Intense pain in great toe, at night, which nothing relieves. Tearing in the two first toes of the left foot, disappearing on moving about (after three-quarters an hour).
Crawling in the right great toe (after two hours and three- quarters).
Generalities
Complete emaciation. Much emaciated, and looked ten years older than he really was. The atrophy becomes general; the patient resembles a walking skeleton. Atrophy. Emaciation, etc. She had been suffering for five or six years or more from various remarkable spasmodic attacks, and was reduced, by their constant recurrence, from a well-make handsome woman to a mere skeleton. Was frequently seized with violent tonic spasms in the arms, fingers, legs, abdomen, and chest, as if she had been taking strychnine. He was wonderfully emaciated. If placed in an erect position, he fell over in any direction if not supported, and he had not the slightest command over the flexors or extensors of upper or lower extremities, especially the upper, which seemed to have ceased to act at all. The deltoids seemed entirely gone; the head of the humerus could be traced in the glenoid cavity quite plainly; his ribs were covered only by skin; in fact, he looked more like a dried skeleton than a living person. Gradually increasing weakness in her extremities, which she first noticed, she thinks, in her hands and arms. She lost all power over her limbs. She lies on her back perfectly helpless, and presenting literally the appearance of a skeleton. Every muscle in the body is wasted to a very unusual and remarkable extent. Those of the back share in the general atrophy, which, however, is perhaps most of all marked in the muscles of the hands and arms. The fingers are flexed, giving the characteristic “griffin’s-claw” appearance, the flexion being of the phalangeal and not the metacarpophalangeal joints. The interossei seem to have entirely disappeared, so that the finger and thumb of an observer can be made to meet between the metacarpal bones. The radius and ulna can be made out throughout their entire length as distinctly as though covered only by integument. The legs and feet are in a very similar condition. So wasted are the abdominal muscles that the spine can be distinctly felt throughout the lumbar region. At first there was great constipation of the bowels, sometimes no action taking place for a month. This warm succeeded after some months by diarrhoea, and she often passed her motions involuntarily.
Greatly emaciated and very weak. On stripping the patient the clavicular and scapular prominences were very remarkable, the deltoid muscles had well nigh disappeared, whilst the supra and infraspinati were atrophied to such a degree as to present cup-shaped depressions above and below the scapular ridges. The latissimus dorsi and pectoral muscles were soft and slightly atrophied. The biceps and triceps of both arms were wasted, those of the right arm more than those of the left. The extensors and flexors of both forearms were soft and atonic from disuse, but as regards their muscular volume they seemed intact, as also were the muscles of the thumbs and hands generally. The spinal, lumbar, and muscles of the lower extremities were sensibly atrophied, the left extremity generally more than the right, more particularly the left gluteals. The sensibility of the two extremities least atrophied-viz., the right leg and left arm-was increased so that the patient was unable to bear the weakest current of electricity, whereas he could bear electricity strongly applied to the alternate leg and arm. All the paralyzed parts are wasted and insensible to all stimuli. Thus, blisters applied to the thighs and arms may be torn off violently without eliciting any sign of feeling. The general plumpness is strong contrast with the wasted condition of the limbs. Marked emaciation of the limbs and body. The paralyzed parts are wasted; their shrivelled dingy-yellow skin seems loosened from the flabby muscles. The adipose tissue seems to have dissolved; the contour of the muscles has disappeared. The hands are blue and slightly infiltrated.
Emaciation supervenes after fifteen days, a month, or whole years of exposure to the fumes, and only in cases where great quantities have been absorbed, He lost strength and flesh, notwithstanding a good appetite. Emaciated and weak. The muscles loss their contour. General feebleness of the muscular system, the muscles throughout the body being soft and wasted.
