In the acute attacks vaso-motor spasm is no doubt partially accountable for the symptoms, and various dilators, previously noted in discussing colic, may be made use of, such, for instance, as amyl nitrite, scopolamine, etc., whilst pyramidon, antipyrin, phenacetin, and other similar drugs may be given between the attacks. Under no circumstances should any person who has suffered from encephalitis or other cerebral symptom of lead poisoning be allowed to resume work in a lead industry.
The treatment of eye affections in lead poisoning requires little comment, as the essential treatment must be the same as in other cases, mainly devoted towards the elimination of the poison. Attempts may be made to treat paresis of the ocular muscles by means of mild electric currents, but of this we have had no experience. About 50 per cent. of cases of lead amaurosis and amblyopia recover, but a number progress to total and permanent blindness, and prognosis in such cases must always be guarded.
Prognosis.
—The prognosis of the first attacks of lead poisoning of simple colic or even slight unilateral paresis is good; practically all cases recover under proper treatment. It is unusual for a person to succumb to a first attack of simple colic, or paresis.
In most cases the serious forms of poisoning only make their appearance after three or four previous attacks of colic, but a single attack of paresis is much more frequently followed by a severe form of poisoning, such as encephalitis.
A limited number of persons are highly susceptible to lead poisoning, and these persons rapidly show their susceptibility when working in a dangerous lead process. Lead poisoning occurring in an alcoholic subject is more likely to result in paretic and mental symptoms than in a person who is not addicted to alcohol, and the prognosis of lead poisoning in an alcoholic is much less favourable than in the case of a normal person.
Mental symptoms very rarely follow from a single attack of lead colic, and as a rule do not become established under three or four attacks at least.
A small number of persons exposed to excessive doses of lead absorption through the lungs develop mental symptoms, such as acute encephalitis, without any prodromal stage. The prognosis in such cases is always exceedingly grave.
Sudden generalized forms of paralysis are not common in the early stages, but are invariably of grave import. A few cases of paresis, particularly those of the peroneal type, and affecting the lower limbs, become progressive, and eventually develop into a condition resembling progressive muscular atrophy with spinal cord degeneration.
The prognosis of simple colic in women is about as good as for males, but if an attack of abortion is associated with lead poisoning, eclampsia often supervenes and permanent mental derangement may follow. In the dementia associated with lead poisoning the prognosis is not so grave as in other forms of dementia, especially alcoholic, but depression is an unfavourable symptom. The mania of lead poisoning is not so noisy as that of alcoholic mania, but where there is suspicion of alcoholic as well as lead poisoning the prognosis is exceedingly grave.