Document g2kjbvr3deeNQwNygOvDLMk4q

October 20, 193? fr A# B, O sterberg rouartmer.t of Bioch em istry Mayo C lin ic Heeh cat er , fe York Bear Doctor O ater b er gs- : Dr* Graham Edgar o f th e Et h y l Gasolin e Corporation t o ld me se v e r a l days ago* hen I was in h is o f f i c e , t h at yon had t o ld him o f a ease o f le ad en ceph alopath y which had been seen a t th e Mayo C lin ic In which th e presum able sou r ce o f th e le ad was t e t r a e t h y l lead in ga so lin e , th e p a t ie n t h avin g Given a h ist o r y of in ge st in g gaso lin e w h ile siph on in g from the tah k o f M s o ar * I sh ou ld -ap p r e ciat e i t ver y much i f you would l e t rae know th e fa c t s l a the sist t o r and th e b a sis o f th e d ia gn o sis* I a s en closin g a s e l f ad d r esse d , stamped en velope fo r your con ven ien ce* O bviously i t i s not w ell to have any pre-cGn ception about such a c ase , and I am p e r fe c t ly w illin g t o examine th e c l i n i c a l d at a and t o bo con vin ced by i t , i f i t la adequ ate* On th e oth er h an d, I can n ot con ceal my sk ep t icism * The t o xic dos of t e t r a e t h y l lead when in gest ed by experim en tal an im als i s fa i r l y h igh , the reason bein g t h at t e t r ae t h y l load i s n ot r e a d ily absorbed from th e alim en tar y t r a c t * Thor have boon c ase s o f load poison in g in human b ein gs from th e in gest io n of con cen trated Eth yl F lu id , and t h e r e have boon f a t a l e a se s* Xu t h ese in st an ce s th e q u an t it y a c t u a lly absorbed in to th e body was q u it e co n sid e r ab le * A sl i g h t c a lc u la t io n o f th e q u an t it y pr esen t in gaso lin e would ser ve t o show t h at a p r o h ib it iv e q u an t it y o f gaso lin e would have t o bo in gest ed b efor e von a a ig n lfle a n t dosage o f t e t r a e t h y l le ad cou ld be in trodu ced in t o th e body, much l e s s absorbed Thus 100 co o f gaso lin e withth h igh e st concen t r a t io n o f t e t r a e t h y l lead which occu r s on the market would con tain on ly about 75 i l l igra o f lead as t e t r a et h y l le a d * Th is q u an t it y i s e n t ir e ly I n sig n ific a n t when in trodu ced o r a l l y , and cou ld h ar d ly be expected t o produce even th e sligh t e st t o x ic symptoms. Perh aps sons d iar r h e a would occur fo r a ver y sh o r t p er iod of time on such a d osage, bu t t h is i s th e w orst symptom t h at would be ex pected# On th e ot h er h an d, t h is q u an t it y o f ga so lin e would be expected t o produce acu t e symptoms both with r e sp e c t t o th e alim en t ar y t r a c t and th e c e n t r a l n ervous system The amount o f n ervous system in volvement would \ Dr* A* E. Oaterberg depend upon the degree of ir r it a t io n of the alimentary t r a c t . Thus I f retch in g and vomiting and aoute diarrh ea were to occur, the absorption of gasolin e would probably be diminished and system ic e ffe c t s might be lim ited* I f con dition s were such th at absorption of the gasolin e took place t o any con siderable degree, one would expect some cen tral nervous system symptoms, varyin g from extreme i r r i t a b i l it y to profound drunkenness* In gen eral th ese symptoms of gasolin e In toxication disappear fa ir ly promptly but cases have been described in which the. nervous system symptoms p e r sist for some l i t t l e time* For the above r eason s, I should h disposed to regard nervous system symptoms as at t r ib u t ab le to gasolin e r ath er than to lead , u n less evidence of lead absorption was Indeed very str on g. From the above you can see how curious I am about t h is case and how In terested I am in knowing the fa e t s as to the c lin ic a l course of the p at ien t . I f i t i3 p ossib le to oblige me In th is r esp ect , I should be very gr at efu l to you. Cordially yours, RAK: i s HoSerirXr"lieHoo," ' ! KJT 001208