Pale and emaciated. The muscles throughout the body are soft and flabby. Muscles are soft and weak. Muscles rather firm, not soft and pliable. Flabbiness and paleness of the muscles. Flesh soft and wasted; his countenance was more emaciated than the rest of his body, and showed profound despondency. Pale and rather emaciated. Appearance meagre. Anaemic and cachectic appearance. She was anaemic, and in a condition analogous to that of a person suffering from paralysis agitans. Profound anaemia. Anaemic and very thin, with a sallow aspect. The whole surface is pale, anaemic-looking, and of a characteristic hue. Anaemia. General cachectic condition and hectic fever. The patient presented a cachectic appearance, pale, anaemic, with a jaundiced tint, Cachectic condition after second attack of colic, which kept him from working for six months. The patient looked like one suffering in a high degree from anaemia and atrophy. Ictero-plumbic appearance. Excessive anasarca. Swelling of the body. Face, feet, and legs have become oedematous. Mucous membranes pale. Mucous surfaces of a waxen hue. Mucous membranes lose their normal color. He was seized with symptoms of asphyxia and died suddenly (after three weeks and four days). Six cases of gout were observed out of one hundred and eighty-four. Had had several attacks of gout. Gout is much more frequent in persons suffering from lead-poisoning than in others; this arthralgia of lead-poisoning is distinguished by the absence of redness and tumefaction; a tumor that appears on the dorsal surface of the wrist, in some cases coincident with the paralysis of the extensors, extends along the tendons, is not changed in color, consistence, or mobility; it is caused by hypertrophy of the tendinous expansions, never commences in the articulations. Dropsies. Diminished secretions and nutrition. The secretions generally are torpid. Consumption. Gangrene. Ganglion. Most pernicious gangrene, General scorbutic symptoms, with ulcers in the lungs. Complete absence of oedema throughout the whole case, through the urine was highly albuminous, and the patient suffered from uraemic convulsions. The number of blood- corpuscles is very largely diminished, in some cases to the number of 2, 200, 000 in a cubic millimeter of the blood; but while the number is so much diminished, their size becomes greatly increased, being relatively to the size of healthy blood-corpuscles, as 9 to 7, true macrocythemia; this increase in the size of the red corpuscles is found not only in cases of acute by also of chronic poisoning. Blood-corpuscles diminished from 1, 800, 000 to 1, 500, 000, and afterwards to 1, 300, 000.
The serum of the blood shows a slight yellow reflection, but with no shade of green. The blood, under the microscope, shows an abnormal number of white globules. Nervous prostration not infrequently destroying life. Death of children within the first three years of their lives. Great mortality among children, especially during the first weeks of life. Apoplexy. He seems as if attacked by apoplexy. Death either by apoplexy or complete wasting with hectic fever. Death either by apoplexy or syncope, with complete immobility and insensibility. Since his sickness, complete suppression of normal perspiration; walking difficult, can only take a few steps, and soon gets tired; disposed to sadness; loss of memory; much emaciation. (In this case the symptoms of poisoning were confined entirely to the parts most frequently brought in contact with the lead cement). Nutrition and all the secretions fail, and the skin becomes dry and discolored.
Electro-muscular contractility of the parts unimpaired. No paralysis, anaesthesia, or hyperaesthesia on the left side. No redness, swelling, or morbid heat of the affected parts. Neither palsy nor anaesthesia affect the right side. No redness or swelling of the painful parts. During the colicky paroxysms he lies flat on his belly, rolls about, presses his fists into the umbilicus, screams. Lies upon his back, apparently much prostrated. Dorsal decubitus. Lies on the back, with limbs relaxed and powerless. At intervals of about five or six minutes there was a short resting spell, when he became quiet, only groaning a little now and then. Lies on his left side doubled up. Decubitus on right side; lower limbs strongly flexed upon the abdomen, and the head sunk between the shoulders, so that he seems doubled up and huddled together. Lies in bed, sometimes one way, sometimes another. When quiet he would lie on either side, generally on his left, with his thighs pressing against the abdomen. He lay upon a sofa, on his right side, having his legs flexed upon his thighs, and these, in a slight degree, upon his abdomen. One other characteristic spoken of by Tanquerel was well marked in this case. It was the approximation to recovery and diminution in force of the attacks, so as to excite strong hopes of a speedy and complete restoration, and then a return of all the symptoms in their severity, followed by another amendment, what I should call getting up three feet and falling back two. After a few days he was taken with the characteristic symptoms of lead-poisoning, the diagnostic blue line on the gums included; he continued to be affected with the disease, with remissions and relapses alternating, for a period of two months, after which the recovery was progressive, though slow. First taken with vomiting, colic, and all the symptoms of lead- poisoning; since then has never been quite well; has an aversion to food; occasional slight colic and constipation. About four months after resuming work had a bad relapse; besides colicky symptoms there was a general debility, tremor in the legs and arms, and some oedema about the ankles; in a few days the hands were paralyzed. (Colic in 1850; second attack 1869; 1871, third attack. Paralysis began; lead-rheumatism set in at the same time with the debility. Since the latter period, sleep has been troubled with nightmare. Since 