Document qvDnXLV98BmDv05r7KkwY4qK
July .26, 1940
Dr. C a M. Hillenbrand Hax'riaon. Radiator Division General Motors Corporation Lockpor t, Rev; ^ork
Dear Doctor Hillenbrand:
.'
-
I have gone over the
exchange of correspondence between you and Dr.
Gradwohl coneerning the quesuion of stippling. I have
also noted the comparison.of the report's .from Dr.
Gr adwohl'3 la 00r ator y ,an d your own Lockport 1a:>ora tory
I am returning all of the correspondence and reports
to you hero with.
It would seem to me that
the significance of this discussion Is fairly well
.
demonstrated oy the; comparison of the two reports,
You are able to express your findings in quantitative
terms which have a comparative significance., while Dr. '
Gradwohl's reports, ,on the other hand, are in symbols
to which certain arbitrary..interpretations -can be given,
I believe It is quite clear that Dr, Gradwohl's method
of approach can not produce anything better than rough :
estimates, and it Is net Sufficiently precise in its ;
quantitative expression to be of real value either from
the point of view of medical control or medico-legal
consideration
.
:.
* s I have stated to you be
fore, the thick drop method ox making smears has a certain
advantage in enabling one to see a large number of ervthro
cytes at one time. It has the unfortunate disadvantage
that one does not see as clearly and is, therefore, in
some doubt as to the significance of what he sees. There
is the further disadvantage that It is impossible to
estimate with even approximate accuracy the number of
erythrocytes which occur in a microscopic field, For
this reason th^re can never be any quantitative expression
of the results, and in as much as quantitative expressions
are necessary both for Interpretation and for medical-lega
purposes, the method may be put down as definitely un
satisfactory and inferior to the one which you are using.
As far as staining is
,
concerned!, the Giemsa stain can be used, but I think
Wright-*a stain is preferable and I believe methylene
blue, as we have used it, is also superior' These are
mere details and undoubtedly experience in the use of
various stains can be wholly satisfactory. The chief
objection to the thick drop method lies in one's
inability to express the results in even roughly
quantitative terns, and if one is to rely upon guess
work in this field, I should think that he might just
a3 well guess without doing any work as to have to
continue to guess after carrying out laboratory pro
cedures. . . By this I do not mean to indicate that thick
drop smears are entirely valueless for diagnosis purposes.
C-n the other hand it is almost entirely valueless for the
purpose for whi ch you want. to. use bleed examinations.
. I was very, glad to see you again and to find out how well your ..work had been going 'on. I trust it will continue to go along :satisfactorily.
regards, X am.
With kindest personal
Cordially yours,
PM is
Rob er t A , Kehoe, M .D .
KE 0003670