGAPORE. Dear Sirs, WOODLANDS NORTH We regret to have to inform you that three of our daily-paid labourers are now in hospital suffering from suspected lead poisoning. Furthermore, two others who reported feeling unwell have been examined by the Company's Doctor. We have recently been cleaning Woodlands North Tank No. 3 which has been in use for the storage of leaded aviation gasoline and as the people concerned were directly engaged on the cleaning work we must assume that their present condition is the result of working in the tank. In order to give you a clear picture of the methods employed in undertaking the cleaning of the tank in question we give the following informations- 1. After the tank had been emptied of 100 Octane Aviation gasoline it was filled with water to over-flowing for the purpose of rendering it gas-free. The tank was then drained out com pletely but since slight traces of gasoline were detected it was again refilled to approximately halfway for the purpose of draining off the traces of gasoline through the main valve. After this the tank was completely drained. 2. On the 8th September the one manhole cover on the front end of the tank and which, as you are aware is located within the tank tunnel, was removed and the tank left open to gas-free until the iVth September. 3. On the l^-th September Bennett together with a N 24427 y PRIVATE & CONFIDENTIAL 7th October 1950 The Shell Co. of Singapore Ltd., Shell House, Collyer Quay, SINGAPORE. Dear Sirs, WOODLANDS NORTH We regret to have to inform you that three of our daily-paid labourers are now in hospital suffering from suspected lead poisoning. Furthermore, two others who reported feeling unwell have been examined by the Company's Doctor. We have recently been cleaning Woodlands North Tank No. 3 which has been in use for the storage of leaded aviation gasoline and as the people concerned were directly engaged on the cleaning work we must assume that their present condition is the result of working in the tank. In order to give you a clear picture of the methods employed in undertaking the cleaning of the tank in question we give the following information:- 1. After the tank had been emptied of 100 Octane Aviation gasoline it was filled with water to over-flowing for the purpose of rendering it gas-free. The tank was then drained out com pletely but since slight traces of gasoline were detected it was again refilled to approximately halfway for the purpose of draining off the traces of gasoline through the main valve. After this the tank was completely drained. 2. On the 8th September the one manhole cover on the front end of the tank and which, as you are aware is located within the tank tunnel, was removed and the tank left open to gas-free until the l^fth September. 3. On the lMjh September Bennett together with a fitter and four labourers - all clad in overalls, rubber knee-boots and gloves (but without res pirators) entered the tank in order to lay a hose from the water line in the tunnel to the extreme end of the tank. We should like to add that our purpose in placing the hose at the extreme end of the tank - which is 150 feet long - was that we planned to pump water from the far end along the bottom in order to wash any sludge remaining back towards the manhole cover through which it was allowed to flow out along the tunnel into the drain and eventually into the sea. These men were in the tanks for about 5-10 minutes only. 4^ 1 - 2- With the hose in place on the morning of the l*+th September water was pumped from the jetty at the rate of approximately 35 tons per hour and this flushing continued during working hours until the 18th by which time all sludge appeared to have been cleared and the water running back through the manhole was clean and, we assumed, sludge-free 5. Under the supervision of Bennett, five men clad in protective clothing (but without respirators) entered the tank on the 18th September for the purpose of hosing and sweeping. Here we wish to emphasise that the surfaces were kept running wet from two hoses during the whole period of cleaning. However at one period Khamis bin Mohomed, Ali bin Abu Bakar and Jaffar bin Suboh were found to have removed the overalls from their shoulders,,and were working with their bodies uncover#!^ ^xiiese' men worked approximately one hour in the tank with half-hourly intervals in the open. 6. Cleaning work continued from the 18th to 27th September with a break of four days, three whilst a tanker was discharging into an adjacent tank and one on "Hari Raya". During this period an internal inspection of the tank: was made by the Branch Engineer. 