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LEAD                                                                539

abortion has caused death.91   A drop or two of pure lead tetra-ethyl may
cause serious symptoms.92

Fatal Period.—Uncertain. Death may occur on the second or third day.
A man, aged 26 years, died in about 34 hours after taking red lead.93 In
some cases the acute form is followed after a few days by the symptoms of
chronic poisoning.

Treatment.—Give a stomach wash with 1 per cent sodium sulphate solu-
tion or warm water, if the poison has been taken recently. In the absence
of the stomach tube vomiting should be excited by giving simple emetics.
Give 1 ounce of magnesium sulphate to rapidly remove the lead from the
intestinal tract. Give demulcent drinks such as milk, egg white or barley
water. Give calcium gluconate 15 grains intravenously for colic, if neces-
sary hypodermic injection of morphine and atrophine for relieving severe
pain. Later on to help deposition of lead in the skeleton from the blood
stream give slowly 5 to 20 cc. of 5 per cent calcium chloride intravenously,
and 15 to 30 grains of calcium phosphate and sodium citrate by mouth three
times a day. High doses of vitamin D, 100 mg. of vitamin C and plenty of
milk are also recommended.

Aldren Turner04 mentions a new approach to the treatment of lead
poisoning by using a chelate. Ethylenediamine tetra-acetic acid (E.D.T.A.)
forms chelates with certain metals, in particular calcium and lead which are
water-soluble, non-toxic, non-ionised, non-metabolised, and excreted intact
in the urine.

After hospitalising the patient for deleading give intravenous solution of
calcium disodium versenate (calcium disodium ethylenediamine), the con-
centration should not exceed 3 per cent. Dilute one 5 cc. ampoule of 20 per
cent solution (15 .grains) with 250 to 500 cc. of normal saline or 5 per cent
glucose and give by drip method—taking one hour to give it. It may be
given morning and evening for five days, if necessary the same course of treat-
ment may be repeated after a rest interval of two days. The above method
is an effective way of removing lead.

Post-mortem Appearances.—The signs of acute gastro-enteritis are
present. The mucous membrane of the stomach may be thickened and
softened with eroded patches, and may be covered with a whitish-grey
deposit. The same appearances may be observed in the duodenum.

Chronic Poisoning (Plumbism, Saturnism or Saturnine Poisoning).—This
occurs among persons employed in factories and industries in which lead and
its salts are used ; thus, it occurs among painters, compositors, plumbers,
pewters, enamel workers, glass blowers, electric light workers, glaziers, lace
workers, lead smelters, card players, etc. It may also result from tinned
foods contaminated with lead, from drinking water or cider stored in leaden
cisterns and from the constant use of hair dyes and cosmetics containing
lead. M. Bodron,93 Public Health Commissioner, Brest, describes in the
Presse Medicale an epidemic of lead poisoning in which thirty-three persons
were affected after eating bread baked in an oven, which was heated with
wood that had been obtained by breaking old boats. The wood was found
covered with paint that was rich in lead salts. Clayton9G describes an out-
break of chronic lead poisoning amongst yarn workers at Accrington
involving nine women.

91.   Lesser, Vierteljahraschr. f. ger. Med.a 1898 ; Dixonmann, Forens. Med, and Toxic.,
Ed. VI, p. 397.

92.    Thienes, C. H. and Hailey, T. J., Clinical Toxic., Ed. II, p. 100.
93:   Bengal Chem. Examiner's Ann. Rept., 1936, p. 13.

94.    The Lancet, March 26, 1955, p. 662.

95.    Jour. Awer. Med. Assoc,, Nov. 25, 1925, p. 1981.

96.   Brit. Med. Jour., Feb. 10, 1906, p. 311.                                                                   * •