Document 65KVJZpddX8Ox2aO4djX4v2b6

April 19, 195U- Dr. Irving Gray Forty-One Eastern Parkway Brooklyn, Hew York Dear Dr. Gray: By the time you receive this letter you will undoubtedly have received the series of articles which I sent you under separate cover. I am naturally pleased Tilth your interest in the ?;ork which we have done, and I believe that you will find of especial practical interest my discussion on lead absorption and lead excretion in relation to the diagnosis of lead poisoning. r There is one point with regard to treatment to which I have been driven by our observations to have a rather strong point of view. This is in relation to the deleading of persons who have absorbed considerable amounts of lead. You will note that I have stated that I do not think this is a good therapeutic measure. In the first place I consider it quite unnecessary since patients will delead themselves down to the normal level if they are left alone. And second, I consider it dangerous even in adults although there have been few instances of the recurrence of dangerous symptoms in my experience. The danger resides in the fact that just to the extent that it is effective,(which it is not in many instances),it elevates the lead concentration in the blood and promotes the deposition of lead in organs that are least able to take care of it, particularly the central nervous system. Our observations show beyond any reasonable doubt,I believe, that lead which is deposited In the central nervous system has a tendency to remain there indefinitely. I should, therefore, hesitate to carry out any therapeutic measure which is likely to increase the lead concentration in the brain, and in the peripheral nerves I have seen some Instances, especially In children, where attempts at deleading precipitate/acute cerebral symptoms. Moreover, I have seen animals without symptoms precipitated into an acute attack of lead intoxication by reason of attempts at deleading* I therefore regard it as a very questionable procedure, and except as it may be justified by Certain special circumstances, I should definitely advise against it Dr* Irving Gray I mention this point in this letter only because I want to make sure that my own position in the matter is not misunderstood* I shall be delighted to see you in June at the American Medical Association meeting, and It will be a pleasure to discuss with you the interesting problems which are involved in lead absorption and lead poisoning* Cordially yours, RAK:IS Robert A* Kehoe, M*D.