For other instances of the corrosive action of spring water on lead the reader may refer to Dr. Lambe’s treatise. Dr. Lambe was led by his researches to imagine that no spring water whatever was destitute of this property in a dangerous degree. This wide conclusion is not supported by valid facts. Yet his work contains several accurative and instructive examples of the action in question. Thus among other instances he mentions that he had found the water of Warwick to act on lead with great rapidity, and once saw holes and furrows in a cistern there, which was the second that had been used in the course of ten years.[1253] Sir G. Baker, in a letter to Dr. Heberden, has related another striking instance of the same kind. Lord Ashburnham’s house in Sussex was supplied from some distance with water, which was conveyed in leaden pipes. The servants being often affected with colic, which had even proved fatal to some of them, the water was carefully examined, and found to contain lead. The solvent power of the water was ascribed to its containing an unusual quantity of carbonic acid gas.[1254] This may be doubted.
In the course of the preceding remarks, allusion has been made to the danger of keeping the same portion of water for a length of time in leaden cisterns, if it has the power of acting on lead even in a trifling degree. The following illustrations deserve particular notice.
It was mentioned in p. 409, as the result of experiments on the small scale, that although the water of Edinburgh does not contract a sensible impregnation of lead on remaining a few days in contact with it, yet a sufficient action ensues in the course of a few months, to show that it might be dangerous to keep that water long in a lead cistern. After coming to this conclusion, I had an opportunity of verifying it on a large scale. A cistern in my laboratory in the University having been left undisturbed for four or five months with about six inches of water in it, I found so large a quantity of pearly crystals lying loose on the cistern and diffused through the water, that when the whole was shaken up and transferred to a glass vessel, the water appeared quite opaque. Mérat observes that at the laboratory of the Medical Faculty of Paris there was procured by evaporating six loads, or probably about 1000 pounds of water, which had been kept two months in a leaden pneumatic trough, no less than two ounces of finely crystallized carbonate of lead.[1255] Water in such circumstances has proved eminently poisonous. Thus, the crew of an East India packet having been put on short allowance of water, in consequence of being delayed by contrary winds, the men got their share each in a bottle; but the officers united their shares and kept it all in a lead cistern. In three weeks all the officers began to suffer from stomach and bowel complaints, and had the lead colic for six weeks; while the men continued to enjoy good health. The surgeon detected lead in a tumbler of water without the process of concentration, by adding to it the sulphuret of potass.[1256] A similar accident has been briefly alluded to by Van Swieten. He mentions, that he was acquainted with a family who were all attacked with colica pictonum in consequence of using for culinary purposes water collected in a large leaden cistern and kept there for a long time.[1257] The composition of the water has not been mentioned in any of these instances; but the water of Paris is so strongly impregnated with calcareous salts, that in ordinary circumstances its action on lead must be trifling.
It was probably from confounding the consequences of keeping the same water long in a lead cistern with the action in ordinary circumstances, that Dr. Lambe was led into the error of supposing that all spring waters whatever act on lead so powerfully, as to render it in his opinion advisable to abandon the use of this metal in the fabrication of pipes and cisterns. It must be admitted, however, that in all likelihood many waters will contain a trace of lead, without being kept more than the usual time in the pipe or cistern. For Dr. Lambe’s results correspond to a certain extent with the more recent and accurate researches of Dr. Thomson, who mentions many instances where a faint trace of lead was found in the residue of the evaporation of a large quantity of spring water by himself, as well as by Dr. Dalton, Dr. Wollaston, and Mr. Children.[1258] But, as Dr. Thomson properly adds, when the quantity does not exceed a 600,000th or a millionth part of the water, as in these instances, it is ridiculous to imagine that any harm can result to man from the constant use of it for domestic purposes.
Another fact of some practical consequence, which flows from the experimental conclusions stated above is, that although it may be perfectly safe to keep some waters in leaden cisterns, it may be very unsafe to use covers of this metal, because the water which condenses on the covers must be considered as pure as distilled water. It has been found that white lead forms in much larger quantity on the inside of the covers of cisterns than on the cisterns themselves, where both are constructed of lead. A remarkable illustration of this is mentioned in a paper read before the Academy of Sciences at Paris in 1788 by the Comte de Milly. About a year after getting two leaden cisterns erected in his house, to keep the water of the Seine for general domestic purposes, he was attacked with severe and obstinate colic; which led him to examine his cisterns. He found that the sides, where they were occasionally left exposed by the subsidence of the water, and more especially the leaden cover, were lined with a white liquid, which was constantly dropping from the lid into the cistern, like the drops in caverns where stalactites are formed. The water was in consequence so strongly impregnated with lead as to give a dark precipitate with liver of sulphur.[1259] The reason of this occurrence is, that the water in the cistern is a solution of preventive salts, but what reaches the lid is in a manner distilled. In Edinburgh the lids of the cisterns are invariably made of wood, whether on account of its superior cheapness merely, or because a leaden cover had been found perishable, I have not been able to discover.
It may be well to conclude these remarks on the action of spring waters on lead with a general summary of the chief circumstances to be adverted to in using lead for keeping or conveying water; to which may be added a few hints for preventing action where it is found to have taken place.
The general results of the preceding inquiries are that rain or snow-water for culinary use should not be collected from leaden roofs, nor preserved nor conveyed in lead;—that the same rule applies to spring waters of unusual purity, where for example the saline impregnation does not exceed a 15,000th of the water;—that spring water which contains a 10,000th or 12,000th of salts may be safely conveyed in lead pipes, if the salts in the water be chiefly carbonates and sulphates;—that lead pipes cannot be safely used, even where the water contains a 4000th of saline matter, if this consist chiefly of muriates;—that spring water, even though it contain a large proportion of salts, should not be kept for a long period in contact with lead;—and that cisterns should not be covered with lids of this metal.
