Document o3Y9r1OGzEdgp12KdQBEKgjr

M. M. YANSANDT, A. B., M. B., M. D. Van Sandt & Van Sandt PHYSICIANS AND SURGEONS OFFICE* WEWOKA HOSPITAE WEWOKA, OKLAHOMA Aoril 14, 1956 Dr. R. A. Kehoe 345 Resor Ave . Cincinnati, Ohio Dear Dr. Kehoe: I don't expect you to remember me very definitely, but the enclosed case report, after forty^eight hours observation, is the reason for my writing you. Having never seen a case of this type, find ing very little definite work in my library or periodicals with reference to this tyoe of case, I wish you would give me your impressions. Any suggestions Ahato specific treatment, since I am using only supportive type, symptomatic in general, will be greatly appreciated. Feeling that you are qualified to give me an im pression of this, since it comes under compensation law, I feel that I need some authorative advice both as to probable etiology and any advice as to treatment. Yours truly M M V :rp Enc. P. S. I am sending this bo your home address bo make sure bhat you receive it. April 14, 1936 Aetna Casualty & Surety Company Exchange Bank Building Tulsa, Oklahoma Attn: Mr. Ford J. B. Barnes Drlg. Go. De :r Sir: Pursuant to your request by telephone yesterday, this letter la a description of the above case. This man, aged 23, married, one child, with an absolute neg.--t.ive oast history, with ref^r-*nce to any gastro- intestlonal disturbance, taken both from himself, his . rife a.nd the men with Thom he ha? worked over a period of the last four y<-\nrs. This history, from these sources, reveals that this man has always been in good health, has never b->en ill. He had been employed by the J. B. Barnes Drilling Company about five d a y s , however, he has worked a considersbio length of time in this same crew for other employers and apparently has no compensation record. The present case had its beginning about 4:30'A.M., April 10th, while cleaning out the gasoline lines of a Fred Jones Ford, motor electric plant. In doing this he sucked in end shallowed several mouths full of gasoline, the gaso line being tetra-ethylelead, or Hred gasoline**. He im mediately became ill, nauseated, vomited, but was able to finish his tower, quitting at 8 A.II. the morning of the 10th The nausea, vomiting and mild diarrhea continued through the 10th and 11th. He was unable to return to work the night following {work ng morning tower 12 mid-hight to 8 A.M.). A continuance of the disturbance lead him to take some castor oil the evening of the llth. He felt some bet ter the morning of the 12th, walked to town and took some Pluto water and repeated this the same evening. He has not vomited since the llth. O n the morning of the 13th, he was told that he looked like a corpse. He im mediately reported to our offices, at 9 A .IU , giving me the above history. 'iqU'/A '4 Aetna Casualty % Surety Company - 2 He states that his vomiting within four hours after the ingestion of the gas became black and that after sevarai bowel move-^nta these became black. He states that he has swallc-'ed gas at ether times, but has never swallowed -"Ethyl gas. . On presenting himself at the office, physical examination revealed a well developed, well nourished, white sale, not apparently in any discomfort, but terrificaily p a l e . There was absolutely no color in his face, ears, lips or nail beds. There mas no shock, very alight dyspnea on exertion; complained of a. moderate headache, which had ... been more sev re up to twenty-four hours ago. The eye :1 grounds were pale, the mucous membranes are pale; there is no visible lead line. Chest - normal Heart normal. Blood pressure 120/70. Pulse regular, full and equal. Abdomen slightly, distended, slightly tender generally, which the patient states was much more severe up to twenty-four hours ago. Extremities and reflexes normal, with the exception of marked palor of the nail beds. Laboratory* findings - rbc 1,800,000, vbc 6,000, clifferentM. count stab 2., polys 50$ r small lymphs -27, large lymphs 12, myelocytes 2, eosinophils 4, basophils 3, hemoglobin 52$ Helige, color Index 1.4. ' ' - There has been no vomltus examined-because the patient has not vomited since admission. Occult blood test shows posi tive stool specimen, but this is unreliable since I find the patient had some red. meat on the 11th. On the evening of the 13th, the following blood work showed rbo 1,900,000, v b e -.'5,600, hemoglobin 50$, differential stab l, polys 69, small lyrapha~19, large lymphs 3, eosinophils 3. This morning t h e 'following blood picture was found -- rbc 1,600,000, wbc 5,800 , 42$ hemoglobin? differential stab 6, polys 76, small lymphs 16, myelocytes 2. Aetna Casualty &. Surety Company - 3 The peti nt has been typed for transfusion and this will be done this date. His .general condition today is much the same as yesterday, as far as physical examination is concerned. I am ancing a copy of this report to Dr. Xehoe, of Cincin nati, -."ho is connected with the Ethyl Corn, there, for his impressions concerning this case. On receiving that report I will furnish you with a copy. Vary truly yours, ' drp. v a n smim & van sandt By_____________________________ MPVtrp cc - Dr.K. Xehoe, Cincinnati, Ohio ;|g i -1 Jj&t;