Document pm9QVVJNeGGq79vJmZOgMVe8B

ty'> j i L.i A ; S T . J O H N , M . D . 25 CH A RTER OAK AVENUE Ha r t f o r d , - C o n n e c t i c u t ' V'":"": ; :-V-u'isiSi-r.,: September 29, 1932. Standard. Oil Company of H. rersonel - Safety Dept. Medical Section 112| ,state street Albany, K r. f. . . RE: j4 . u-entlemen; \; /- T he-follow ing is a re p o rt to date on the above cases : of ^.thyl Lead ro iso n in g th a t occurred at the H artford P la n t September lo th , 1932. . -. HISTORx: The t h r e e men were assigned, to c l e a n an . n th y l Lead Tank. For two days th e y worked w ith a mask, th e th ree, g o i n g i n a n d w o r k i n g i n r e l a y s . On t h e t h i r d d a y , S e p t e m b e r 9 t h , they went in to g e th e r w ithout a mask due to th e f a c t , as they claim , t h a t t h e a i r tu b e was n o t s u f f i c i e n t l y lo n g to re a c h th e c e n te r of th e t a n k . They re m a in e d i n s i d e f o r a p e r i o d o f n i n e t y m in u te s when t h e y w ere f o r c e d t o comd o u t b e c a u s e o f f e e l i n g " d i z z y . " D iB e r n a r d , who was i n c h a r g e o f t h e j o b , a l l o w e d and t o go home . a l i t t l e e a r l i e r t h a n q u i t t i n g t i m e b e c a u s e , a s h e p u t i t , "we w e r e . a l l dizzy and sick".. .' ; ,/ S eptem ber l o t h , t h e t h r e e men r e t u r n e d t o work a f t e r p u ttin g in a sick night co m plaining of re s tle s s n e s s , insdmnia, d i z z i n e s s , v o m i t i n g a n d . d i a r r h e a . , .. ; T h e y -were f o r c e d t o q u i t , w o r k o n S e p t e m b e r l o t h a t 10 o ' c l o c k A.M. -and t h e t h r e e r e p o r t e d t o my o f f i c e . f o r e x a m in a tio n . T h eir, symptoms, were - as, f o l l o w s : . ' h . _ (1) d iz zin ess* ' _ .. - ` ' j Ti n s o m n ' i a ' rf iyg oj' . j . :. ddgh kb h f '" g"' , ; ( 3) V o m itin g ^ .. :, (4)' muscle p ain s - : - f - -- . - . (5) diarrhea*^ . ' (6) w eakness^ . ' ( 7) e x c i t a t i o n ^ . . . ... . . .. Their physical examinations at this time revealed n o t h i n g unusual. 1 concluded from-the history and findings therefore that these-men were suffering from mild gasoline-poisoning from the fumes present in the tank and after assuring them that their, cases were not serious, ordered them home. . jl p r e s c r i b e d cathartics (iipsom Salts; for their d i a rrhea and: c r a m p s , dnd. a sedative for their excitation as all" of the m .seemed uo. be ..considerably, nervous. and frightened.: ...They seemed/ to tebw a n d ^ fe b 'th a t fumes :of-/i s. t h y l L e a d w e r e d e a d l y p o i s o n o u s . i b ; f a p t l ; ;had-considerable d i f f i c u l t y in a ssu rin g them th a t 1 be- , lie v e d t h e i r symptoms were d u e .to m ild g a s o lin e p o iso n in g and n o t le a d , x / a s h e d t h e m > t o c a l l me ...the- f o l l o i n g : d a y i f .t h e y s t i l l f e l t ; s i c k a n d . dizizyi, v y ' v. . ' ' \- ' ..... } 'lb.; . b .... ' ; September 11th - _ ioth put in house c a lls w h i c h a.made about ,5 o 1c look.r. M. .I .founi .era u p a n d a b o u t a t homo, They had not "slept that night and t h e v ^ n ^ M n o t k e e p down f o o d . They ' were very m u c h ..excited, especially who f e l t p o s i t i v e h e - 'was going to "die". He h a d read somewhere about t h e d a n g e r of- l e a d p o i s o n - ing. I realized, n o w that 1 was deal i n g xvith s o m e t h i n g more, t h a n o r d - i n a r y " g a s o l i n e fume p o i s o n in g and ordered, th e men to th e h o s p i t a l , for.' treatm ent and ob serv atio n , n th e meanwhile was s i m i l a r l y a f- f o o t e d . He l i v e s i n New Bnl en m iles from H artford) and conso- . q u e n t l y c a l l e d i n h i s f a m i l y p h y s i c i a n who l i k e w i s e o r d e r e d h i m t o t h e nor. i t a l . ^New B r i t a i n G e n e r a l H o s p i t a l . ) September 11th to 17th in c lu siv e . under observation a t a t. Frances H o sp ital. During f i r s t th ree days stay in the h o s p ita l they c o n t i n |n e d t o v o m i t t h e i r f o o d , o n l y I n t h e A.M. h o w e v e r . f a i n i n a b domen,; c h