The disease has been described by authors under the name of the colic of Poitou,[[381]] or colica Pictonum,[[382]] from the circumstance of its having raged with such epidemic fury in that province, in consequence of the adulteration of its wines with lead. It is also mentioned as the painter’s colic, since this class of artists is very commonly visited by the disease, in consequence of the white lead contained in their pigments. At the Lead Hills, it is known to the miners, under the provincial name of milreek; and in Derbyshire, under that of belland.[[383]]
2. Symptoms arising from the introduction of lead into the system, by small and repeated doses.
The effects produced upon various artists by the imperceptible operation of lead, sufficiently shew the power which this metal possesses of accumulating in the human system, and it is probable, says Sir George Baker, that from an observation of such slow, but certain effects of lead, the French and Italians derived the hint of preparing their celebrated poisons, called “Poudres de Succession;”[[384]] the basis of which has been supposed to have been some preparation of that mineral. Zeller mentions a certain chemical operator, near the confines of Bohemia, who, after having diligently applied himself to the composition of poisons, did, by means of lead, combined with some more volatile and corrosive substance, prepare a most slow poison, which given to dogs and other animals, had the power of destroying them, without producing any violent symptoms, after several weeks, or even months.[[385]]
The following-curious case,[[386]] communicated by Dr. Wall, of Worcester to Sir George Baker, will serve to illustrate the present subject, and to shew that lead may gain admittance into the human body, unobserved, and even unsuspected. “A gentleman of Worcester was the father of a numerous offspring, having had one and twenty children, of whom eight died young, and thirteen survived their parents. During their infancy, and indeed until they had quitted the place of their usual residence, they were all remarkably unhealthy; being particularly subject to disorders of the stomach and bowels. The father, during many years, was paralytic; the mother, for as long a time, subject to colics and bilious obstructions. She died at last of an obstinate jaundice. This disease had been several times removed by the use of the Bath water; but it always came on again soon after her return to Worcester; and at last eluded every method and medicine which was tried. After the death of these parents, the family sold the house which they had so long inhabited. The purchaser found it necessary to repair the pump. This was made of lead; and, upon examination, was found to be so corroded, that several perforations were observed in the cylinder, in which the bucket plays; and the cistern in the upper part was reduced to the thinness of common brown paper, and was full of holes like a sieve. The waters of this town are remarkably hard. It is then more than probable that the water of this pump, thus impregnated with lead, occasioned the unhealthiness of the family who drank it. I have been just informed by the plumber,” adds Dr. Wall, “that he had several times repaired the pump in question; and that he had done so not more than three or four years before the gentleman’s death; when he found it nearly in the same state as it has been described; so that the corrosion was effected in a short time; and consequently the water must have been very strongly impregnated with the noxious quality of the metal.”
Organic lesions discovered on dissection.
The reports of the dissection of those who have been destroyed by saturnine poisons are far from being satisfactory. Where the person has died from the primary effects of a large dose of the acetate of lead, the stomach has betrayed a state of inflammation, similar to that which results from the action of a corrosive poison; black points and spots, from venous extravasation, have been also observed in the interior of this viscus; M. Orfila states that he has seen in the stomach of animals who have taken a large dose of the acetate of lead, and have not vomited, a membraneous lining tolerably thick, of an ash colour, easily detaching in small pieces; the origin of which appeared to be owing to the decomposition of a part of the acetate of lead by the mucous, bilious, and other fluids, contained in this viscus. The mucous membrane lying under this lining, was of a dark grey colour throughout its whole thickness, and appeared to have exercised the same action on the acetate of lead. The case is very different in those who have died from the slow action of this metal; all anatomists agree in reporting, that in the colica pictonum, the digestive canal exhibits no vestige of inflammation;[[387]] but the diameter of the large intestines, especially that of the colon, is generally contracted; thus displaying the effects of that operation, which is supposed to be characteristic of the compounds of lead, and which has bestowed upon them the peculiar designation of astringent poisons. Foderé states that the mesentery and its glands; and the lacteal and lymphatic vessels, are inflamed and obstructed, and the thoracic duct almost obliterated; the liver, spleen, pancreas, and lungs often inflamed, tumefied and purulent, and even the heart shrivelled;[[388]] and the whole body, in consequence of the constriction of the chyliferous vessels, in a state of complete marasmus. Upon this passage Orfila makes the following observation. “We are under the necessity of declaring, that almost all these signs are wanting in the majority of the cases of simple colic of lead, terminated by death.” Fourcroy, in a note to his translation of Ramazzini, “De Morbis Artificum,” observes that the intestines have, in these cases, been discovered distended by air, parched, and slightly altered in colour; and that in the larger ones, balls of dry, dark coloured, excrementitious matter, have been found.
