Document pBny6jdX2NgNg5OXpV4Znd7ZB

(YY THE KETTERING LABORATORY COLLEGE OP MEDICINE, UNIVERSITY CP CINCINNATI EDEN AND BETHESDA AVENUES CINCINNATI 1 9 , OHIO INSTRUCTIONS : BEFORE PROCEEDING PLEASE READ THE REVERSE SIDE OF THIS FORM The i n f o r m a t i o n r e q u i r e d b e lo w i s o f m a j o r i m p o r t a n c e .f o r t h e p e r f o r m a n c e c f t h e s e r v i c e t h a t y o u h ave r e q u e s t e d . FAILURE TO COMPLETE THIS SECTION OF THE FORM FULLY - w i l l r e s u l t i n d e l a y i n c a r r y i n g ' o u t b o t h t h e a n a l y s i s and the subsequent i n t e r p r e t a t i o n (where a p p lic a b le ) of the r e s u l t s . P l e a s e PRINT o r TYPE. Patient : Name Address Nor t h Char l est on, S. C. City Zone S ta te Race y s e x m Agez+s I n d i g e n t _____P r i v a t e x O t h e r _______________ H o s p i t a l : _____________________________ ____________________ ______________________ "Name Address C ity ' Zone StaTe" R e q u e s t e d b y : Dr . C. H. Bayl or Name Texaco Co. Address _____ New Yor k, ______ 17 1 C ity Zone N. Y. State- B i l l : D o c t o r ____ H o s p i t a l ___ O t h e r Texaco Co. ______ ____________________________ Send R e p o r t To : D o c t o r x H o s p i t a l ______O t h e r __________________________________ I n v e s t i g a t i o n D e s i r e d : _______________________________________________________________ H is t o r y : In c lu d e n a t u r e of e x p o su re , a c t u a l tim e of exposure i f known o r surm ised, and e s p e c ia lly the l a s t day or hour of exposure; c h a ra c te r and time of onset of ill n e s s ; course of illn e s s and p resen t s ta tu s ; previous p e r t i n e n t m e d i c a l h i s t o r y . Ti me and nat ur e of exposur e not known. Devel oped weakness gr i p and of ext ensor muscl es of r i ght wr i st i n November 1962. No def i ni t e r ef l ex changes. P h y s i c a l F i n d i n g s : Weakness of f l exor and ext ensor muscl es of r i ght hand. BP 140/ 100. P e r t i n e n t L a b o r a t o r y F i n d i n g s : 2k sampl es of ur i ne r epor t ed as showi ng l ead - 1 - 3. 6 mg. # 2 - negat i ve. # 3 - 1. 6 mg. # k - negat i ve. # 5 - negat i ve. # 6 - negat i ve, l o st i ppl i ng of r ed cel l s. seen. I m p r e s s i o n : Pr obabl e l ead poi soni ng wi t h per i pher al neur opat hy. Treatm ent: Specify medications and dates of in s titu tio n and completion of t h e r a p y . 500 mg. Ver senat e gi ven I - V t wi ce a day f or 5 days - Dec. 8- 12, 1962. N13175 The K e tte r in g L ab o rato ry i s a t o t a l l y s e i f - s u p p o r te d r e s e a r c h u n i t the U niversity of C incinnati engaged in research in the f i e l d s of i n d u s t r i a l hygiene and m e d ic in e . The L a b o ra to ry i s n o t a m ed ica l s e r v i c e lab o rato ry , and c lin ic a l d iag n o stic se rv ic e s, as such, are not performed. We do u n d e r t a k e t o a s s i s t p h y s i c i a n s w i t h t o x i c o l o g i c p r o b l e m s o r o t h e r s p e c i a l problems in t h i s and r e l a t e d f i e l d s , as a c o u rte s y , when adequate f a c i l i t i e s a r e n o t a v a i l a b l e l o c a l l y . We s h a l l make e v e r y e f f o r t t o be o f a s s i s t a n c e p r o v i d e d t h a t we c a n o b t a i n t h e i n f o r m a t i o n we r e q u i r e , and i f the work th a t is to be done w ill y ie ld , in our opinion, inform ation t h a t w i l l be h e lp f u l in e s t a b l i s h i n g a d ia g n o s is , in the management of a case, in teaching, or in contributing to