As a rule, when complete amaurosis occurs in lead poisoning, blindness follows through double optic neuritis or neuro-retinitis, but amblyopia may be present without fundus changes. Occasionally the loss of sight may be regarded as of central origin. The renal disease so often associated with lead poisoning may cause the retinal changes accompanying it. An albuminuric neuro-retinitis may occur without albumin in the urine. As a rule, the eye of a lead-worker reacts to light and accommodation. Ophthalmoscopic examination may show very pink discs, patches of pigment scattered about irregularly outside the discs, with occasional definite hæmorrhage. The edge of the discs may show blurring, with further sclerosis and peri-arteritis of the vessels, a white sheath around the arteries being often visible. The neuritis on one or both sides may be associated with disturbances of sight, and diffusely red and cloudy papilla, with swelling or hæmorrhages. In choroidal atrophy pigmentation may also be seen. =Muscular System.=--One further point may be referred to in relation to the muscular system--namely, the occurrence of pain of a rheumatic type. Quite a number of cases of mild degrees of lead poisoning complain of arthralgic symptoms--that is to say, “rheumatism.” Careful examination of such cases shows no evidence that the pain is a true arthralgia, neither does it seem to have a true relation to gout. The pain as a rule is referable to the muscles themselves, and in such instances digital examination of the muscle in the region of the pain generally exhibits deep-seated tenderness. There does not appear to be any special marked tenderness along the trunks of the nerves supplying the muscle, nor is there evidence of hyperæsthesia of the skin. Such hyperæsthesia does occur in lead poisoning, but is generally associated with cerebral lesions. The pain, therefore, must be regarded rather as myalgic, and intercostal distribution of the pain is not infrequent; but although the symptom is one that is often complained of, it is an exceedingly difficult one to differentiate from other myalgias as a definite symptom of lead poisoning. The chief point in favour of the inclusion of this so-called lead rheumatism as a symptom of lead poisoning is the frequency with which it is noted in the reports by certifying surgeons. While, therefore, having no evidence to regard it as necessarily a definite symptom of poisoning, it is one which has been recorded in a considerable number of cases. As has been already suggested, there is some reason to think these myalgic pains may be due to minute hæmorrhages taking place in the muscles, thereby producing localized irritation to some extent comparable with the “bends” of divers.