Physician Report by Dr. Philip Reister for Former President Harry S. Truman

TRUMAN, Har P. REISTER, D. This 84 year old former President of the United States, was admitted for the fifth time to Research Hospital, His first admission was in 1954 for cholecystectomy and appendectomy, at which time he had a pseudo-membraneous enterocolitis. He was readmitted in 1963 for urinary infection, cystoscopy and herniorrhaphy. In 1964 for a fall which he sustained with lacerated eyelid and fractured ribs. Evaluation then included cerebral scan, I 131, hepatic scan, etc., and these were all normal. In 1966 he had a bowel problem which was primarily a result of a fecal impaction. At that time barium enema with skull films, echogram, T-3 etc were done, and all were normal. CC flocculation however was slightly elevated. Present admission followed an episode of some syncope at home, when he fell over backwards, striking the back of his head. He was confused for some time following the fall. It was apparent that his fall was due to rather rapid onset of overwhelming weakness which was followed by two episodes of vomiting at home, two after arriving at the hospital with mild febrile type of illness, and very hyperactive bowel sounds at the time of his examination. At the time of admission he had no loose stools, however, examination revealed a marked hyperactivity of the bowel and diarrhea was predicted which did occur, after his admission. Except for some of the recent marks of time, Mr. Truman has been doing well. Over the last two years he has developed some evidence of purposeless movements of the extremities, particularly the right arm and leg, bitting and chewing on his false teeth. On this admission some increase in his hyperactivity has been noted, including upward rising of his eyelids and brows repeatedly, some hyperactivity of the right lower extremity. PAST HISTORY, SYSTEMIC REVIEW: Essentially unchanged from previous admissions. PHYSICAL EXAMINATION Reveals elderly male who is about average weight for his age and height. He is reasonably alert when conversation is directed his way. However, when he is not conversing the hyperactivity of the right extremity, (lower) and of the forehead and palpebral muscles is noted. The pattern of raising the eyes to look up is symmetrical The right leg moves back and forth slowly and has involuntary pattern of agitation. As noted he is aware of time, place, etc., but has been a bit confused earlier in the evening. Temperature 100.4, pulse 84, respirations 20, b1. pr. 132/80. (CONTD) KAUMAN NARA