7. Having completed all cleaning work by the 27th September, Contractor Wong & Co. commenced work laying a concrete bottom to the tank, its purpose being to facilitate the draining of water after the receipt of cargoes of aviation spirit. On the 28th September a further internal inspection of the tank work was made by the Branch Engineer. Concreting work was completed on the 3rd October and at the time of writing no ill-effeets have . been reported by the Contractor's \irorkmen. 8 On the 29th September the following Depot Labourers who formed the cleaning gang complained of sickness and headaches KE 0020949 and alX but (who refused to atten the Company's oocnor; were sent to Dr. Robertson for s s : s ss r M rsSSsa r - a- S - S T aludpe-fre nnder the supervision of Bennett, five men clad in protective clothing (Jut .without respirators) entered the tank on the 18th September for the purpose of hosing and sweeping. Here we wish to emphasise that the surfaces were kept running wet from two hoses during the whole period of cleaning. iri r at |i ^ HBtand kin to have T H P i r e e overalls !'W>I UiUlr s h o u l ^ g r s ^ d were working with their bodies uncover*^ ^These'men worked approximately one hour in the tank with half-hourly intervals in the open. Cleaning work continued from the 18th to 27th September with a break of four days, three whilst a tanker was discharging into an adjacent tank and one on "Hari Raya". During this period an internal inspection of the tank was made by the Branch Engineer. Having completed all cleaning work by the 27th September, Contractor Wong & Co. commenced work laying a concrete bottom to the tank, its purpose being to facilitate the draining of water after the receipt of cargoes of aviation spirit. On the 28th September a further internal inspection of the tank work was made by the Branch Engineer. Concreting work was completed on the 3rd October and at the time of writing no ill-effeets have been reported by the Contractor's workmen. On the 29th September the following Depot Labourers who formed the cleaning gang complained of sickness and head aches and all t>ix-b (who rorasea -bo attend the Company-s Doctor j w S J ^ S f f t to Dr. Robertson for examination on the 29th September. Unfortunately at that stage the Doctor was not informed as to the type of work upon which the men had been engaged and in his report on each man no reference was made of sus pected lead poisoning. Copies of the Doctor's reports are enclosed herewith (see enclosures A,B,C, and D). ' KE 0020950 9. On the morning of the 2nd October we were informed that the three men who had been examined by Dr. Robertson were still unwell and was unable to get up from his bec^^iieaTisini^xhat lead poisoning may have been the cause of the trouble our Branch Engineer telephoned Dr. Smith, explained to him exactly what the men had been doing and requested and ^ m m H B p i K w e r ^ q u ^ e ^ a b i ^ t^wsLu^ibou^^* and they v e r ^ ^ ^ ^ ^ ^ ^ j ^ ^ m i t h 's surgery but in the case of > Or. Frame visitted him at his h o m e ^ ^ A l t e r ine examinations Dr, Smith telephoned Mr. Dobree and informed him that he could find no trace of lead poisoning and in his reports (refer enclosures B, C, and D), you will note that this telephonic advice is confirmed. 10. Dr. Fr dvlsed the Branch Engineer verbally ;hat _ was found to be acting in a peculiar manner out he was not sure of the cause and recommended that the man be admitted into hospital for observation. A letter of admittance to the 1. Singapore, was given by the Doctor to and the Depot Superintendent arraS ^ e a f o r t h l ^ a a n to be transported to the General Hospital immediately, but he refused to enter hospital and was seen the same evening in the vicinity of Woodlands. He claimed that he did not know where to go and that he would treat himself with some local medicine. The Superintendent informed him that since he had disobeyed the Doctor's instructions he would o have himself to blame if anything serious happened. .11 On the tfth October condition had worsened and he w a ^ ^ a k e i ^ 3 ^ n ^ ? e p o t Superin tendent and admitted to Johore Bahru Hospital. The Medical Officer on duty was advised verbally of our suspicions and he has since advised that the man is still under observation but lead poisoning has not yet been established. The medical report we have called for is still awaited and this will be sent to you in due course. The Medical Officer-in-Charge also intimated that it would be necessary for him to report the matter to the Singapore Health Authoriti KE 0020951 12. _____ who was examined by Dr, Smith on the 2nd October showed no signs of progress, in fact his condition deteriorated somewhat" and on the morning of the 5th October he was reported to the Branch Engineer as behaving in a peculiar manner and in structions were issued for him to be taken to Johore Bahru Hospital immediately. This was done and he was admitted. The Medical Officer-in-Charge was again advised of our suspicions and this man is at lead poisoning may have been the cause of the trouble our Branch Engineer telephoned Dr. Smith, explained to him exactly what the men had been doing and requested that he carry out an immediate examination of eaci and __ and they wereservtJ^Dr^jjm^bh 's surgery but in the case of Dr. Frame visiftted him at his h o m ^ ^ After the examinations Dr* Smith telephoned Mr. Dobree and informed him that he could find no trace of lead poisoning and in his reports (refer enclosures B, C, and D), you will note that this telephonic advice is confirmed. 