Document NeZoDBaKyQdpGORjoNmaJvn4p

Febru ary 28, 1940 Dr# Lu cie n Y# D y r en fo r t h St , Luke's H ospital Ja c k so n v ille , Flo r id a Dear Doctor D yren forth : I was v e r y much d isa p p o in t e d t o h ave m isse d you when I was in Ja c k so n v il le l a s t Sat u r d ay sin c e n ot o n ly would I h ave been p le a se d t o make your acq u ain t an ce b u t I w ish ed t o obtalx^ som e sp e c i fi c in fo r m at io n from you in th e case o f talk w ith you r a ssi st a n t s and a l so exam ined ah e m icr o sco p ic se c t io n s o f th e t i ssu e s which were a v a ila b le # U n for tu n ately we w ere u n ab le t o fin d an y se c t i o n s o f th e b r a in and X am cu riou s as to th e in t e r p r e t at io n o f th e lym ph ocytic r e act io n o f th e c e r e b r a l t issu e # m t h i s con n ect ion I wonder i f I co u ld im pose upon you t o su p p ly me w ith a se t o f t h e m icr o sc o p ic se c t i o n s in t h i s c a se fox'1 fu r t h e r st u d y o r , i f t h i s i s in c o n v e n ie n t , p e r h ap s you m igh t be w i l l i n g to sen d me you r p a r a f f i n b lo c k s w h ich we w i ll be g la d t o r e t u r n t o you when we h ave h ad th e o p p o r t u n it y t o male some se c t io n s fo r ou rselves# The q u e st io n w h ich I w ish ed to r a ise concerned th e p o ssib ilit y of the con tam in ation of t h e t i s s u e s in th e p r o c e ss o f t h e i r rem oval from t h e b od y, and t h e ir st o r a g e in you r la b o r a t o r y * Vie w ere u n ab le t o fin d any a d d it io n a l t issu e s excep t t h at th e o r d e r ly foun d a la r g e c o n t a in e r w it h a se c t io n e d b r a in wh ich h e s a i d was t h at o f Hubbard# I t occu r r ed t o me, t h e r e fo r e , t h a t you p rob ab ly sen t u s a l l o f th e v isc e r a t h at you h ad except t h at o f th e b r a i n . I f t h a t were th e c a se , t h e r e seem s l i t t l e o r no p o ssib ilit y th at th ese b i t s o f t issu e cou ld h ave been sig n i fic a n t l y con tam in ated w ith le ad w h ile in your h an ds* N ever th eless, becau se o f th e im portan ce of t h is c a se , I would b e v e r y much p le a se d i f you would l e t me know how th e t i s s u e s were h an d led a ft e r t h e ir rem oval from t h e body, and what p r e cau t io n s w ere taken in th e m at t er o f r e aso n ab le c l e a n l i n e ss in h a n d lin g them# I am t h in k in g, o f c o u r se , p a r t i c u l a r l y o f t h e p o s s i b i l i t y t h a t t h e y h ave come in c o n t a c t w ith some c o n t a in e r w h ich h ad le a d in i t in th e form o f so ld e r or so lu t io n or what n ot# 0021052 2- W hile I was t h e r e , I look ed a ft e r th e q u e st io n o f th e embalming flu id s and was ab le to o b t a in sam p les of th e m a t e r ia l u se d in embalming p r io r t o th e n ecr o p sy . In a s much a s i t seem ed apparen t t h a t you h ad ample q u a n t it ie s o f b r a in t i s s u e , I wonder i f you w ould n o t b e w i l l i n g t o sen d me an a d d it io n a l sam ple o f abou t 100 gram s or more o f t h is b r a in fo r a fu r t h e r a n a l y s i s . In my o p in io n th e r e s u l t s ar e q u it e c o n c lu siv e bu t I sh ou ld lik e to check th e m atter fu r t h e r . A lso , as I h ave in d ic a t e d , I