PLUMBUM (see vol.iii, p. 642)
II. 43. Dr. G. L. Walton records a fatal case of lead poisoning in which ataxia was the prominent symptom. The patient was a man, aged 54, whose first manifestation was numbness in the hands. This passed off; then numbness showed itself in the left foot, and persisted, gradually spreading up the leg till it reached the back. This numbness and an increasingly staggering gait were the chief things he complained of. There was an uncomfortable sensation in the head, hardly amounting to headache. He had no eye troubles, no pains, no wrist – drop, no loss of power in the limbs, no vertigo, no gastric crises. He could not stand with his feet together and his eyes closed; there was some loss of sensation in the left leg, knee – jerks natural, no ankle – clonus, pupils natural, urine natural. The opinion was formed that he was suffering from neuritis of obscure causation. Two months later, the suggestion having been made that the case might be one of arsenical or lead poisoning, examination was directed to these points, and after the administration of iodide of potassium, lead was discovered in his urine, but he still had no blue line and no wrist – drop, and no other manifestation of lead – poisoning. The patient was treated with iodide of potassium, and continued to excrete the iodide of lead, but he steadily grew worse, and died four months after the lead was first recognised. The only source of lead poisoning that could be found was an old kettle; it was tin – lined, and some water boiled in it for some time was subsequently found to yield traces of lead. (Three cases of pseudotabes from lead poisoning have been reported by Dr. J. J. Putnam.) (Bost. Medorrhinum and Surg. Journ., Oct., 1890.)
44. A chemist advised a girl to make vaginal injections of a strong solution of pl. ac., and furnished her with a large quantity of the solution. A friend of the girl’s having asked her what the medicine was for, she replied that it was for purging. Thereupon the friend some day afterwards took a tablespoonful of the solution. Almost immediately she had a violent pain in epigastrium, flushes of heat and perspiration came on her face; she had desire to vomit, weakness, vertigo, confusion, everything seemed to tremble and waver before her; her temples felt as if squeezed in a vice and were the seat of acute shooting pains. She went to the chemist’s, but fell down unconscious on coming thither. The poison had been taken 1/4 h. She got an emetic and water to drink, which caused her to vomit. After 1 hours (9 a. m.) she had violent colics, she pressed on her belly, rolled on the floor, and screamed. The pain was all over the belly. This attack ceased after 2 hours more. She had at same time supra – orbital headache, palpitation. She had 3 tetanic convulsions, her skin was bathed in sweat, she had acute prickings in hands, forearms, throughout the lower extremities, and then the limbs grew stiff, the jaws were closed convulsively; all movements, even standing, was impossible for 10 m.; then she had shivering chilliness, and recovered somewhat. She was taken to the hospital, where she got a quantity of sulphate of soda in solution. Her symptoms on admission were – face little altered, colour pretty bright, skin fresh, pulse very small, rather quick, regular, tongue clean, red at edges. She has a styptic, acrid taste, abdomen soft, sensitive to pressure, especially at epigastrium and left side; on these parts the pain is considerable, and ascends oesophagus to throat. She has had one stool since the accident. She complains of great pain in lumbar region; the menses, which had ceased 2 day previously, reappeared at 9 o’clock. During the day there were frequent chills and 2 or 3 attacks like that described, with pricking on the skin and contractions of jaws and limbs, violent supra – orbital pain, shootings and constriction in temples. Pulse stronger and slower. During n. sleep much disturbed by dreams, more frequent spasmodic attacks, formication in limbs. – Next day, November 18th, same state, giddiness, contraction and shooting in temples, supra – orbital pain, tinnitus aurium, styptic taste, pain behind sternum and in epigastrium, no appetite, tongue red, prostration, fatigue, frequent stupefaction. Seidlitz powder. – 19th. Same epigastric pain, formication and cramps return occasionally, but less frequently and less severely. The purgative has caused several loose stools without colic. – 20th. On account of the continued pain in epigastrium 20 leeches were applied. The following days the appetite returned and she felt pretty well. She has only occasionally formication in the limbs. – 22nd. Left hospital quite well, except a little pain behind sternum and in epigastrium. (Journ. des Conn. Medorrhinum – Chir., Oct. 1st, 1851.)
45. A man, aet. 33, house painter, entered asylum May 28th, 1878. As early as April 14th he had been easily affected and moved to tears, and on this day, suddenly and without premonitions, he lost consciousness, grew pale, collapsed, and only came to himself after some convulsions. This crisis, immediately followed by vomitings, ended in a burst of tears. On the 18th he had a similar attack, and there was persistent sleeplessness. By May 1st, straightened in his affairs, he worried himself immoderately; his disposition sound, he could not bear contradiction, scolded his workmen, did his own work badly. A prey to impulse, he took to drinking, and could not let his wife alone day or night. Sleep failed entirely, or if it came was troubled with frightful dreams and nightmares. He had no memory for recent occurrences. 15th. – He is plunging into excessive expenditure; is continually running away to Paris; has altercations with coachmen; loses his watch or has it stolen, also his money; buys hats by the dozen, and accumulates stores of material for his work. He had previously suffered from arthritic attacks of saturnine origin. He was now put upon K. iod., and on admission to asylum his certificate was ” Folie paralytique. ” He did not know what he was doing, had exaggerated ideas of his wealth, wished to give 50,000 francs to the poor, &c. June 5th. – Delirium of ambitious type, with loss of memory and unconsciousness of his surroundings; he received his wife’s visit unmoved, and did not seem to know that they had been separated. He soiled himself night and day, and was vexed when this was notice. Improvement set in from beginning of July, and went on to complete cure. (Doutrebente, Ann. med. – psych., Mai, 1879.)
