Document DvKeDYBoqv89QMEK58E19EEe5

Fe b r u a r y S , l^ f-O Dr . C. F . Ye a ge r Remington Arras Company In c , Br id ge p o r t , Co n n e ct icu t Dear Do ct o r Ye a g e r :- I have been very d ila t o r y in r e p ly in g t o yo d r l e t t e r o f Ja n u a r y by reason o f t h e p r e s s u r e o f a g r e a t d e a l o f w or k. Vie have r e ce iv e d t h e sam p les w hich you se n t t o n s , and In due t i: e t h e y w i ll be a n a ly s e d . However in as much as we have a gr e a t d e a l o f a n a ly t ic a l work ahead o f u s , t h e y w i ll be w r k e d in as cir cu m s t a n ce s w i ll p e r m it an d we s h a ll n ot have the r e s u lt s fo r you as prom ptly as I should w is h . As t o t h e t r e a t m e n t w hich we have u se d in o a s e s of le a d p o is o n in g , I can co ve r t h e s it u a t io n ve r y b r i e fly by s a y in g t h a t we know o f no s u c c e s s fu l s p e c ific t r e a t m e n t . Vie t r e a t ou r p a t ie n t s s ym p t o m a t ica lly . Ther e a r e Ju s t t h r e e t h in g s w h ich I am su r e i t i s ve r y u s e fu l t o d o. F ir s t th e com plete e lim in a t io n o f a l l exp ocu r e* Secon d t h e m ain ten an ce o f ad eq u ate alim en tar y evacu ation in order to preven t the r e -a b so r p tio n o f le a d . W it h in t h e li m i t s w h ich a r e fe a s i b le , t h e more r a p id t h e em ptying t im e , t h e more com p lete w ill be th e e lim in a tio n o f lead and th e le s s w ill be the op p or tu n ity fo r r e -a b s o r p t io n from t h e a lim e n t a r y t r a c t . The t h ir d is th e prom otion o f th e In ge s t io n o f an adequate d ie t . We have fo u n d t h a t i f we oan g e t ou r p a t ie n t s t o e a t in g w e ll/ t h e ir a p p e t it e s improve w it h th e e a t in g and t h e y r ecove r fa i r ly p r om p tly. The o n ly fu r t h e r s u gge s t io n w h ich 2 ca n make i s t h a t ad eq u ate flu id s sh ou ld b e give n to m ain tain e lim in a tio n a t as h igh a le v e l as p o s s ib le , and a s a lt b a la n ce sh ou ld be m ain tain ed so fa r as i t is p o s s ib le . I am ve r y d u b iou s o f t h e v a lu e o f la r g e d ose s o f s a lt o f any k in d e xce p t fo r t h e c a t h a r t ic e f fe c t . I am con vin ced th a t any gr e a t d is t o r t io n o f the s a lt balan ce in the body, in clu d in g t h a t o f ca lciu m , is lik e ly to be d is a d va n t a ge o u s . Th e r e fo r e la r g e q u a n t it ie s o f ca lciu m s a lt s a r e p r o b a b ly c o n t r a -in d ic a t e d , a lt h o u gh we h ave no ce r t a in evid en ce th a t t h is is t r u e . 2- Among some common symptoms w h ich have t o bo t r e a t e d ar e th ose o f c o lic , c o n s t ip a t io n , and in some in s t a n c e s , p a r a ly t ic le s io n s . The c o li c may be r e lie v e d , when s e v e r , by in t r a ve n o u s ca lciu m ch lo r id e and ca lciu m g lu co n a t e . In some in s t a n ce s m or phine h as been u sed fo r t h i s p u r p ose * b u t we sh ou ld p r e fe r not t o u s e morphine in any c a s e . I f s e d a t iv e s a r e r e q u ir e d , we use the b a r b itu r ic a cid p r ep ar ation s. I f th e co lic is r e lie v e d by calciu m ch lo r id e , i t is u s u a lly prevented from r e c u r r in g by t h e m ain ten an ce o f a lim e n t a r y e v a cu a t io n . For th e co n s t ip a t io n I p r e fe r th e s a lin e c a t h a r t ic s , e s p e c ia lly magnesium s u lp h a t e in moder ate d o s e s . The n e u r itic le sio n s are tr ea te d lik e any other n e u r itic le s io n , a lth ou gh I sh ou ld be d isp o se d , fo r ge n e r a l t h e o r e t ica l r e a so n s, t o U3e r a t h e r la r g e d o s e s o f thlafc&ti in t h e hope o f o ffs e t t i n g the vrorst e ffe c t s o f th e p a r a ly s is as s p e e d ily as p o s s ib le . Ap p a r e n t ly ve r y d r a m a t ic r e s u lt s have been o b t a in e d by t h is means in a number o f in sta n ce s o f n o n -s p e cific n e u r it is . I t i s .Ju st co n ce iv a b le t h a t t h e same mechanisms a r e in vo lve d In le a d and a r s e n ic p a r a lys e s as ar e concer ned In th e p r o d u ct io n o f b e r i- b e r i. I have no o f f i c i a l b r ie f fo r t h is h yp oth esis* but i t is a t le n o t p la u s ib le and ju s t ifie s th er ap eu tic 3tudy. Host o f the r e ce n t d is cu s s io n in th e lit e r a t u r e has had to do w ith th e sup p osedly s p e c ific r o le o f ca lciu m or p h osp h or u s, or b o t h , on th e d is t r ib u t io n o f le a d in t h e b o d y. I am n ot s u r p r is e d t h a t you a r e con fu s e d a t th e s t u d ie s in th e lit e r a t u r e on t h is p o in t . There h as been much t o much s u p p o s it io n and much too l i t t l e p r e c is e e xp e r im e n ta l work on t h is p o in t . X hope we s h a ll soon have some sound b a s is fo r an o p in io n on t h i s a s p e ct o f the n a t t e r . With k in d e s t p e r s o n a l r e g a r d s , I am Sin ce r e ly you r s. HAKt ls Ro b e r t "A. Xe h o e , M.D.