Document 0gVBwbKmq1Kg9kZrpKMM9yE8k

February 27, 1947 Dr . 8. F . Miller, Medical Supervisor, E. I. au Font de Nemours and Co., Old Hickory Plant, Davidson County, Tenn. Dear Dr . Miller: "We are sending you separately containers fortt^^jol^jction of samples of blood and ur ine on your patient You will find Instructions accompanying the containers, and these should be followed with meticulous care. I am afraid I may have misled you somewhat if I gave you the impression that subjective symptoms are without value in the early diagnosis of lead poisoning. As a matter of fact a detailed and careful consideration of' the onset of symptoms, and of their development, is of the greatest consequence in the individual case. The physical signs, as you know, are not very helpful in many instances. The presence of a lead line, when demonstrable, is significant only in that it demonstrates that significant exposure has occurred. Inasmuch as the symptoms are usually gastro-enteric in character, the differential diagnosis must be made largely on the basis of the history rather than the results of physical examination. The presence of blood changes may be significant, but the results have to be quantitative and they must be interpreted on the basis of previous observations on the same individual. In this situation the analytical results on blood or urine or both preferably, are of great value, since they enable cue to estimate the extent of exposure and to determine whether it has been within safe or unsafe limits. Inasmuch as a considerable amount of detailed information is necessary in order to deal adequately with this problem in an industrial plant, I am sending you herewith a booklet, which, in my opinion, is the best information available on this entire problem. I think the study of this work will give you the back ground on which any advice of mine would inevitably be based. After we have analysed samples of the blood and urine of this man, I shall be better prepared to give you specific advice in his case. Very truly yours, FAK ef lober t A . Kehoe, M. D.