_Nephritis._--Affections of the kidney associated with lead poisoning are almost entirely confined to sclerosis. The presence of albumin in the urine is not a very common symptom. As has been pointed out already, the presence of lead in the urine is by no means a regular feature of lead poisoning, though it may at times be present, and the urine should always be examined for changes in the kidneys; but as a number of cases of chronic lead poisoning are associated with alcohol poisoning, the changes in the kidney cell are almost certain to be present. On p. 95 the illustration showing the disease in the kidney produced by experimental dosage with lead, and the kidney of a fatal case of lead poisoning in a man who at the same time had a strong alcoholic history, shows fairly definitely the difference between these two points. Acute nephritis occurs so rarely in the course of industrial lead poisoning that it cannot be considered to be a disease due to lead. In chronic nephritis treatment should be along the ordinary lines and the same remark applies to enlargement of the liver. _Heart._--Symptoms due directly to disease of the heart are rarely caused by lead alone. The heart muscle may suffer in the same way as the other muscles of the body, and in lead poisoning in animals distinct hæmorrhages are found between the muscular fibres in the heart muscle, and it is therefore probable that a form of myocarditis may exist in lead poisoning. This, together with the increased arterial tension, may cause dilatation, but the symptoms are those related more to the general condition of arterio-sclerosis than to any direct heart lesion, and as a rule these symptoms do not call for any special treatment. =Treatment of Nervous Manifestations in Lead Poisoning.=--With one or two exceptions, the diseases of the nervous system associated with lead intoxication only appear when actual lead poisoning is established. Certain evidences of affection of the nervous system are occasionally seen in the prodromal stage, or stage of lead absorption. These may be merely temporary and disappear often under treatment, by change of employment and reduction in the quantity of lead absorbed. Thus, dilatation of the pupils--the reaction to light being extremely sluggish or absent--is often a feature of the later stages of the condition of lead absorption. Tremor may also be a symptom, the outstretched hands exhibiting a fine undulatory movement, often increased on attempting to perform some act such as touching the nose, or touching the two fingers together, and when these symptoms occur they must always be regarded as of somewhat grave import. But it must be remembered that tremor may occur as a common complication of alcoholic cases, and further, follows excessively hard manual work, though there is usually little difficulty in distinguishing between the various forms.