Document 8RO6eOdmw89m6YmrKk8385xKd

F. W i l l i a m S u n d e r m a n , M . D . 701 M ALON EY BUI LDI NG H o spi t a l o f t h e U n i v er si t y o f Pen n sy l v a n i a * PHI LADELPHI A 4 March 14, 1946 Dr, Robert A. Kehoe Kettering Laboratory of Applied Ph:fsiology College of Medicine Eden Avenue University of Cincinnati Cincinnati 19, Ohio QJl ^ - ~~- Dear Doctor Kehoe: ' Under separate cover second blood and urine samples from Ceasare Ponti were sent to you, Enclosed is my check for ten dollars to cover the cost of these analyses, I was pleased to receive your comments regarding the un reliability of conclusions drawn from testing spot samples of urine. As in the case of other electrolytes, I should believe that it would be impossible to draw conclusions regarding lead exchange in the body without complete balan ce studies. For this reason it always seems to me that the concentration of lead in the blood should offer a better guide to the presence or absence of piumbism. than testing spot samples of urine. The urine sample sent to you represent a portion of a 24-hour specimen which was collected in care fully prepared pyrex flasks while the patient was on our medical ward. The total volume of urine excreted in 24 hours was 1148 ml. As I indicated in a previous letter, the patient received ammonium chloride medication for a month, I give you these data for what they are worth. prom my clinical observations of Ceasare Ponti I am beginning to suspect that he is malingering. He refuses to go to work because his union tells him he is suffering from lead poisonin He is a big, husky man \Tho ssems to be quite active around th ward, although when questioned he states that he is too weak work. He has not worked around lead since 1940. I would certainly appreciate your help in arriving at a correct inter pretation. Thanking you most kindly for your valued assistance and with the best of all good wishes, I c+ (D FWSsrlg F. William Sunderman, M.D.