Physician Report by Dr. Wallace Graham for Former President Harry S. Truman

RESE. CH HOSPITAL AND MEDICAL CENTEh Kansas City, Missouri TRUMAN, President Harry S. Wallace H. Graham, M.D. President Truman was admitted to the Research Hospital on 21 January 1971, after having been awakened from sleep early this morning, at approximately 12:30, with severe intestinal cramping which seemed to be throughout the entire abdomen. The severe cramps apparently began with sudden onset, followed by severe, uncontrollable diarrhea, which occurred approximately 12:30 to 1:00 a.m. The severity of the intestinal cramping or abdominal pain stopped. However, the diarrhea continued, and he has not complained of any pain or distress. He feels that he had a very slight temperature the past 24 hours prior to the onset of the abdominal cramping. He also complains of having extreme dizziness. However, this has been present to a certain degree the past ten years and particularly is noted with sudden change of position. It is also seemingly more marked in the early morning hours after arising from a night's rest; and for the first 3 to 4 hours of the morning, he has difficulty maintaining his equilibrium unless he walks and stabilizes himself, maintaining himself in a more deliberate manner. This has been increasing of late, and at first he was of the personal opinion that this may have something to do with his eyes, as it is necessary for him to change his glasses. He wears two different types of prescription lens, and at times it does seem to help. How- ever, his vision has been very good; the focus of his vision has been very good, and he continues to read tremendously every day. At this particular time, he has considerable nausea, and near vomiting, or some regurgitation, and there is considerable borborygmus present. It is noted in taking his history at this particular moment. Hyper- peristalsis is obviously detectable, and can be observed through its action in the anterior abdominal wall. Generally his vital signs are normal and constant. The abdomen is soft, and somewhat doughy throughout, to palpation. No abnormal distention is noted, and there is no muscle guarding. There is no evidence of hernia, nor is there any palpable fecal impaction, although minimal proctitis is noted by the inflammatory area around the anal verge. The President has had similar bouts with this colitis-like syndrome in the past, but there has never been any evidence of amebiasis, or any direct bacterial infection. The appendix and the gallbladder have both been removed, and there is no evidence of carcinoid is JOHN syndrome. This is not a condition of chronicity from the standpoint of having it daily, or even every week, and there does not seem to be any evidence of a chronic type of ulcerative colitis. Although he is allergic to the Sulfas, Terramycin, and some other few medications, there is no indication that this medication has been administered, and there seems to be no evidenge of a true viral enteritis. There has HISTORY & PHYSICIAL EXAMINATION OPERATIVE REPORT DISCHARGE SUMMARY DELIVERY NOTE (Continued) CONSULTATION REPORT Prenatal history Form 10 - 86 -