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Bulletin of the History of Medicine 78.1 (2004) 197, 199

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Author's Response

Ellen Silbergeld

Dr. John Burnham makes several comments on my essay "The Unbearable Heaviness of Lead," which discussed two recent books on the history of childhood lead-paint poisoning in the United States by Christopher Warren and Peter English. Dr. Burnham takes issue with my comments on the latter's account, although my concerns extended to both, and he challenges my misgivings about how historians should use the documentary materials entered into evidence in litigation.

I read these two social histories of lead poisoning as a scientist. The attempts to "reconstruct" lead poisoning as a punctate social phenomenon by both English and Warren ignore the substantial scientific and medical record of the continuum of knowledge regarding exposures and hazards of lead—specifically for children, and specifically related to the use of lead in paints. Moreover, to use childhood lead poisoning symbolically, as both Warren and English seem to do, is to ignore the fundamental role of lead in lead poisoning. All the social histories in the world cannot effect a reverse alchemy, producing lead poisoning out of dirt and poverty, unless lead is present.

As a scientist, I read the history of lead poisoning more as a continuum of knowledge, as an example of "seek and ye shall find": the more closely we have examined exposures and outcomes, the more strongly we have confirmed and reconfirmed the earliest warnings of its hazards for all ages. For example, in March my colleagues and I published a paper reporting for the first time on associations between lead exposure and hypertension in older women, due to the mobilization of bone lead. 1 Do I claim this to be startling new information? No: just about ninety years ago, Sir Thomas Oliver opined that lead might lie hidden for years within [End Page 197] [Begin Page 199] some cells of the body, to be called forth over the aging process, as an explanation for the recurrence of lead poisoning in workers long after their occupational exposures ceased. 2

As to the use of litigation discovery as a tool for historical research, which Burnham defends, I would note (as an infrequent participant in litigation) that these materials are always carefully selected and designed by the attorneys to tell one side of a story. They may have value for historians, certainly, but they must be carefully weighed and amplified by other sources, as in Emmanuel Le Roy Ladurie's magnificent use of ecclesiastical trial records in his history of Montaillou. 3 Moreover, expert witnesses who write history often have access to materials not made part of the public record, particularly if cases are settled. I look forward to further discussion among historians on this topic.

Finally, Dr. Burnham castigates me for drawing admittedly rhetorical parallels between the apologists for the lead industry and earlier examples of those who have turned diseases into signals of social or personal sins. Yet he is silent about the rhetoric of the lead industry, whose representatives referred to the lead-poisoned children of Baltimore as little rats and their mothers as overfecund imbeciles. 4 Dr. Burnham is also unhappy with my implication that the lead industry was "monolithic" and can be said to have spoken in one voice. Yet it was the lead industry that organized itself specifically into a single entity early in the last century, for the express purpose of behaving monolithically (and was so charged for antitrust violations by the federal government), not least to counter the rising tide of biomedical evidence of childhood lead-paint poisoning throughout most of the twentieth century. Legal culpability for this behavior is still under dispute; that it was deliberate in intent and successful for far too long is evident.

Ellen Silbergeld is Professor of Environmental Health Sciences, Epidemiology, and Health Policy and Management at the Bloomberg School of Public Health, The Johns Hopkins University, 615 North Wolfe Street, Room W4108A, Baltimore, MD 21205 (e-mail: She is trained in environmental engineering...


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