Industrial saturnism: with special reference to the acuter forms of the condition

Abstract

1. Industrial poisoning can be produced with great rapidity from inhalation of fumes of the soluble salts of lead. 2. Where fumes are present in sufficient density four or five weeks are sufficient to produce profound cachexia, wasting, and anaemia. 3. The individual is now liable to violent attacks of abdominal pain accompanied by high arterial tension and slowing of the cardiac rhythm. 4. If renal complications occur they are parenchymatous in nature, and albumen may be found in the urine. 5. Alternatively, cerebral complications may supervene especially in females with "toxic" hysteria, convulsions, and coma, generally followed by death. 6. Where blindness ensues in last case, it is due to high intracranial pressure producing an acute optic neuritis. 7. Pigmentation may be found in the gums and cheeks; and post-mortem in the intestine. In the first case, the pigmentation or blue line is of great diagnostic importance but not necessarily an indication of poisoning, merely indicating presence of lead in tissues. 8. Lead salts have a destructive action in highly specialised tissue, notably the blood and renal cells on which the chief stress apparently falls. Blood changes include profound secondary anaemia; with or without normoblasts and stippling of the red cells. 10. In more chronic poisoning neuritis may occur generally affecting the dorsal interosseous nerve of the forearm and is a peripheral lesion. 11. Long- continued irritation of renal capillaries produces a chronic interstitial nephritis or small red kidney. 12. Chronic poisoning fosters arterio-sclerosis and obliterative endarteritis. 13. ti frequent.cause of death in chronic cases is uraemia or cerebral haemorrhage. 14. Prevention is better than cure, only persons having a high tolerance to lead, or where excretion can keep pace with absorption should by employed in lead.processes. Where poisoning is contracted treatment must aim first at giving relief and later at elimination. 16. The classical ,drug to be exhibited is potassium iodide in small doses' accompanied by acidulated drinks and saline purgatives. 17. Cases of peripheral neuritis should receive treatment for paralysed muscle groups and strychnine therapy when nerve regeneration is becoming established.