10. D r ^ F ^ m ^ a d y ^ e d t h e Branch Engineer verbally that f H H H H H P v a s found to be acting in a pecrnTa^fflffll^^TOt he was not sure of the cause and recommended that the man be admitted into hospital for observation. A letter of admittance to the Genera^^gSJ^ta^^^igapore, was given by the Doctor the Depot Superintendent arranged for this man to be transported to the General Hospital immediately, but he refused to enter hospital and was seen the same evening in the vicinity of Woodlands. He claimed that he did not know where to go and that he would treat himself with some local medicine. The Superintendent informed him that since he had disobeyed the Doctor's instructions he would onl have himself to blame if anything serious happened. 11, On the ifth October condition had worsened and he wa^Tak e r ^ 5 y ^ n ^ 5 e p o t Superin tendent and admitted to Johore Bahru Hospital. The Medical Officer on duty was advised verbally of our suspicions and he has since advised that the man is still under observation but lead poisoning has not yet been established. The medical report we have called for is still awaited and this will be sent to you in due course. The Medical Officer-in-Charge also intimated that it would be necessary for him to report the matter to the Singapore Health Authorities 12. who was examined by Dr, Smith on the Hid October showed no signs of progress, in fact his condition deteriorated somewhat and on the morning of the 5th October he was reported to the Branch Engineer as behaving in a peculiar manner and in structions -were issued for him to be taken to Johore Bahru Hospital immediately. This was done and he was admitted. The Medical Officer-in-Charge was again advised of our suspicions and this man is at present under observation'but lead poisoning has not yet been established and the MedicaTOfficerLs Remot is awaited. As in the else o f t f --the matter will be reported to the mgapore Heal Authorities. If / / -If- 13 was again examined by Dp. Smith onHih^ftfOJctober who advised "I cannot find any evidence of organic disease - advise continue present medicine - report in three days". This man appeared to be much better on 5th October but we allowed him to rest. However on the 6th October as he complained of occasional loss of the use of his arms he was sent for yet another exami nation this time by Dr. Frame, who recommended that he be admitted to hospital and the same evening he entered the Johore Bahru Hospital for observation. Dr. Smith at the time he on the 2nd October told him to report for a further examination on the 5th October but on the morning of the 5th he reported for duty saying he was quite well. However since he was a suspect we insisted that he be re-examined by the Doctor. Once more the Doctor reported that the tests carried out were negative and he is apparently alright. (Refer Enclosure10 1 for Doctor 1s Resort) 15. in addition to the four men already mentioned, Bennett and three other of our workmen were engaged on the cleaning and modification of this tank and since we wished to ensure that they were all free from the effects of possible lead absorption we arranged for the remainder to be medically examined and this is being done today, Saturday 7th October. Acting on the advice of Dr. Frame we have issued to the Depot Superintendent for distribution calcium lactate tablets which the men are taking three times a day, and we are also supplying them with a pint of milk morning and afternoon as a precautionary me asure. 16. Recapitulating, it will be appreciated that the only times during which any of the men were exposed to the lead hazard without suitable respirators was (a) when Bennett ftccomnanl<=>d hv fitter Chew Tonrr nnd fnur labours and ________________ _ __________ __ Entered th^TS!B^PIW?TffFl^^for the purpose placing the hose in position and this part of the operation took 5 to 10 minutes and (b; during the cleaning operations between 18th and 27th September. However as we have said the plates of the tank were kept wet and in Jew of this we considered the risk of lead absorption due to inhalation to be small and since no really suitable respirators were available at the time, we con sidered tne calculated risk taken regarding the HE 0020953 v* ii.