Where action is observed to take place in the instance of particular waters, it may in some cases be impossible to prevent it by any attainable means. But the inquiries detailed above suggest two modes by which a remedy may be generally found. It appears that, where a crust of carbonate is allowed to form slowly and quietly on the surface of lead, even distilled water ceases to have any material action; and that the action is reduced almost to nothing if a crust be thus formed in a solution containing a minute quantity of some powerfully protecting salt, such as phosphate of soda. It appears to me then that a remedy may be often found in the instance of unusually pure spring waters—either by leaving the new pipes filled with the water for a few months, care being taken not draw any water from them in the interval,—or perhaps even more effectually by filling the pipes for a similar period with a solution containing about a 25,000th of phosphate of soda. I had determined to try the latter plan with the pipes in the Dumfries-shire case mentioned above, but recommended that in the first instance the pipes should be left for a few months full of the water of the spring, and the stop-cocks kept carefully shut; and on this being done for three or four months, it was found that the water afterwards passed with scarcely any impregnation of lead, and what little was contracted at first gradually diminished in the course of time.—Probably neither of these methods will be of more than temporary use, when the chief or only salt present is chloride of sodium, even though the proportion be considerable. Both plans seemed to answer for a time in the instance which occurred at Lord Aberdeen’s (p. 411); but after a while the action recommenced, probably owing to the deposited carbonate being slowly dissolved. At the time of publication of my paper in the Transactions of the Royal Society of Edinburgh, the cure appeared complete, and was there represented to be so.
I should add that an effectual remedy has been lately introduced by a patent invention for covering lead pipes both externally and internally with a thin coating of tin.
In the remarks now made on the action of water on lead no account has been taken of the effect of the galvanic fluid in promoting it. This, however, is a most important co-operating agent, or rather perhaps it ought to be considered a distinct power; for it acts with energy where water alone acts least, namely, when there is saline matter in solution, because then a galvanic current of greater force is excited. In general it is necessary that two different metals be present in the water before galvanic action be excited; but a very slight difference may be sufficient. For example, it seems enough that the lead contain here and there impurities, constituting alloys slightly different from the general mass of the pipe or cistern. It is probable that galvanic action may be thus excited by the joinings being soldered with the usual mixture of lead and the more fusible metals. At least I have seen pipes deeply corroded externally, when made of sheets of lead rolled and soldered; and the action was deepest on each side of the solder, which had itself entirely escaped corrosion. Even inequalities in the composition of the lead may have the same effect. Sheet lead long exposed to air or water is sometimes observed to be corroded in particular spots; and these will always be found in the neighbourhood of parts of the metal differing in colour, hardness or texture from the general mass. I have not analyzed such spots; but I conceive the supposition now made is exceedingly probable, and supplies a ready explanation of the corrosion. Similar effects may arise simply from fragments of other metals lying long in contact with the lead. They may also arise from portions of mortar being allowed to lie on the lead; but the action here is not galvanic.
I have no doubt that many of the instances of unusually rapid corrosion of lead by water, such as that mentioned by Dr. Wall [p. 410] are really owing, not to the simple action of water, but to an action excited obscurely in one or other of the ways now mentioned.
Water acidulated with various acids acts on lead with different degrees of rapidity.
The effect of acidulation with carbonic acid has not yet been accurately ascertained. The effect of sulphuric acid is peculiar. Distilled water feebly acidulated with that acid acts much less rapidly on lead than when quite pure. Thus I have found that, if it contained a 4000th or even only a 7000th of sulphuric acid, fifty grains of lead kept in it for thirty-two days gained a seventh or a twelfth of a grain in weight, and were covered with beautiful crystals of sulphate of lead. A minute trace of lead could be detected in the water. Hydrochloric acid is somewhat more active as a solvent. Distilled water containing a 3000th of that acid acquired in thirty-two days a sweetish taste, and yielded by evaporation a considerable quantity of muriate of lead, while the lead rods lost weight, and were covered with acicular crystals of the same salt.
It is much more important, however, to consider the effects of the vegetable acids on lead and its oxide, because their solvent power is a fruitful source of the accidental as well as intentional adulteration of many articles of food and drink.
Acetic acid in the form of common vinegar, even when much diluted, attacks and dissolves metallic lead, if by exposing the surface of the fluid to the air, a constant supply of oxygen be maintained to produce oxidation. The citric acid will attack it under the same circumstances, but acts more slowly. In a solution of five grains of citric acid in twenty-four parts or two drachms of water, three lead rods lost two grains in weight in nine weeks. The greater part of the citrate of lead separated slowly in white powdery crystals; but a small portion was dissolved by the excess of acid, and imparted to the fluid a pleasant sweetness. Tartaric acid acts much less energetically. In a comparative experiment with the last, the lead gained nearly half a grain in weight by acquiring a crystalline coat of tartrate of lead. But I could not detect any lead in solution; and there was no loose powder. The tartrate of lead is very sparingly soluble in an excess of its acid, so that a sweet taste cannot be communicated by it to a fluid acidulated with tartaric acid. Malic acid, according to MM. Chevallier and Ollivier, acts so quickly as a solvent, that if a solution be kept in a lead vessel for three hours, the metal may be detected in the fluid by any of its ordinary tests.[1260]
The acids act with greater rapidity on the protoxide of lead than on the metal; and the presence of air is of course not required to enable them to effect its solution.
