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
_Aorta._--Atheroma near its bifurcation.
_Arteries._--All more or less thickened.
_Peritoneum._--Retroperitoneal hæmorrhage in region outside pancreas.
Mesenteric glands enlarged, indurated, bluish on section.
_Stomach._--Normal.
_Intestines._--Vessels congested. Large bowel constricted at
irregular intervals.
_Cæcum._--Mucosa slate-coloured.
_Colon._--Dark-greenish mass.
_Liver._--Blue on section; pale yellow areas; soft in consistency.
Weight, 47³⁄₄ ounces.
_Spleen._--Normal.
_Kidneys._--No fat. Cirrhotic, adherent, atrophic cortex, granular.
_Muscles._--Generally dark in colour; wasted.
A very complete histological examination was made of the brain and
spinal cord, and throughout the particular changes noticed were
proliferation of the glia, hyaline thickening of the walls of the
vessels, both arteries and veins, and presence of congestion; and
here and there rupture of the smallest vessels, causing miliary
microscopic hæmorrhages into the perivascular sheaths and the
substance of the brain. There was no infiltration with lymphocytes
and plasma cells, as is found in general paralysis. The neuroglia
showed a formative hyperplasia resulting from chronic irritation.
In the cortex there was neuroglia proliferation in the polymorpho
layer and the molecular layer. Changes were seen in the Betz cells,
particularly in the Nissl substance, with perinuclear chromatolysis,
such as is generally found in chronic peripheral neuritis, whether
due to lead, alcohol, or other toxic causes.
There was no coarse atrophy or degeneration of the fibres of the
cortex. Neither the cerebellum nor the spinal cord at any of the
levels examined showed fibre atrophy or degeneration, except possibly
a slight diffuse sclerosis in the crossed pyramidal tracts of the
lumbar region.
Microscopical examination was made of the heart, spleen, kidney,
liver, lung, and suprarenal gland. There was a general condition
of angiosclerosis; in the liver a fibrotic overgrowth around the
vessels; in the kidneys well-marked interstitial fibrosis.
A chemical examination of the brain was also conducted by the copper
potassium nitrite method, but no lead was found.
=Excretory System.=--A large number of observers have shown that great
stress is thrown on the kidney in the excretion of lead. Discussion
has taken place as to whether the effect is a primary interstitial
or a parenchymatous nephritis. Most observers are agreed that the
histological changes found in the kidneys of lead workers have very
little by which they may be differentiated from the effects of alcohol.
Although the kidney suffers directly from the effect of circulating
lead, the amount of lead excreted by the kidney in chronic cases is
usually small, variable in quantity, and very rarely exceeds more than
5 milligrammes in the twenty-four hours.
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