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
Recurrent colic is as a rule less severe than the simple acute form,
but may last for several weeks, clearing up for three or four days at
a time and then recurring with little diminution in violence from the
first attack. Such cases are probably due to the gradual excretion of
lead by the intestine, and should be treated on this supposition.
In the continued or chronic colic the pain may persist for as long as
two months, during the whole of which time the patient complains of
uneasiness and even constant pain in the lower part of the abdomen,
which becomes considerably worse after each evacuation, and almost
invariably is associated with exceedingly obstinate constipation. It is
this type of case that olive-oil or liquid paraffin relieves, while in
the acuter forms drastic purgatives such as castor-oil, croton-oil, or
pulv. jalapæ comp. may be administered.
For the treatment of pain in colic one of the various vaso-dilators
should be used, as, in addition to the spasm of the intestine, a very
considerable vaso-constriction of the whole of the vessels in the
mesenteric area occurs. Amyl nitrite gives immediate relief, but the
effect passes off somewhat rapidly, whilst scopolamine, although taking
somewhat longer to act, is better for continuous use, as its action is
longer maintained. Sodium nitrite, liquor trinitrini, and antipyrin are
also of use. Atropin may be used, but it is perhaps better given in
conjunction with magnesium sulphate.
Whatever form of purgative is given, some form of anodyne should be
combined. Drissole and Tanquerel[3] are said to have obtained excellent
results with croton-oil; one drop is given, followed seven or eight
hours later by another, and then by an enema of 2 pints of normal
saline. After two or three days the croton-oil may be again given, one
drop at a time each day. In addition, Tanquerel made use of belladonna
and opium together, finding that their combined action was better than
that of opium alone, as the physiological effect of belladonna probably
assists in preventing the intestinal cramp.
Hoffmann[4] recommends the use of olive-oil and opium, giving 3 to
4 ounces of olive-oil. He says that this relieves the spasm of the
pylorus, and is of particular use where severe vomiting is associated
with the colic. This use of olive-oil, first suggested by Hoffmann
in 1760, and revived by Weill and Duplant[5] in 1902, is somewhat
interesting, in view of the modern tendency to administer paraffinum
liquidum in the treatment of chronic constipation.
Public-domain text, read in full here on John Shaqi.
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