Document Ev1BBYkQ5D1Y1rYq8n48gE080

October .19, 1964 Samuel Charache, M.D. 1004 Clinical Science Building Hie Johns Hopkins Hospital Baltimore, Maryland (21205) Bear Doctor Charache; I shall do my best to reply constructively to your letter of October 3rd. This is a tardy attempt because of my absence from my office (at the APIA in New York) when it came, plus the difficulties of catching up on my return. The problem of studying patients is a difficult one, since it is rare that human cases of lead poisoning occur in groups, except among children. The occasional case of occupational plumbism that is in need of being hospitalized, or that comesto be available for study hardly fills your specifications. Moreoever, the possibility of studying groups under suitable conditions (for your purposes) in industry is remote for two very good reasons. (1) If such cases occur unexpectedly under unusual circumstances in a well-managed industry, they are the signal fbr immediate preventive measures that eliminate them. (2) If they occur in a badly managed industry, with some regularity (that is, if there are always persons who have absorbed too much lead and are mildly intoxicated or on the brink of intoxication)no one is made aware of this fact, and no investigator would be given access. We, for example have eliminated, systematically, our own opportunities for studying cases, except as we come upon them inadvertently. I believe your best chance in Baltimore would be to investigate, in the late winter and spring, the cases that are in the making for the summer months. You have an environmental reservoir for lead poisoning there, as we have in Cincinnati. A few of the cases appear in the winter, and a few occur in the spring, but a fair number of children have high levels of concentration in the blood. I should think that the Department of Health (this may not be the formal name) would be a good source of information, for I believe that analytical data are obtained by them during the year. (You know more about the details of their activities than I do, and can find out more readily than I, if you have need to do so). I am sure that we could find case material of this type in Cincinnati, and I believe, on past experience, that this should be just as easy, if not easier, in Baltimore}than in Cincinnati. city As to the whereabouts of a colony of poisoned animals, I have no idea, and while there are experiments that can be done with animals, I have not undertaken them for some years, for the reason that my interest in the metabolism of lead in man has required that man should Samuel Charache, M.D. - (2) - October 19, 1964 be the subject of our observations, I think it unlikely that you will get much of. an answer to your problem from the study of animals. Cordially yours, RAK:vr Robert A, Kehoe, M D.