Lead Poisoning.

The first history we have about this condition is where the reference is made in the fourteenth century to the lead miners in England, and in the mineral district of Eastern Germany, who suffered a great deal with a colic, and the use of their hands, and it was attributed to the excessive heat used to melt the lead from the ore. Since that time we have frequent references to the trouble, but it has only been in the last fifty years that a true etiology has been demonstrated. The lead enters the system by the skin, inhalations, or the digestive tract. Those who are occupied in the manufacturing of lead paints, and in the manufacturing of tin, and, less frequent, type-setters suffer oftenest. Often the cause can be traced to where the drinking water has been stored in lead lined or painted tanks, or where the water supply passed through long lengths of lead pipe. Pure water has a chemical action on lead, but the impure waters so often supplied by the companies to the larger cities soon form a coating on the inside of the pipes, which prevents dissolving of any of the lead. Accidental contamination has been caused by the use of hair dyes, cosmetics, the use of canned goods, solder used in sealing these cans, and materials which have been packed in lead foil, as snuff, chewing tobacco, and the use of articles which have been dyed with lead preparations. The symptoms were attributed to the action of the lead on the tissues, the colic by the deposit of the lead in the muscular fasiculi, and in the unstriped muscular fibre cells, and the palsy to the action of the lead in the nerve cells and centers.

Partially it can be attributed to the condition of the arterioles causing anemia of the tissues. More recent investigation seems to show that all the symptoms are due to a direct neurosis. The period of infection may be from a month to several years. From the symptoms manifested, it would be supposed that the morbid changes would be very well marked, but the most striking ones are that the muscles are fatty and fibroid, the kidneys become fibroid and the nerves show a

fatty degeneration. Sometimes small hemorrhages have been noticed in the various parts of the brain, and atheroma of the arteries have been seen. Only the most prominent symptoms will be touched upon. The colic is the most marked, and sometimes it is necessary to make the diagnosis from this one symptom. The pain is located in the neighborhood of the umbilicus, and, on pressure, it is ameliorated. It may be only a dull pain, or, again, very severe and excruciating. The abdominal walls are contracted and sunken sometimes to such an extent that the vertebra can easily be felt through from the front. The pulse is often slowed, being as low as forty beats to the minute. Groups of muscles are attacked with cramps at the same time, and will last very much longer than the abdominal pains. Constipation is always present. The blue line on the gum is almost diagnostic. Muscular paralysis is common, and the extensors are oftener involved than the flexors, causing the drop wrist, which is so characteristic of the disorder.

Recovery depends to a great extent upon the amount of saturation the system has taken with the lead. Ordinary cases recover, but if the patients make themselves liable, by working in the lead again, to other attacks, recovery from the second attack does not give as good prognosis.

The treatment should be energetic from the first and kept up for a long time. The first thing to do is to remove the patient from any danger of further contamination by seeing that everything in the room and all the eating vessels have no lead in the structure of them. The pain is the first thing which will demand relief, and Papine should be given in teaspoonful doses every three or four hours.

The pain, again, can be relieved by the use of hot poultices, or better, very hot baths, for, in the use of the baths the lead is, to a certain extent, eliminated from the system; in the bath, using the sulphuret of potassium about three ounces to twenty-five or thirty gallons of water. Papine, however, will almost instantly relieve the pain. The same treatment can be used for the pain in (Continued on page 976.)

the different parts. In this trouble there is constipation, which is very obstinate, and to relieve this condition there seems to be nothing better than the sulphate of magnesia in large doses followed by large draughts of water, one theory being that this drug, from its action on the lead, forms a soluble salt, which is removed in the feces.

The pain being relieved, the treatment must be directed to the process of eliminating the lead from the system, and for this purpose the bath mentioned is very good, but it should be accompanied by good laxatives and diuretics. The iodide of potassium seems to be the best to cause elimination, and this should be taken in fairly good size doses, followed by large quantities of water. Hot sulphur vapor baths have been recommended for this purpose, and in a few cases have been very beneficial.

For the paralyzed muscles the faradic current of electricity should be used daily to prevent atrophy, or to develop the partially atrophied muscles. Blood producing food should be freely used, together with iron. Strychnine should be used in fairly good size doses to overcome the nervous and muscular symptoms which are manifested.

As a word of precaution to any of the profession who have among their families any who work in lead, if the proper care is taken in reference to food, bathing, and clothing, the danger of being afflicted can be overcome. These people should be scrupulously clean, both in reference to their bathing and clothing, as well as to their food. Frequent hot baths and changing of the clothing, especially the underclothes, should be made, for the clothing soon becomes saturated with the particles of the lead. Todd has recommended hot sulphur baths, and this kind of bath seems to be a very good prophylactic. The sulphuret of potassium, about three ounces, and about twenty-five gallons of water, makes a very good proportion to use in the bath, and if used regularly has a great tendency to prevent plumbism. Mehu recommends hypochlorite of sodium in the bath, which should be as hot as possible. Those employed in lead works should not keep

their dinners in the factory, and when eating their food the hands should be scrupulously clean. The factory should have the best of ventilation, for, if this is carried out, it will do away with a great deal of the danger. Painters, printers, tinners, and zinc workers should all practice the same precautions as the lead manufacturers.-DR. DAVID L. FIELD.

How People Sleep.

In England the old four-poster bedstead is still the pride of the nation, but the iron or brass bedstead is beating it out of the field. The English beds are the largest beds of the world. A peculiarity of the German is its shortness; besides that, it consists frequently, in part, of a large down pillow or upper mattress, which spreads over the person and usually answers the purpose of all the other ordinary bed clothing combined. In the tropics men sleep in hammocks or upon mats or grass. The East Indian unrolls his light, portable charpoy or mattress, which, in the morning, is again rolled together and carried away by him. The Japanese lie upon matting, with a stiff, uncomfortable wooden neck-rest. The Chinese use low bedsteads, often elaborately carved, and supporting only mats or coverlids. The ancient Greeks and Romans had their beds supported on frames, but not flat like ours. The Egyptians had a couch of a peculiar shape, more like an old-fashioned easy chair, with hollow back and seat.-Indian Lancet.

Tape Worm.

One drop of croton oil dissolved in thirty drops of chloroform and one ounce of glycerine, given at night, on an empty stomach, followed in the morning by sufficient castor oil to purge well, will remove tape worm.—Medical Summary.

Dyspepsia.

Dr. H. Y. Neiman, Pottstown, Pa., says: To treat cases of indigestion, acid stomach, and the many forms of a dyspeptic nature, successfully, there is nothing which will take the place of Seng.