Document gakMDmgvYXB214LRq1v4bEGjV

March 13, 1956 D r. .C harles H. Daffin 5 36 E a s t F o u r th S tr e e t Panam a C ity, Florida D ea r D octor Daffin: . Your le tte r of M arch 3 r a ise s qu estion s w hich cannot be an sw ered with absolute certain ty. H ow ever, an answ er can be given in such a way as to deal sa tisfa cto rily with a ll but the m ost unusual c a s e s . In g en era l, exp osu re to g a solin e vapors in high concen tration is ser io u s as to life , sin c e the hydrocarbons induce n a r c o sis prom p tly when in s u ffic ie n t c o n c e n tr a tio n (I don't know ju s t w hat you m e a n by 100% c o n c e n tration , but I m u3t a ssu m e that you m ean a high concen tration. Your patient m ust not have been trapped, for if he had been, he m ight e a sily have lo st his life), and u n less one escap es before unconsciousness en su es, or u n less he is rem oved and resu scitated prom ptly, he does not resum e breathing. On the other hand, resu scitation is follow ed gen erally by com p lete r e c o v e r y in a fa ir ly sh ort tim e . The outcom e depends, to a c o n sidarabie extent, upon the com position of the gasolin e, how ever, The higher the concen tration of arom atic h yd rocarbons, the m ore lik ely one is to have a m ore prolonged illn e s s . You w ill recogn ize, I b eliev e, that m odern gasolin e is quite.a m ixture o r sp ecia l blend of petroleum products, and th e r e fo r e it is hard to a n ticip a te all. o f its e f f e c t s . In g e n e ra l I shoddnot ex p e ct ev en s e v e r e e x p o su r e to g a s o lin e v a p o rs fo r a few m in utes to r esu lt in c lin ic a lly d em on strab le dam age to the liv e r . I do not say that it is not p o ssib le , but it is u n lik ely. One w ond ers, th erefo re, w hether your patient w as not ill or in the clu tch es of an illn e s s (one of the form s of clin ica l hepatitis w hich occur not infrequently) at the tim e of his exp osu re to g a so lin e . It is not quite the sam e thing, but one d oes not exp ect s e v e r e d a m a g e to th e liv e r co o c c u r a s th e c o n s e q u e n c e o f e v e n q u ite an a lc o h o lic b in g e . Mo m o r e w ou ld I e x p e c t it in c o n n e c tio n w ith th e e x p o s u r e to g a so lin e w hich you have described (too b riefly to enable one to e stim a te it3 sev e r ity ). C ertainly chloroform induces sev e r e liv e r dam age with m uch g rea ter e a se and frequency than do the petroleum hydrocarbons, but only rarely does it, when used b riefly, cause persisten t hepatitis or h ep a to sis. (I am sp eak in g h ere of a tim e when ch lo ro fo rm w as u sed freq u en tly , fo r the prom pt and b rief induction of a n e s th e sia .) n< a *) D r . C h arles H . D affin * (2) - M arch 13, 1956 If I w ere resp on sib le fo r your patient, I would w ish to m ake sure w hether o r not he now has so m e p e r siste n t form of liv e r dam age o r d is e a s e . If he does not have evidence of such d ise a se , I would con sid er carefu lly w hether h e m ay have had an attack of h ep a ti^ d isea se of a type that .may r e c u r ., If, h ow ever, the h isto ry and the seq uence of even ts in h is illn e s s w as such that the hepatic injury see m s alm o st certa in ly to have stem m ed from h is exp erien ce with g a so lin e, I would te ll him to fo rg et about the lik elih ood of further trouble from that ca u se. The type of injury that m ight occu r from that cause should be com p letely rev ersib le and without seq u el. I should be in ter e sted to know how your patient g ets along in the n ear fu ture, and if you w ou ld .care to w rite to m e fu