Document ExkVL8kewgG36z1n8RQ78a6vg

8l Collin3 Street, IIELB0URN3, 0.1. Professor E. A. Kahoe, College of medicine, Jdiversity of Cincinnati, Cincinnati, - - --J -- U 'U O . *I l6th October, 1?47. Dear Brofossor memos, . I was delighted to receive your letter of Seote.Tiber -7tk ;'3 Dr, bl^c^bura* s cases of T.E.L. poisoning. I must ad;nit it left me fsslin somewhst deflated. I h\va seen the excellent results of B.A.L. in. orcooia poisoning era imnodietely after Sr. Blackburn's cases 1 suggested tri -I of L. is ordinary dosage ia a case of pluabism in a battery '..or.car. .--is colic had subsided under intravenous c-i-lciun thero ay. dithin. soee w a i v e hours of eo-otceacin ar >>..t.L. , the most severe colic he had ex perienced lavsloped. 1. ..L. ..--r stopped at ones ana calcium s rosin used. ; iccessfally. Hors I thought the B.A.L. baa mobilized an eccossive amount of lead from the skeleton in a man exposed to absorption of considsrable mounts of lead over a Long time and decided that, if L. sears to be used at .11 In such cases, It should hs tried only in snail iosna over a orolonoad .U'iou to accolerote load excretion, iiovsver, I still felt that the coincidence of iniu'r;n vent Imaudintoly foil win g .....L , in Dr. Blacks jrr.'s c a m s when it vns used temporarily in large doses with relapse after the dooe had been reduced corsiJoroily for sous days suggested that the mass action of iar?s doses of ..., was effective in fixing the large amount of land suddenly introduced, into the body in these coses cud that by so doing it hod relieved the stress on the brain. In r.'B.L. poisoning ore need not worry usually chant lead stored in the skeleton sines it is practically invariably an scute poisoning doe to rapid absorption of a considerable amount of 1?*.;!. do I felt happy a..out the B.A.L. until I got your letter. * dilnanls report to you that they could not save animals given a lethal dose of T.l.L. even with the B.B.L. -riven before symptoms developed is a most depressing finding. dnd your work (the re- orint from Science is not yet to hand) that the B.A.L.-Bb complex is more .- ts.cic than eith.wX' of its components separately is equally disappointing, .,ni nan, I fear, will not behave differently from the animals. I have read of one cuss of cadmium poisoning where t'ne B,d.L.-cadmium complex was stated so have caused renal homage and that its use was contra-indicated ir cadmium, goinoing, though one or two other reports hove said it is useful in this no l i l t ion. - ' There seems gonora1 c-.greensnt that it is very valuable^ for arsenic, mercury and gold poisoning. JE K 00, 34 * Professor R. P. Xehoe 16th O ct ob er , 1947 The a r r i v a l o f B.A .L. d o e s, h owever, giv e one h ops t h a t some compound w i l l be foun d t h a t w i l l be a s e f f e c t i v e in le a d p oison in g a s B.a .L. i s in th ese oth er heavy m etal p oison in gs. The t o x i c a c t i o n o f a r se n i c i s a t t r i b u t e d t o an e f f e c t on t h e -Sfi gr ou p s in c e l l s i n t e r fe r i n g w it n a c t i v i t y o f t h e p y r u vat e o xid ase syst em . I s t h i s t h eory a l so h eld r e gar d in g th e t o xic e f f e c t s o f le ad ? Has any work been p u b lish ed on t h i s ch em ical a sp e c t o f l e a d p o iso n in g? I w i l l be most in t e r e st e d to h ear o f your r e su l t s with B.A.L. glu co sid e . Dr . Black b u r n h as l e f t fo r U .3.A . and w i l l be c a l l i n g on you . He w i l l be in t e n se ly i n t e r e st e d in you r c r i t i c i s m s . u n fo r t u n at e ly he l e f t before your l e t t e r a r r iv e d , so I have not been ab le t o communicate i t s con t en t s t o him. Once a ga in I air? remin ded by you r l e t t e r o f t h e old t r a p o f a t t r i b u t i n g "p o st h oc" t o "p r o p t e r h oc"1. In th e ab sen ce o f any c l i n i c a l ex per ien ce of such c a se s, the d r am at ic improvement fo llow in g th e ver y lar ge d o se s o f D -i-Ja Z.n i t i a l l y u se d by Dr . Black b u r n le d u s a st r a y . I f the B.A .L.?b complex i s in v a r ia b ly more t o x ic th an lead i t s e l f , i t d oes sosm st r an ge t h at t h e se d o se s (4 .4 mg p er Hg, o f body w eigh t ) 4 h ou r ly fo r 4 d o se s d id n ot make th e p a t i e n t s w or se, But t h e i r c l i n i c a l co n d it io n was rem ar kably b e t t e r fo r fou r d ay s. Tould th e se d a t io n and su p p o r t iv e t r eat m en t co u n t e r act such expect ed ext r a t on ic e ffe c t s? Does the B.A.L.-P b complex have t oxic ce r e b r al e ffe c t s? .h ere t o e s i t a c t ? I know i t can ap p a r e n t ly r e s u l t in se v e r s i n t e s t i n a l c o l i c . I f the B.A .L.- ?b complex d o ss n ot h ave more t o x ic e f f e c t s on t h e b r ain th an lo a d , o:j :i ons n e c e ssa r i l y ap p ly t h e r e s u l t s o f an im al exp er im en t s t o man and sc n ot put i t s u se t o the t r i a l o f exper im en t in manwhen i t ap p ar e n t ly h as bad no ad v e r se e f f e c t s in t h e se two c a se s? Thebe ar e m erely q u e st io n s which a r i s e from you r l e t t e r in which yea ask ed fo r any comments. Lie sat in e , I h rve se n t a co v e r in g l e t t e r t o our d o c t o r s here, wit h r e p o r t :' forw ar ded fro: our Aeibcu r n e O ffic e o f Dr . Blackbu rn * 3 two c a se s and your comments t o me abou t them, I h ave i n st r u c t e d them to r e l y on the st an d ar d t r eat m en t and n ot t o use B.A.L. sh ould th ey bo u n fo r t u n at e enough t o see any c a se s o f k'.D.L. p o iso n in g. be f e l t t h a t Dr . Black b u r n *s r e p o r t o f t h e se two c a se s in t h i s country' would se r v e to em ph asise t h e n e c e ssi t y fo r them t o be on t h e i r t o e s t o d e t e c t any p o ssi b l e e a r ly c a se s. I h ave gr e a t l y ap p r e ciat e d you r l e t t e r and t h e moot v alu ab le c r i t i c i sm s t h e r e in and look forw ard t o t h e r e c e i p t o f fu r t h e r in for m at ion from you on t h i3 i n t e r e st in g su b je c t . I n c id e n t a lly , sin ce zin c i s gr e a t ly in cr e ase d in th e blood and l i v e r e t c . in leu k aem ia and in can cer ou s t i s s u e , I am p lay in g ar oun d with sm all d o sa s o f B.A.-u. over a p r olon ged p er iod i n a cou ple o f c a se s o f leu k aem ia and in o p e r ab le can ce r . One case o f acu t e leu k aem ia f i r s t seen by me fo u r days befor e death was stiven treatm en t w ith or d in ar y d ose s o f B.A.L. w ith out obvious e f f e c t . I do n ot exp ect an yt h in g t o come from t h i s , but i n such c a se s an yt h in g i s worth a t r i a l i f th ere i s th e rem otest chance t o h elp them. Tith kin dest r egar d s, Tours sin cer ely , /Lxz. T>. 0 01 3 4 i 6