Document 99E1doBgayNkbJpEw7neRNMzL

CO P Y January 20, 1933 Mr. W. G. Violette Standard Oil Company Louisville, Ky. Files JOB Dear Mr. Violette! This is to reply to your letter of January 6th addressed to ray assistant Dr. I. J. Sehradin. Br. Sehradin visited Kingsland and made an examination of Mr. on January 12th. The man in question is quite illTn^allness dating over a period of some two ye -^'s. The question of diagnosis at this time is one which is rather difficult to make particularly because v there are a number of possibilities involved, and particularly because the conditions of life which surround Mr. are such that there is a considerable difficulty in carrying out the examinations which are necessary in order to arrive at a diagnosis* Perhaps a quotation from Dr. Sehradin*s report will make clear my meaning! " The family is in dire straits, none of them having worked for many months. At the present, they are destitute and are living without adequate food. The house made up of unpainted boards is in very poor con dition, the roof collapsing, glass out of the windows, the rooms very dirty, and the roof leaking in such a way that water runs into the room where the patient is lying." Hr. Sheffield, the former employer, is providing gratis what little there is to eat. The food has been com posed of hominy and small-amounts of pork over a period of many weeks I shall not detail Dr. Sehradin*s eomplete report of his examination for he is making arrangements at present to obtain further samples of stool in order to verify the presence of hook worm ovar in the stool. Suffice it to say at this tine, that there is nothing either in the history or present physical condition to suggest lead poisoning. The possible diagnoses ares (1) pernicious anemia - {blood examination gives a characteristic picture of pernicious anemia but it is possible that the condition is due to an advanced secondary anmia of parasitic originj (2) pellagra} (3) hookworm disease} and(l|), bjastic anemia. Any one of these conditions may be wholly responsible for Mr. illness, or there may be a combination of them. A craSrereRial diagnosis can only be made by means of careful observations, which in this Instance it seems practically impossible for us to provide Very truly yours,