Document G5mY7993d5NOo8veKJbdd3OBV

March 5, 1940 Dr. Bruce I . Ryder Henry Illin ois Dear Doctor Ryder: I am now in position to give you the information requested in your le t t e r of February 23rd. Accordingly I am en closin g herewith a copy of Dr, Sch radin *s examination record. I h a ^ i| j^ seen the var iou s Items of information which Mr. brought with him in cludin g the dat a obtained and supplied by Dr. Kroneriberg. I r e aliz e th at the case requ ires soraev/hat fu lle r cem en t than I made in my recen t le t t e r to you. I should point out f i r s t of a l l th at a l l of the experimental and c lin ic a l evidence has in dicated th at measureable lead absorption does not occur as the r e su lt of slcin con tact with commercial leaded gasolin e, or as the r esu lt of the inh alation of vapors ar isin g from such gasolin e. We have been studying t h is problem in a var iet y of ways over a period of many y ear s, and we have never been able to obtain any evidence which demonstrates the occurrence of appreciable lead absorption even under the most severe con dition s of long continued exposure. This man*s occupation al h ist or y gave no b asis for the b e lie f t h at he had absorbed lead . On the oth er hand h is h ist or y of skin ir r it a t io n is in keeping with the known pr oper ties of commercial gaso lin e. From time to time we have seen gasolin e derm atitis in mild and also In more severe forms. Second the medical h ist or y as given by Mr. i s not sp e c ific a lly suggestive of lead in toxic at lap in x&y mind, th e only item of consequence being an obst in ate con stipation which obviously I s not n ecessar ily lim ited to the e ffe c t s of lead absorption . Fin ally the an alytical data which we have obtain ed are e n t ir e ly within the normal lim it s, and th ere i s no evidence in them of sign ifican t lead ab sor ption . In cid en t ally the same Is tru e of the r e su lt s reported by Dr. Kronenberg in sp it e o f h is In ter pr etation of them. The discovery of 0.066 m illigram s of lead per l i t e r of urin e i s quite d e fin it e ly n ot an abnormal fin d in g. The mean r e su lt obtain ed on a lar ge group of normal in -  Qm dividual by our methods which, have a h i$ i degree o f se n sit iv it y and accuracy i s approximately 0*035 m illigram s per l it e r * In dividual r e su lt s within th e normal group* however* range from 0*01 to 0*08 m illigram s per l i t e r * I t Is a m istake* th er efor e* t o regard any r e su lt in excess of the mean value as abnormal* Rather i t I s n ecessary to con sider the r e su lt s within normal lim it s u n less th ey exceed th e range of normal fin d in gs* In our opin ion * as expressed In the lit e r a t u r e * the r e su lt must be in excess of one ten th of a m illigram s per l i t e r to be d e fin it e ly and sign ific an t ly abnormal* Th is same i s tru e of the r et icu locyt e oount which* as a matter of fa c t * in normal in dividu als may run as high an one per cen t* The same i s true of t he s t ippled c e lls* 15*6 st ip p led c e lls per 100*000 reds t fon t ?d efin itely abnormal. Groups of normal in d ividu als y ie ld valu es up to almost ten tin es t h is figu r e* Here again the mean r e su lt In a lar ge se r ie s of normal In dividuals by our method of examination i s approximately 30 per 100*000 reds or * as we express I t , 320 per m illion * This figu r e * as you can see* i s not even as h igh as the average r e su lt in a large group of normal persons# I t i s apparent from a l l of th ese fin d in gs th at no evidence was obtain ed which was adequate to su b st an t iat e the d iagn osis of lead absorption in th e case of t h is man* In view o f th ese fa c t s and in view of the r e su lt s of our examination, we think i t i s fa i r to say t h at t h is man did not have abnormal qu an t it ies of lead in h is body, and th at h is con stipation had no r e la t io n to le ad absorption * With t h is p o ssib ilit y excluded* i t becomes n ecessary* i t seems to me* to base th erapeutic measures on some oth er e t io lo gic facto*'# From the Xfray p lat e availab le* I t would sea th at some type o f path ologic process e x ist s in th e colon* The nature of t h is would require somewhat more d e t aile d study* I t r u st t h is report has given you the information you r equ ir e* bu t I f we can be o f any fu rth er assist an ce to you ojv.ff we can give you any oth er information * I should be very glad to do so* Cordially yours* RAEsis fcober fc A* Kehoe,&*$*