Document byr2E5LVR9y5egoboyZ27d166

October 4, 1932 Dr* P* H* Kilbourne 870 Fidelity Medical Bldg*, Dayton, Ohio Dear Doctor Kilbourne: Severa3^_days ago I examined your patien^^^ -r. After going into Mr. Mstor^caremiX^and after have examined not feel that his present condition is due to exposure on his part to dusts In the course of his work* Un doubtedly he did have some exposure to dusts contain ing chromates* Apparently there was nothing more than a superficial irritation since none of the characteris tic chromate lesions developed in the nose* In my opinion, his present condition is of an infectious type and is very like that of any other person with a posterior sinus drainage* I feel that many of these infections are allergic and I have seen a number of them respond yery well indeed to desenltizatlon with autogenous antigeiis* 1 should feel if Mr* Gerard has any significant anatomical abnormalities of the nose, these should be corrected* I doubt the presence of polypi but if they are present he can not expect to recover ex cept as they are removed* In any case either before or after surgical interference, I should feel it desirable to culture out his upper respiratory flora and to give him skin tests to determine any specific sensitivities. He should then be desensitized, I think, to any organisms to which he shows a sensitivity* The tendency to allergic reactions which is shown in Mr. history, is strengthened somewhat by the presence of a relatively high eosinophils count n^)* My physical examination did not disclose any re markable abnormalities outside of the condition of the nose and throat* Cordially yours. s-t IS