Document 3n3Dg6XMNex28E3GR1aDMydn

October 4, 1932 Dr* P* H* Kilbourne 870 Fidelity Medical Bldg*, Dayton, Ohio Dear Doctor Kilbourn: Several days ago I examined your p a t i en^^ --r. G5-n8 into Mr. M s t o r ^ c a r e S f f x ^ a n d after have examined h i m ^ i ao not feel that his present condition is due to exposure on his part to dusts In the course of his work* On- doubtedly he did have some exposure to dusts contain ing chromates* Apparently there was nothing more than a superficial irritation since none of the characteris tic chromate lesions developed in the nose* In my opinion, his present condition is of an infectious type and Is very like that of any other person with a posterior sinus drainage* I feel that many of these infections are allergic and I have seen a number of them respond very well indeed to desenltlzatlon with autogenous antigeiis* I should feel if Mr. Gerard has any significant anatomical abnormalities of the nose, these should b corrected* I doubt the presence of polypi but if they ar present he can not expect to recover ex cept as they are removed* In any case either before or after surgical interference, I should feel it desirable to culture out his upper respiratory flora and to give him skin tests to determine any specific sensitivities. He should then be desensitized, I think, to any organisms to which he shows a sensitivity* The tendency to allergic reactions which is shown in Mr. history, is strengthened somewhat by the presence of a relatively high eosinophils count 716 My physical examination did not disclose any re markable abnormalities outside of the condition of the nose and throat* Cordially yours, R A K jIS