Plumbum

Plumbum metallicum, aceticum, carbonicum.

Preparation , Triturations.

Authorities. (Nos.

1 to 63 , from Hartlaub and Trinks, Mat. Med., 1, p. 8).

1 , Bethmann; 2 , Hartlaub; 3 , Hering; 4 , Nenning; 5 , Trinks; 6 , Act. Nat. Cur. Ann. III, Obs. XXX, effects in a worker in pewter; 7 , omitted; 8 , G. Baecker, Trans. of Coll. of Physicians, in London, and from Percival, effects of applying lead to a troublesome itching; 9 , Bernt, Rettungsmittel; 10 , Boerhaave, Elem. Chem., 2, 454; 11 , J. Alex. v. Brambilla, in Schmidt's Antigoulard, in part, effects of cosmetics in a girl; 12 , De Hæn, Ration. Medendi Contin., iii, 1, p. 403; 13 , Dioscorides, Mat. Med., lib. VI, c. 27; 14 , Ettmüller, Coll. Cons. Cas., 26; 15 , Fothergill, in Abhandl. f. Pract. Ærzte, 3, 519; 16 , Gabreely, in den Abhandl. d. K. Jos. Med.-Chir., Acad., 1, 189, in a woman working in paints; 17 , Gardane, sur l'Électricité Méd. avec des Rech. sur la Colique Métallique, Paris, 1778; 18 , Habenes, in Schmidt's Antigoulard, p. 145; 19 , Hahnemann, in Henke's Zeit. f. die Staats., 7, 1, 151; 20 , Haase; 21 , Hecker, Arzneim; 22 , Hirn, in Schmidt's Antigoulard, p. 94; , J. Fr. Henckel, Ueber die Bergsucht und Hüttenkatze, Freiberg, 1728; , Hermbstædt, from Orfila; , Fr. Hoffmann, in der Aum. zu Lotier Opper. Med. ac Chem., Franckfort, 1698; , Hohnbaum; , Huberthy, in Fischer's Antigoulard, p. 87; , Jahn, Mat. Med., 2, 312; , Laurent, in Fischer's Antigoulard, from external application of lead water to a raw surface; , Lindestolpe, de Venenis, effects of sugar of lead, drank in wine; , Med. Ephem., Chemnitz, 1793; , Mœgling hei Zeller, Docimasia Signa Causæ et Noxæ Vini Lythargyro Mang., Tubniger, p. 24; , Jo. Nardius, Noct. Genial., Ann. 1, Bonon., 1656, 4, No. IV, from internal use of white lead; , Nicander, in Alexi. Pharm.; , Orfila, Toxicologie; , Plenk, Toxicologie, p. 253; , Plinius, Hist. Nat. Lig., 33; , Poterius, Cent. II; , Ramazzini, Diatribe de Artificium Morbis, Batav., 1713, ix, p. 54; , Reinhartz, in Schmidt's Antigoulard, p. 228; , Rhodius, Cent. III, Obs. 10, internal use of sugar of lead; , Richter, Therapie; , Schmidt, Antigoulard, Wien, 1785, p. 231, mostly from the internal use of white lead, in oil and brandy, for gonorrhœa, in a healthy man; , Sennert, in Fischer's Antigoulard, p. 61; , Stockhausen, Libell. de Lytharg. Fumo Noxio Morbifico, etc., Goslar, 1556, 16, p. 10; , Stoll, Ratio Medendi, Th. VII, p. 309; , Streitt, in Schmidt's Antigoulard, p. 186; , Fernelius, de Lue Venereæ, 7; , Thunberg, in den Schwed. Abhandl., 1773; , Tissot, Epist. Med. Pract., p. 222; , Tralles; , Tronchin, Ueber die Kolik von Poitou in Kühn's Samml., Leipzig, 1784, effects in a woman, of sugar of lead, in hæmoptysis; , Wall, in Percival on the poison of lead; , Waderoliet, in den Samml. fur pr. Ærzte, VIII, p. 634; , Vering, in Fischer's Antigoulard, p. 108; , Volpi, in Fischer's Antigoulard, p. 77; , Galen, de Med. Sec. Loc. Lib., 7, effects of drinking water from leaden vessels; , Faber, Lanchymag., Lib. IV, p. 7, c. 32; , Vekos-krift for Lækare, T. VI; , Borelli, Obs. Cent., IV, Obs. 32; , Quesnoy, Traité de la Suppuration, Paris, 1779, effects of the external application of sugar of lead; , W. Cullen, Lectures on Mat. Med., p. 192, effects of applying ext. Saturni in erysipelas; , Redlich, Diss. de Colic Saturn., Lipsiæ, 