e s t , m uscle cram ps, e t c . They were i n a c o n s t a n t s t a t e o f e x c ita jtio n and co u ld n o t s le e p . They c o n tin u a lly ta lk e d of b ein g "done fo r" e t c . , and of "going to d ie ",' in s p ite of a l l the se d a tiv e s x could; a d m i n i s t e r them. (120 g r a i n s o f sodium brom ide and 9 g r a i n s o f sodium Amyto1 a t b e d tim e .) -- A fter the th ir d day the nausea and vom iting l e f t hut the i n s o m n i a , a n d f e a r o f d e a t h p e r a. s t e d . i t was m o s t d i s t r e s s i n g a n d annoying and i t was e v i d e n t t h a t th e y were b e g in n in g to f e e l th e e f f e c ts of the loss' of s le e p . They rem ained at the h e p p ita l u n t i l th e l v t h of Septem ber when they i n s i s t e d on g o ing home. They f e l t t h a t t h e h o s p i t a l was `" g e t t i n g o n t h e i r n e r v e " a n d t h a t i f t h e y w e r e home w i t h t h e i r f a m i l i e s t h e y would " f e e l b e t t e r " ; a l s o t h e y w anted oo b e o u t i n t h e a i r a n d e x e r c i s e . i n o r d e r t o " t i r e ou t. " s o t h a t , t h e y m i g h t g e t some, s l e e p . - r ' R e a l i z i n g - ; t h a t y t h e . c h a n g e a n d m o d e r a t e e x e r c i s e m i g h t b e I p t h e m v t o ^ s l e e p y i - d i a c h a r g e d l ^ ^ e m . g f ,;f. ., ` ./' - Septem ber 1 7 th to September. 22nd, i n c lu s iv e . ' D u rin g .th e above d ates w e r e u n d e r my c l o s e ' o b s e r v a t i o n . ,, The o th e r w a ^ u m h o s p i t a l i z e d in New B r i t a i n u n d e r ..; b o t h t h e c a r e d n ^ ^ u f e o r g e Dunn of. New B r i t a i n and m y s e l f . ( i w i l l Sivw you h i s r e p o t -in. d e t a i l s e p a r a t e l y l a t e r . ) D uring t h e s e d a t e s 1 v isite d both anc^ a t l e a s t t w i c e d a i l y and. s o m e t i m e s t h r o e t jim o s . As p r e v i o u s i y e x p i a i n e d , t h e . c h i e f amd m o s t a n n o y i n g a n d . p e r s i s t a n t symptom was in so m n ia. The o t h e r s , w eakness, n e rv o u s n e s s and ' muscle p a in s e t c . , which were due to the la c k o f s le e p and p roper r e s t , were bejeoming more m arked i n b o t h t h e s e c a s e s . M e d ic a tio n t h e th e mean-. - , w h ile gjave no r e l i e f . i t was e v i d e n t t h a t t h e y were n o t g e t t i n g b e t t e r - ; and werp, i f anything, g e ttin g worse. . ' .' ' -. ' ." . . . ` .. . b-vh.,. ' : . .V . ; . . , ' ' ' -- v " 1 -, On S e p t e m b e r 1 8 t h , D r . n d l l a r d M a c h l e who i s f r o m C i h c l n n - a,t;l and I s c o n n e c te d w i t h t h e L t h y l C o r o n a tio n o f A m erica, was s e n t t o me b y t h e s t a n d a r d o i l Company o f Hew o r k t o h e l p a n d ' s u g g e s t t h e t r e a t m e n t . o f t h e s e c a s e s . Dr. Machle and I c a r e f u l l y r e - e x a m i n e d th e t h r e e men. As o h t h e p r e v i o u s e x a m i n a t i o n t h e p h y s i c a l s i g n s w e r e n<b _ rem arkable and t h a t .th e re were v ery few abnormal fin d in g s.. iheylW ere a s f o l l O T ps : .. ' i * t `J._ w# : (1> m uscle, w eakness '` ~ . {2) s l i g h t l y e x ag g e ra te d r e f l e x e s ' .. * ,, JF . [ o ) l o w b l o o d p r e s s u r e , i n B o n i n i 1s c a s e o n l y ) ihe symptoms w e re; f v1 ) w e a k n e s s ' \2) e x c i t a b i l i t y and nervousness ;3) insomnia / D r . M a c h l e a n d i d i s c u s s e d t h e s e c a s e s . t h o r o u g h l y . He h a s h a d c o n s i d e r a b l e e x p e r i e n c e w i t h x e t r a L e a d p o i s o n i n g . He. i n s t r u c t e d .. me a s t o h i s m e t h o d o f t r e a t m e n t a n d a d v i s e d me t h a t my c a s e s w e r e ggag t y p i c a l a l t h o u g h m i l d 6 i e t r a L e a d P o i s o n i n g ; t h a t t h e i n s t u n n i a . I s o n e ' h V g y of the f i r s t symptoms to appear and a v ery s i g n i f i c a n t one in making a diagnosis; th a t I t is the fa c to r th a t causes the muscle weakness, . nervousness and e x c i t a b i l i t y in th e se types of cases; and th a t s e d a tiv e s and. d r u g s co mm on ly u s e d t o p r o d u c e s l e e p a r e o f n o a v a i l . He a l s o o u t - 5pjl lin e d a course of treatm ent th a t he has su c c e ssfu lly used in the treatment./, o f s u c h "e r a s e s .