Document 6RYn3d1oGNwboxJ7Bvj7w2bp3

COPY MAYO CLINIC Rochester, Minnesota April 15 1935 A - 822122 Dr. William A. White The Lind Tuscarawas and McKinley N.W. Canton, Ohio i I- Dear Dr. White: In regard to Mr. no definite diagnosis could be made in this case. The nearest we could get to this problem was that he h s a disease of the smaller blood vessels- what we call at intimitis with partial proliferation and cutting off of the blood supply; neur itis with marked degeneration of the nerve fibers in the larger nerve trunks; ischemic ulcers and a casomotor disorder of the skin which is apparently secondary to the neuritis. \ This case is being reported by Dr. Barker and Dr. Baker, and I am enclosing a copy of the paper (unedited) for your perusal. Will you return it t.o me please, as soon as you can, as I am taking the liberty of sending this paper to you in the absence of Dr. Barker from the Clinic and am taking the responsibility of getting it back to him. , It is quite possible that the profound nerve disturbance was the result of his previous lead poisoning- in fact, we know of no other cause. Trophic changes secondary to the neuritis is probably the basic cause of the ulcers. The treatment in this case is indeed a problem. I think that injec tion of the triple typhoid special fever vaccine (Lederle's) in doses starting with 25 million intravenously and increasing 10 million at each dose every three or four days, probably is as good a treatment as any that we know. In addition, rest and local treatment may help. Apparently this case represents a syndrome which, in our experience, is quite unique. I s h a i ^ ^ e r y interested to hear from you as to the progress in Mr. case, and if we can be of any assistance, please do not hesitate to let us know. Yours very truly, (Signed) GKO3GB B. BROWN k E 0016697