Document o98k1jDyvJO2YKbRz6G94jeo8

- _,,r ~ - , : ' `y . '' m0m f: V : . . ' - ` Y .. . : Kay 29, 1939 Dr, vJard Ceffm&n 713 Market S tre e t , Z anesville* Ohio Dear' Doctor Goffman *. ' .'X m very. glad to have had ' a'chance to e e e y o u r Mr, McConnell whom 1 examined and from whom t o b tain ed c e r ta in camples o f blood and ex- . . gretft- f o r an a ly sis* -Before. d isc u ssin g -th e - question o f .. le a d poisoning in h i s c a s e * X ehould l i k e to say th a t my , im pression from the h is to ry aM from sy oxamint ion i s t h a t Mr, McConnell h as some d e f in ite source o f i r r i t a t i o n ' o f th e nerve tra n k s * C h iefly in' th e Xumbs-saeraX re g io n , : th e muscle spasm along both sid es o f the lumbar vertebrae* together w ith the pains which are described* is in its e lf q u ite adequate to give me t h i s im pression. As to what has o ccu rred n th e sh o u lder g ir d le to produce s im ila r i r r i t a tio n th ere* X am q u ite unable to say s in c e t h i s co n d itio n i s not much in evidence a t present* ' X should th in k * th e re fo re th a t wo are d e a lin g here e ith e r w ith a s p in a l a r t h r i t i s o r -w ith some m echanical f a c to r In th e v e rte b ra e column which is resulting in irrita tio n , ' AS to th e r e la tio n s h ip of le a d to th in case* X should say in the f i r s t place th a t the lesions in no wise resemble th e e f fe c ts of le a d in to x icatio n * so fa r as my experience can be regarded as a c r i t e r i o n , The. m u ltip le n e u r itis o f lead in to x ic a tio n is almost always p a in le ss and i s c e rta iftly always predom inantly motor ra th e r than -' sensory#' The absence o f motor d i s a b i l it y in a co n d itio n th at has p ersisted with sensory disturbance as long as in t h i s case* would-be q u ite enou^v to convince me t h a t le a d was not a facto r* However* even i f th e case were somewhat more su g g estiv e o f le a d absorption* X would s t i l l be in great doubt asto the significance of lead in the m atter sin c e t h i s man' s occupation i s not and has never been, so f a r as X Can find* a s s o c ia te d w ith s ig n if ic a n t le a d exposure. In th is connection i t may be o f some In terest to you to know that there has never been a reported or authenticated case of lea d poisoning in a f i l l i n g sta tio n employee or garage mechanic as a consequence o f the handling o f leaded g a so lin e , < - These occupations are sim ply not to be regarded as hasardons In the sense o f in volvin g p o te n tia l lead exposure,' The fa cto r o f in h alation i s w holly inadequate to produce sig n ific a n t lead absorption and there i s no meaeureable absorption o f lead through th e skin* as a consequence o f con tact w ith commercial leaded g a so lin e ? I do n o t q u ite know where th e id e a aro se th a t such exposure is p o te n tia lly dangerous w ith respect to lead* hut a ll of th e in v e s tig a tio n s which have been made on t h i s problem have . y ie ld e d e n tir e ly n e g a tiv e inform ation* We, fo r example# have never been able to find a single fillin g statio n operator who has absorbed le a d a s consequence o f h is employment in q u a n titie s ,g re a te r than are found in p e rfe c tly normal healthy in d iv id u a ls who do n o t work in th e le a d tr a d e s , These occu p atio n s, therefore# are not lead exposures in the c lin ic a l sense o f the word, , . - ' In lin e w ith the conclusions and statem en ts made above# th e study o f H r, HoConnellts blood and excreta with reference to lead yielded the following in fo rm atio n , The le a d in th e blood amounted to 0,035 mgs* p e r 100 grams o f blood which i s r ig h t a t th e mean r e s u l t f o r normal in d iv id u a ls such as o u rs e lv e s . The u rin e showed 0,085 mgs, o f le a d p e r l i t e r as compared w ith the mean normal fig u re o f 0,037* I t i s q u ite apparent th a t Mr, Mc C onnell h as had no re c e n t occu p atio n al le a d exposure and th a t he is e n tire ly normal w ith resp ect to the lead oontent of h is tissu e s and excreta* I am disposed to b e lie v e t h a t th e re i s come f a c t o r o f n e u ro sis in Mr, HeConnell*s p re se n t -- p ic tu r e ,4;:- X iroul& 'hot attem p t to determ ine how g re a t a f a c to r i t is # b u t X am d isp o sed to f e e l th a t some re assu ran c e w ith re sp e c t to th e s a fe ty of h is p a rt time occupation might be b e n e f ic ia l, Xn any case you dan assu re him t h a t h is work a t th e f i l l i n g s ta tio n w ill in no w ise r e a c t disadvantageously on h is h e a lth from th e p o in t of view of le a d ab so rp tio n . J - ..X am not in th e h a b it o f ta k in g oases in consultation fo r the sake of the fee involved s in c e X do n o t have tim e f o r such work u n le ss i t i s d e f in ite ly concerned w ith the fie ld o f our present stu d ies. Accordingly X charged Hr* McConnell only f o r th e a c tu a l c o s t o f making th e le a d d eterm in atio n s, and X s h a ll not send him any f u r th e r b i l l ; ' X make m ention of t h i s only because X should want you to be q u ite C lear as to my reasons f o r being in te r e s te d in seeing such a ease, ; ' . - - 'Milh k in d e st p e rso n a l re g ard s, ` nv. MAXJIs - V. . % %.W' H Z ~i . ' : ' . ; . !,,f * *, - ^ /r;%41 :-u 001,143 0 S incerely yours# .V k ;'* - .' - ' ; . ki=;;v:v w k ' - i: K