These facts seem to outweigh the negative results obtained by others. Nor are they invalidated by the alleged existence of lead in the healthy animal textures. For in the first place,—although M. Devergie says he has always found traces of lead in the substance of the stomach and intestines of men and women, who had not used preparations of lead or been in any way exposed to it,[[1302]] and Professor Orfila confirmed these observations by also finding traces of lead in the alimentary canal under similar circumstances,[[1303]]—the conclusion flowing from their researches is after all doubtful; for in a later inquiry MM. Danger and Flandin could not find any lead, unless it had been purposely introduced into the body.[[1304]] And secondly,—Devergie adds to his remarks, that the quantity of lead he found in the textures and secretions of those who had died of lead-colic was far greater than in those who had not been exposed to lead preparations before death; and Orfila ascertained that the process by which he detects adventitious lead is incapable of indicating that which may be present naturally in the body.[[1305]]
It is probable that all the preparations of lead are poisonous except the metal, and perhaps also the sulphuret. The experimentalists at the Veterinary School of Lyons found that nearly four ounces of the metal might be given to a dog without even vomiting being excited; and Orfila remarked that an ounce of carefully prepared sulphuret had as little effect.[[1306]] The effects, which have been occasionally ascribed to lead-shot, and which will be mentioned by and by [see p. [435]], seem at variance with these experiments, but cannot outweigh such precise negative results. It is probable that irritant poisoning can be produced only by those compounds which are soluble, such as the acetate, subacetate, and nitrate. It appears indeed from the experiments of Orfila with the acetate and my own with the nitrate, that these compounds are true corrosives, and of no mean energy when given in large doses moderately diluted.
The insoluble compounds, such as the carbonate, red oxide and protoxide, possess little irritant power. The experimentalists of Lyons found litharge to be irritant in large doses of half an ounce.[[1307]] Orfila gave dogs large doses of the red oxide and carbonate without observing any signs of irritation in the stomach. A case has been published of a young woman who swallowed accidentally an ounce and a half of the carbonate without any bad effect whatever either at the time or afterwards;[[1308]] and Dr. Ogston of Aberdeen has informed me he met with a similar case, that of a girl who took an ounce with the view of destroying herself, but without sustaining any harm whatever. In a remarkable case, published by Mr. Cross of London, in which six drachms were taken accidentally by a pregnant female instead of magnesia, vomiting and violent colic were produced, and afterwards fainting, paralysis of the extensor muscles, and contraction of the flexors; all of which symptoms, however, after enduring without abatement till eight hours after the poison was swallowed, gradually disappeared under antidotes and laxatives. But such a case bears no great resemblance either to the acute or chronic form of poisoning with lead, and was probably hysterical.[[1309]] Orfila has found that an ounce and a quarter of sulphate of lead had no effect whatever on a dog.[[1310]] Mr. Taylor mentions a case where the chloride of lead caused vomiting, but no other ill consequence.[[1311]] Dr. Cogswell found that three drachms of iodide of lead caused in a dog merely depression and weakness for a few days; but forty grains killed a rabbit in twelve days, with symptoms of exhaustion and constipation; and doses frequently repeated, to the amount of eleven drachms in eighteen days, killed a dog under symptoms nearly the same.[[1312]]
It may be presumed that all the compounds of lead which are soluble in water or in the animal fluids may produce in favourable circumstances the lead colic and palsy. Dr. A. T. Thomson, indeed,[[1313]] has endeavoured to show by some experiments, that the carbonate is the only compound of lead which possesses this singular power; and that if the acetate of lead produces similar effects, it is only because that salt usually contains an excess of oxide which becomes carbonate from the action of free carbonic acid in the stomach and other parts of animals, or because the salt is decomposed by double decomposition from the accidental presence of alkaline carbonates. It does not appear to me, however, that the researches of Dr. Thomson, taken along with the prior inquiries of other physiologists, will bear out this conclusion. The experiments of Wibmer in particular would seem to show that the carbonate is at least not more active than the acetate; nor does it appear probable that the small doses of acetate given by him, seldom exceeding two or three grains at a time, could yield any carbonate in the alimentary canal of a dog, where there is commonly much free muriatic acid. Farther, in many of the instances of lead colic related above as produced by cider, wine, and other acid substances acting on lead or its oxide, the acid must have been so greatly in excess, that it was scarcely possible that carbonate of lead could have been formed afterwards by any ordinary accident. And even supposing the carbonate to be more active than other compounds in occasioning colic and palsy, as Dr. Thomson’s inquiries would tend to show, the fact may be admitted without necessarily leading to the inference, that it is the only active compound of lead, or that other preparations must be converted into the carbonate before they can act as slow poisons. For the superior activity of the carbonate may be owing to the great obstinacy with which its impalpable powder adheres to moist membranous surfaces, and the consequent greater certainty of its ultimate absorption. It certainly appears at least but consistent with a general law, to which hitherto no undoubted exception has been found, that the carbonate must be dissolved before it can act constitutionally.
