Document vyzaBGd4Yp458jnKozZmL1E9w

Jdiversity of Cincinnati, Cincinnati , V. J------' "* `J '"->0 3l Collin3 Street, IISLBQURNE, 0.1. lStri October, 174-7. Dear Professor Ivehoe, I y-;o s delighted to receive your letter of bsotembor 171k re Dr. Blackburn*s cases of T.L.L. poisoning. I must admit it left me feslincr .jo.asuvhst deflated. I hove seen the excellent results of B.A.L, in srcoeic poisoning and immadi ataly after Sr. Blackburn* s cases I suggested a trl-.l of L. is ordinary dosage in a case of piunbism in a battery . or.ar. mis colic bed subsided under intravenous c lc iun therapy. Aithin. cone twelve lours of commanci:i=r B. h .1. , the most severe colic he had ex perienced developed.. 1. ,.L. .vs scoffed at ones and calcium v;as again used leoossfuliy. Lore I thought the B.A.L. bad mobilized an e-ccassive amount of lead from the skeleton in a man exposed to absorption of considerable mounts of lead over u long tine and decided that, if u.L. pears to be used at .11 in such cases, It should hs tried only in smell doses over a prolonged. .nri-vi to accelerate lend excretion. iiovvsvsr, I still felt that tbs coincidence of im)v.vPiut isuiodi cutely iolleving ..... 1, in Dr. Elacds urn* s cisos when it ?ns used temporarily in large doses with relapse after the doos had been reduced considerably for come days suggested that the 01033 action of larrs doses of was effective in fixing the large amount of lend suddenly introduced into the body in these coses end the a by so doing it hod relieved the stress no the brain. In r.h.l. poisoning vxe need not worry usually shout lead stored in the skeleton since it is practically invariably on acute poisoning doe to rapid absorption of a considerable amount of leg;!, do I felt happy a..out the B.A.L. until I got your latter. dilnaii* 3 report to you that they could not save animals given a lethal dose of T.l.L. even with the B.A.L. (riven before symptoms developed is 3 most depressing finding. And your work (the re- orint from Science is not yet to hand) that the B.A.L.-So complex is more toxic than either of its components separately is equally disappointing, wl man, I fear, will cot behave differently from the animals. I have read of one cuss of cadmium poisoning where the B.A.L.-cadmium complex was stated so h.-.va caused renal damage and that its use was con.tr?.-indicaied ir cadmium poi waning, though one or two other reports have said it is useful in this -munition. There seems general agreement that it is very valuable^? for arsenic, mercury 3nd gold poisoning. Profensor H. A. Xehoe I6th October, 1947 The arrival of B.A.L. does, however, give one hops that some compound will bs found that will be as effective in lead poisoning as B.a .L. is in these other heavy metal poisonings. The toxic action of arsenic is attributed to an effect on the -SH groups in cells interfering with activity of the pyruvate oxidase system. Is this theory also held regarding the toxic effects of lead? Has any work been published on this chemical aspect of lead poisoning? I will be most interested to hear of your results with B.A.L. glucoside. Dr. Blackburn has left for U.3.A. and will be calling; on you. he will be intensely Interested in your criticisms. Unfortunately he left before your letter arrived, so I have not been able to communicate its contents to him. Once again I aim reminded by your letter of the old trap of attributing "post hoc" to "propter hoc". In the absence of any clinical ex perience of such cases, the dramatic improvement following the very large doses of A) nrjj d Z. nitially used by Dr. Blackburn led us astray. If the B.A.L.?b complex is invariably more toxic than lead itself, it does seem strange that these doses (4.4 rag per Hg. of body weight) 4 hourly for 4 doses did not make the patients worse, Pat their clinical condition was remarkably better for four days. .-ould the sedation and supportive treatment counteract such expected extra toxic affects? Does the B.A.L.-Pb complex have toxic cerebral effects? .hers does it set? I know it can apparently result in severe intestinal colic. If the B.A.L.-Pb complex doss not have more toxic effects on the brain, than load, cun one nocsssnrily apply the results of animal experiments to man and so not put its use to the trial of experiment in man. when it apparently has bed r.a o dr eras effects in these two cases? Thebe are merely questions which. arise from your letter in which yyj asked for any comments, liesutime, I have sent a covering letter to our doctors here with report? forwarded from our Melbourne Office of Dr. Blackburn?s two cases nni your comments to me about them, I have' instructed them to rely cm the etunderd treatment and not to use B.A.L. should they be unfortunate enough to cos any cases of b'.I.L. poisoning. he fslt that Dr. Blackburn* s report of these two cases in this country would servo to emphasise the necessity for them to be on their toes to detect any possible early cases. I have greatly appreciated your letter and the most valuable criticisms therein and look forward to the receipt of further information from you on this interesting subject. Incidentally, since zinc is greatly increased in the blood and liver etc. in leukaemia and in cancerous tissue, I am playing around with small doss of B.A.L. over a prolonged period in a couple of cases of leukaemia and inoperable cancer. One case of acute leukaemia first seen by me four days before death was given treatment with ordinary doses of B.A.L. without obvious effect. I do not expect anything to come from this, but in such cases anything is worth a trial if there is the remotest chance to help them. Tith kindest regards, 'fours sir.cerely, Z>. 00134.16