CHAPTER XVIII.

PREPARATIONS OF LEAD.

Lead, in its metallic state, is not injurious. It is, however, really

acted on by acids, exposure to the atmosphere, &c., and converted into

carbonate of lead. The chief compounds of this metal which have been

found to produce poisonous effects are the acetate, subacetate, and the

carbonate.

ACETATE OF LEAD (_Sugar of Lead_).--This is sold as a glistening white

powder, or in the form of crystalline masses resembling loaf sugar. It

is more frequently used as a poison than either of the other compounds.

It is very soluble in water and has a sweetish metallic taste. Three or

four instances are recorded in which recovery has taken place after an

ounce of this substance has been taken in solution.

Mr. Bancks, of Stourbridge, has reported the particulars of a series of

cases of poisoning by the acetate of lead (_Lancet_, 5th May, 1849). It

appears that thirty pounds of this substance were accidentally mixed at

the miller's with eighty sacks of flour. This was made into bread, from

eating which 500 persons suffered severely. The chief symptoms were a

sense of constriction in the throat and at the pit of the stomach,

crampy pains round the navel, stiffness of the abdominal muscles,

paralysis of the lower extremities, constipation, scanty urine, and the

formation of a deep blue line round the gums. Although in many cases

there was great prostration with other alarming symptoms, yet under the

use of purgatives all recovered. It was noticed that after a temporary

convalescence many of the symptoms returned in an aggravated form

without any apparent cause. Sometimes there has been vomiting and

purging, and there is great prostration, with cramps and convulsions.

_Post-mortem Appearances._--They are not usually very distinct. The

stomach and intestines have been found inflamed, and the surface of the

former softened and, in the case of animals, corroded. There may be no

characteristic signs in chronic poisoning.

SUBACETATE OF LEAD (_Goulard's Extract_).--This substance is known to

have proved fatal in three or four instances, after having caused great

agony. It is a more powerful poison than the acetate. It is found in the

shops as a whitish-colored liquid.

CARBONATE OF LEAD (_White Lead_, _Ceruse_, _&c._).--This is sold in

heavy white masses, looking like chalk. It is readily acted on by acids,

but is very insoluble in water.

Dr. Snow has reported an instance in which a child ate a portion, about

the size of a marble, mixed up with oil; it died on the fourth day.

Carbonate of lead derives its greatest interest from the chronic form of

poisoning which it produces among white lead manufacturers, painters,

&c., known as "the painters' colic," which too often terminates in "lead

palsy." In these instances the lead finds its way into the system by

absorption from the digestive canal, the lungs, or the skin; producing

its characteristic effects when a sufficient amount has been absorbed.

It is this salt which is formed by the action of air and water upon

lead.

The other preparations of this metal do not require any separate notice.

_Treatment._--The sulphates of soda or magnesia should be freely given

dissolved in water. Milk, or milk and eggs will be useful. If vomiting

is absent, an emetic of sulphate of zinc should be administered, or the

stomach-pump may be advantageously employed.

For a chemical antidote in poisoning by carbonate of lead Dr. Taylor

recommends a mixture of vinegar and sulphate of magnesia.

_Tests._--The presence of a salt of lead in solution may be thus

ascertained:--1. On passing sulphuretted hydrogen through it, or on

adding a few drops of sulphide of ammonium, a black precipitate is

given. 2. A white precipitate results from the use of liquor potassae or

liquor ammoniae. 3. Dilute sulphuric acid gives a similar precipitate,

which is insoluble in nitric acid. 4. Iodide of potassium affords a

bright yellow deposit (iodide of lead).

CHRONIC LEAD POISONING.--The chronic and insidious effects produced by

lead upon the constitution are deserving of careful attention. Water

impregnated with this metal in its passage through lead pipes or

cisterns, acquires poisonous properties. Lead-pigments are sometimes

improperly used to color cheese, lozenges, snuff, &c. The endemic colic

of Devonshire was due to the absorption of lead contained in cider,

which had been made in leaden vessels; and in the wine district of

Poictou attacks of colic were so common, from the impregnation of wine

with this metal, that we still speak of "colica Pictonum."

The pernicious influence of lead is manifested among those engaged in

the manufacture or use of lead compounds, especially painters, lead

smelters, plumbers, color grinders, shot manufacturers, workers in sugar

of lead, potters, compositors, enamellers of cards, &c. These artisans

should be advised to prevent disease by great cleanliness, by avoiding

intoxicating liquors, and by drinking freely of sulphuric acid lemonade.

The substitution of moist for dry grinding has proved useful.

The most prominent _symptoms_ of chronic poisoning by lead are as

follows: A blue line around the gums, and the liability of the latter

to bleed from any slight cause; emaciation, a pallid tint of the

complexion, poorness of blood, and a feeble quick pulse; obstinate

constipation, with attacks of colic relieved by pressure; diminution of

the renal secretion and rheumatic pains; afterwards comes weakness of

the hands, wrists, and arms, ending in paralysis of the extensors, or

"dropped wrists," creeping up the arms.

The _treatment_ of these cases must consist in the first instance in the

use of purgatives; none being better than sulphate of magnesia with the

dilute sulphuric acid. But the remedy of all others is the iodide of

potassium, in five or ten grain doses thrice daily; this agent acting

most beneficially when employed in conjunction with galvanism to the

paralysed limbs.

Memoranda on Poisons · 第 18 / 30 章