a b e tte r understanding of physiologic or pathologic mechanisms. MO SPECIMEN WILL BE ACCEPTED FOR ANALYSIS UNLESS PRIOR ARRANGEMENTS m MADE BY TEE 'TTEDMx R "KSIR RESFTS lAW WITH A PHYSTTi r T N THE EEt EIING" LA'OKTOr Y Ts i s n e c e s s a r y f o r a number 'of reaso n s. F i r s t , unless proper specimens are c o lle c te d w ith s p e c if ie d c a re , in s p e c ia lly processed c o n ta in e rs , and in adequate amounts, they a re l i k e l y to be contam inated or u n s u ita b le f o r a n a l y s i s . S e c o n d , we m u st be s u r e t h a t we a r e a w a r e o f p e r t i n e n t h i s t o r i c a l f a c t s a n d c l i n i c a l f i n d i n g s s i n c e we p r o v i d e f r e q u e n t l y i n t e r p r e t a t i o n s o f t h e r e s u l t s , T h i r d , ou.r s t a f f members m ust f r e q u e n t l y r e v i s e work sc h e d u le s on sp o n so red r e s e a r c h in o r d e r t o c a r r y out th e a n a l y s i s . The L a b o ra to ry makes a charge f o r r e 'mbursement of th e a c t u a l c o s t of the service performed, since otherwise funds earmarked fo r research w i l l be e x p e n d e d f o r m e d i c a l s e r v i c e ue vi a t .. on 1 r om t h u s >o 15 made when pat:' e n t s a r e in d i g e n t o r when t h e c o s t of t h e s e r v i c e would cause undue economic h a rd sh ip . T h erefore, i t is requested th a t the a t t e n d i n g p h y s i c i a n a s s i s t us by m a rk in g t h e a p p r o p r i a t e l i n e on th e r e v e r s e sid e of t h i s form., ' 4. K 001 34, Form G - 44 : r J E ZSG ..: V CO < > Date / V / G^/> 3 _______ n___ d O f c -C. c? * / : ase: Attend to N o t e and return ' Pr ep ar e r ep l y f o r m y , As r eq u est ed Slan at u r e i!Lr--J 1 r Fo r your ,1 com m ents ; Sen d m e i n f o r m at i o n ! an d su g g est i o n s ; | N o t e and fo rw ard to req u ired t o answer j Q Does at t ach ed m eet i Fi les V 7"" . "1 w i t h yo u r a p p r o v a l ? . Sf r o r yo u r i n f o r m at i o n j _ See (p h o n e ) m e re ^ ! [ j Fo r si g n at u r e, i f you ' at t ach ed As per con versation I ap p ro ve Other Remarks :z C t/ 6 i c* . 1 -- t ` sj -J i i you N13175.01 Kfc O O l i , i 4d 165 RU T LED G E A V EM C H A R L E S T O N . S. C It .JO.) /' / J a n u a r y 12, 1`j o 4 Dr . C. UH. Ba y l o r Tex ac o. i nc . 135 Eas e f +2nd St r ee t Ne w Yor k , 17. Ne w Yo r k Dear Dr . Bay l or : Th a n k y o u v e r y mu c h f or y o u r l et t er of J a n u a r y 3, 1363 For your f u r t h e r i n f o r ma t i o n I a m e n c l r y u y a c o p; of my : : s ehu s u mma r y on Mr . f l j j j HHHHH f o l l o wi n g hi s d i s c h a r g e f r o m t he Ro p er Ho s p i t al l as t Hr i t ol d me t hat he had a l s o us ed s ome ma t e r i a i s cont ai ni ng l c . wo r k at home. Wh e t h e r or not he had l ead p o i s o n i n g , and f r o m wh a t s o u r c e i t wa s d e r i v e d , i t i s c e r t a i n l y q u e s t i o n a b l e . Our l a b o r a t o r y h e r e has r e p o r t e d l ead i n a f a i r l y l ar ge n u mb e r of c a s e s , s ome q u e s t i o n a b l e , but . wi t h t he. t y pi c al p e r i p h e r a l n e u r o p a t h y 1 do not t h i n k i t c an be c o mp l e t e l y d i s c o u n t e d . I shal l be gl ad t o have any i deas f r om y ou and c er t ai nl y t o s end a n y s p e c i me n s t o Dr . Ke h o e i f y o u wi s h . RW: v m S i nci - r e 1y y o u r s , >- ' ' \ H h5l\ l c t v ^ Ro b e r t Wi l s o n , M. D . rt 4 N13175.02 He 00.1f.54 j AV Dr . C . H . 3 a y i o r Tex a c o , or . 