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molar. She shows presence, the first bicuspid of the right lower
jaw, of erosion et the base of the crown and also evidente of
an eroded piece of the jaw bone alongside of this tooth. The
upper left last molar also shows some erosion at the base of the
crown and the left last lower molar shows the same erosion in
the Same situation. The rest of her teeth look fairly healthy
but Dr. Knef claims that they do not show as well in x-Tays and,
although he had x-rays, he did not produce them. Her jaws worked
perfectly without any click or sign of erosion at the jaw, with
no lateral or false point of motion and, apparently, there is no
involvement of the articulation with the skull.
This woman has a decided increase in thyroid condition, particu-
larly the right lobe, which she says she has had for four years.
She said that it came on itself, not suddenly but gradually. (Dr.
Knef mentioned at this time that evidently radium, was not good
for goitre; namely, that it was not curitive for thyroid). She
admits she has had no other physicians excepting Dr. Knef, that
she has had no operations, excepting those he speaks of; namely,
the scrapping of the lower jaw bone. She said that she has never
been employed by any other radium corporation. As a result of this
enlarged thyroid which is noticeable and about the size of 2 1/2"
by 3" on this right side of her neck, she has a Tachycardia, (rapid
heart), her heart rate running well over 100. She has no other
symptoms, such as a Stellwag sign and no decided increase in nerve
tension, although there is a slight increase in her case. Her
principal sign in relation to the thyroid is the rapid heart.
Dr. Knef also says this woman complains of spine and long bone
pain but I could not illicit any tenderness on deep pressure
along the long bones or along the spine. Motion of her back is
full, free and normal without protective spasm and no complaint
is made when motion of the neck, back, hips, shoulders, or other
joints is made. This woman's blood pressure is 130-93. This
also is evidence that she has not a real toxic goitre, because
there is no decided increase in pulse pressure. Her pulse is of
good quality and regular in force, rate and rhythm, although
rapid. The rest period, of course, is not particularly adequate
because of the rapidity of the heart beat.
This woman's only signs departing from the normal at this time
are the thyroid which, in my opinion, has nothing to do with
any underlying condition she may have as the result of being
radio-active, but is a separate condition entirely. She has the
increased heart beat because of the thyroid and the missing teeth,
aside from those I have mentioned she still possesses, the ero-
sion of the teeth I have mentioned and the exposed pieces of jaw
bone on the right side of the lower jaw.
JAMES H. BROTHERS, M. D.
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"ocrText": "- 2 -\nmolar. She shows presence, the first bicuspid of the right lower\njaw, of erosion et the base of the crown and also evidente of\nan eroded piece of the jaw bone alongside of this tooth. The\nupper left last molar also shows some erosion at the base of the\ncrown and the left last lower molar shows the same erosion in\nthe Same situation. The rest of her teeth look fairly healthy\nbut Dr. Knef claims that they do not show as well in x-Tays and,\nalthough he had x-rays, he did not produce them. Her jaws worked\nperfectly without any click or sign of erosion at the jaw, with\nno lateral or false point of motion and, apparently, there is no\ninvolvement of the articulation with the skull.\nThis woman has a decided increase in thyroid condition, particu-\nlarly the right lobe, which she says she has had for four years.\nShe said that it came on itself, not suddenly but gradually. (Dr.\nKnef mentioned at this time that evidently radium, was not good\nfor goitre; namely, that it was not curitive for thyroid). She\nadmits she has had no other physicians excepting Dr. Knef, that\nshe has had no operations, excepting those he speaks of; namely,\nthe scrapping of the lower jaw bone. She said that she has never\nbeen employed by any other radium corporation. As a result of this\nenlarged thyroid which is noticeable and about the size of 2 1/2\"\nby 3\" on this right side of her neck, she has a Tachycardia, (rapid\nheart), her heart rate running well over 100. She has no other\nsymptoms, such as a Stellwag sign and no decided increase in nerve\ntension, although there is a slight increase in her case. Her\nprincipal sign in relation to the thyroid is the rapid heart.\nDr. Knef also says this woman complains of spine and long bone\npain but I could not illicit any tenderness on deep pressure\nalong the long bones or along the spine. Motion of her back is\nfull, free and normal without protective spasm and no complaint\nis made when motion of the neck, back, hips, shoulders, or other\njoints is made. This woman's blood pressure is 130-93. This\nalso is evidence that she has not a real toxic goitre, because\nthere is no decided increase in pulse pressure. Her pulse is of\ngood quality and regular in force, rate and rhythm, although\nrapid. The rest period, of course, is not particularly adequate\nbecause of the rapidity of the heart beat.\nThis woman's only signs departing from the normal at this time\nare the thyroid which, in my opinion, has nothing to do with\nany underlying condition she may have as the result of being\nradio-active, but is a separate condition entirely. She has the\nincreased heart beat because of the thyroid and the missing teeth,\naside from those I have mentioned she still possesses, the ero-\nsion of the teeth I have mentioned and the exposed pieces of jaw\nbone on the right side of the lower jaw.\nJAMES H. BROTHERS, M. D."
}