[3] GOADBY, K. W.: Departmental Committee on Lead Poisoning, etc., in China and Earthenware Manufacture, Appendix No. XXV. [4] MEILLÈRE AND RICHER: Meillère’s Le Saturnisme. Paris, 1903. [5] BLYTH: Abstract of Proc. Chem. Soc., 1887-88. [6] HOUGOUNENCQ: Meillère’s Le Saturnisme, p. 73. [7] DIXON MANN: British Medical Journal, 1893. [8] GAUTIER: Société de Biologie, April, 1903. [9] OLIVER, SIR T.: British Medical Journal, May 13, 1911, p. 1096. [10] GLIBERT, D. J.: Le Saturnisme Expérimental. Extrait des Rapports Annuels de l’Inspection du Travail. Bruxelles, 1906. [11] OLIVER, SIR T.: Diseases of Occupation, p. 139. [12] CHYZER, A.: Des Intoxications par le Plomb se présentant dans la Céramique en Hongrie. Budapest, 1908. [13] GARROD: The Lancet, 1870. [14] GOADBY, K. W.: Departmental Committee on Lead Poisoning, etc., in China and Earthenware Manufacture, Appendix XXV. [15] HUNTER, WILLIAM: Severest Anæmias. [16] GOADBY, K. W.: The Lancet, March 11, 1911. CHAPTER IV STATISTICS OF PLUMBISM[A] [A] Based mainly on reports received from certifying factory surgeons during the ten years 1900-1909. Classification of notified cases of lead poisoning was carried out on practically the same lines between the years 1900 and 1909, and comparison of the data so collected has interest, in view of their large number--nearly 7,000--in respect of (1) increase or decrease in recorded amount in each one of eighteen classes of industries; (2) severity and number of attack--_i.e._, whether first, second, third, or chronic; and (3) main symptoms. Notification was first enjoined by Section 29 of the Factory and Workshop Act, 1895, which subsequently, on consolidation of the Factory Acts, became Section 73 of the Act of 1901. This enactment requires every medical practitioner, attending on, or called in to visit, a patient whom he believes to be suffering from lead poisoning contracted in a factory or workshop, to notify the case forthwith to the Chief Inspector of Factories at the Home Office; and a similar obligation is imposed on the occupier of a factory or workshop to send written notice of every such case to the certifying surgeon and inspector of factories for the district. In form there is close similarity between this section and that requiring notification under the Infectious Diseases (Notification) Act; but whereas the symptoms of these diseases are, within well-recognized limits, precise, in lead poisoning the differential diagnosis has not infrequently to be made from a variety of common ailments--headache, anæmia, rheumatism, abdominal pain; and there is no precise standard of what constitutes lead poisoning.