135 Eas t c, 2r d St r e e t Ne w Yor k , 17, Na w Yo r k Dea r Or . Sa y l or : So . r 3 ! 0a y s agei 1 s ent y o u a c o p y c * ny u ; u c t o r c e *. :v -- : oil ; wnen he 1- f t t he R0per Ho s p i t a l . One adui i t i on a 1 f ac t i s n 0 ;':e t r ;..i : .0 L ,rt "i j r * ng t pa s t s p r i n u he had us ed s ome - : nd of s o ! v on r i : , 1) i s heme . He S not s ur e wh e t h e r or no: t he pa i r, t r un: any P 3. h . A d i d f i nd ;i -t t hat t he s ol v ent di d not havt s t hi s . Si r ? ` e a v i n q t he h o s p i t al hp k, as s h own Hpf i o ; t ' - 1- ' : . 1 s a w h i m on De c e mb e r 2 6t h t he g r i p i n t he r i ght h a nd wa s ar t ; t e i y we ak ; i Les t t hi s by h a v i n g t he p a t i e n t s q u e e z e a s p h y g mo ma n o me t e r ana che<. t he r e ad i n g, s t a n d a r d i z i n g i t s o t hat my g r i p e q u a l s 200 mm of me r c u r y p r e s s u r e . On De c e mb e r 26t h t he r e ad i n g of hi s s t r e n g t h i n t he r i ght h and me a s u r e d I r i s wa y was o O mm. , an d wh e n i l as t s a w h i m on J a n u a r y 12t h i t wa s 160 mm. Th i s i s a r ough t es t but i t d o e s v e d e f i n i t e e v i d e n c e of t he s t r e n g t h . 1 hav e s a mp l e s of hi s ' mr wr i t i n on t hes e . wo o c c a s i o n s and t he l at t er i s d e f i n i t e l y c l e a r e r and he r hi i i - s mo r e l i k e t hat of hi s o wn us ual wr i t i n g . Du r i n g t hi s i nt er v al he has b e e n on ; 00 mq . of t h i a mi n c h l o r i d e a day . I h a v e r e c e i v e d t he r e q u e s t s t o s end s a mp l e s of b l o o d ar i d u r i n e t o Dr . R. A. Ke ho e, an d t he s e we r e ma i l e d t wo d a y s ago. Si n c e r e l y y our s , RW: v m ,- Ro b e r t Wi l s o n , M. D. ) N13175.03 K & 00 j &55 0 P a tien t* A cfo itted t 12- 6- 62 Pd'f-IR T'fh.AL r c ?.: dblifiK H o sp it a l t e b e r * B37h36 Disci?, a'10BdJ 12-13-62 xffca p a tie n t a s a ij8 year o ld clsm ist ?*i;o w*s e>ur-ined ou b'overabcr 2 3 , 1?62 because p y thi? recc.tt d . velop n en t o f p ain s in both arras, t.iore on the r ig h t than on the l e f t , and weakness In the r ig h t hand* fo e blood p ressu re treus 1UQ/10G* There wa . s-r.-ne corunjsri In V ie carta t o f th e right, era- U e fle x e s were s l i g h t l y in c r ea se d -n a c t i v i t y , the .rip l i ] the r ig h t .-and .as much weaker than th a t in the l e f t hand arid so v a s tn e s s o f the vSa&Qnsor rm aclss o f the ri.-.b:. w r is t was p r e s e n t, w ith a d e f in it e *e r ip n e r n l neuropathy* JU^d p o iso n in g v?es su sp ected and a 2i* hour sample o f t.v*> u rin e snowed 3*7 npia o f le a d ^ jbn yre sen t On rep eatin g th e t e s t no lea d wan f u n d but a 3rd cpeciraen 1*6 m@n w. reporter? and th e p a t ie n t was sebnitted to th e hoopi- a l fo r Vui.-si.noi f orapy* heno r....i end u r in a ly s is uor- n e g a tiv e * The blood sugar was 80 m<an%a A C!1N 17i b '> m y o f th e e n t ir e 01 .r a c t r w ith in no m a l lim it s * The p a tie n t -.ran given $0:-- mgtn o f Vorecnate Y b * i,d * fo r days* Uo load was found 'in Be r specim ens o f the ux-lns arid i t war- not com p letely determ ined th a t load p o iso n in g tho causa o f the d i f f i c u l t y , but w ith the fin d tn y c o f load in some specim ens a-u-' ty p ic a l oripbercX neuropathy tho d ia g n o sis o f probable load p o iso n in g was nncJe* The p a tie n t wnc d I k c >.arged as improved on December 13 1?62* F inal Diagnosis* Probable lead poisoning* with j rlp h era l neuropathy ) mdb N13175.04 K 0 1?,3 b i