Document kDVmEZbwM6qKYQLKKxLwBmL0q

May 4* 1939 Dr. 3 . B, (J. B la ck sto n e Delaware H osp ital 1105 Jefferson S treet W ilmington, Delaware Dear Doctor B la ck sto n e:- I am sen d in g you h erew ith re p o r ts o f our a n a ly se s on samples o f v a rio u s mate r i a l s o b ta in ed from your p a tie n t Mr. Theodore Jones and se n t to us from the Delaware H o sp ita l. I am in th e u n fo rtu n a te p o s it io n o f having no inform ation whatever about t h is c a s e , and fo r th at reason an in te r p r e ta tio n o f the r e s u lt s I s not a lto g e th e r ea sy to make. I s h a ll do th e b e st X can* however* in th e in t e r pretation o f the a n a ly tica l data-them selves. I t would appear th a t th e samples were o b tain ed .in our co n ta in e rs and I presume they werobtained in ac cordance w ith our in stru ction s. I t is not clea r to me, however* how th e. sample o f b lood was c o lle c t e d s in c e I am n ot su re th a t one o f our n e e d le s was su p p lied fo r the c o lle c tio n o f t h is sample* X mention t h is p o in t because i t i s n ecessary to use a s p e d a i type o f n eedle which has no, and which i s not fa b r ic a te d w ith s o ld e r . O therw ise the r e su lts obtained w ill be lik e ly to be m isleading. X mention the m atter fo r th e furthsi reason th at I f our n eed le was a v a ila b le * i t was not retu rn ed to u s , and i n a s much a s our n e e d le s a re o f s p e c ia l fa b r ic a tio n and a re e x p e n siv e , X vpr much w ish to g e t the n eed le back. X would apprcia t. i t , th e r e fo r e , i f you would l e t me know w hether or. a o f our n e e d le s was u sed and what has become o f I t i f indeed i t was u sed . I t i s my u n c e r ta in ty about th e m atter o f th e n eed le and whether or not a syringe was u sed which makes me q u estio n th e p r e c is e v a l i d i t y K S 0020086 o f th e r e s u lt ob tain ed upon th e blood* In any case* however* the lead content o f th e blood i s w ith in the range o f normal v a lu e s and i t i s * th erefo re* not in d ic a tiv e o f any recent s ig n ific a n t le a d exposure. My o n ly q u e stio n a r i s e s froift th e f a c t th a t th e v a lu e ' fO'.?nd i s s l i g h t l y above the average normal v a lu e , and w hile not s ig n ific a n tly high* i s s ll^ x tly q uestionab le. I f th ere was any p o ssib le fa c to r o f contam ination, i t may w e ll be th a t th e a c tu a l b lood in th e p a tie n t s v e in s was o f average or l e s s than average m agnitude. The v a lu es o b ta in ed in th e case o f the urine and fe c e s are e n tir e ly w ith in the normal range o f v a lu e s , and in d ic a te th a t there has been no r e c e n t -sig n ific a n t exposure to le a d on th e part of th is patient. Taking the above data Into a cco u n t, i t i s q u ite c e r ta in th a t any symptoms o f in to x ic a t io n which may be p resen t in t h l3 p a tie n t a t ; t h i s tim e , or which may have e x is t e d a t th e time th e sam ples were drawn* were not th e r e s u lt o f le a d I n to x i c a t io n . More than th a t i t i s n o t p o s s ib le to sa y w ithout a ca r e fu l exam ination o f th e c l i n i c a l h is t o r y , and without p r e c ise knowledge o f the n atu re, duration/and time o f c e s s a t io n o f th e p a t ie n t *a presumable le a d exposure' - : T his b rin g s me to the c h ie f p o in t o f ray l e t t e r . Gur la b o ra to ry i s n ot in p o s it io n to do a n a ly t ic a l work fo r com pensation, and although we are w illi n g to make o b se r v a tio n s from tim e to tim e in th e in t e r e s t o f sound c l i n i c a l p r a c t ic e , we can not make a b u sin ess o f th is type of work. G enerally i t is our ru le not to make le a d d eterm in a tio n s o f t h i s ty p e excep t when th e c l i n i c a l inform ation and th e h is to r y o f the p a tie n t Tire made a v a ila b le to u s . In a s much as th e se sam ples had a lrea d y o cca sio n ed some expense and tro u b le when they came in to our h and s, I d id not l i k e to d e la y the a n a ly ses o f them unduly by correspon d en ce. T herefore we went ahead; and made th e a n a ly s e s . An a d d itio n a l fa c t o r in our d oin g so was th e f a c t th a t our good c o lle a g u e Dr. Gehrmaftn h a d .: . . been instrum ental in providing the containers and, therefore* we knew th a t th ere was good reason fo r th e a n a ly t ic a l pro ced u res. I should a p p r ecia te i t very much in d e ed , however, i f you would make a v a ila b le to me the com plete c l i n i c a l record in t h is case at your convenience. Obviously the only value o f these oases to us la in the accumulation of ad dition al u seful inform ation. ' D espite the above comments, I am sending to you h erew ith a b i l l fo r th e a c tu a l c o st o f th e s e r v ic e s rendered in making the a n a ly se s . I t i s 3 not our purpose to c o l l e c t p r o fe s s io n a l f e e s on ca ses o f t i l l s ty p e , but we do sake i t a p o in t , i f and when the. p a tie n t can a ffo r d i t , to coyer th e a c tu a l c o s t of o u r s e rv ic e s ^ If in t h i s in sta n c e y o u r p a tie n t can not afford to pay th is b i l l , yon are a t lib e r ty to ignore i t . However I send i t fo r such d is p o s itio n as seems s u ita b le to the circum stances in your mind. Very tr u ly you rs. RAKi i s .- Robert A,"" Kehoe,- MkQ* KE 0020088 Dr, Robert Kehoe K ettering laboratory College of K edoine C in c in n a ti, Ohio Mar 13% So Dr, B, B, G-, B la ck sto n e She Delaware H o sp ita l I I 05 J e ffe r s o n S tr e e t W ilmington, Delaware . f o r th r e e a n a ly se s o f th e b lo o d , urino and f e c e s in th e ca se o f Theodore Jones a t s?500 each 15* 00 ' KE? 0020089