1871, seven other attacks of colic, each successive one more severe, and accompanied by pain along the limbs, severe headache, and arthralgia; no delirium; no paralysis. In November, 1874, he left off working in lead; nevertheless, January 6th, without apparent cause, he was attacked by very severe colic). For four or five days has had severe symptoms of lead- poisoning; pain in the hypogastrium for two days; headache, restlessness, and even fully developed epileptic attacks for two days. (First attacked when at Montevideo; very severe colic, lasting fifteen days, accompanied by violent cerebral symptoms, so that he lay as if dead for some hours. Two months later another attack of colic, lasting three or four days only, but which he had scarcely got over when gradual paralysis set in, which so disabled him that he had to be fed by hand. Two months later the symptoms returned, only there was less paralysis than the first time). (His health remained good eight years, when he had a violent attack of colic, lasting about three months. Eight years later, weakness of the lower limbs; walking difficult, especially in the dark; from time to time, lancinating pains through the lower limbs; these grew much worse, and he could not clearly see a light). (Has had eight attacks of colic. Present symptoms: Dull colic; paralysis of extensors, of extensors, of long-standing; face much altered; profound cachexia; skin deep yellow). All the symptoms were aggravated at night, and particularly by lying in bed; they produced such a continual agitation and anxiety as to compel him frequently to rise and walk about the house; in this mode he passed the nights, until the light of a new day saw him lie down on his couch worn out by fatigue and exhausted by suffering; these nightly walks always needed the aid of another person, and he retained when walking the same bent position as in repose. Had his first attack of lead colic (quite a violent one) about twenty-two years ago. Had no further trouble of the sort until his second seizure in 1865. For some time previous to the latter date there had been a weakness of his upper extremities, to which, at the time of the second attack, there was added a trembling in them, that became in a few days very great. In a month, however, he left the hospital completely cured. Since then the tremor returned at varying intervals of time, but not very severely. It was worse in the morning, and he informs us that if he drank two or three glasses of brandy it would cease during the rest of the day. The affection had never been such as to prevent him from working. He had other symptoms of alcoholism, such as raising of phlegm in the morning, illusions of sense, etc. In the course of the last two months he had to spend several day in sandpapering some old waist cots painted in white lead, the process raising a fine dust, which he inhaled largely. On July 25th he had another and very severe attack of colic, and the trembling returned at the same time with great violence. According to his custom he took some brandy to relieve this latter symptom, but did not succeed in removing it. Being now disabled from work, he entered “La Charite” August 3d. The tremor affects the whole body. The upper limbs are agitated by rapid and well-defined oscillations. He has some difficulty in grasping objects, but electro-muscular contractility appears to be almost unimpaired. The lower extremities are similarly affected when he is standing up. The gait is uncertain; he staggers in his walk. The head also trembles perceptibly, the tongue quivers, yet there is no hesitation of speech. The dynamometer indicates a marked diminution of strength; the compressive force of the right hand equals seven kilograms, that of the left four and a half kilograms. The first symptoms which I can recall (I now speak of my first attack) are a peculiar uneasiness or moderate pain in the bowels, with a sort of feeling that there was or would be required some action of them, but no effect of the kind ordinarily followed, or could be induced by natural effort. Yet there was at that time no excessive constipation. This uneasiness, or these sensations, were not constant, but grew in frequency, the pain gradually creeping round to the lumbar region, when it became fixed and constant; by degrees, however, diffusing itself over the system, particularly the lower limbs. I do not recollect any pains in my head. But by the middle or latter part of the summer of 1838 I became greatly debilitated, yet was without fever, the pulse not elevated. An uneasiness or pain in the lumbar region now caused me continual suffering. I had a feeling of great misery; could walk but a few steps without wanting to sit down; and if I did so it was a great effort to rise again. I had a sense of constant lassitude or weariness, and an indisposition to motion. I was perplexed by the symptoms. The least fatigue, and all motion fatigued me, aggravated the suffering. I have now a very vivid recollection of going with two or three friends to pass a day at Nantasket Beach. We went out in a boat, and I well remember my sufferings as I lay listless in one end of it, trying by various changes to put myself in a posture of some ease, which I could not succeed in doing. I remember distinctly the question asked me by one of my companions; “Are you in pain?” I was scarcely able to get home. We rode in a carryall, and I remember the difficulty I had in supporting myself, holding as I could by different parts of the carriage. The bowels had now become wholly inactive, and it was, I think, two days, at least, before they could be moved, and then very imperfectly. During this time I was in a most restless state, day and night.
Born in 1837in Westminster, Vermont. . He was an orthodox doctor who converted to homeopathy
Dr. Allen compiled the Encyclopedia of Pure Materia Medica over the course of 10 years.
In 1881 Allen published A Critical Revision of the Encyclopedia of Pure Materia Medica.