3/07/40 Dr. George Baehr's letter to Dr. Samuel H. Geist re
Mr. [257]:
Dr. Samuel H. Geist
100 East 74th St.
New York City [Report from Mt. Sinai Hospital]
Dear Dr. Geist:
The diagnostic examination of your patient, Mr. [
257] has
been completed. Five years ago, a slight amount of blood
streaking was observed in his stool on a number of occasions.
The expulsion of gas and bowel movements often cause a
spattering of tiny drops of blood. He observes this
bleeding regularly after alcoholic indulgence and following
the ingestion of beef. One year ago, a rectal polyp was
removed by Dr. Winkelstein. [See
257-197 Reports.] Barium
enema examination at that time was said to have revealed no
other significant findings. He received five injections of
snake venom which afforded temporary relief of the bleeding.
During the past two and one half years, he has been taking
saffron tea. During this period, he has been subject to
occasional mild cramp like pain and distention which have
been relieved by the passage of flatus or feces.
PHYSICAL EXAMINATION: A well developed and nourished man,
47 years old. Pupils react to light and accommodation.
Mucous membranes of the mouth and throat negative. No
thyroid or glandular enlargement. Lungs are clear. Heart
sounds are of good quality. No murmurs. Abdomen: mild
tympanites. No enlarged or tender masses or viscera.
Genital: negative. Rectal examination: Slight
irregularities in mucosa of internal sphincter suggestive
of hemorrhoid. No blood of glove. Extremities are
negative. No pathological reflexes. Reflexes are active
and equal. Blood pressure: 120/85
FLUOROSCOPY OF THE CHEST: Shows no evidence of
parenchymatous lesions in the lungs. The heart is normal
in size and configuration.
BLOOD EXAMINATION: Hemoglobin 89%, leukocytes 8,900 of
which the polynuclears constituted - segmented 62%,
eosinophiles 1%, staph 2%, basophiles 1%, lymphocytes 29%,
atypical lymphocytes 2%, monocytes 3%.
SEDIMENTATION TIME: Was 4 hours which was normal.
KAHN TEST: For syphilis was negative.
URINE EXAMINATION: Clear, acid. No albumin. No sugar.
Specific gravity 1024. Microscopic: Few epithelial cells.
Rare W.B.C. Very rare R.B.C.
ELECTROCARDIOGRAM: A copy of which is enclosed shows deep
Q wave in Lead 111.
REHFUSS TEST MEAL: Specimens of the stomach were removed
at 15-minute intervals over a two hour period and showed a
gastric anacidity but but the response to histamine excludes
a true achlorhydria. A copy of the Rehfuss chart is
enclosed.
X-RAY examination of the COLON: By barium enema shows a
complete obstruction in the proximal descending colon. There
was a large circular intraluminal defect at the site of the
obstruction, suggesting the presence of neoplasm. The
possibility of its being partly or entirely due to
intussusception should be considered clinically.
SUMMARY: X-Ray examination disclosed a complete obstruction
in the proximal descending colon. The roentgenological
findings are somewhat suggestive of an intussusception.
In addition, there is a large circular intraluminal defect
at the site of the obstruction suggesting the presence of a
neoplasm. There is no other clinical evidence of malignant
disease in this case. In view of the fact that a rectal
polyp was removed one year ago, the clinical and
roentgenological findings suggest that the obstruction in
the descending colon may be due to an intussusception
resulting from a benign polyp. There have been no clinical
symptoms of intestinal obstruction and the obstruction which
was observed roentgenologically is apparently intermittent.
The polyp in the descending colon is the probable cause of
the rectal bleeding of several years' duration.
TREATMENT: Surgical intervention is advised as the
possibility of malignant degeneration of the polyp cannot
be excluded.
The following members of the visiting staff of the Hospital
took part in the investigation of this patient:
Dr. George Baehr
Dr. Herman Lande
Dr. Coleman B. Rabin
Dr. Sylvan Moolten
Dr. John Beck
Dr. March L. Sussman
Sincerely yours,
George Baehr, M.D.
Director,
Consultation Service.
3/13/40 Mr. [
257]'s, not having rec'd above report from
Dr. Geist, obtained Ck. Physical Rdg.
257-218 for severe
facial neuralgia.
3/18/40 Mr. [
257] wrote, enclosing
3/07/40 Dr. Geist's letter:
Dear Judge:
I just came from the Doctor's. Dr. Geist, who was [wife
[
903]]'s doctor sent me to Mt. Sinai to take the full clinic
investigation. You will note the report states definitely
that I need an operation to remove an enlarged polyp or
tumor. This is a great surprise to me as it, no doubt,
will be to you. But, before I consider an operation I
would like to see what the Reading says and answer these
questions. It comes at a bad time, with [bro.-in-law
[
1565]'s] father so ill and also after the siege I have
had, but I'd better know about it and know what to do about
it.
Please have the suggestions read as I've written them. I
will be in the office Friday A.M. and will be very quiet at
11 A.M. if you set the date. You will have the body of
[
257] ... Ave., New York City. - please go over it thoroughly
and especially examine the upper part of the colon and
describe any abnormal condition you find, or any polyps,
tumors or growths that you may find, advising present
condition, danger involved and what to do to correct it
- the proper time and person to do it. Questions:
1. Five doctors have signed the report which I am holding.
They state it is a tumor - Is their statement correct?
2. What caused this growth to develop?
3. If the Forces disagree how can we account for this
picture showing the tumor?
4. If it is a tumor, is is benign or malignant?
5. When should an operation be performed if same is
recommended?
6. Would be the best doctor for it?
7. How long would it take for a full recovery if operation
is performed?
8. What preparations necessary to aid a quick clean
operation?
9. Is there any way to dissolve a tumor entirely?
10. Considering body and mind of patient, is this operation
safe to perform?
11. If an additional medical opinion is necessary who would
be person to consult?
12. Doctors recommend an operation - Do the forces agree with
this recommendation?
13. Why haven't the Readings described the growth before?
14. Is it advisable to have the operation performed in
Mt. Sinai or would the forces recommend some other hospital
nearer home?
15. Shall I take Saffron Tea, Elm Bark, and Grape Juice?
16. Under present condition, shall I have the front tooth
and tooth on upper right side taken out as dentist
recommended?
17. Under present condition, what will effect of colonic be?
3/21/40 He obtained Ck. Physical Rdg.
257-219.



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