46. Man, aet. 60, colour – grinder, had had saturnine troubles in 1875. Two mos. ago he was again seized with severe colic and obstinate constipation; therewith he lost appetite and grew weak. Admitted to hospital Feb. 7th, 1879; though much emaciated, he seemed still vigorous. Skin and conjunctiva were of sub – icteric tint; he complained of sharp darting pains in abdomen, coming on paroxysmally, and bowels had not acted for 10 d. Belly was retracted, and on palpation intestines seemed hard and constricted. Slight localised pressure, as with finger, increased pains, which, on the other hand, were calmed by applying open hand to abdomen. Urine was abundant, amber – coloured, and threw down a copious brick – dust deposit. Tests showed absence of colouring matter of bile. There were no nervous symptoms, and no atrophy of extensors of forearm. L. knee presented a slight arthropathy, but there was complete absence of the usual pains along the limbs. Radial and other vessels were hard and incompressible, and seemed to roll under pressure; sphygmograph showed short and vertical ascent, a prolonged summit, and a regular descent with but slight undulation. There was cardiac dilatation with hypertrophy, and decided pulmonary emphysema, especially on left side. (Hardy, Gaz. des Hopitaux, Sept. 18th, 1879.)
47. a. A man of 30, a year or two after commencing work as a house – painter, began to have what he called rheumatism in his wrists and ankles. They were stiff and lame, and very weak and painful, particularly in the m. when he went to work. After a time he became troubled more and more with neuralgic pains in all parts of the body, and with great pain in stomach and bowels, accompanied with obstinate constipation. About July, 1874, he was obliged to give up the work on account of the severity of the pain, and has never resumed it. His symptoms at that time, as nearly as I can gather them from his mother, were the ordinary symptoms of lead colic, accompanied with more than the usual cachexia. He had great pain in the stomach, and at times in all parts of the body, so severe as to be almost unendurable; most obstinate constipation; great difficulty in urinating, due, I suppose, to a spasm of the muscles around the urethra and of the sphincter vesicae, for great difficulty was experienced in passing the catheter, and the subsequent history has proved there was no permanent stricture.
47 b. June 1st, 1875, I saw him for the first time. His present condition is as follows: He has but little strength, and is barely able to sit in a chair or walk across the room. His teeth are much decayed and loose; the edges of his gums are red and raw and ragged, and frequently bleed, and there is a slight blue line, as spoken of by most authors. His tongue is coated yellow or white, and his breath has, at times, a very fetid smell. His urine is free from albumen, sugar or lead, and is generally natural, but occasionally loaded with a dark brown sediment. His bowels are obstinately constipated, except that a few times he has had slight diarrhoea, and once a mild attack of dysentery. He has several times vomited yellow mucus and bilious matter. His appetite is poor. His sleeps but little at a time, on account of the great pain he suffers. The only time he is free from pain is when he can be perfectly still in bed. His hand is unsteady and trembling, his eyes are at times wild and shiny, and his speech is dragging and slow. He is very sad; has no desire to live, and has threatened to destroy himself; and is very fault – finding with his friends. He has constantly great pain in the bowels, and at times in the testicles and spermatic cord, and also painful drawing in these organs, and contraction of the scrotum. Every day or two he has an attack of spasmodic contraction of the flexor and adductor muscles. His legs are forcibly flexed on the thighs, and the thighs on the abdomen, and sometimes one leg is drawn over the other. His arms are drawn so forcibly against his chest that it is impossible to raise them, and the forearms and wrists are forcibly flexed. The muscles of the neck, particularly the sterno – cleido – mastoid, draw the head clear down upon the thorax, and greatly to one side, and occasionally the head is jerked from side to side. During these attacks he is perfectly conscious; but if he attempts to talk, he stutters and makes peculiar indistinct sounds, but cannot articulate. He also makes a groaning sound, which he says is involuntary. During the attacks of spasm he suffers intolerable pain, and is left completely prostrated when they are over. During his worst attacks the pulse does not exceed 85, and generally it is about 65, full and steady. The rectus abdominis, upon each side, contracts so as to be prominent, and hard almost as bone, and all the muscles attached to the ribs contract so forcibly as to draw them in, and produce such pressure upon them as to cause him to frequently cry out that they are breaking. There is great pain in the muscles of the back, but there has been no spasmodic contraction there. (H. L. Waldo, Amer. Journ. of Hom. Mat. Medorrhinum, Oct., 1875.)
Hughes was a great writer and a scholar. He actively cooperated with Dr. T.F. Allen to compile his 'Encyclopedia' and rendered immeasurable aid to Dr. Dudgeon in translating Hahnemann's 'Materia Medica Pura' into English. In 1889 he was appointed an Editor of the 'British Homoeopathic Journal' and continued in that capacity until his demise. In 1876, Dr. Hughes was appointed as the Permanent Secretary of the Organization of the International Congress of Homoeopathy Physicians in Philadelphia. He also presided over the International Congress in London.