Document zVny1qjk9k8MQE5rKVaoLnY6

F e b r u a r y 21, 1955 Dr , Adrien Ver Bruggh en 122 South Michigan Avenue Chicago, Illinois Dpar Doctor Bruggh en : On looldng into the m atter, following our con versation in the Un iversity Club in Ch icago, I find that we (and our asso ciat e s in Cincinnati) have published, little or nothing on the problem of lead poisoning in ch ildren sih ce 1933, at which tim e I put togeth er an accumulation of data on the n orm al lead m etabolism of lead in infancy and childhood. During that peiriod, h owever, we have done quite a bit of in vestigative work on case m ater ial, ou r selves being lar gely in the position of collaborators on the diagn ostic (more recen tly on the th erapeutic) approach to the problem . Our prin cipal contribution h as been that of the application of sam plin g and an alytical techniques as m ean s of in terpretin g the sign ifican ce of the exposure to and absorption of lead. Th ese have grown out of our exten sive work on in du strial lead poison in g, its diagn osis and preven tion. It is because of th ese developm en ts, no doubt, that the incidence of lead poisoning among ch ildren in Cincinnati (as well as in Baltim ore) appear s to be much h igh er than it is in m ost cit ies, i,e , the diagn ostic technique, to which pediatrician s have been aler ted in th is m edical cen ter, is such thaJt case finding, while not en tirely certain , h as been greatly im proved. I send you a list givin g the n umbers of case s by y e ar s, in which it is pos sible to see the effects of lap ses of in ter est (based on more concen trated attention to seem in gly m ore urgen t m atters) on the part of the st affs of the two prin cipal h ospitals to which our case s have come. I have no doubt that the actual flow of case s over the la st fifteen or twenty y ear s lias undergone but little ch an ge. I could be wrong in th is, but 1 h ardly think so. I cannot sen d you the reprin ts of the ar t icles which may be of in t er est to youj in th is connection, but I cite the r efer en ces on the attach ed sh eet. I have induced the people at the Ch ildren 's and the Cincinnati Gen eral h ospitals to begin to get th eir data togeth er so a s to publish a se r ie s of ar t icle s on th eir c a s s. Th is, 1 hope, will be done in the n ear fu tu re. Meanwhile I can give you the figu r s which Sam Trufant gave me a few days ago, which b ear on the m atter which we touched on in Ch icago. Th ese also ar e list ed in tabu lar for m on the attach ed sh eet, I can also say that the group h ere is of the opin ion ,ten tatively, that the u se of disodiu m calcium D r . A d r ie n V er Br u ggh en - (2) - F e b r u a r y 2 1 , 1955 eth ylen ediam in etetraacetic acid (officially known as edathamil calcium disodium ), h as been m ore ben eficial in th ese case s than h as any other method cf th erapy employed. Obviously the careful examination of the data from a se r ie s of case s will be of much m ore value than th ese im pression s. I r egr et that our in form ation is not in better form , but such as it is, I send it. Cordially yours, RAK ef E nc. Robert A. Xehoe, M. D. / l PS n 7 f) D A TA O N C A SE S O F LE A D P O ISO N IN G (CH ILD R EN ) Mild Cases Cases involving su r gical de- Resu lt com n yession ____ 2 Favorable outcome 1 Some benefit 5 No benefit 8 Number of case s Cases not involving su r gical decom pression 3 5 8 Severe Cases 1 Favorable outcome 0 4 Some benefit 2 4 No benefit 3 9 Number of cases 5 Note: The sad set of r esu lt s, especially in the m ore sever e c a se s, convinced the n eurosurgeon s that th eir th erapeutic intervention was essen tially futile, and the procedure h as been abandoned. ( 2ts> R eferen ces On!the Norm al Absorption and Excretion of Lead IV. Lead Absorption and Excretion in Infants and Ch ildren ; Jou rn al of In dustrial Hygiene 15: 301, 1933. (See the oth er ar t icle s in th is se r ie s (page 25 through 340) for sou r ces of lead absorption , amounts in n orm al t issu e s, etc. Lat er ar t icles give m ore information on adults but not on ch ild r en .) )