The solvent power of the acids is liable to be counteracted by various substances; the operation of which, however, has not been well ascertained. It appears that substances containing gallic acid or tannin throw down the lead; and on this account various adulterations which would otherwise take place are either prevented or corrected. It has been also ascertained by Proust, that the vegetable acids do not attack lead when it is alloyed with tin. For as the latter metal has a stronger attraction than the former for acids, no lead can be oxidated before the tin undergoes that change.[1261]
From what has been said of the action of the vegetable acids, it follows that the preparation or preservation of articles of food and drink in leaden vessels is fraught with danger. For, if they contain a vegetable acid, more particularly the acetic, as many of them do, and if they are allowed to remain in the vessel for a moderate length of time, they will be apt to be impregnated with the metal. In this way lead has been often insidiously introduced into the food of man.
Thus milk has been poisoned by being kept in leaden troughs. An instance of the kind has been related by Dr. Darwin. A farmer’s daughter used to wipe the cream from the edge of the milk which was kept in leaden cisterns, and being fond of cream, had a habit of licking it from her finger. She was seized in consequence with the symptoms of lead colic, afterwards with paralytic weakness of the hands, and she died of general exhaustion.[1262] The circumstances under which the lead is acted on have not been carefully examined. It appears to be sometimes used with safety. It will of course be dissolved, if the milk should become sour.
Rum has been also supposed to be sometimes adulterated with lead by being left in contact with the metal. The dry belly-ache of the West Indies, which appears to be the same disease with the lead colic, has been ascribed by some to the same cause. But on this subject precise information is still wanted. Dr. J. Hunter has stated, that an epidemic colic, which attacked three of our regiments in Jamaica during the years 1781 and 1782, and which seized almost every man of them, was traced by him to the presence of lead in the rum; and he endeavours to show that the spirit might dissolve the lead in passing through the leaden worms of the distilling apparatus.[1263] He adds in another work, that, according to information communicated by Dr. Franklin, the legislature of Massachusetts passed an act in 1723, prohibiting the use of leaden still-heads and worms in the distillation of spirituous liquors.[1264] It is certain that rum has been often impregnated with lead; but it is by no means clear that Dr. Hunter has successfully accounted for the mode in which the adulteration is effected.
Wine has been accidentally impregnated in like manner, in consequence of the bottles having been rinsed with shot, and some of the shot left behind. An interesting example of this has been related in the Philosophical Magazine. Severe abdominal symptoms were caused by a bottle of wine; and the cause was discovered to be the action of the wine on some shot in the bottom of the bottle. The shot had been so completely dissolved, that it crumbled when squeezed between the fingers.[1265] The illness in this instance must have been owing to the arsenic contained in the shot, because the quantity of lead was hardly sufficient to excite violent symptoms.—At one time home-made British wines must have been frequently adulterated with lead, from the makers being ignorant of the dangerous nature of the adulteration. Sir G. Baker quotes the following receipt in a popular cookery book of his time: “To hinder wine from turning.—Put a pound of melted lead in fair water into your cask, pretty warm, and stop it close.”[1266]
But by far the most remarkable adulteration of the kind now under review is that of cider. At one time a disease in every respect the same as the lead colic used to prevail in some of the south-west counties of England at the cider season; and it was generally ascribed, in consequence apparently of the opinion of Huxham, to the working people indulging too freely in their favourite beverage during the season of plenty. The subject, however, was carefully investigated in 1767 by Sir George Baker, who succeeded in proving, that the disease arose from the cider being impregnated with lead, sometimes designedly for the purpose of correcting its acescency when spoiled, but chiefly by accident, in consequence of the metal being used for various purposes in the construction of the cider-house apparatus. The substance of his researches is,—that a disease in all respects the same with the lead colic was in his time so prevalent in Devonshire as to have supplied 289 cases to the Exeter Hospital in five years, and 80 to the Bath Infirmary in a single season (1766); while, on the contrary, it was little, if at all, known in the adjoining counties of Gloucester, Worcester, and Hereford, although cider is there an equally common drink among all ranks:—that in the latter counties lead was seldom or never used in constructing the apparatus of the cider-houses, while in Devonshire it was used sometimes for lining the presses, but more commonly for fastening the iron cramps, and filling up the stone joinings of the grinding troughs, and for conveying the liquor from vessel to vessel:—that lead did not exist in the cider of Herefordshire, but might be detected both in the ripe cider, and more especially in the must, of Devonshire:—that from eighteen bottles of cider, a year in bottle, 4½ grains of metallic lead were procured.[1267] The accuracy of these facts, and the soundness of the conclusions which Sir George Baker drew from them have been universally admitted; and lead is now, I believe, completely excluded from the cider apparatus.
Notwithstanding the notoriety of these facts, accidents from adulterated cider seem still to occur occasionally in France. So recently as 1841 a set of cases which presented the incipient symptoms of lead colic were traced by MM. Chevallier and Ollivier to cider having been adulterated with lead to the amount of nearly two grains and a half per quart, in consequence of a publican having kept his cider for two days in a vessel lined with lead.[1268]
If lead is previously oxidated, the presence of vegetable acids in articles kept in contact with it is still more likely to give rise to a poisonous impregnation, than in the case of lead itself.
