[Gastro-intestinal] system.
[Nervous] system.
[Excretory] system.
[Circulatory] system.
Gastro-Intestinal.
—As the chief early symptom of all types of chronic poisoning is abdominal colic, early investigators turned their attention to the pathology in this region, and ascribed the colic to various causes.
Oliver[2] noted that, in animals poisoned with lead, the intestine was found to be irregularly contracted, and ascribed the pain in abdominal colic to the irregular contraction of the intestines themselves, supposing that the effect of lead was on the muscular tissues. He also noted the presence in the intestine, both large and small, of staining due to lead, and the considerable amount of lead to be found in the large intestine. We have only met with staining by lead in the large intestine.
Dixon Mann[3] pointed out that the fæces contain two-thirds of the amount of lead taken by the mouth in experimental cases, and considered that the lead was re-excreted into the intestine; and a number of other observers hold this view. Recent work confirms the supposition, and there is no doubt that lead is eliminated in this way.
Stockvis[4] has occasionally seen small ulcers or abrasions in the small intestine; these he thinks may be due to small hæmorrhages.
Ménétrier[5], quoted by Meillère, describes a form of glandular atrophy of the stomach which is met with in chronic lead poisoning. He states that the alcoholic gastritis generally present in persons the subject of saturnine gastritis renders the differentiation exceedingly difficult. This observer is also in complete agreement with many others who associate much of the chronic lead poisoning to association with alcoholic intemperance. The particular type of gastric degeneration Ménétrier regards as due to the effect of lead is “une sclérose regulière, inter-tubulaire, se recontrant d’une manière diffuse et générale dans le muqueuse gastrique.”
He further considers that this gastric sclerosis occurs earlier than the disease of the kidneys.
Kussmaul and Meyer[6] describe a chronic intestinal catarrh with chronic degenerative changes in the intestinal mucosa very similar to the changes described by Ménétrier.
Tanquerel[7] inclined to the view that the colic was not associated with spasm of the intestines, and states that no clinical evidence could be found of intestinal spasm by rectal examination during a spasm of colic. But, as Bernard[8] points out, intestinal spasm may occur with “ballonment” of the rectum.