Document GKNqQk5VN7BNk3qNYkEXG0kV7

tPhysicians: Jj >1(_rf^krfiH*BOSTOCK. D.P.M., F.R.A.C.tt. CJL. j . J a r v is n y e , f .r .a .c .p . ! CLIVE H. SlPFE, M.R.C.P. D. p. h a n n a f o r d Sc h a f e r , m.r .c JP. NORMAN V. YOUNGMAN, K.D M.R. Gr e g o r y m u r ph y , m.d ., f ^r .c .pL ATHOL ROBERTSON, D.T.M'.H., M.R. A.C.P. LYNN D. WALTERS, M.O., M.R.A.C P'. Surgeons: ALAN E. LEE, M.O., F.R.C.S. (ENG ATHOL F. QUAYLE, D.L.O., F.R.C.! . (SO.') C. PETFR ROW, F.R.C.S. (ENG.) CLARENce a . c. L e g g e t t , m .s .. P.R. A.C.8. 'fBxisbmz Cfew WICKHAM TERRACE BRISBANE B 17 Queensland AUSTRALIA, March I?th 1947* Robert.A.Kehoe.M.D* Kettering Laboratory ? Applied Physiology, UnCiIvNeCrIsNitNyAToIf. Cincinnati, U, S. A, Dear Dr Kehoe, Re Pluralamand Chronic Nephritis. I was pleased to receive your air letter of March 1st and note your scepticism concerning the relationship between these two conditions. This is not surprising to me for , rbauyto, ibnsemrvyamtiionnds,aifnteradsutultdsy'ainreg tshiemiplraorblteomyfoourrs nearly twenty years I amquite convinced of the rieslaintioynosuhngipcbheitlwdreeenn.the two,if the absorption a part in chIta'nigsingpobsosdibylemetotaobotlhisamt acnlidmmataekinpglaythse subject more susceptible to lead effects* When I first began ay investigation of the cause of juvenile Nephritis here I was seeking tfuorrneadbbaacctkertioo tloexadic. origin but I was constantly Here in brief is the position - In the early nineties two skilled physicians,one a London M.D, and the other from Edinburgh observed * from time to time cases with paralysis and or Encephalopathies. They at first thought they were duq to Encephalitis but eventually came to the con- ,hat of The led i r >lem, or Ions '<e, 3lS to W ** < b * v i4 i V 4 4 W* ^ w -- -- -- jj experience, or rather my lack of experience, does not entitle me to an opinion, hut on general clinical and historical grounds as well as pathological considerations, I 3till find myself in con siderable doubt. Hobait* A.Kahgj>. MtD* March mh 1947. -elusion that thay were due to lead intoxication Dozens of expert physicians since their time have proved the correctness of their diagnosis - the association of Burton' s blue line in the gums,punctate basophilia, selected areas of paralysis,optic neuritis and abnormal secretion * of lead in the urine left no doubt whatsoever as to the correctness of the diagnosis* These cases occurred throughout Queensland . The problem was to find the source of lead and it was eventually tracked down to leadi paint In this country,owing to the heat,the lead powders after tro.or three years and this is brushed off readily or adheres to the fingers. Also,in the past, there was a characteristic type of dwelling built on high blocks with a verandah on which children were penned for many hours during the day, Afurther indicting observation was that almost invariably the affected children were nail biters r finger suckers* So far we had this indisputable fact that in this State of Queens land a certain number of children suffered from chronic *lead intoxication from sucking powdered lead carbonate from verandah railings into thAellftihelids.workWhwenasIdoanrreivbeydphheyrseicaiabnosutbtewfoernetyIyceaamrse ago I was amazed at the number of cases of juvenile Chronic Nephritis seen at the public hospitals either in their late teens or early twenties. I had rarely seen a case in the Southern States or in England or U,S*A.so I beg^n a search for the cause looking for,as I have said,a bacterio toxic factor but,while I could find no such cause I was struck at the frequent association of lead poisoning in the childhood of these victims. I then began to follow through the life history of every! child having lead poisoning and I can now state even more dogmatically than I have before that,if a child is affected with lead posioning sufficiently severely to cause paralysis that child will almost invariably die of arterio sclerotic nephritis in early adult life. )ugh ren :-e 3f nay r*e that of The a ted y blem, I or tions y re, sis to experience, or rather my lack of experience, does not entitle me to a n o p i n i o n , Taut o n g e n e r a l c l i n i c a l a n d h i s t o r i c a l grou n d s as w e l l as p a t h o l o g i c a l c o n s i d e r a t i o n s , I 3till f i n d m y s e l f in con<siderable i doubt. Robert A.Kehoc M.D* March I7th 1947. These observation incriminating lead are not due to mere (coincidence* I amconvinced that lead plays a primary role. The important question to my mind is whether lead has a selective action on young vascular tissues* I think it does for one does not find the same effects in adults. The other question is whether our climate (tropical and sub-tropical)alters our meta bolism and makes us more susceptible to its effects I believe this must be so* T It. is of interest that load poisoning amongst children is nowrarely if ever seen* This I attribute to many fact ors which I mention in my book such as prohibition of the use of lead paint in places accessible to children, smaller familiesjbetter care and hygiene of children, Creche and Kindergarten care of children and a change in the type of house* ' It is a most fascinating problem* Unfortunately I am tooa busy in our large Clinic practice to pursue it any further* Areesearch group with time and facilities would find in it a most intriguing quest and it is my belief that such a bo<dy would be able to tell the world as a result of their wor|kl that minimal amounts of lead absorbed over long periods n susceptible infants and children is the cause of much of the arteriosclerosis seen in adult life DUgh ven re Of may e that If you could come out to do this work the Queensland Research Institute I feel sure would welcome you and would give you every facility in this very important work* of The a ted Can we hope to see you soon? With greetings. Yours sincerely A. , > y iblem, I or tions iy ?re, sis to UXXCt 1/ U V W U ~ *v ~v--- -- _ - - experience, or rather my lack of experience, does not entitle me to an opinion, but on general clinical and historical groun s well as pathological considerations, I 3till find myself in con siderable doubt . ,