1800, 4; , Duncan, Med. and Philos. Comment., 1784, p. 202, effects in a man, from frequent bathing a scalded leg with Goulard's lead water; , same, p. 314, effects in several, from drinking water from a leaden cistern; , Bartlett, Med. and Phys. Journ., 1804, p. 403, effects in a typesetter; , Horn., Horn's Archiv., 1807 (Frank's Mag., 2, 210), poisoning of a worker; , Meade, N. E. Med. Journ., 1813, p. 258, poisoning of a family of eight persons, by eating stewed apples that had stood for some time in an eathen, crock, the glazing of which was broken; , Kerkhoffs, Journal Univers., 1820 (Frank's Mag., 4, 677), poisoning by extract of lead, taken for gonorrhœa; , Long, N. E. Med. Journ., 1823, p. 455, poisoning of a family of four, by eating sugar that contained white lead (it was used for five weeks); , same, special symptoms, in Mrs. L.; , Baumer, Rust's Mag., 1824 (A. H. Z., 9, 79); , Archives Gen., 1825 (Lancet, 1825), effects in a worker in carbonate of lead; , same, in a brazier; , Pierson, N. E. Med. Journ., 1825, p. 27, effects in a painter; , Boston Med. Intell., 1827, Oct. 16, case of a painter; , same; , same, in a plumber; , Jackson, Am. J. of Med. Sc., 1827, p. 300, case of worker in white lead; , Hohnbaum, Henke's Zeit. f. Staats, etc., 1827, poisoning of a family by food cooked in an imperfectly glazed vessel; , Roots, Lancet, 1828-9, p. 636, case of worker in white lead; , Milroy, Lancet 1828-9, p. 234, a woman aged forty, swallowed three teaspoonfuls of sugar of lead (was suffering from urinary and menstrual disorders); , Helbig, Heraclides, 1, 51, effects of bathing the hands, forehead, and cheeks with Goulard's water; , same, proving with 1/10000th grain of Acetate of lead; , Lancette Française, 1828, case of worker in lead; , Hamilton, Lancet, 1829-30, p. 356, case of worker in lead; , same, second case; , Bright, Lancet, 1829-30, p. 356, case of painter; , Pittschaft, in Hufeland's Journ., 1830 (Heraclides, 1, 51); , All. Med. Cent. Zeit., 62, 1830, effects of a solution of 1 ounce of sugar of lead; , Barkhausen, Frank's Mag., 3, 613, effects of working in lead; , same, second case; , Chancerel, Journ. de Méd., 1831, a woman, aged seventy, took some oil containing 3 ounces of extract of lead; , , , Duplay, Archiv. Gén. de Méd., 1834 (Frank's Mag., 3, 304), cases of workers in lead; , Latham, Lancet, 1834, 2, 687, worker in lead; , Lancet, 1834, 2, 795, painter; , Zeppenfeld, Caspar's Woch., 1835 (Frank's Mag., 1, 276), poisoning of a man by 2 ounces of the Acetate; , Thompson, Lancet, 1835, 1, 92, a man took about 1 ounce of the Acetate; , Mansa, Hygea, 3, 43, a woman, took 2 ounces of white lead; , Caspar's Woch., 1835 (Frank's Mag., 1, 278), a pregnant woman took 3 ounces of white lead; , Elliotson, Lancet, 1836, 1, 653, painter; , Sander, Caspar's Woch. 1836 (A. H. Z., 9, 12), general effects in a large number of cases; , , Dugas, Bost. Med. and Surg. Journ., 1837, p. 41 (Southern Med. Journ.), effects in printers; , Cross, Lancet, 1837, 1, 849, a woman, aged thirty-three, took 6 to 8 drachms of Carbonate of lead; , Bost. M. and S. Journ., 1837, p. 239, a man, poisoned by peas, that had stood in an earthen jar with imperfect glazing; , Brockmann, Hanover Annals, 1837 (Frank's Mag., 1, 268), diseases of workers in lead; , Bressler, Casp. Woch., 1837 (Frank's Mag., 1, 