The symptoms observed in man from the preparations of lead are of three kinds. One class of symptoms indicate inflammation of the alimentary canal: another spasm of its muscles: and a third injury of the nervous system, sometimes apoplexy, more commonly palsy, and that almost always partial and incomplete. Each of these classes of symptoms may exist independently of the other two; but the last two are more commonly combined.
The irritant effects of large doses of the soluble salts of lead come first under consideration. Of these the acetate, or sugar of lead may be taken as an example.
Here it will, in the first instance, be observed that, according to the experiments mentioned above, the acetate of lead, though certainly an irritant poison, is not very energetic,—being much less so than the vulgar generally believe, and far inferior to most of the metallic poisons hitherto treated of. This farther appears from the experience of physicians as to its effects in medicinal doses. The acetate has been often given in pretty large doses in medical practice; and although it has sometimes excited colic when continued too long, ordinary irritation of the stomach seems to have been rarely observed. Mr. Daniell, in a paper on its effects as a remedy for mercurial salivation, states that he gave it in doses of ten grains three times a day, and that he never observed it to excite any other unpleasant symptom except slight colic, which seldom came on till after the fourth dose.[[1314]] I have often given it in divided doses to the amount of eighteen grains daily for eight or ten days, without remarking any unpleasant symptom whatever, except once or twice slight colic. Van Swieten even mentions a case in which it was given to the amount of a drachm daily for ten days before it caused any material symptom.[[1315]]
Yet facts are not wanting to prove that acetate of lead in an improper dose will produce violent and immediate effects. The symptoms are then either those of simple irritation, or more commonly those of inflammation united with the peculiar spasmodic colic of lead, and sometimes followed by convulsions and coma, or by local palsy.
In one of Sir George Baker’s essays there is an instance of immediate and violent symptoms having been caused by a drachm taken twice with a short interval between the doses. The subject was a soldier who took it in milk to cure a diarrhœa. Five hours after the first dose he was seized with pain in the bowels and a feeling of distension round the navel. After the second these symptoms became much more acute; and he was soon after seized with bilious vomiting, loss of speech, delirium, and profuse sweating, while the pulse fell down to 40. He recovered, however, with the aid of diluents and cathartics.[[1316]]
A case which proved rapidly fatal has been related in a French journal. A drummer in a French regiment, who was much given to drinking, stole some Goulard’s extract, and drank it for wine. Neither the first symptoms nor the dose could be ascertained. On the second day he was affected with loss of appetite, paleness, costiveness, and excessive debility; on the third day he had severe and excessive colic, drawing in of the belly, loss of voice, cold sweats, locked jaw, and violent convulsions; and he expired before the evening of the same day. The morbid appearances will be mentioned in their proper place. Sugar of lead was detected in the stomach.[[1317]]