Document mXp2MMj6NB93dzyGM3Mmezbk

October 19, 1351 Dr. E. M. Freese, 527 East State Street, Columbus, Ohio Dear Doctor Freeses In the absence of Doctor Kehoe I a answering your inquiry of recent date. Also a enclosing some pamphlets giving the distribution of lead in the various tissues of the body. As to cases manifesting central nervous system involvement I sight say briefly that under proper conditions and taken into the body in sufficient quantity lead will be found in the central nervous system in varying amounts with a resulting encephalopathy depending on the amount of lead in the tissue. Here a more or less permanent fixation occurs which accounts for our inability to adequately treat this type of case and the poor prognosis* While a considerable number of these cases result fatally others may partially recover with residuals such as a lowered mentality, insanity, or as in your case epileptiform seizures. Since in this type of case all laboratory examinations may show normal findings, a diagnosis must be made on history, symptomatology and clinical findings alone, and since this is impossible many times a positive diagnosis is only made on post-mortem examination, four case as described may be the result of a lead encephalitis in the past depending I should say, in the absence of positive laboratory findingSjon the type of lead poisoning the map had two years ago* As to treatment which at best is inadequate Doctor Kehoe has found the intravenous use of magnesium sulphate of some value* Regret the delay in answering your letter and sorry Doctor Kehoe is not here to answer you personally. Very sincerely yours