would lik e t o h ave th e means of making fu r t h e r m icr o sco p ic st u d y o f th e t i s s u e s , and e sp e c i a l l y the b rain . I n c id e n t a lly I s h a l l make a f u l l r e p o r t on ou r fin d in g s when we h ave gat h e r e d t o ge t h e r a l l o f t h e lo o se e n d s, I b e lie v e we s h a l l n ot o n ly be a b le to e st a b lish a d e fin it e d iagn o sis, but w ill be able to trace th e m ech an ism by w h ich se r io u s exp osu r e t o le a d o c c u r r e d , -- W ith r e fe r e n ce to the exam in a t io n o f b i o lo g ic a l m a t e r ia ls fo r le a d , I w ish to say w ith ou t appearin g to be c r i t i c a l, th at the sp in al flu id i s n ot a good m a t e r ia l fo r e xam in at io n . The le a d co n t e n t o f sp in a l fl u i d i s alw ays q u it e low u n der even th e m ost extrem e c o n d it io n s o f e xp o su r e , and i t h as n ot been e st a b lish e d ad e q u at e ly t h a t th e c o n c e n t r a t io n o f l e a d in t h e sp in a l f l u i d sh ows an y r e l a t i o n sh i p to th e lead con ten t o f the b r ain or the oth er t issu e s. In the li v in g p er so n th e b lo o d and u r in e ar e t h e m ost u se fu l m a t e r ia ls fo r exam in ation , and th e lim it s of t h e n orm al co n ce n t r at io n s as w e ll a s th e r an ge o f v alu e s foun d u n der co n d it io n s o f le ad ab sorp tion have been worked out qu ite ad equ ately fo r both of th ese m a t e r ia ls. In th e d eceased p e r so n , i t i s w ise t o examine a l l o f th e v isc e r a and a lso p a r t s o f t h e sk e le t o n b o t h o f the lon g b on es an d o f th e f l a t b o n e s, and to d et er m in e th e con cen t r a t io n s in su ch a manner as to be ab le t o c a lc u la t e ap p r o xi m a t e ly t h e le a d c o n t e n t o f t h e b od y . When i t i s n o t p o ssi b le t o do t h i s , th e m ost u se fu l t i ss u e s t o exam ine ar e th e sk e le t a l t i s s u e s , th e l i v e r , t h e k id n ey and im p e r a t iv e ly ,in c a se s o f su sp e c t e d en ce p h alo p at h y , th e b r a i n . The n orm al c o n c e n t r a t io n o f le ad In th ese t issu e s h ave been f a i r l y w ell worked out alt h o u gh n o t w it h t h e same d e gr e e o f co m p le t e n e ss as in th e c a se o f th e b lo o d and u r in e . I n c id e n t a lly th e exam in at ion o f th e fe c e s I s alm ost u se l e ss un der any se t o f co n d it io n s and e sp e c ia ll y fo r m e d ic o - le g a l p u r p o se s, fjyjgce le a d i s alw ays p r e se n t in t h e alim e n t ar y t r a c t , and sin c e q u a n t it ie s t h e r e var y w itif^rLde lim it s by r eason o f th e v a r ia b le le ad oon ten t of food su b st an ce s* I f you sh ou ld be In t e r e st e d In th e d a t a In su p p o r t o f my st a t e m e n t s w h ich I h av e made ab ove, and a l s o In th e m eth ods o f a n a l y si s w h ich h ave been w orked out in more or l e s s r e ce n t y e a r s, I sh a l l be gla d to forw ard t h e se to you. In con clu sion p lease accep t my t h an k s fo r you r v er y gen er ou s c o o p e r a t io n an d my fu r t h e r t h an k s in ad van ce fo r an y a ss i st a n c e -which you can g iv e me alon g th e lin e s of th e foregoin g paragraph s* C ord ially you rs, RAKjis Robert' A# Keh oe, M*D* 0021054