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
Chronic parotitis is not infrequently cited as a symptom in cases
of reported industrial lead poisoning, and may owe its origin to
impairment of the salivary gland by the passage of the metal. Chronic
parotitis, or even tenderness of the parotid glands, does not occur
frequently among lead-workers with symptoms of lead absorption.
Excretion, however, of lead through the salivary glands is not of
great importance, except from the occasional complaint of a metallic
taste in the mouth in chronic lead poisoning, and in such instances
possibly definite excretion of lead is taking place through the parotid
glands. A case may be cited which rather supports the view that lead
may be excreted through the salivary glands. A certain worker engaged
in a dangerous lead process from time to time, but never as a constant
symptom, showed distinct pigmentation in the internal surfaces of
both cheeks in the region of the buccal papillæ of the parotid duct.
The pigmentation was intermittent; at times a large patch of deep
blue-black pigmentation was found in the situation on both sides,
with no staining of the cheeks around or of the gum margins, although
his teeth in these regions were coated with foul tartar. If the lead
in this instance gained access through the mouth, why should it have
been deposited merely upon the cheek in this one situation, despite
the fact that several other situations in the mouth exhibited the
same conditions of bacterial decomposition for the production of
sulphuretted hydrogen? We have not observed this pigmentation in the
neighbourhood of the ducts of the submaxillary and sublingual glands,
but only in the parotid.
By far the most important organ in the excretion of lead, from the
point of view of symptomatology and diagnosis, is the kidney. Lead is
not uncommonly found in the urine of lead-workers and in the urine of
those suffering from lead poisoning. The quantity present is usually
small and in a form in which it is exceedingly difficult to detect.
Yet very pronounced changes in the kidneys may take place, with little
evidence in the urine itself that pathological changes are taking place.
The urine of workers in lead factories is frequently high-coloured; in
fact, as a general rule the degree of pigmentation is greater than is
normal, and in those persons who show some degree of icterus, with the
curious yellowish-brown colour of the conjunctivæ, hæmatoporphyrin may
be detected on applying suitable tests.
In well-established cases of chronic poisoning, albuminuria as a rule
is found, together with certain alterations in the other constituents
of the urine, such alteration frequently making its appearance before
the definite onset of albuminuria. Further, the changes in the eye,
referred to under a special heading, have been frequently described as
albuminuric retinitis of lead origin, it being true that eye changes
are often associated with chronic changes in the kidney.
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