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
Briquet[6] recommends 4 grammes of alum and 4 grammes of dilute
sulphuric acid three times daily, with the addition of 0·05 gramme of
pulv. opii at night. Briquet says that although the purgative method
rapidly diminishes the colic, the elimination of the poison does not
take place as rapidly as by means of the treatment he recommends,
though it is open to doubt whether the use of either of these two
drugs is likely to produce any further neutralization or excretion of
absorbed lead than sulphate of magnesia. It is quite certain that the
magnesium sulphate does not act as a neutralizer of the poison, as in a
factory where sulphate of lead is manufactured some cases of definite
lead poisoning occurred, in which at least half must have been due to
the inhalation of lead sulphate dust. Under these circumstances it
seems hardly worth while to attempt to form a sulphate of lead in the
body. The action of magnesium sulphate and other salines, however,
in promoting the flow of fluid towards the intestines, and rapidly
diluting and washing out the contents, tend to eliminate such lead as
has already been excreted into the bowel.
A number of other drugs have been given from time to time for the
purpose of forming an insoluble compound with the metal in the
intestine, such, for instance, as sulphur in many forms, which is still
much used in French hospitals. Peyrow[7] advises sulphide of soda,
whilst Meillère prefers potassium sulphide as being less irritating.
He considers sulphuretted hydrogen a proper prophylactic against
reabsorption. Both experimental work and clinical observation show
that a change to sulphide does take place in the lower bowel, and that
staining of this part of the intestine is due to lead sulphide; but
as the figure on Plate II. shows, the lead may exist in the form of
granules of a dark nature, deeply embedded in the intestinal wall,
besides being situated in the exterior.
Stevens[8] suggests the use of ¹⁄₂-grain doses of calcium permanganate
thrice daily to relieve pain.
A certain number of other drugs may be also made use of from the point
of view of diminishing the pain, and one French observer advocates the
hypodermic injection of cocaine, but it is doubtful whether any good
would follow from such a procedure. Hypodermic injections of morphia
should be given whenever the pain is great, and diaphoretics as well
as diuretics should also be given, such, for instance, as ammonium
acetate, citrate of potash, or soda. Chloroform water and chloral and
bromine water may be also used, and when no other drug is at hand, the
inhalation of chloroform will rapidly relieve the acute vaso-motor
spasms associated with colic.
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