- rva vuKuuoi wnu auvisea x cannot find any evidence of organic disease - advise continue presentmedicine - report in three days". This man appeared to be much better on 5th October but we allowed him to rest. However on the 6th October as he complained of occasional loss of the use of his arms he was sent for yet another exami nation this time by Dr. Frame, who recommended that he be admitted to hospital and the same evening he entered the Johore Bahru Hospital for observation. 1*+. Dr. Smith at the time he examined this man on the 2nd October told him to report for a further examination on the 5th October but on the morning of the 5th he reported for duty saying he was quite well. However since he was a suspect we insisted that he be re-examined by the Doctor. Once more the Doctor reported that the tests carried out were negative and he is apparently alright. (Refer Enclosure1D ' for Doctor's Rerort) 15. In addition to the four men already mentioned, Bennett and three other of our workmen were engaged on the cleaning and modification of this tank and since we wished to ensure that they were all free from the effects of possible lead absorption we arranged for the remainder to be medically examined and this is being done today, Saturday 7th October. Acting on the advice of Dr. Frame we have issued to the Depot Superintendent for distribution calcium lactate tablets which the men are taking three times a day, and we are also supplying them with a pint of milk morning and afternoon as a precautionary measure. 16. Recapitulating, it will be appreciated that the only times during which any of the men were exposed to the lead hazard without suitable respirators was (a) when Bennett accomp^Led bv fitter Chew Tong_aa-2ur labourers^_________ ______ tan d anc ____ __ .entered t h ^ a t i n n m a n y for the purpose 'of"placing the hose in position and this part of the operation took 5 to 10 minutes and (b; during the cleaning operations between 18th and 27th September. However as we have said the plates of the tank were kept wet and in view of this we considered the risk of lead absorption due to inhalation to be small and since no really suitable respirators were available at the time, we con sidered the calculated risk taken regarding the latter not to be unjustified. Absorption through the skin at this stage was con sidered to be unlikely as rubber gloves, rubber boots and overalls were used. Neither Bennett nor the fitter have suffered any ill-effects and both have been medically examined with negative results. - 5- 17 lie also considered it reasonable to suppose that '* after having puraped approximately 1100 tons of water along the bottom of this tank from the far end it would have been sludge-free before the actual cleaning work commenced and our supposition was qualified (to some extent) by the fact that the water flowing back from the tank was clean. 18. Having assumed the tank to be sludge-free the cleaning party equipped with brooms and two hoses entered the tank on 18th September and commenced hosing and sweeping. It is pointed out however that small quantities of sludge had become en trapped - along the bottom - in the angle of the tank ribs and this was swilled out with water. 19. Enquiries are made daily regarding the condition of the men in hospital. Our BranchEng^iee^^^ end in hospitsp^u^ue Uiitober ariaTTTTOI details of this visit are given in Enclosures A & B. Perhaps we should mention that we were unable to interview the Medical Officer In charge of the case as he was axtfay from the hospital at the time and the Duty Medical Officer - -we were advised by the Superintendent - knew nothing of the case. The Branch Engineer therefore telephoned Dr. Frame and it was arranged that in company 'tilth Mr. Dobree the three would visit the hospital on Sunday, 8th October for an interview with the Medical Officer- in- charge. 20. To date the general position is still fluid but since we are anxious to acquaint you with the facts this report is being despatched and we shall keep you advised of further developments. Yours faithfully, K E 0020955 P.S. Qq-fober 8th __ and Visited oyur. Wallace CMedical Dfficer-In-charge,Johore Bahru Hospital), Dr. Frame, Messrs. Dobree and Jones Both patients showed signs of improvement but we ^ea^iered were occasionally violent. k ^ 1 *&i^nZ K seen durinS this visit b i l W W ^ W i a c e ^ W f H f e d that he was in a general ward. However during the night of 7th restraint at one sta^e was Wallace Informed us that hecon! sidered all had a fair chance of recovery. No positive signs of lead poisoning had been establishe / ,/ J ENCLOSURE HArt NAME: ADDRESS : ampong Woodlands Age: 30 years Joined Company: 15.