Industrial manganese poisoning runs its course extraordinarily slowly, and resembles chronic poisoning by other heavy metals, such as lead and mercury, in that nervous and psychical symptoms, rather than digestive, are prominent. Sometimes—but not always—the disease is introduced or accompanied by psychical symptoms, both of excitement and depression (hilarity, laughing, or depression and weeping). In the course of the disease nervous disturbances arise, deafness, tingling, paralysis and paræsthesia, in the arms and legs, giddiness, difficulty of walking, tremor, increased knee-jerks and difficulty in speech. Often at the same time swelling of the lower extremities (œdema) and loss of strength (cachexia, marasmus) come on. Slight cases make a good recovery. An interesting case of illness is described by Jaksch as manganophobia, in which the symptoms were simulated, and were brought on solely by the fear of manganese poisoning.
As regards treatment, electricity, massage, and baths are advocated to allay the nervous symptoms, as in the case of chronic metal poisoning and suitable strengthening food.
CHROMIUM, CHROME COMPOUNDS
Chromium trioxide (CrO₃) dissolves in water, forming chromic acid (H₂CrO₄); of the salts of chromic acid the neutral and acid alkaline salts concern our inquiry. These are normal and acid sodium or potassium chromate (K₂CrO₄ and K₂Cr₂O₇). Chromate of lead (PbCrO₄) can cause lead poisoning.
Poisoning can be produced by dust and by alkaline chromates, the latter, when hot, giving off steam which, as has been proved, contains excessively fine chrome particles. Chrome compounds attack especially the surface of the body, the skin and the mucous membrane.
The bichromate and chromate dust produce ulcers where slight injuries to the skin already exist. The ulcers develop slowly, and have a smooth, heaped-up, undermined edge; deep-seated, they can even pierce to the bone; they heal with great difficulty. Naturally they occur most frequently on the uncovered parts of the body, especially on the arms and hands. Characteristic also is an analogous ulceration attacking the mucous membrane of the nose, from which hardly any chrome worker (especially if brought into contact with chromate dust) is free. Perforation and destruction of the cartilaginous septum of the nose is very common. Ulcers on the mucous membrane at the entrance of the throat (on tonsils and palate or in the larynx) have been occasionally observed.
Absorption of small quantities of chrome compounds into the body are said to cause disturbances of digestion of an inflammatory character, and especially inflammation of the kidneys.
The treatment of chrome ulcers is similar to that of other chronic ulcers. An antidote for industrial chrome poisoning is not known.