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
In the experiments on animals, subjected to poisoning over considerable
periods, the condition of the kidney in every instance showed distinct
histological changes; and the longer such animals had been subjected
to the poisonous effects of the metal, the more advanced were the
signs of degeneration in its structure. In the earliest cases the
disease partook much more of the nature of an interstitial nephritis,
and it was in the later and more chronic stages only that changes
in the glomeruli and fibroid degeneration were to be found, but in
even these earliest cases of poisoning definite minute interstitial
hæmorrhages were to be found scattered about the kidney. These minute
hæmorrhages did not cause symptoms of hæmaturia, as in none of the
experimental animals was bloody urine observed. On the other hand,
besides definite small areas of hæmorrhage, patches were discoverable,
indicative of hæmorrhage which had undergone fibroid change. Even in
the illustrations given by Glibert[5], there appears to be evidence
that hæmorrhage had taken place and had undergone fibroid degeneration,
and there is very little doubt that in cases of kidney disease, the
preliminary action of the poison determines small local yieldings
of the vessel walls, with leakage, often hardly amounting to true
hæmorrhage, at such spots. There is nothing opposed to the theory in
the findings of other observers; in fact, if the preliminary gross
effect be leakage of the description given, all the other lesions
described by various observers follow as a corollary.
In the kidney, as in the other regions of the body, the venioles rather
than the arterioles appear to be the preliminary site of destruction,
and microscopical observation of the sections leads to the view that
the intima of the vessels and not the media or the muscular coat is
the one affected in the first place. Capillary hæmorrhages under
these conditions are easier to understand than if the arterioles
themselves or their muscular or middle coats were primarily affected.
As degenerative changes progress, the whole of the vessel--external and
middle coats and intima--undergoes change, ultimately resulting in the
extreme narrowing and consequent blocking of the vessels themselves.
Further shrinkage taking place in this area produces the shrunken
sclerosed kidney.
Zinc in the form of oxide behaves in very much the same way upon the
kidney as does lead. An experimental animal, which was given 0·2 gramme
of zinc oxide per kilogramme body weight by hypodermic injection in
the muscles of the back, died in fifteen days, and the kidneys showed
extensive hæmorrhages--not merely the minute and capillary hæmorrhages
found in lead poisoning, but hæmorrhages extending right through from
the cortex.
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