Document vB8KnbkDy5xmbGRBnv9q0B7Xq

FILE NAME: Norfolk & Southern - WC Case - Ancel Wheeler (NS) DATE: 1951 Nov 3 DOC#: NS034 DOCUMENT DESCRIPTION: Physician Report F Y EJMER R. MAURER, M.D. Y f te 82? Union Contrai Elds Cincinnati 2, Ohio November 3, 1951 Harrison M. Fuerst Attomey-at-Law 543 Society for Savings Bldg. Cleveland 14, Ohio Dear Mr. Fuerst: Rei Ancel Wheeler Wheeleraburg, Ohio Mr. Ancel Wheeler was seen in consultation in my office on Ootober 25, 1951. Jj This 39 year old, white male patient was in good health until October 1, 1950, at which time he first experienced pain over the right chest and a hacking cough which eventually became chronic. The cough has never been productive of pus or blood. During the ensuing year, the. patient has developed dyspnea and the cough has persisted. The pain over the right chest is intermittent, but persistent. According to the history obtained from the patient, he has been employeti.as a laborer for the Norfolk and Western Railroad since June, 1944. 'The patient's particular work involved the operation of a grinder which pulverised asbestos re moved from boilers. The patient was engaged in this work reputedly without any protective device. During the past several months, the patint has developed somevAieezing and the dyspnea is more severe on exertion. Physical Examinations Temperature 98.6 Blood pressure 125/70 in the left arm, with the patient upright, Mr. .Wheeler is very markedly obese, weighing an estimated 224 lb3. The only significant findings are limited to the chest. There is impaired percussion note with distant breath sounds and numerous coarse to fine crackling rales over the lower lobe, right lung, posterior and lateral. The heart was not remarkable to percussion an the sounds were clear and of good quality, no murmurs or arrhythmias being noted. The remainder of the physical examination was not remarkable. X-Raya1 A review of the roentgenograms of the chest, PA and lateral projections made on April 16, 1951 in the offices of Drs. Mahrer, Krause, & Lub'ert, in Cleveland, reveal a diffuse mottling throughout both lower lobes. The mediastinal structures appear,to be normal and the upper one-half of each lung field appears to ber clear. The mottling of in filtrate is most severe in the right lower lobe. The patient was not fluoroacoped in this office, but it is my understanding that there voas some limitation of motion of the right diaphragmatic leaf. Impressions It is my opiton that Mr. Wheeler is Buffering from moderately severe pneumoconiosis (asbestosls) involving both lower lobes of lungs, most severs on the right side. This diagnosis is suggested by the classical history of exposure to fine asbestos dust and the focalisatlon of the physical findings and infiltrate in the lower lobes of the Tuns, particularly severe on the right side. The limited excursion of t diaphragm would also suggest this diagnosis when une above x-ray bindings are encountered. I would estimate that Mr. Wheeler's dis ability will moat probably be a total and permanent one. The sputum sample obtained frora-Mr. Wheeler has been sent on to Dr. Robert Ritterhoff, a pathologist in this city, to see if any acid-fast organisms or asbestos particles can be identified in the sputum. Tubercu losis is an uncommon complication in asbestosis, and in..this particular respect is different from silicosis. As soon as I have obtained the report from Dr. Ritterhoff'a laboratory, I will forward it on to you immediately. We will mail the x-rays to the offices of Drs. Mahrer, Krause & Lubert. Thank you very much > r asking me to examine Mr. Wheeler for you. Sincerely yours, ERM:sd Elmer R. Maurer, M.D.