Of accidental adulterations of this kind the most important is that which arises from the action of vegetable acids on the glazing of earthenware. This glaze is well known to contain generally a considerable quantity of oxide of lead, and in consequence is more or less easily dissolved by vegetable acids. A good example has been noticed by Dr. Beck.[1269] A family in Massachusetts, consisting of eight persons, were all seized with spasmodic colic, obstinate costiveness, and vomiting; and the disease was satisfactorily traced to a store of stewed apples, which had been kept some months in an earthenware vessel and had corroded the lead glazing. Another interesting example has been described by Dr. Hohnbaum of Hildburghausen. A family of five persons were all violently affected for a long time with spasmodic colic, and some with partial palsy. After examining many articles of food, Dr. Hohnbaum at last found that the vinegar for dressing their salads was kept in a large earthenware vessel capable of holding eight or ten quarts, and glazed with lead; that an ounce of vinegar remaining in the vessel contained no less than nine grains of lead; and that the whole glazing of the vessel was completely dissolved.[1270] Accidents like this appear from the statements of the same author to have been common in Germany not long ago. Luzuriaga attributes the great prevalence of colic in Madrid and the neighbourhood to the general use in the kitchen of earthenware glazed with lead.[1271] Jacob imputes it to the same cause.[1272] But others have doubted the accuracy of this explanation.
The effect of acids on lead glazing appears to be variable. Sometimes they hardly act on it at all.[1273] The difference probably depends on differences in the composition of the glaze. Gmelin says, that if there is little oxide of lead present, acids and fat do not corrode it; but that potters often use too much, to render the glaze more fusible; and that then it is easily corroded.[1274] Westrumb states, that, if the lead glaze is thoroughly vitrified and not cracked, the strongest acids do not attack it.[1275] Farther experiments are still required to elucidate this subject.
It is not, however, by accident only that the food or drink of man is subject to be poisoned with lead. Many articles are adulterated with it designedly for a variety of purposes. These adulterations it is necessary for the medical jurist to study.
No kind of adulteration with lead is more common than that of wine; which, when too acid and harsh from the first, or rendered acescent by decay, may be materially improved in taste by the addition of litharge.
The practice of correcting unsound wines in this way seems to have been well known at an early period. Betwixt the years 1498 and 1577, various decrees were passed against it by the German emperors; and in some provinces the crime was even punished capitally.[1276] For some time afterwards the dangerous effects of the practice appear to have been lost sight of in Germany. But towards the close of the seventeenth century, the attention of physicians and legislators in that country was pointedly directed to the subject by various writers in the Acta Germanica.[1277] The same practice has been long prevalent in France. The famous endemic colic of Poitou, which appeared in 1572, and raged for sixty or seventy years, has been with justice ascribed in modern times to the adulteration of wine with lead, and has given to the lead colic its scientific name of colica pictonum. More recently, the practice became exceedingly prevalent in Paris. About the year 1750, the farmers-general found that for some years before that, 30,000 hogsheads of sour wine were annually brought into Paris for the alleged purpose of making vinegar, while the previous yearly imports did not exceed 1200. An inquiry was accordingly set on foot; which led to the discovery, that the vinegar merchants corrected the sour wines with litharge, and thus made them marketable.[1278] Notwithstanding the active system of medical police in the French capital, the crime is not yet eradicated. Indeed the small tart wines used so abundantly there by all ranks, hold out great encouragement and facilities to its perpetration.
The process employed for correcting the acescency of wine is not precisely known. Some wines are easily corrected; Mérat found that a bottle of harsh wine, which had a sharp, bitterish, rather acrid taste, took up in forty-eight hours twelve grains of litharge, and became palatable.[1279] With other wines this simple method will not answer, because the colour is destroyed, and a taste is substituted which has no resemblance to that of the genuine wine. Thus Orfila remarked, that Burgundy, neutralized with litharge, acquired a saccharine taste and became pale-red, because the insoluble salts of lead which were formed, combined with and removed the colouring matter.[1280] On the whole, it is probable that the adulteration of wine with lead can only be practised with success on the common tart kinds, such as those used by the lower orders on the continent.
Some excellent observations have been published on this subject by Fourcroy. In order to render what he has said intelligible, it is necessary to premise, that in the course of the fermentation of wine, the bitartrate of potass, which accelerates the conversion of the sugar of the fruit into alcohol, is itself partly converted into malic acid; that in sound wine, therefore, there is a mixture of tartaric and malic acids; but that if the malic acid originally existed in the fruit in too great abundance, the fermentation of the sugar is imperfect, and the wine is consequently both too acid and too weak; and lastly, that all wines, if neglected, are apt to ferment too much, in consequence of which they pass the vinous stage of fermentation, and become impregnated with acetic acid.[1281]
Now Fourcroy found that the oxide and other preparations of lead correct acescency and harshness in wines, not so much by throwing down the acids, as by combining with them in solution, and imparting to the liquor the peculiar sweetness of lead. Hence tart wines, which owe their acidity to too great a proportion of tartaric acid or bitartrate of potass, cannot be improved by adulteration with oxide of lead. For the bitartrate of potass cannot act at all as a solvent on the oxides or carbonate of lead, and even pure tartaric acid takes up so little, that wine containing it, could not acquire the sweet taste which is the purpose of the adulteration. This statement I have confirmed. But the case is very different when the wine contains acetic acid, the presence of which is the general cause of spoiling or acidity. For Fourcroy remarked, that acetic acid dissolves not only oxide and carbonate of lead, but likewise the tartrate, notwithstanding its great insolubility in water or in its own acid. Hence the presence of tartaric acid in a wine spoiled by co-existence of the acetic, will not prevent the liquor from taking up oxide of lead in sufficient quantity to acquire an improved taste and flavour. Nay, an obvious mode of correcting excessive acidity, produced by too much tartaric acid, is to add tartaric acid, and then to treat the mixture with oxide of lead. Fourcroy farther thinks, that the malic acid possesses the same solvent power as the acetic over tartrate of lead, and that its presence may therefore be the reason why some tart wines, which do not contain the acetic acid, become nevertheless impregnated with the poison. The solvent power of acetic acid is increased by the presence of other vegetable principles in the wine.[1282] I may add, that I have found the citric acid to possess the same property with the acetic and malic acids. It dissolves so much of the tartrate of lead as to acquire a pleasant sweetness, unmixed with metallic astringency.
