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
Blood is obtained by a small puncture, and slides smeared and allowed
to dry. Immediately on drying the slip is flooded with the stain,
and allowed to remain for two minutes. This causes fixation. At the
end of the two minutes the stain is diluted with an equal volume of
distilled water, and allowed to remain on for a further three minutes.
At the end of this time the stain is poured off, and the slip washed in
distilled water for another three minutes, or until the characteristic
purple-violet appearance is produced. It is better to examine such
films with an oil-immersion lens, the oil being placed directly upon
the films, and not covered with a cover-slip, as the action of Canada
balsam tends to decolorize the blue. If such specimens are required
to be kept, the oil may be washed off with xylol. It is possible to
observe basophile staining with a good sixth, but an oil-immersion
lens gives much the best result. The typical staining produced by this
means gives darkish bodies scattered about the red corpuscles, staining
sometimes deeply as the nuclei of the white corpuscles. In other cases
the appearance is like that of fine dust scattered throughout the cell.
In addition to these two forms, the whole red cell may take on a slight
generalized lilac tint, the normal cells remaining free from granules,
and stained red by the eosin. Search of 100 fields of the microscope
should be made, and if no basophile granules are found in such fields
it is unlikely that they will be found.
Basophile staining is not more pathognomonic of lead poisoning than of
any other form of anæmia, but may be regarded as a highly important
confirmatory diagnostic sign.
A differential count of the leucocytes present may be also made on
the same film in which basophile staining is observed; 300 should be
counted at least. In a typical case of lead poisoning it is found that
diminution in the polymorphonuclear leucocytes has taken place with
a corresponding increase of the lymphocytes, and possibly also the
large mononuclears, and probably a slight increase in the number of
eosinophiles.
This hæmatological method of diagnosis is of the utmost importance
in lead poisoning. A differential count such as is given on p. 137,
showing a large diminution in the polymorphonuclears, an increase in
the lymphocytes, evidence of changes in the red cells, consisting
of basophile staining, alteration in the shape of individual cells,
poikilocytosis, with vacuolation, is strong presumptive evidence of
lead absorption.
To complete the hæmatological examination, the hæmoglobin should
be estimated. This is best performed with Haldane’s instrument--an
exceedingly simple one to use. The estimation of the number of red
cells and white cells present is useful, but does not by any means give
such valuable information as does the differential count and search for
basophile granules.
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