624

INDUSTRIAL HYGIENE AND

OCCUPATIONAL

MEDICINE

Dr. John Cass Jr., Brookline, Mass.: What is the pathology in regard to the rest of the
body ?
Dr. Hardy: Well, we see in the liver, not in all cases but in a fair number of them,
the same type of cellular change which we see in the lung. Dr. Sander reports an autopsy
in one of his cases in which the lesions were in the kidney. I had never heard of one in the
kidney before, and Dr. Klemperer said this morning that beryllium was found in the bone.
There is one case from the Chicago area in which certain bizarre changes in the bones were
discovered that were called “marble bones.” I believe there were also changes in the epicardium
and myocardium in this same case.
Dr. Cluxton : There is just one other thing I’d like to call your attention to. As you
know, we just recently completed our second ACTH clinical conference in Chicago. Dr.
Ransohoff, of Cincinnati, brought out very dramatically the alleviation of some of the psychoses
■ in patients being treated with ACTH and cortisone, by giving them increased amounts of
potassium. I don’t know what Dr. Frawley might have to say about that because, as I under­
stand them, they are long-term patients. You use it as a routine? Do you in your short-term
treatment patients ?
Dr. Thomas Frawley, Boston: We have not used potassium routinely in those who have
been receiving the drug for about seven days. I am going to take this opportunity to clear up
what'apparently may be a misconception about the psychoses. We see psychoses in patients
about whom one just can’t predict whether they are going to get into trouble or not. I have
the feeling that one should try to eliminate those who, one thinks, might get a psychosis, but
there is nothing one can do about those who are going to get mental symptoms. Even those
who one would say, by the rough criteria we have or any of us would have, are the most stable
persons may blow; up with frank psychosis. The potassium chloride dosage may have to be
increased, depending on the circulating level of steroids and the amount of adrenal stimulation
that is obtained.