The practice of adulterating wine with lead does not seem to have been ever pursued to any material extent in Britain. Home-made wines may be adulterated in this way, as may be inferred from the receipt formerly quoted for preventing acescency. But I have never heard that any such adulteration has been suspected in the foreign wines usually drunk in this country. Considering, indeed, the nature of these wines, and the class of people who alone make use of them, it is not likely that adulteration with lead could be practised with success. If the foreign wines used in Britain should become acescent, lead could hardly restore their taste so thoroughly as to impose on the consumer.
Sometimes spirituous liquors and preserves have been adulterated with lead, in consequence of sugar of lead having been used to clarify them, or to render them colourless. Cadet de Gassicourt says it is a common practice in France to clarify honey and sugar of grapes, and to make brandy pale in this way; and M. Boudet has detected lead in many samples of these articles in Paris.[1283] Hollands has likewise been poisoned in the same manner. Dr. Shearman mentions his having detected an extensive adulteration of smuggled Geneva by an excise officer, which had been sold and dispersed over an extensive tract of country, and which committed great ravages among the inhabitants.[1284]
The adulterations hitherto noticed take place through means of the chemical action of the adulterated articles on lead or its oxide. Some other substances are occasionally contaminated by its compounds being merely mechanically mixed with them. There is no end to the number and variety of adulterations of this kind. But the following will serve as examples. Gaubius once detected an adulteration of butter with white lead at a time when it was very scarce in Flanders, owing to a dreadful mortality among cattle.[1285] An instance of poisoning with lead, in consequence of cheese having been mixed with red lead, is mentioned in the Repertory of Arts.[1286] This variety deserves to be remembered. Red lead was at one time a good deal used to communicate the peculiar reddish-yellow colour, which is supposed to characterize the finer qualities of certain kinds of English cheese. In the Transactions of the Medical Society of London, a singular instance has been related by Mr. Deering, of lead colic attacking a whole family, and proving fatal to two of them, in consequence of the insidious introduction of white lead into the body. Although the nature of the symptoms in the several cases left no doubt that lead was the cause of them, it was long before the source of the poison was discovered. Every vessel and article used in the kitchen was in vain examined; when at length it was discovered that the sugar used by the family had been taken from a barrel which had formerly contained white lead, and that, as the sugar from the centre of the barrel had been dug out, and given away to various friends, the outer part of it next the white lead was chiefly used by the family themselves.[1287]
In the first place, a little nitric acid should be added to the suspected matter before filtration; for nitric acid redissolves any insoluble compound formed by the salts of lead with albumen and other animal principles, as well as some of those formed with vegetable principles; and consequently renders it more probable, that the poison will be detected in the first part of the analysis, if present at all.[1288] This being done, sulphuretted-hydrogen gas is to be transmitted through the fluid part of the mixture; and if a dark-coloured precipitate is formed, the whole is to be boiled and filtered to collect the precipitate.
In order to ascertain that the precipitate positively contains lead, those who are accustomed to use the blowpipe may put the sulphuret into a little hole in a bit of charcoal, and reduce it by the fine point of a blowpipe-flame; when a single globule is procured, which is easily distinguished by its lustre and softness. A better process, for those not accustomed to the blowpipe, and perhaps a better test of the existence of lead in all circumstances, is to heat the sulphuret to redness in a tube, and to treat it with strong nitric acid, without heat or with the aid of a gentle heat only. The lead is thus dissolved without the sulphur being acted on. The solution is then to be diluted with water, filtered, evaporated to dryness, and gently heated to expel the excess of nitric acid. If the residue be dissolved in water, it will present the usual characters of a lead solution when subjected to the proper liquid tests. Of these the hydriodate of potass is to be preferred when the quantity is too small for trying more of them. But for this purpose care must be taken to expel all the excess of nitric acid, because an excess will strike a yellow colour with the test though lead be not present.
If the preceding process should not detect lead in the filtered part of the mixed fluid, then the insoluble matter left on the filter is to be incinerated, and the residuum dissolved in nitric acid, and tested as above. This branch, however, will be rarely required, if lead be present, because the precaution of adding nitric acid, previous to filtration, dissolves the lead from most of its compounds which are insoluble in water. The process of incineration in medico-legal analysis generally should be avoided if possible, as it is not easily managed by unpractised persons.—The present branch of the process of analysis will be particularly required for the contents of the stomach or vomited matter, when any sulphate or phosphate has been given as an antidote.
