The comatose and convulsive forms of encephalopathy may end in dementia.
Urine.-Chronic lead poisoning affects the kidneys and causes a typical red granular nephritis. The urine is very copious, of low specific gravity and contains small quantities of albumin and casts.
Circulation.-Lead poisoning may lead to arteriosclerosis and high blood-pressure. The number of the red corpuscles of the blood is greatly reduced. The drug checks the separation of urates from the blood and their excretion by the kidneys, hence gout is very common in those poisoned with lead.
Sexual.-It causes pregnant women to abort, and for this reason has often been used as an abortifacient. Young girls who work in lead, long before they get colic, suffer from retarded or suppressed menses and become markedly anaemic. An abnormal number of the children whose parents work in lead are idiots or epileptics.
Respiration.-Epistaxis, haemoptysis and consolidation of the apex of the lung occurred in two cases of poisoning (in one case the right and in the other the left).
Sleep is restless, the patient assumes strange postures in sleep and has a constant desire to stretch. With the exception of nephritis and neuritis, there is no organic change that can with certainty be attributed to the action of lead.
The above account of chronic lead poisoning is mainly an abbreviation from “Tanquerel des Planches,” quoted in C.D.P.
THERAPEUTICS.
Nervous System.-As would be expected from the action of plumbum as sketched above, the metal has its principal therapeutic application in the treatment of nervous affections, especially of paralyses, neuralgias and convulsions. An enumeration of the nervous diseases in which it has been found useful will include infantile paralysis, locomotor ataxy, paralyses of local groups of muscles, such as writer’s or piano- palsy, paralyses of pharynx, tongue, eyes and facial muscles, post-diphtherial paralyses, chronic forms of epilepsy, epileptiform convulsions, lock-jaw, neuralgic pains, especially of the sciatic nerves, and those accompanying cerebral or spinal diseases, such as the lightning pains of locomotor ataxy, and crampy pains in various parts which, when occurring in the various parts which, when occurring in the chest, may simulate angina pectoris.
Plumbum will often follow opium in cases of cerebral haemorrhage. Paralyses requiring plumbum are usually preceded by an altered mental condition, the patient becomes slow of perception, his memory is impaired, he cannot find the right word, is anxious and restless, sad and dejected, there may be causeless fright and paroxysms of screaming if the patient is a child, or, if an older person, sudden fainting on passing from one room to another, or on entering a room full of company. Melancholia may be followed by delirium. Certain physical symptoms also commonly precede paralyses, viz., trembling, spasms, shooting pains in the course of the large nerves, violent headaches and dimness of sight.
With paralysis of any part there is wasting, not only of the affected muscles, but of the skin, which becomes shiny and cold, and of subcutaneous tissues from which the fat disappears, so that a paralysed limb is much emaciated and looks like only skin and bone.
Neuralgic pains indicating plumbum are sharp and constant, acute by paroxysms, sometimes lightning-like and wander from part; they are relieved by hard pressure and are worse from motion. Cramps, which are common, may be mistaken for rheumatism. Excessive hyperaesthesia of the skin is an indication for plumbum in post-diphtheritic paralysis, as it may be also in other complaints. Vaginismus, for which the drug is useful, is the result, of combined hyperaesthesia and spasm.
In epilepsy plumbum is indicated in the chronic forms: before the attack the limbs are heavy and numb and the tongue swollen, after the attack there is long-lasting confusion in the head; there is no aura.
Neuralgic pains may alternate with colic, which is the same thing as saying that pain in the nerves of the limbs may give place to pain in the nerves of the intestinal walls, and is an instance of their wandering character.
