Document XzdvnKzKYpQ3XdgXdNyDe19Gy

November 4, 1971 Lucien B. Guze, M.D., Chief Staff for Research and Education Veterans Administration Wadsworth Hospital Sawtelle & Wilshire Boulevards Los Angeles, California 90073 Dear Doctor Guze: Re: 691/151 '-j I have gone over the proposal entitled "Lead Metabolism in Human Subjects" with care and I may say also with pleasure - also with some dismay. As for the latter, let me get this off my chest at once, so as not to confuse the issue. My dismay, if I may speak of it so, arises from the fact that the person (or persons) who prepared this proposal, have not done their homework very well, and I would hope that they improve their knowledge of the status of the overall problem which they propose to investigate before they go very far in their investigation. Their discussion of the "Background" is more than a little naive; they consider the issues, in a number of respects, in much the same manner as they have been considered in the daily press, and voice the doubts of various amateur investigators and lay commentators in a fairly irresponsible manner. It is this which distresses me, for the matters involved here are serious and significant features of physiology and they deserve much more careful consideration than they have been given. The proposed experimental work has a very different flavor, and I feel sure that it will produce very useful data. Let me point out to the investigators, however, that the principal unknown in this situation, in view of the evidence now in the literature, relates to the fate of lead (particulate lead) which is inhaled. The clearance of lead,deposited in various parts of the human respiratory tract, is not at all clear in detail, and this information is badly needed. With the facilities (equipment, etc.) available in the vicinity of your establishment, this matter could be elucidated, I think, more readily than it could be elsewhere, through following the total behavior of a radioactive lead compound of short life, which would not persist within the body (especially in various skeletal structures) for more than a brief period. Incidentally, careful study of our data, will reveal much more useful information than will be obtained in the experiments outlined in the proposal^, with respect to the quantitative relationships and the fate of lead introduced into the alimentary tract, and I am not at all convinced that these experiments will clarify the quantitative relationships and the fate of inhaled lead. Almost everyone has made unjustified assumptions about this aspect of the matter, and I should like to be certain that these investigators do not repeat this mistake. I am app<flled, for example, that they have accepted whole heartedly, it seems, the quotation by Patterson of California Technical institute as to the meaning of our data and those of others, when it is quite clear that Patterson fails almost utterly to understand the meaning of these data. I must insist, in this matter, that data speak for themselves (when they are valid), and these men will have to study their data carefully beside those of other investigators, as very few people have done, if they are to develop out of these experiments the information so made available. I speak here to this question, which I must emphasize - do the investigators ask the right questions in their experimentation? This can be done in this instance, Lucien B. Guze, M.D. Page 2 November 4, 1971 in which there is much information, only by careful study of what is now available and by going beyond it. I recognize the fact that this part of my reply to your letter is not what you asked of me, for I am speaking of the investigators rather than the details of the investigation. However, this is what must be inquired into in the experimental approach to this broad physiological subject, and I have undertaken to put the inquiry into its proper setting. Let me conclude my remarks, however, by saying that the general plan of this investigation is, I think, good, and that much useful information can be obtained by the means described. I wish these men well in their work, and I predict that once they become involved in it, they will find it difficult to give it up. If this comment and prediction sound a bit avuncular, it is not with this idea in mind that it is expressed. . Sincerely yours, KAK:wb Robert A. Kehoe, M.D. Professor Emeritus of Occupational 4Medicine P.S. I am retaining the copy of the proposal Please let me know if you wish it returned to you. RAK