A process different from the preceding, and analogous to those for detecting copper and antimony in complex organic mixtures, has lately been proposed by Professor Orfila, especially for those cases in which lead is to be sought for in the textures of the body, where death is supposed to have been occasioned by it. The subject of analysis, such as the liver, spleen, or kidneys, being cut into small pieces, and boiled in distilled water, and the filtered decoction being evaporated to dryness, the extract is to be carbonized with nitric acid as directed under the head of copper (p. 357); and care must be taken that the heat be not raised to redness, so as to inflame the mass. The residuum is then to be boiled with nitric acid; the solution being evaporated to dryness to expel the excess of acid, the saline matter left is to be redissolved and acted on by hydrosulphuric acid gas; and the sulphuret thus formed may be recognized by the means mentioned above.[1289]
A question has been recently started, whether all the processes for detecting lead in the tissues of the human body are not rendered fallacious by the alleged existence of lead in the healthy animal textures. In the first place, however, it is doubtful, as will be seen presently, whether lead ever exists naturally in the animal organs. But besides, the fallacy, if a real one, is obviated by the process of Orfila; who states that lead, naturally combined in the animal tissues, cannot be indicated by his method, if the animal matter be charred by nitric acid without deflagration. And farther, in regard to the tissues of the stomach in cases of acute poisoning with the preparations of lead, it appears that in most instances there may be seen on the villous coat little white points, which are blackened by hydrosulphuric acid, a phenomenon never occasioned by lead naturally contained in the substance of the membrane. [See p. 439.]
The effects of the preparations of lead on the body are very striking. They differ according to the rapidity with which it enters the system. Large doses of its soluble salts cause symptoms of irritant poisoning. The gradual introduction of any of its oxidated preparations in minute quantities brings on a peculiar and now well-known variety of colic, which is often followed by partial palsy, and in violent cases by apoplexy.
The physiological effects and mode of action of the soluble salts in irritating doses have been examined experimentally by Professor Orfila, M. Gaspard, Dr. Schloepfer, and Dr. Campbell. Their experiments agree in showing that these poisons have a direct irritating action, and a remote operation of an unknown kind; but the results obtained by different experimentalists differ as to some of the details. The acetate may be taken as a type of the whole genus.
Orfila found that it was hardly possible to bring dogs under the action of the acetate if swallowed in solution, because they speedily discharged it all by vomiting. But if the salt was given in powder in the dose of half an ounce, or if the solution was retained in the stomach by a ligature on the gullet, the symptoms produced were those of violent irritation in the first instance, succeeded by extreme weakness and death, sometimes in nine hours, more generally not till the second day or later. The appearances in the body were unnatural whiteness of the villous coat when death was rapid, and vascular redness when death was slower. The whiteness in the former case Orfila ascribes to chemical action. But as neither this appearance nor the redness in the latter case was considerable, while at the same time the symptoms were not those of continuous irritation, he was led to doubt whether the poison causes death in consequence of its irritant properties. And the phenomena observed by him when acetate of lead was injected into the jugular vein prove that death is owing to certain remote effects. Introduced through this channel thirteen grains killed a dog almost immediately, death being preceded by no other symptom except convulsive respiration; five grains killed another in five days, and the leading symptoms were weariness, languor, staggering, and slight convulsions, none of which symptoms appeared till the third day; and it is remarkable that in neither animal could he find any morbid appearance on dissection.[1290] Mr. Blake states that large doses, such as a drachm, suddenly arrest the heart’s action; but that small doses of three grains, injected into the jugular vein, cause diminished action of that organ, and afterwards gorging and hepatization of the lungs; and that when injected backwards into the aorta from the axillary artery, this salt occasions obstruction of the capillary circulation, indicated by increased arterial pressure,—and then an action on the nervous system, producing insensibility, violent movements of the tail, and at last arrestment of the respiration. It may be inferred from Mr. Blake’s researches that lead obstructs both the systemic and pulmonary capillaries, that it acts powerfully on the nervous centre, and that it likewise depresses the heart’s action when the dose is large.[1291]
The experiments of Gaspard coincide with those of Orfila in assigning considerable activity to the acetate of lead when it is directly introduced into the blood,—the quantity of two or four grains generally causing death in three or five days.[1292] The experiments of Campbell farther show that death may be induced by applying it to a wound, and that the symptoms antecedent to death resemble those remarked by Orfila when it is injected into a vein.[1293] But the two last experimentalists differ from Orfila in assigning to sugar of lead a property like that possessed by arsenic, of acting on the alimentary canal, even when applied to a wound, or directly introduced into the blood. For Campbell found the stomach corrugated and red, and the small intestines also vascular; while Gaspard not only observed analogous appearances after death, but even also witnessed all the symptoms of violent dysentery during life. In farther proof of the local irritating power of this poison, it may be added, that when sugar of lead was injected into the rectum Campbell found it to cause purging, tenesmus, itching of the anus, and great debility.
I have found that the nitrate of lead is powerfully irritant and corrosive in the dose of 400 grains. This quantity dissolved in four ounces of water killed a strong dog in sixteen hours, producing violent efforts to vomit and diarrhœa. And after death the whole inner membrane of the gullet and stomach, and the villi of the upper half of the small intestines, were uniformly white, brittle, and evidently disintegrated; and the mucous coat of the great intestines was bright red in parallel lines.
The only inquiries I have hitherto met with, which assign to lead in continued small doses the power of producing in animals the peculiar colic and palsy often produced by it in man are those of Schloepfer, related in his thesis on the effects of poisons when injected into the windpipe. He found that the acetate, introduced through this channel in successive doses of ten grains, brought on all the symptoms of colica pictonum, preceded by oppressed breathing, and ending fatally with palsy and convulsions in the course of three weeks.[1294] More recently Dr. Wibmer, in the course of some experiments on the long-continued use of acetate and carbonate of lead, remarked weakness and stiffness of the limbs in dogs; and in the rabbit I have observed in the like circumstances gradually increasing weakness, ending in complete palsy of the fore-legs.
