Lead poisoning and lead absorption : $b The symptoms, pathology and prevention, with special reference to their industrial origin, and an account of the principal processes involving riskLegge, Thomas Morison, Sir
Science
Lead poisoning and lead absorption : $b The symptoms, pathology and prevention, with special reference to their industrial origin, and an account of the principal processes involving risk
Legge, Thomas Morison, Sir
Lead poisoning
There is no evidence to show that lead is excreted by the salivary
glands. A number of cases of poisoning certainly complain of a metallic
taste in the mouth, and, judging from the analogy of mercury, it is
possible that excretion of small quantities of lead may take place
through the saliva; but such a point is merely of scientific interest,
and has no practical bearing on the question of lead poisoning.
Pigmentation in the salivary glands suggesting excretion of lead has
not been observed, notwithstanding the constant presence of potassium
sulphocyanide in the parotid saliva. The blue line of Burton may
occasionally be observed, in other regions of the body. From time to
time the intestine is found stained with a bluish-black deposit of lead
sulphide, and in a case of acute poisoning following the ingestion
of a large quantity of lead acetate, and in the cases described by
Oliver of the ingestion of lead oxide (litharge), black staining of
the intestines was peculiarly well marked. In all the animals referred
to it forms a constant feature in the large intestine, and in the
chapter on Pathology this blue staining of the large intestine is
more minutely described. We have met with it once in the post-mortem
examination of a man who died of lead poisoning, and when found it may,
we think, be regarded as a diagnostic sign. Macroscopical evidence is
not sufficient; it is necessary to make a histological examination of
the tissues, when the stained areas are seen to be associated with
the lymphoid tissue in the intestinal wall, and not only interstitial
portions, but actually the interior of the cells themselves, are found
to be packed with small bluish granules. Such a histological finding
would be highly characteristic of an extreme case of lead poisoning.
Where considerable quantities of lead have been taken into the
gastro-intestinal canal, a blue ring has occasionally been described
surrounding the anus.
About 85 per cent. of cases of lead poisoning with colic show obstinate
constipation as a leading symptom. The constipation generally exists
for several days preceding the onset of the colic, and may persist
for as long as twelve to fourteen days, while six to seven days is a
common period. There is very little that is characteristic about the
constipation other than its intractability; indeed, it is frequently of
the greatest difficulty to relieve this symptom. No doubt the direct
origin is due to the excretion of lead into the large intestine (see p.
94).
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