Document VvBpwVzgy0rdVpkMbd1j0ja8

September 6, 1951 Dr. C. R. B. Blackburn Clinical Research Unit Royal Prince Alfred Hospital Mlssenden Road Camperdovn, N.S.'W. Sydney, Australia Dear Doctor Blackburn: A short time ago, to my surprise, I came across your letter of August 3, 1950, in a sheaf of material which had been set aside for examination and disposition at some convenient time. Apparently your letter came last summer during my.trip abroad, when I was in England and France on some of the affairs of Associated Ethyl for a period of weeks. The accumulated material was gone over, but apparently I missed your letter, for certainly I had not seen it before, nor had it had the courtesy of a reply. It would seem, from this circumstance, that you and I are practically even with respect to our apparent neglect of correspondence. In any case, I can assure you that this was not deliberate on my part and that I am net guilty of any Intended discourtesy. My reply at this late date Is not solely for the purpose of making an apology for an apparent neglect, but rather I am constrained to do so by one of the comments in your letter concerning the administration of B.A.L. to children with lead encephalopathy. This question has been with us in a very active manner here In Cincinnati during the past several months. We have had an unprecedented frequency of occurrence of cases of encephalopathy in children In the local hospitals. Such cases have occurred from time to time over a period of years, and we have followed quite a number of them with laboratory studies which established the facts with reference to lead absorption, and which in some instances extended to analysis of quite a variety of tissues in fatal cases. Over the period of years there have been some sixty cases In our files, these extending from 1931 or*32 on to the present time. During the current year we have had more cases than we have seen in any full year previously, despite the fact that the year is only half gone. This has created much more than the usual amount of concern, for which I am rather glad, since I have been following this problem with some concern for a good many years. Under the present stimulus we shall be able to track down some of these cases as to their origin. The facts are known in a general way, but certainly not in a specific way in the individual case. This requires to be done well, and I think ve shall be able to gather together some interesting and important facts, which will relate  LL COMM Dr. C. R. B. Blackburn - (2) - September 6, 1951 to the prevention of this disease. The treatment of these cases, which in most respects is unsatis factory, has come up for review. The pediatrists have made use of B.A.L. in some Instances, and some of the men are quite enthusiastic about it, largely because of the results reported by Earrison and his associates, who believe that they have had favorable results. Frankly I am not impressed, since,in my opinion, the prognosis, at present, depends much more upon other factors than the therapy. I think >we will have to admit that the therapy of this condition is in an unsatisfactory state. Our surgical colleagues have been opening up the skull, and not infrequently inserting catheters in the ventricles. This appears to have saved life at times, but one may ask whether the eventual results of the therapy may not be as bad as the more prompt fatal outcome. This remains to be seen, of course, but it is a type of treatment that is not attractive. Here, as in the case of tetraethyl lead poisoning, I am much more concerned with prevention than with therapy, although I am certainly not lacking in interest in a satisfactory therapy. I was sorry indeed that circumstances took you out of your asso ciation with Doctor Fairley and his group in Associated Ethyl Company. I realize, however, the attraction which took you into your present work. I trust that the opportunity has been all that you expected of it, and that you are having a very satisfactory time. I still hope that I shall be able to get my working household into such a state that I may be able to visit your part of the country in the not too distant future. At the moment this does not seem to be likely soon, for we are heavily involved in a variety of activities, including a most demanding graduate training program in the field of industrial medicine. With kindest regards and best wishes to you for the success of your work, I am Sincerely yours. RAH ef Robei* u ""AIKehoe, M. 'D. Kf 0013315