Document 9GLop7YBVwpQMpygRgK0GZgR

Docentor 27, 1944 Er. n. v. mttcrhsf Director of Laboratorioc xho Suberoulosis Hospital Prico nill Cincinnati S, Ohio plaintiffs exhibit fio-T-P Oca? Br. nitterhcf: 2 an very pleased indocd that yon could let uo save ouch q generouo omaple of tloeuo fop chculccl analysis of you? fascinating ocso of caroold and aabeatoeic. tfo will give It ttys vorha in order Oo ascertain what arc present. Tho otory will lnolcdo cot only ohcnlcal and JS-?ay diffractioa analycoo but 2 chall sod it off fop a opcctpogruphlo cnalyclc. Z cn doing this bso&use Z an Icohing for control caterlal to a serieo of carcoid or caroold-llbo cncco fron tho fluorosoent lacp industry. 2 ea doing everything that 2 can to do tomine whether there cay bo on indue trial environsente! faotor involved in tho etiology. fhuo far we actually tnov very littlg; thcao people caSo fluorescent and other typo a of lenpoand radio tulba in a vory clean faotcry. Dcrylliun ic under suspicion but In opito of intoaaivo study the espoaurc to any particular oubotnnoo coena very United. Espcriuontal vorh up^n aany of tho ohcuiealo involved has ca yot produced co decisive resultc. 2t So cy own fooling that caroold ic probably due to coze Snfooticn uhooc eauco lo anhsovn at tho present 'ties. Perhape it Jin a virus. 2 can't reconcile the tiotolcgioal picture with "nbercnlooie ae Pinner does oo oaoily cor dooo it seen hitdy that tho dieceeo ic duo to lepra bacilli or other acid-fact organiezn. Z telioro thr.t if any ccr.-cpcoific irritant So concerned, Stc role sunt ho a cnor. one, pro bably cotlag ao a trigger coohanlcn to ellcv tho vires or wfcatover to do ita act. . ** - In year cane tho pros once of asbeotooio would seen to no probably ocroly ooinoldental, at least thio is ths firot tico thia^ooobination hno boon reported. Z have studios on approximately fifth oases of aebostoaio and 1 hnvo never ceon ono oooplioated by Carco id. 2 would infer that Sc 7 cur case the two conditions dcvoloped soro or lean eiaultancooaly but. inat probably tho aofceotooio waa proaent to ooae degreo before the oarocid appeared. This oplnioD i* based on the ooourenoe of asbestos flbros *nd other iron-oontaining particles in the-Interior of the tubsrolo-liha modules and in eone oaees within the giant cells thenaelvoa. The oalciua enorueted inolueione in the giant Celia are very frequent in all of the pulnonary sarcoids that I havo otudled. I do not know what they are but they looh libs bits of elaetlo Dr. n. O. Hittcrbn? Dcocrbor 7P 191C Siocue that fcsuo attracted lino caltcs othcro^fcavo on oyctcr chcll oppccrsnoc vhoco origin ic bard to Scagloo. 2 ocv la tho ooetioca of your cane a few of those dooply stained todies which ore a feature of oarcoid and in addition, Z noted# on you mentioned, oertain portions cf fibre that h^vo & yollcvicb oast which ono cuopectn coy bo csbcctoc. Shoe's, of couroo# ere not uncommon ic uncomplicated aotcatoaic. On tho other hand, tone of Ohs acbootoois bodies 'in preparations fcavo assumed coot biaarr eppearanooo. At the riah of being cionotonous about tho occupational crposuro Z would appreciate it if you would toll no what oort of a plant tho Philip Care7 Kacufacturlng Company operates and whethor you havo any idea of the nnturo of their products, a on interested, of oourso# not only in tho exposure to asbestos but in tho possibility of an expoauro to fluorescent substances. Vo ohall probably be cblc to determine the precence or absenco of the latter by opectrographic analysis but it would bo helpful to fcnav vhat poooibilitieQ aro invoiced ^ Personally I would he citato to cocnit nycelf on the question of causal relationship betvecn acbeotcols and sarcoid. Cuch relationship cay exist but fron tho ovidence before us Z would find it difficult to decide which waa osuoo arid which was effect. Sn view of tho fact that tho two conditions occur oo raroly in the coco lung Z would rather entertain the opinion that chanoo use responsible for their oicultaneoua ooourecoo ic your oaoc. After wo get cur various chemical and o-ther analytical data together Z would bo very glad to giro you cy furthcr'cocncnto to bo used Id your case report, if you co doeirc. 2 will admit that after inspecting the grocc catorial I cn core innrocced with the extent of the nstcotoalc. In ooaporioon with our other material tho pigmented foci in your caso adea to show sore flbroeia and Icoq looallsod enphyccnn. Sis to logioally this can probably bo oxplaiced by tho procenoo of oarcoid . noduloa within the aeboototio cones of reaction. Again nay I express cy epproolotion for being allowed to study this unusually interesting caoo. Qlnoorcly yours, - LUO: P.3 Loroy C ."Oardnar, X. D. Dir 3-tor