The compounds of lead seem to produce their effects on the animal body through the medium of absorption. At all events they are absorbed in the course of their action, and are diffused throughout the animal textures. Lead was long sought for with variable and dubious success in the fluids and solids of men and animals killed by it or labouring under its effects. But the late improvements in physiological science and chemical analysis have demonstrated, that it may always be detected in favourable circumstances in the liver and kidneys, often in the spleen and in the urine, and sometimes even in the muscles. Wibmer was the first who satisfactorily proved its presence. In dogs poisoned slowly by the acetate or carbonate of lead in frequent small doses, and dying with symptoms of lead-colic and palsy, he found the metal distinctly in the liver, muscles, and spinal cord, and more obscurely in the blood, by drying and deflagrating the animal matter with nitre, acting on the residue with nitric acid, neutralizing the solution, and testing it with hydrosulphuric acid, carbonate of potash, and iodide of potassium.[1295] On repeating these experiments, I succeeded in detecting lead in very minute quantity in the lumbar and dorsal muscles of rabbits, but not any where else.[1296] Professor Orfila has since frequently found lead, by means of his method of analysis described at page 424, in the kidneys, liver, and urine of animals which had taken large doses of acetate of lead, and once in the urine of a girl who had swallowed above an ounce of the acetate twenty-five hours before the urine was passed.[1297] About the same time M. Ausset, under the directions of Lassaigne, detected lead largely in the blood and urine of a horse during life, and in the liver and kidneys after death.[1298] Mr. Alfred Taylor found traces of it in the milk of a cow accidentally poisoned by carbonate of lead.[1299] M. Tanquerel Desplanches says it has been detected by M. Devergie and himself in the palsied parts of persons who had died of colica pictonum;[1300] and Dr. Budd observes, that Mr. Miller found lead in abundance in the paralysed extensors of the hand in a man who died in a London Hospital of the epileptic form of the effects of this poison.[1301]
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]
In both these instances the disorder excited partook very much of the character of the spasmodic colic which is caused by the gradual introduction of lead into the body; and in the last the whole course of the man’s illness was very like that of the worst or most acute form of colica pictonum. But in another example which came under my own notice, the symptoms were more nearly those of ordinary irritation,—namely, vomiting, burning, and pricking pain in the throat, gullet, and stomach, with trifling colic subsequently; but the patient recovered in two or three days. The quantity taken was supposed to exceed a quarter of an ounce. So, too, in a case which occurred to M. Villeneuve of Paris, the symptoms were chiefly vomiting and purging, with faintness and some convulsions. His patient swallowed intentionally above an ounce of acetate of lead in solution. Sulphate of soda and sulphate of magnesia were given promptly as antidotes; in an hour the symptoms had abated materially; and next day she was well.[1318] This was the case in which Orfila found lead in the urine. Of the same nature, also, are two cases briefly alluded to by Mr. Taylor, as having been caused in London in 1840 by Goulard’s extract. The subjects, who were children, were seized with vomiting, purging, and other symptoms like those of Asiatic cholera; and both died within thirty-six hours.[1319]
In another instance, related by Mr. Iliff of London, where an ounce of the acetate was accidentally swallowed in solution, the symptoms were at first colic pains and vomiting, in the course of a few hours vomiting and tenderness, and, after these symptoms receded, a peculiar state of rigidity and numbness, which was not entirely removed for several days. In this case no remedies were used for three hours; and even two hours later, when the stomach-pump was resorted to on account of the slightness of the vomiting, lead was found in the first fluid withdrawn,—a new proof of the feeble action of acetate of lead, compared with some other metallic poisons.[1320]
So much for the operation of the acetate of lead in large doses. Physicians, however, are much better acquainted with the effects of lead when introduced in the body continuously and insidiously in minute quantities. For all tradesmen who work much with its preparations are apt to suffer in this way, and many other persons have been brought under its action in consequence of articles of food and drink being impregnated with it. The disease which is thus induced may be divided into two distinct stages.