Digestion.-Plumbum is an important remedy for affections of the alimentary tract when colic and constipation are present. It is useful for gastralgia when pains are very sudden and severe, are relieved by hard pressure and associated with vomiting of food; there may be a sensation in the epigastrium as if a ball rose into the throat and caused suffocation, preventing speaking and swallowing (ignat., rumex., lach.). When the vomited matters are faecal or a brownish blood-stained fluid, and there are abdominal cramps some obstruction of the fluid and there are abdominal cramps, some obstruction of the bowels is indicated. Plumbum is the remedy if with the colic the abdominal muscles are hard and knotty and there is a sensation of retraction of the umbilicus, the patient bends double and presses hard against the abdomen. The symptoms retraction with the colic is very characteristic of this remedy, it may be a sensation only or there is an actual retraction of the umbilicus towards the spine which causes the contour of the abdomen to be concave. The colic is so severe that the pain as it were overflows and radiates to the back loins anus, lower extremities, chest and upper arms. Colic of this description are cured by plumbum, more especially when associated with constipation. A similar colic with diarrhoea requires colocynth. In the plumbum constipation the patient strives in vain to pass a motion being hindered by spasm of the sphincter ani. Faces when passed are hard, dry, black balls or small balls agglomerated, like sheep dung. Plumbum is a remedy for chronic constipation though there is no colic; retraction of the abdomen and the character of the stools are the indications. such a constipation may be due to impaction of faeces from paresis of the bowel, or may be an obstinate habitual constipation caused by long neglect or by the bowel being exhausted by the abuse of purgatives. Plumbum will be useful in cases of incarcerated hernia and in any form of obstruction that is not the to a mechanical cause; in these cases there may be tympanites instead of retraction. It acts by restoring harmonious peristalsis and, probably, by invigorating paralysed sections of the intestines as well as by quieting those in spasm.
Neuralgia of the rectum associated with spasm is relieved by plumbum. It is useful in hepatitis with jaundice, vomiting and constipation when the characteristic colic is present,
Urine.- It is a remedy for retention of urging or the urine is passed drop by drop with great effort, which increases the pain; also for haematuria with severe pain which increases the pain also for haematuria with severe pain down the course of the urinary disease for which plumbum is most valuable is nephritis, especially chronic interstitial nephritis, with abundant urine of low specific gravity and little albumin or anasarca, with hypertrophy of the heart, mental depression and a dry, yellowish skin.
Sexual.- Plumbum is indicated in spasmodic dysmenorrhoea when the characteristic colic and retraction of the navel are prominent symptoms. It is a remedy for abortion when this results from failure of the uterus to develop normally during pregnancy, and for anaemia of an inveterate kind associated with constipation and a tendency to neuralgia; the mucous membranes are very pale and there are great lassitude and prostration.
Respiration.- It has been used in Phthisis in the stage of suppuration, with short dry cough and purulent sputa. It is sometimes of service in haemoptysis when this is due to arteriosclerosis secondary to granular kidney.
Treatment of lead poisoning:-
Acute poisoning: Emetics or washing our the stomach; sodium or magnesium sulphate to form an insoluble sulphate and to open the bowels; morphine or opium to allay the acute pain of lead colic.
Chronic poisoning: Mainly preventive by removing sources of poisoning; sulphuric acid lemonade. Physiological antidotes; alumina aethusa, nux, opium, colocynth (colic).
LEADING INDICATIONS.
(1) Paralyses: of single muscles or groups of muscles, especially of extensors of the wrist.
(2) Colic, with retraction of the navel; with constipation.
(3) Constipation; faeces of dry, hard balls; spasmodic contraction of rectum and sphincter ani.
(4) Neuralgias and cramps, better from hard pressure and worse from motion.
(5) Anaemia.
(6) Coldness; emaciation; earthy or yellowish wrinkled skin.
(7) Slowness of mind and functions.
(8) Hyperaesthesia in acute affections; transient and wandering anaesthesia in chronic affections.
(9) Blue line along margins of the gums.
(10) Atrophy of affected parts.
(11) Chronic interstitial nephritis.
(12) Epileptiform states; spasms.
(13) Abortion.
AGGRAVATION:
From touch, motion, at night in room full of company, mental exertion, lying on left side (palpitation)
AMELIORATION:
From hard pressure, at rest lying down, bending double (colic), stretching limbs.
Edwin Awdas Neatby founded the Missionary School of Homeopathy and the London Homeopathic Hospital in 1903, and run by the British Homeopathic Association. He died in East Grinstead, Sussex, on the 1st December 1933. Edwin Awdas Neatby wrote The place of operation in the treatment of uterine fibroids, Modern developments in medicine, Pleural effusions in children, Manual of Homoeo Therapeutics,