LEAD.
Introduction
Platinum is one of the few metals not proved by Hahnemann. It was first proved by Hartlaub, one of Hahnemann’s followers, and incorporated in the provings are the results from the acetate and carbonate as well as those from the precipitated metal. among the pathogenetic symptoms are necessarily many developed as the result of poisoning, especially by inhalation.
Plumbum is a remedy that we do to begin to use often as it is indicated and it is one that will repay us for the time devoted to its study, and I would advise you all, as soon after graduation as may be convenient, to red the article on this remedy as found in Hughes Pharmacodynamics.
Symptoms
Plumbum produces general interstitial inflammation characterized by proliferation of connective tissue. Various organs, notably the kidneys, heart and liver, become affected when lead is taken into the system and undergo degeneration tending towards sclerosis, or thickening with condensation.
The most striking effects of lead appear to originate from its action on the spinal cord and the nerves proceeding from it, namely colic, with violent contraction of the intestine, nd abdominal walls, and obstinate constipation.
(One of the first symptoms resulting from poisoning by lead is the colic with its terrible griping, tearing pains and retraction of abdominal walls. Dilute sulphuric acid, five drops in water. given in teaspoonful doses, is useful during a severe attack of lead colic; it is supposed to act by forming the insoluble sulphate of lead. Our tincture is not quite as strong as the dilute sulphuric acid is the U.S. Pharmacopoeia.)
Plumbum produces paralysis, first attacking the extensors of the extremities, with the resulting “wrist-drop,” and then becoming general, with terrific pains in the extremities.
Plumbum produces and is useful in severe cases of general anaemia (15), with weakness and paleness, persistent vomiting of food, more or less gastralgia and pronounced constipation. In anaemia it follows well after the use or abuse or iron.
It is also useful in chlorosis (17), with scanty or suppressed menses (134), palpitation and oedema of the feet and general emaciation.
Plumbum causes degeneration of the brain, and epilepsy and even imbecility may result. It is to be thought of in epilepsy and has been given when the attacks are associated with menstruation (67) and accompanied by dysmenorrhoea, colic and obstinate constipation.
Hering is quoted by both Farrington and Lilienthal in reference to the value of Plumbum for epilepsy due to cerebral sclerosis or tumors. a nd he gives as characteristic symptoms for the remedy a sort of paralytic heaviness of the legs before the attack, and prolonged snoring sleep afterwards.
The headache of this remedy is either frontal or occipital, usually with colic and bilious vomiting, and it has been used with success when, with the headache, there was a sensation of a ball rising from the throat (189) into the head.
Mentally we think of Plumbum in slowness of perception and more or less loss of memory (133), due perhaps to cerebral paralysis. In these conditions of cerebral paralysis we would have impaired speech, where the patient is unable to remember words, cannot think of the one he wants, or simply omits words or syllables (18), and with more or less paralysis of the face, throat and extremities.
The blue or slate-colored line along the margins of the gums in cases of lead poisoning is not of special importance for us in prescribing this remedy. In cases of poisoning, this line is due to the deposition of sulphide of lead, formed by “the sulphuretted hydrogen developed from the tartar of the teeth penetrating the tissues of the gums and uniting with the lead” (Ringer). We can keep in mind in looking for this blue line as the result of poisoning, that while it is like the old lady with her knitting at the donation party, one of the first symptoms to show itself and the last to disappear, that it is seldom found except in those who look upon the tooth-brush as an enemy, that it is seen only at the edge of the gums where they cone in contact with the teeth, and that when the teeth are absent, the blue line is also absent.
There is paralysis of he tongue (192), with distinct speech, and paralysis of the pharyngeal muscles, with difficulty in swallowing liquids.
Vomiting is a prominent feature in the gastric conditions calling for Plumb. We have periodic vomiting of food, or of brown or black liquid, as well as faecal vomiting, all associated with violent, compelling had pressure on the abdomen (175) and with relief from eructations (175).
“Lead colic, due to poisoning, may occur without any premonitory signs; the abdominal walls are retracted and rigid and the pains are usually relieved by firm pressure” (Ringer). The colic for which we prescribe plumbum is severe, with pains radiating in all directions, especially from the navel with relief form rubbing, or from firm and hard pressure The walls of the abdomen are tense and hard, with an actual retraction of the abdomen (11) at the umbilical region; the abdominal wall feels as if it adhered to the spine (11). Along with this we are apt to have extreme distention of the transverse colon, or tympanitic distention (13) in circumscribed swelling (13) as large as the fist, and complete obstruction of the bowels, with frequent vomiting, even faecal.
Plumbum is to be thought of in jaundice (122), with nausea and vomiting, as well as in chronic inflammation and cirrhosis (127) of the liver, with vomiting and most obstinate constipation and with darting pain from the liver to the left side and to the back, or with the sensation of a string pulling the liver back ward.
It is a remedy that has proved useful in many cases of incarcerated (114) or strangulated hernia (144).
It is to be thought of in diarrhoea when we as the guiding symptom sensation as of something pulling the navel backward, and with actual refraction.
In constipation, where we find m, ore frequent indications for the remedy, the stools are dark or black (35), scanty and in small, hard balls the sheep-dung stool (35). the effort to have stool is usually without result, for not only is thee a painful spasm of the sphincter (158), “a finger introduced within the sphincter is immediately grasped” (Lilienthal), but there is also a sensation as if a string were pulling the anus into the rectum. Associated with this we are apt to have the colic of the remedy, with the sensation of the umbilicus being pulled much farther back than it is actually retracted.
While Plumbum may be of use in croupous or parenchymatous nephritis, it is a valuable and too often neglected remedy in chronic interstitial nephritis (124).
One of the later manifestations of lead poisoning is an albuminous urine and in an increased growth of connective tissue in the kidney; in other words it causes interstitial nephritis which goes on to cirrhosis. I look upon Plumbum as valuable in any stage of chronic interstitial nephritis, and while the disease presents but few symptoms in the beginning, loss of appetite and strength, headache, anaemia, lessened urea and constipation will serve to recall the remedy to your mind. Later on in the disease we would have as additional symptoms for the remedy; albuminous urine, and a sensation of numbness (146) or paralysis of the extremities; and at the and it would still be indicated in cirrhosis, with a marked tendency towards uraemic convulsions (36).
In the early stages of interstitial nephritis, I believe that Plumbum will cure. In the latter stages, even with the presence of albumin, it will not only have a tendency to hold the disease in check, but I believe that it has improved the condition, lessening the amount of albumin, with the elimination of casts, and increasing the amount of urea. I also use Plumbum as a prophylactic, if the term can be so employed, in suspicious cases of in those with an inherited, and with seemingly gratifying results.
Plumbum has been used in haemorrhage from the kidneys (85), with severe pain in the ureters, and it has proved useful in paralysis of the bladder (22), with difficulty in voiding the urine, or even with retention (200) and dribbling of urine.
The vaginismus (205) of Plumbum is accompanied by the colic of the remedy and perhaps is associated with painful menstruation, and with the dysmenorrhoea we have the characteristic sensation of a string pulling the abdomen back towards the spine
Pregnant women, whether they, or their husbands only, be the subject of plumbism, are extremely liable to abort, and we find Plumbum useful in threatening abortion (13), or for the tendency to abort, from lack of development of the uterus; the muscular fibres of the uterus not developing in proportion to the growth of the foetus.
In the heart we have “change in the muscular structure of the heart without coincident diseases of valves and with or without atheromatous degeneration of vessels” (fatty degeneration of inner coat of arteries), with hypertrophy (110) and dilation of 1. ventricle” (Hering).