- . September 18th to September 87th in c lu siv e . -- With th i^ m e th o d o f tre a tm e n t, Bonini and Zeboski respond ed v e r y w e l l . V f l H | ^ i s p r a c t i c a l l y . r e a d y ..to r e t u r n t o l i g h t work,' probably about October 3rd. although over his illn e ss is s t i l l weak and, p r o b a b l y w i l l n o t b e . . a b l e t c i . r e t u r n t o w o rk b e f o r e t h e . m i d d l e ,g of October. h o w e v e r . f a i l e d ^ t o r e a c t f a v o r a b l y .. Be /was: t h e meat .nerypiis;;"^agexnDt;able;Lpf.gthe;ythreegthroughout th e whole, c o u rs e . - un September 2 2 ,.1 9 5 2 , he'suddenly^becam e m e n ta lly im balanced. I r e c eiv e d . a h u r r y c a l l t o h i s home,, a t ; 1:30. ,A.M.'and. f o u n d h im i n a m a n i a c a l , stag e. I t re q u ire d four policem en to hold. him. K ealizing th a t th is.w a s ' an emergency I arranged to send him'.?tb;the h o s p ita l In a privatebroom ' and o f course :a day and n ig h t hursepto:..keep c lo se watch, upon him. . I t became n e c e s s a r y t o r e s t r a i n ?iim i n b e d w i t h s t r a p s and a c a n v a s cama- s o l e . As t h e s i t u a t i o n was s e r i o u s a n d a s i t w a s i m p o s s i b l e t o c a r e f o r t h i s man i n a g e n e r a l h o s p i t a l , Dr. Machle and 1 d e c i d e d t h a t he had b e tte r be rwed to the Hartford. R etrea t (a h o s p ita l fo r mental C ases). - On S e p t e m b e r . 2 4 t h we moved h i m t o t h e r e t r e a t w h e r e h e i s now c o n f i n e d . A c o n s u l t a t i o n t h e r e was h e ld b etw een D ra. S t . J o h n , M achle, Schuby, - Adams and Wagner ( t h e l a t t e r t h r e e A r e t h e h o s p i t a l d o c t o r s . ) I t as KE 0017481 1__A . sr. J O H N , M . D . 25 CH ARTER OAK AVENUE H A R T FO R D , - C O N N ECTICU T '-i iH ''in a l l y a g r e e d t h a t :;f l M M | | | | | j ^ i s p r o b a b l y a m e n t a l . c a s e . J u s t abe t t y p e o f i n s a r i t j Mas n o t as y e t been- d e t r m i n e d . l i i s sym rtbus are n o t v e ry c l e a r . At tim e s he a p p e a rs to be a Toxic C y c o sis, At o th e r tim es he has symptoms of a D em entia rra e c o x . I t w ill p roon Pry take s e v e ra l weeks b e fo re a d e f l a t e d ia g n o s is can be made. The l a b o r a t o r y work on th e s e c a s e s , nam ely, b lo o d t e s t s -for le a d s t i u o l m g - - h a e m a g l o o i n - b l o o d c o u n t - r m s s e m a n , e t c . a r e a } l n e g a tiv e . The e x c r e tio n s (u ren e and f a e c e s ; ere now b ein g put through the exam ination fo r lead. ' This is a process th a t takes n o n n o t o t h r e e w e e k s . I h a v e s e n t s p e c i m e n s t o D r. H a c k l e 1s moratory in C o n cin n attl fo r th e s e t e s t s , as th e re are no la b o r a t o r i e s in th i s s t a t e eaulpood to examine fo r le a d ; and u n t i l a re c e iv e a r e p o r t 1 m ill be m a p le to s ta t e ju s t what p e r t, if- any, u h e l e a d p l a y s i vi n B M H K s i c k n e s s . _ I t s e e m s t o b e ' t h e c o n s e n s u s of opinion at th is w ritin g that^BHfMMBfc is probably a m ental case, n o t s ue to le a d p o is o n in g . I t may, h o w ev er, bo n e c e s s a r y l a t e r on to d e c i d e hb e t h e r o r n o t h i s e x p o s u r e t o t h e i o t r a L oad fum es v/as r o s p o n s i d l e t o p r e c i p a t e h i s m e n ta l i n s t a b i l i t y . T his mould be a q u e s tio n ro o? d e c id e d by o s y c h i a t r i s t s . bUHMAkY:- r r e s e n t condition o f very sa tisfac to ry , w ill r e tu r n to li g h t work on or about the b ra of u ctb b er. C o n d i t i o n o . f a l s o v r y satisfactry. h i l l r e tu r n to work aouut unf m iddle o f O ctober. Condition of ' to apoeax- as th o u g h ne b a b l y D e m e n tia rraecox. unsa t i s . f act ory. i t o e p i n s a. mental a b n o r m a l i t y , p r o " A ll o f which i s r e s p e c t f u l l y submitted. L. A. a t . J o h n , M.D.