The first stage is an affection of the alimentary canal, the leading feature of which is violent and obstinate colic. This symptom at times begins abruptly during a state of sound health; but much more commonly it is ushered in by a deranged state of the stomach, not unlike common dyspepsia, seldom so severe as to excite alarm, and commonly imputed at first to a wrong cause. There is general uneasiness and depression, a dingy yellowish complexion, weakness and numbness in the limbs, a sweetish styptic taste and fetid breath, a slaty tint of the teeth and gums, with a blue line along the margin of the gums where they touch the teeth, a slow hard pulse, great emaciation, loss of appetite and tendency to indigestion. This state, which was first well characterized by Mr. Wilson[1321] of Leadhills, and has lately been more fully described by M. Tanquerel,[1322] is of great moment as apprizing the workman of the necessity of taking active measures for preventing the more formidable effects, which otherwise are sure to follow. Of the warning symptoms none is so invariable or so characteristic as the blue line along the edge of the gums, an appearance which was first noticed by Dr. Burton of St. George’s, London,[1323] and has been since observed in every case of lead colic, whether impending or present.—If alarm be not taken in time, the obscure complaints hitherto mentioned become attended by and by with uneasy sensations in the stomach, stretching ere long throughout the whole belly. At the same time the stomach becomes irritable, and the food is rejected by vomiting. Cramps in the pit of the stomach then arise, and extend to the rest of the belly, till at length the complete colic paroxysm is formed. The pain is sometimes pretty constant; sometimes it ceases at intervals altogether; but much more commonly there are remissions rather than intermissions; and it is remarked that both the remissions and exacerbations are much longer than those of common colic. The pain is very generally, yet not invariably, relieved by pressure; even strong pressure seldom causes any uneasiness, provided it be not made on the epigastrium; nay, some patients have been known to bear, with relief to the paroxysms, the weight of two or three people standing on the belly.[1324] The belly is almost always hard, the abdominal muscles being contracted: sometimes it is rather full, more commonly the reverse, and the navel is often drawn in so as almost to touch the spine. The bowels all the while are obstinately costive. Either there is no discharge from them at all; or scanty, knotty fæces are passed with much straining and pain. This state, long supposed to depend on spasm, is now known to arise on the contrary from paralysis, of the intestinal muscular coat. In a few instances diarrhœa takes the place of the opposite affection. The urine is commonly diminished. The saliva has been described as greater than natural in quantity and bluish in colour; but Dr. Burton says he did not observe a single instance of this in forty cases which he carefully examined. From the beginning, or more generally after a few hours or days, the limbs are racked with diffuse cutting pains; which, according to Tanquerel, affect chiefly the limbs, especially near the joints, are worst at night, are often attended with cramps, and are relieved by pressure. The aspect of the countenance is dull, anxious, and gloomy: in advanced cases the expression of gloomy anxiety exceeds that of almost all other diseases. It appears from the latest works on this disease published in France, and particularly from the able treatise of Mérat, that the pulse is rarely accelerated, but on the contrary often retarded.[1325] This does not accord with the experience of some earlier writers;[1326] and in the few cases I have seen in this city the pulse has been always frequent. It cannot be questioned, however, that, as Mérat states, fever is not essential. The skin has a dull, dirty, cadaverous appearance, is often, though not always hot, and in either case is bedewed with irregular, clammy, cold perspiration.
This, the first stage of colica pictonum, may end in three ways. In the first place, the patient may recover at once from it as from an ordinary colic; and it is consolatory to know, that a first attack, taken under timely management, is for the most part easily made to terminate in that favourable manner. In such circumstances it rarely endures beyond eight days. But it is exceedingly apt to recur, if, for example, the patient expose himself to what in ordinary circumstances would cause merely a common colic or diarrhœa; and if he returns to a trade which exposes him again to the poison of lead, the disease is sure to recur sooner or later, and repeatedly, unless he observes the greatest precautions. In one or other of these returns, sometimes even in the first attack, the colic is not succeeded by complete recovery, but gives place to another more obstinate and more alarming disease. This secondary affection is of two sorts. One, which occurs chiefly in fatal cases, is a species of apoplexy. The other, which does not of itself prove fatal, is partial palsy.
In violent and neglected cases of colica pictonum, the colic becomes attended in a few days with giddiness, great debility, torpor, and sometimes delirium; as the torpor advances the pains in the belly and limbs abate; at length the patient becomes convulsed and comatose, from which state very few recover. Tanquerel, who is unnecessarily minute in subdividing the various affections produced by the poison of lead, distinguishes four kinds of affections of the head, coma, epilepsy, delirium, and a combination of all these.[1327] A very rare termination allied to that now described is sudden death during the colic stage, without any symptom which would lead one to suspect its approach. A case of this kind has been related by M. Louis. His patient, five minutes after talking to the attendant of his ward, was found at his bedside in the agony of death; and no cause for so sudden a death could be found on dissection.[1328] Somewhat similar was a case which occurred in 1838 at the hospital of La Charité at Paris. A man labouring for three days severely under the colic stage of the disease, began to breathe stertorously soon after straining at stool, and died in three hours.[1329] In a case which occurred to Dr. Elliotson death was owing to concomitant perforation of the stomach, a concurrence which was probably accidental, but which was also once observed by Dr. Copland.[1330]
In cases, on the other hand, which have not been neglected, and particularly when the attack is not the first, the departure of the colic often leaves the patient in a state of extreme debility, which by and by is found to be a true partial palsy, more or less complete. This affection is sometimes present before the colic departs, but is apt to escape notice till the pain abates. Occasionally it supervenes on a sudden, but more generally it is preceded by a sense of weariness, numbness and tremor of the parts. The palsy is of a peculiar kind. It affects chiefly the upper extremities, and is attended with excessive muscular emaciation. The loss of power and substance is most remarkable in the muscles which supply the thumb and fingers; and in every case which I have seen the extensors suffered more than the flexors. The paralysis is hardly ever complete, except perhaps in the extensors of the fingers. When it is considerable, the position of the hands is almost characteristic of the disease. The hands are constantly bent, except when the arms hang straight down by the side; they dangle loosely when the patient moves; he cannot extend them, and raises one arm with the aid of the other. The palsy is attended, according to Tanquerel, with diminished heat in the parts, and feeble pulsation in the arteries which supply them. There is seldom any loss of sensation in the affected parts. But the paralysis sometimes affects the nerves of the other senses. Thus two cases of paralysis of the nerves of vision have been related by Dr. Alderson of Hull;[1331] and Tanquerel says this affection is not uncommon in Paris, and is attended with dilated and immovable pupils. The latter author also once met with deafness in the same circumstances.—Patients affected with lead palsy usually complain of racking pains in the limbs and arms, digestion is feeble, and trivial causes renew the colic. From this deplorable condition it is still possible to restore the sufferer to health, chiefly by rigorous attention to regimen. But he too often dies in consequence of a fresh attack of colic as soon as he returns to his fatal trade.