Physiological action of Lead Poisons.
The preparations of lead seem to act upon the nervous system, destroying its energy, and thereby producing paralysis. Whether this is effected through the medium of the circulation, or whether they produce their effects without being absorbed, appears to us to be a question which has not hitherto received a satisfactory answer. It must, however, be admitted that they act upon the alimentary canal, by coming into contact with its nerves; and in some cases, where the dose of the acetate has been large, it may have produced death by the local injury which it inflicted. Dr. Lambe observes upon this subject, that “certain facts render it probable that lead does not operate entirely through the medium of the circulation, nor by nervous sympathy; but also topically, affecting the part to which it is applied more than the other parts of the body.” This latter position is clearly established by the beneficial effects occasioned by the topical application of lead to inflamed surfaces; nor can any doubt exist as to the fact of such applications having produced local paralysis. There is a paper in the third volume of the Medical Transactions by Dr. Reynolds, in which the case of a gentleman is detailed, who brought on a temporary paralysis of the sphincter ani, by freely using Goulard’s lotion for the cure of piles. Foreign writers have also maintained that saturnine applications have frequently occasioned impotence; for further information upon this subject the reader may refer to Istitutione di Medicina Forens: di Tortosa, vol. 1, p. 58; also Fritze Compend: sopra i Malat. Vener. p. 189; and Monteggia Annotat. sopra i Mali Venerei, p. 36. Sir George Baker states that he has some reason to doubt, whether litharge, the common basis of our plasters, when used for the purpose of dressing issues, has not, in certain irritable constitutions, produced some of the ordinary effects of saturnine preparations taken internally. There have been instances of children thrown into convulsions, by cerusse, sprinkled on excoriated parts. Zeller quotes, on the authority of Molingius, a remarkable instance of the pernicious effects of litharge, externally applied.[[389]] Sir George Baker met with a most violent and obstinate colic, which seemed to have been occasioned by some litharge, mixed in a cataplasm, and applied to the vagina, with a view to allay a troublesome itching; and he says that he was informed by Dr. Petit that Goulard’s poultice applied for some time to a patient’s knee, in St. George’s hospital, occasioned violent pain in the bowels, which did not cease until the poultice had been removed; nor are authorities deficient to prove, that the fashionable application of cerusse to the skin has been followed by obstinate colics, pains, and tremors. We have been desirous of laying before our readers the above authorities, in proof of the constitutional effects which may be occasionally produced by the external application of lead, since the fact has been questioned, and is still considered by many as involved in doubt and uncertainty. Dr. Lambe is inclined to believe, that “to the production of the saturnine colic, it is necessary that the metal should be applied immediately to the stomach and intestines.” If this hypothesis be just, he excludes nervous sympathy, as well as absorption, as a proximate cause of saturnine colic; and, consequently, no dependence can be placed on the accounts given by the above pathologists with regard to the production of such an effect by lotions and cataplasms of lead.
Of the chemical processes, by which the presence of lead may be detected.
These will necessarily vary according to the different states of combination in which it may be supposed to exist; we shall, therefore, proceed to consider the modes of establishing its presence, 1, In solution in water; wine; spirit; and oils. 2. In a state of mixture with various solids. 3. Combined with solid or liquid aliments.