October 5, 1951
Dr. G. E. Burch
Department of Medicine
The Tulane University of Louisiana
1430 Tulane Avenue
New Orleans 12, La.
I am sorry that I haven't anything to say in answer to your letter about mechanism by which bio-electric potentials are maintained
in the living cell. I haven't done any thinking about this field, nor have I read the literature about it.
May I ask if you have made any tests of methods for preventing crises in sickle cell anemia? It seems to me that the use
of carbon monoxide therapy could be tested out in the hospital. I think that 200 ml of carbon monoxide could be safely administered
to an adult, and corresponding amounts, proportional to hemoglobin content of the individual, to children. Also, Dr. Itano
has suggested that a methemoglobin produced by the administration of sodium nitrite would be effective in preventing crises.
It would be necessary to determine by experiment the dosage of sodium nitrite required to keep about one fifth of the hemoglobin
in the oxidized (methemoglobin or ferrihemoglobin) state. Even though the pharmacological factor for carbon monoxide and
for nitrite is not a large one, it might well be that a treatment of this sort would have some value.
Dr. Itano has just written a paper describing a third abnormal form of hemoglobin, associated with hereditary hemolytic anemia.
This abnormal form has the same electrophoretic properties as sickle cell anemia hemoglobin, but it does not cause the cells
to sickle, and its solubility properties are different.
With best regards, I am