Document RJ6zxnD2vD4z2pMKjjop16J6E

November 7# 1935 Dp , Herbert Kataev Bayonne Hospital and Dispensary East Thirtieth Street Bayonne, Hen Jersey Dear Dr, Katzevg- I am replying somewhat tardily to your letter of October 25th for the reason that I have been out of my office for a little while. However, I hasten to reply. In my opinion the diagnosis of lead poisoning In obscure oases must often depend upon definite laboratory procedures. Of these the most useful and speoifle is the determination of the lead oontent of the blood and urine. It Is sometimes necessary to prove that lead has been absorbed in abnormal amounts before one oan be oonvlnoed of the actual existence of lead Intoxication, Moreover, If one oan establish that no unusual lead absorption has occurred, the diagnosis of lead poison ing oan be excluded. On the other hand, if the Interval between the cessation of exposure to lead and the collection of samples is too great, such analyses may give no useful Information, It is not easy to state offhand, therefore, just what should be done In addition to what you have already done. However, I would suggest the advisability of chemical examination of the blood and urine, if exposure was recent, in order to see just what the lead absorption was. This is a rather complicated procedure and will give useless and entirely misleading results unless it is done by persons who have had a great deal of experience with the available methods. If it is not possible to obtain such information, the diagnosis must be made from the history and the clinical findings. Microscopic blood examinations are useful but they are by no means sufficient, since anemia and stippling of the erythrooytea occur in a number of conditions other than lead intoxication. The treatment varies considerably with the eype of case. Intoxication which is uncomplicated by nervous system abnormalities, is usually satisfactorily - 2/- Dr. Kataev treated by the administration of calcium as a gluconate or as a lactate. The administration of calcium ohlorlde by mouth does not serve the purpose* Other than this, general eliminative treatment le the most useful proce dure* Inake It a point to maintain satisfactory elimina tion through the use of saline oathartics of whioh magnesium sulphate In suitable doses Is the most mseful* In complloated cases the treatment must be modified* Therefore, If there Is anything unusual about your case, I should prefer to know some of the details before giving advice* If you are Interested in the experi mental basis of my opinions on diagnosis, I would suggest that you read what I have had to say on the subject in the Journal of Industrial Hygiene, September 1933* Vol.xv, HO.5* Pages 520-339* Sincerely yours. RAKjis /" i ' Robert"V. Eeho'e, 'M*t>* 00837