Plumbum Metallicum

( Belladonna, Platina, Nux vomica, Cuprum, Opium. Plumbum. < < Opium.

( China. ^ ( Alumina.

The symptoms of Plumbum, or lead, may be studied from its main property, that is, its tendency to cause contraction of muscular fibre, both voluntary and involuntary. It will cause this contraction of muscles, and it will also cause contraction of the bloodvessels, because it affects the involuntary or non-striated muscular fibres. The first symptom that usually follows poisoning by lead, whether taken by the stomach in small doses, as in case of drinking water impregnated with it, or whether by inhalation, as in the case of painters, is lead colic, and this consists of horrible griping cramp-pains, with retraction of the abdominal walls, making the abdomen concave rather than convex.

There is understood to be spasm of the recti muscles; as these are con- tracted, of course they draw the abdominal walls in. Pain radiates in all directions, generally following the course of the nerves, sometimes causing delirium when extending to the brain, dyspnoea when involv- ing the chest, retraction of the testicles when extending in that direc- tion, and violent cramps in the legs when reaching the nerves there. With this colic there is obstinate constipation, and in some cases, even stercoraceous vomiting.

The colic is antidoted by Alumi?ia, Alume?i, Platina, Opium, Nux vomica, Arsenicum, Colocyntk, Sulphuric acid, Zincum, or Belladonna, and is prevented by alcohol.

Next the symptoms of Plumbum that are of a paralytic character. The first characteristic symptom here is wrist-drop from paralysis of the extensor muscles of the wrist. This Plumbum has cured when it has arisen from other causes than lead-poisoning. This paralysis ex- tends to other parts of the body, always involving extensor muscles in

622 A CLINICAL MATERIA MEDICA.

preference to flexors. There appears on the border of the gums a blue line, known as the gingival line of lead poisoning. It is caused by the sulphur that exists in the tartar on the teeth combining with the lead in the bloodvessels, and forming a deposit of insoluble sulphide of lead. As I have said, the paralysis extends and involves other parts of the body, and then it is characterized by atrophy of the affected parts, which is therefore due to true organic changes.

Thus you find Plumbum indicated in paralysis from disease of the spinal cord when that nervous structure has undergone fatty degeneration or sclerosis.

Plumbum suits very nicely that disease known as multiple cerebro- spinal sclerosis. It is indicated by this symptom: tremor, followed by paralysis.

We often find Plumbum indicated in paralysis with contracture.

Progressive muscular atrophy may also call for Plumbum.

Plumbum tends to produce non-development of the uterus. We may, therefore, find it indicated in cases of tendency to abortion. The foetus in utero increases in size, but the muscular fibres of the uterus do not develop in proportion, hence the uterus is no longer able to ac- commodate the growing foetus and abortion ensues.

Sometimes we find Plumbum indicated in delirium, very much like that of Belladonna; the patient bites and strikes at those near him; but it differs from that of Belladonna in this: there is tremor of the head and hands, and yellow mucus collects about the mouth and teeth. The delirium, moreover, alternates with colic, which is not the case in Belladonna .

Other cerebral disturbances from lead-poisoning are not common, but still the following may be met with: insomnia, severe headache, either occipital or frontal, with or without vertigo; noises in ear; dis- ordered vision; diplopia; amaurosis; contraction of pharynx, though liquids are swallowed in gulps and greedily; mind weak, morose, and sad; preceded by albuminous urine.

Plumbum has frequently caused epilepsy. The characteristic symp- toms which indicate it are paralytic heaviness of the legs before the attack, and paralysis and prolonged snoring sleep afterwards. It is especially indicated in convulsions from cerebral sclerosis or tumor.

In constipation you may use Plumbum when the retraction of the abdomen already mentioned is present, and when there is marked spasm or contraction of the sphincter ani. There is urging to stool, and the patient complains of a sensation as though a string were draw- ing the anus up into the rectum.

STANNUM.

It may be mentioned in passing that Baryta carbonica has a colic with retraction of the umbilicus like Lead. Thallium has the same symp- tom as an accompaniment of violent lancinating pains through the stomach and bowels, following each other rapidly like electric shocks. This remedy has relieved the fulgurating pains of locomotor ataxia.

In its action on the kidneys Plumbum produces granular degenera- tion or cirrhosis of those organs. There is very little dropsy or albu- minuria, but a marked tendency to uraemia and consequent convul- sions.