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
_Anæmia._--Anæmia has already been referred to as occurring with great
frequency in persons who are absorbing lead, and it usually forms one
of the chief factors in the symptom-complex of lead cachexia. As the
action of lead is particularly upon the blood and the hæmopoietic
organs, diminishing the number of red cells and the amount of
hæmoglobin, and impairing the organs from which fresh blood-cells are
produced, a disease or state associated with anæmia other than of lead
origin acts as a definite predisposing cause in the development of
toxic symptoms in a worker in an industrial lead process.
Among the anæmias, two particular types may be referred to as of
chief importance. In the first place, chlorosis, the anæmia occurring
particularly in young women, is often associated with intestinal
stasis. Lead anæmia occurring in a chlorotic person is always more
severe than simple lead anæmia. Young persons suffering from chlorosis,
therefore, should not be employed in a dangerous lead process until
the anæmia has been treated. The second type of anæmia, which, from
its frequency, may be also regarded as a predisposing cause of lead
poisoning, is chronic secondary septic anæmia. Anæmias of this type,
as was pointed out by William Hunter[15], resemble in many points the
original idiopathic or Addisonian anæmia, often termed “pernicious
anæmia,” and one of us has had occasion to inquire into the curious
type of secondary anæmia associated with septic affections of the upper
respiratory tract, particularly those related to chronic suppurative
affections of the accessory sinuses of the nose, of the gums, of the
mucous membrane of the mouth and the throat. The commonest forms of
this secondary anæmia are those due to chronic post-nasal discharge,
and to chronic infections of the gums and alveolus of the jaws, the
latter often classed together under the term “pyorrhœa alveolaris.”
This term is an exceedingly clumsy one, indicating a discharge of pus
from the gum edges and sockets of the teeth, which are often loose.
The disease commences as an infective gingivitis along the edges of
the gum, and progresses to rarefying osteitis of the alveolar process,
and often of the body of the bone. The affection rarely gives rise
to pain, and as a rule the individual is entirely unaware that any
chronic suppuration is present, and little or no notice is therefore
taken of the disease. Progressive anæmia may thus be set up without any
knowledge of its cause, partly by absorption of the actual bacteria and
their products through the alveolar bloodvessels, and partly by the
fact of the constant swallowing of pus and bacterial products, which
set up various forms of chronic gastro-intestinal incompetence. From
the discharges of the mouth, and issuing from the gum edges, numerous
bacteria have been isolated, and in more recent work one of us [K. W.
G.[16]] has succeeded in isolating and identifying certain bacteria
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