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
“I plead none the less for an impartial investigation of the symptoms
presented by a lead-worker, before assigning full or even partial
responsibility of the disease to the occupation. If any and every
departure from the normal in a lead-worker is at once assigned--the
occupation being known--to plumbism, early diagnosis naturally presents
very few difficulties to the exponents of such methods. And however
severely we may condemn in the abstract such a careless, unscientific
attitude, the tendency has, in practice, to be reckoned with and
combated. The balance of probabilities would possibly suggest that
the occupation is, after all, responsible, in one sense or another,
for the more usual illnesses classically associated with the poison;
nevertheless, the attending practitioner is in duty bound to take into
consideration, and to estimate the relation of, all the concurrent
causes of such symptoms.”
On the extremely unsatisfactory position the certifying surgeon may
find himself in at a coroner’s inquest King Alcock says:
“The problem, from a strictly scientific point of view, is
complicated--one might almost say that the truth is stifled--by the
fact that the ætiological relations of the symptoms of any suspended
worker are swamped by the insistent legal relations under which he
claims and receives compensation.
“When once a formal certificate of suspension has been issued, which
has embodied a recognition of lead as a cause of certain existing
symptoms, then it becomes almost hopeless ever to reopen the question
of causation of these or other supervening troubles, be their origin
independent of lead or not. The doctor, in a legal cross-examination,
is, in scientific honesty, bound to admit at last the bare possibility
of any fantastic chain of remote sequelæ; and his protests against the
probabilities of such sequelæ are of no avail, as opposed to his own
admission. The _post, ergo propter_, appeal carries the day easily.”
For the purpose of histological examination it is essential that
portions of the brain, spinal cord, liver, kidney, and intestine,
should be examined microscopically. The nervous tissue should be placed
in formalin and Müller’s fluid, and a portion in alcohol for the
examination of the fibres. The liver, kidney, etc., should be placed in
5 per cent. formaldehyde. The tissues are then treated by the ordinary
histological methods, and sections prepared. With nervous tissue it
is essential that those prepared for the examination of the cells
should be made by the celloidin method; the others may be treated by
imbedding in paraffin. The points to be sought for in the tissues are
sufficiently indicated in the chapter on Pathology and Symptomatology,
but may be briefly recapitulated:
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