rth er, I should be p lea sed . I am sending you an a rticle on the subject of gasolin e intoxication w ritten by one of m y form er a sso c ia te s, which covers the subject fa irly w ell. One m u st reco g n ize that aviation g a so lin e v a r ie s from tim e to tim e and from one refin er to another, and that we m ay not have seen a ll of the p o ssib le effects of all of the m ixtu res of petroleum hydrocarbons w hich are now in u se . What I have said fits into our ex p erien ce over quite a p eriod of y e a r s, how ever, and rep resen ts the b est inform ation I can give you. C ordially yours, RAK ef Enc. Robert A . Kehoe, M . D. K 00124 # \J & C H A R L E S H. D A F F I N , M. D. 5 3 6 Ea s t Fo u r t h S t r e e t PANAMA CITY. FLO RIDA 3 March 1956 Dr. R obert A. Kehee D irecto r f Medical Department E th y l Corporation U n iv ersity of C incinnati College of Medici Gincinn&ti 19, Ohio. Dear Dr. Kehee: I have a p a t i e n t who works w i t h a v i a t i o n g a s o l i n e and he was r e c e n tly s u b je c te d te approxim ately 100$ c o n c e n tra tio n f a r a few m i n u t e s . He was made q u i t e i l l f o r t h e n e x t few m in u te s and f e l t roekyias he says i t ) f o r the r e s t of tb s day. The next few weeks he l o s t h i s a p p e t i t e , f e l t b a d , l o s t t h i r t y ( 30#-) pounds w e i g h t . B e l a t e d l y he s o u g h t m e d ic a l a d v i c e and. was found t hav non i c t e r i c h e p a t i t i s . He was s e n t t a May C l i n i c and now has r e t u r n e d t o w ork. He a s k e d me t c w r i t e you c o n c e r n i n g t h e t o x i c e f f e c t s of high ectane g a so lin e , the d u ratio n of any p o s sib le damage, and a p ro p e r management of to x ic e f f e c t s i f o b tain ed . He had w r i t t e n somewhere f o r t h i s in f o r m a .tia n and h ad a l o i t e r which s ta te d th a t i f h is d o cto r would w rite you th a t the inform ation would, be s e n t t o th e p a t i e n t ' s f a m i ly p h y s i c i a n . Hoping to hear from you in the near fu tu re , I aa, sin cerely yours CHB:dd / Mr 214 Bunkers Cove Ed. Panama C ity , F lo rid a February 1?, 1958 This is in referen ce to your l e t t e r dated February 15,1958 in which you re q u e ste d in fo rm atio n concerning the to x ic ity hazards o f a v ia t io n g a s o lin e . A s e c tio n e n t i t l e d ''H e a lth H azards o f A v iatio n Fuels" i s included on Page 9 o f the 'co o k iet, "A viation F uels and Their E ffe c ts on Engine Perform ance", copy of which is b e in g fo rw ard ed to you under s e p a r a te c o v e r. T his i s i n no se n se intended as a m edical tr e a tis e on the su b je c t, I have d isc u sse d y our l e t t e r w ith Dr, C, J , Sprunk of our 'D e tro it M edical D epartm ent and a t h is s u g g e s tio n we are fo rw a rd in g i t to D r, R obert A, Kehoe who i s Head o f th e M edical D ep artm en t o f th e S th y l C o rp o ra tio n and r i l l toko such a c tio n as he deems d e s ir a b le . I t ' i s p o s s ib le th a t he would f e e l raore in c lin e d to d isc u ss th is case d ir e c tly w ith your d o c to r and i t i s suggested t h a t y o u r p h y s ic ia n c o n ta c t D r, Keiios whose addr ess i s: D r, R o b ert A, Kehoe College o f M edicine Uni.varsity of C incinnati C in c in n a ti 19, Ohio lo u rs vary tru ly , EVKtrel c e: D r, R. A, Kehoe D r. C. J . Sprunk C entral F ile ORIGINAL SIGNED BY. ROBERT V. KERLET. R o b ert V. K e rle y , D ire c to r Products A pplication D ivision fc v -itiu L x & * * * * fr iS i ^ u a C j )jl ^ A xX ^. . ^l J- . 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