*+.19^6 1. Periods of work in tank (a) l^th September - For a period of 5-10 minutes for the purpose of placing hose in position at end of tank. (b) 13th to 27th September (with break of *+ days 22nd 25th September inclusive) - engaged on washing and sweeping out of tank. 2. Date first reported feeling unwell - 29th September 3 . Visits to Company^ Doctor - None - refused to report for medical examination 29th September. *+. Visits by Company's Doctor - examined at home by Dr. Frame on 2nd October who recommended hospital treatment. 5. Action - Sent on 2nd October in packed lorry to Singapore and left at General Hospital entrance. Did not report to hospital and was later seen at Woodlands the same evening. Advised Depcfc Supt. he did not know where the hospital was and would take local medicine. October -3rd - Unwilling to be taken to hospital. October fy-th - Condition worse and persuaded to go with Depot Supt. to Johore Bahru Hospital where he was admitted "under observation". Medical-Officerin-Charge requested to issue Medical Report as soon as possible. October 5th - Patient became violent and placed in barred enclosure. 6. Remarks ,Qc&ob,e - Visited in hospital by Branch Engineer. Patient found lying on floor of enclosure unconscious having earlier been given a suppressive injection. t" Ho Doctors were in the hospital at the time and the Tf Tf Branch Engineer was informed that the Medical Officer in-Charge of the case was off duty and the Duty Medical Officer at home. It was suggested that the 0020956 - wujTK m tank: -(a) iM-th September - For a period of 5-10 minutes for the purpose of placing hose in position at end of ' tank. (b) 18th to 27th September (with break of 1+ days 22nd - 25th September inclusive) - engaged on washing and sweeping out of tank. 2. Date first reported feeling unwell - 29th September 3 . Visits to Company's Doctor - None - refused to report for medical examination 29th September. If. Visits by Company*s Doctor - examined at home by Dr. Frame on 2nd October who recommended hospital treatment. 5. Action - Sent on 2nd October in packed lorry to Singapore and left at General Hospital entrance. Did not report to hospital and was later seen at Woodlands the same evening. Advised Depcfc Supt. he did not know where the hospital was and would take local medicine. October 8rd - Unwilling to be taken to hospital. October *fth - Condition worse and persuaded to go with Depot Supt. to Johore Bahru Hospital where he was admitted "under observation". Medical-Officerin-Charge requested to issue Medical Report as soon as possible. October 5th - Patient became violent and placed in barred enclosure. 6.. Remarks 6th October - Visited in hospital by Branch Engineer. Patient found lying on floor of enclosure unconscious having earlier been given a suppressive injection. No Doctors were in the hospital at the time and the Branch Engineer was informed that the Medical Officer in-Charge of the case was off duty and the Duty Medical Officer at home. It was suggested that the Duty Medical Officer be called out but as the Super visor advised that the Duty Officer had not attended the case it was decided to call again in company with Dr. Frame, 7th October - Patient's wife and mother called at Woodlands Depot to say they wished to remove the patient from the hospital. Depot Supt. instructed by Branch Engineer to request them to refrain until a further visit had been made by the Branch Engineer and Dr. Frame. Hospital advised patient had had a bad night. 8th October - Visi^ted by Dr. Wallace (Medical Office in Charge7~Johore Bahru Hospital), Dr. Frame, Messrs. Dobree and Jones. Noticeable improvement in condition On this occasion he was conscious. Had had a better / i i t 'S / // ENCLOSURE B WAMS: ADDRESS: 37, Jalan Ibrahim Johore. Age:21 years Joined Company: 2.1.19^7 1. Periods of Work in Tank (a) l*fth September - for a period of 5**10 minutes for the purpose of placing hose in position at end of tank. (b) 18th to 27th Sept, (with break of b days - 22nd -25th Sept.) engaged on washing and sweeping of tank. 2. Date first reported feeling unwell - 29th September 3. Visits to Companyfs Doctor. 1st. 29th September examined by Dr. Robertson. Report - "Influenza". 2nd. 2nd October - examined by Dr^ Smith. Report - "Pains left shoulder and leg - insomnia 3 days' duration only. Ho indication due to lead" . By ^th October condition deteriorated with violent spells. if. Action. ^th October Taken to Johore Bahru Hospital and admitted ''under observation". 6th October Became violent and placed in barred enclosur Remarks. Visited by Branch Engineer - patient found naked (having undressed himself) in barred enclosure. Behaving in violent manner and shouting - recog nized Mr. Jones who he called by name. Con versation unintelligible. Ho doctors were present in the hospital at the time of the visit and the Branch Engineer was informed that the M.O. jin charge of the case was off duty and the Duty M.O. at home. It was suggested that the Duty M.O. be called out but as the supervisor advised that the Duty Officer had not attended the case it was decided to call again in company with Dr. Frame. 7th October Hospital advised patient had had a bad night. 8th October Visited by Dr. Wallace (Medical 8360200 3 1. Periods of Work in Tank (a) 14-th September - for a period of 5*10 minutes for the purpose of placing hose in position at end of tank* (b) 18th to 27th Sept, (with break of 4- days - 22nd -25th Sept.) engaged on washing and sweeping of tank. 2. Date first reported feeling unwell - 29th September 3 . Visits to Company*3 Doctor. 1st. 29th September examined by Dr. Bobertson. Report - "Influenza". 2nd. 2nd October - examined by Dr* Smith. Report - "Pains left shoulder and leg - Insomnia 3 days' duration only. Ho indication due to lead". By 4-th October condition deteriorated with violent spells. 4-. Action. 5th October Taken to Johore Bahru Hospital and admitted "under observation". 6th October Became violent and placed in barred enclosur ?. Remarks. Visited by Branch Engineer - patient found naked (having undressed himself) in barred enclosure. Behaving in violent manner and shouting - recog nized Mr. Jones who he called by name. Con versation unintelligible. No doctors were present in the hospital at the time of the visit and the Branch Engineer was informed that the M.O. in charge of the case was off duty and the Duty M.O. at home. It was suggested that the Duty M.O. be called out but as the supervisor advised that the Duty Officer had not attended the case it was decided to call again in company with Dr. Frame. 7th October Hospital advised patient had had a bad night. 8th October Visited by Dr. Wallaae (Medical Officer in charge Johore Bahru Hospital), Dr. Frame, Messrs. Dobree and Jones. Noticeable improvement in condition. On this occasion was less violent and clad in shorts. Had passed a better night. Kt 0020959 ADDRESS: Ho. 31 - Kampong Woodlands Jo;lned company:29.6.19^6. 1. Periods of Work in Tank (a) lVfch Sept, for a period of 5-10 minutes for the purpose of placing hose in position at end of tank. (b) 18th to 27th Sept, (with break of days 22nd - 25th Sept, inclusive) engaged on washing and sweeping of tank. 2. Date first reported feeling unwell - 29th September 3 Visits to Company*s Doctor: 1st - 29th Sept. - Examined by Dr. Robertson Report "Mild Bronchitis" 2nd - 2nd Oct. - Examined by Dr. Smith. Report "Complains of insomnia but says he sleeps from 8 p.m. to 3 a.m. No com plaint when work easy but when rush of work gets odd aches and pains and cannot sleep. I cannot find any sign of disease." 3rd - Vth Oct. - Examined by Dr. Smith. Report "I cannot find any evidence of organic disease. Advise continue present medicine - report in 3 days. ifth - 6th Oct. . - Examined by Dr. Frame. Report (verbal). No trace of lead poisoning but recommended enter hos pital for observation. if. Action 6th Oct. Taken to Johore Bahru Hospital and admitted "under observation". 5. Remarks. Before entering hospital this man suffered lapses of memory and appeared unsteady. He also developed bouts of trembling. 8th October Accommodated in a general ward but during night of 7th restraint necessary. HE 0020960 \ ENCLOSURE *D1 ADDRESS > 31-P Kampong Woodlands Age 21 years Joined Companyi l ^ A . l ^ 1. Periods of work in tank 18th to 27th Sept, (with break of b days - 22nd Sept to 25th Sept.) engaged on washing and sweeping of tank. 2. Date first reported feeling unwell 29th September 3. Visits to Company's Doctor 1st - 29th Sept. Examined by Dr. Robertson. Report - "Headache - cause unknown". 2nd - 2nd Oct. Examined by Dr. Smith. Report - "Cough 3 days - probably cataErh. No evidence of lead pdsoning". 3rd - 6th Oct. Examined by Dr. Frame. Report "1 examined the above employee, one of the gang of labourers exposed to lead poisoning on tank cleaning operations. He himself made no com plaints and stated that he was in good health. Direct questioning on the signs and symptoms of lead poisoning were entirely negative. A general physical examination was carried out, special attention being paid to the digestive, nervous and bbod systems. In all cases the examination revealed nothing of a suspicious nature and a thin blood film revealed no sign of a Punctate Bosophilia". *+. Action 6th October - on Doctor's verbal recommendation issued with 2 pints of milk per day and $ calciu lsobate tablets. This will be continued for a month. 5. Remarks this man is working but will be examined again should it be considered necessary. 0020961