277), poisoning of a girl, by lead ointment applied to burns; , Annali Univers. (Lond. Med. Gaz., 1837, 1, 948), effects of swallowing about 6 ounces of short on two successive days; , Hornung, Frank's Mag., 1, 800 (Aust. J., 1837), effects of 4 ounces of the acetate; , Seymour, Lancet, 1838-9, 30, effects in a painter; , Montault, Journ. de Méd. et Chir., 1838, working in an atmosphere of lead; , Tauflieb, Gaz. Méd. de Paris, 1838, application of lead plaster to an ulcer on the leg; , Bayrenson, Journ. de Chim. Méd., 1839, effects of a solution of the acetate ( to , from Tanquerel des Planches, des Mal. de Plomb., Paris, 1839); , "primary effects of various preparations;" , a workman drank wine containing litharge; to , workers in lead; , effects of daily doses of the Acetate, 3 to 24 grains, for two weeks, for cardiac hypertrophy; , same, repeated; , , workers in lead; , effects of injecting into the vagina Goulard's solution for uterine hæmorrhage at the menopause; , effects of taking the acetate for several days, in a man; to , effects of working in lead; , effects of eating bread baked in an oven heated by wood covered with white lead, Tanquerel, l. c. 2, 267; to , effects on workers in lead; , effects in a young man, from taking the Acetate for seminal emissions; to , effects on workers in lead; , Alderson, Med.-Chir. Rev., 1840, 32, p. 11, a woman, aged twenty-five, worker in a lead factory; , same, in a man, from drinking water from a leaden cistern; , Villeneuve, Journ. des Conn. Méd., 1841, a girl took 1 ounce of the Acetate in solution; , Budd, Lond. Med. Gaz., 1841, 1, 411, a painter; , omitted; , Williams, Lond. Med. Gaz., 1841, 1, 478, in a painter; , Schilbach, Fror. Notizen (Lond. and Ed. Med. J., 1841, 1, 220), poisoning of six persons by eating flour that contained lead; , same, one individual; , Buchner, Œst. Med. Woch., 1841 (Hygea, 15, 430), worker in lead; [The autopsy showed that the kidneys were less than half their natural size, granulated, dirty white, with numerous blackish-blue pigment-like deposits, and with cysts containing brownish serum.]; , Johnson, Prov. Med. and Surg. Journ., 1841, effects in a plumber; , Beer, Œst. Woch., 1841 (Frank's Mag., 1, 779), working in lead; , Wilson, Med.-Chir. Rev., 1842, p. 40, worker in lead; , Ann. d'Hyg. Publique, 1842, six persons poisoned by cider, that had stood in a leaden vessel; , Bryce, Lancet, 1842, 1, 498, a man swallowed 3 ounces of shot, in three days, for a boil; and , Shipman, Am. J. Med. Sc., 1843, p. 89, several persons were poisoned by cider from a tub newly painted; , Otto, Zeit. f. die Ges. Med., 1843, poisoned by snuff containing red lead; , same, in a young physician; , Knapp, Rust's Mag., 1843, lead poisoning; , Snow, Lancet, 1844, 2, 144, a child ate white lead, a piece as large as a marble, death on fourth day; , Schrœder, Med. Zeit. f. Preuss., 1844, in a painter; , Schubert, Casp. Woch., 1844, a man poisoned by 5 or 6 drachms of lead; , Otto, Frank's Mag., 3, 887, a girl took 3 drachms of the Acetate ( to , from Morea, l'Empoisonnement aigu par le Plomb. et ses Composés, Paris, 1875); , Reynaud and Porral, poisoning by the Acetate; and , workers in lead; , poisoning by the Extractum Saturni, from Rabateau, Toxicologie; , Boudant, poisoning by 1 ounce of the Acetate; , Pearle, Lond. Med. Gaz., 1845, effects on a man and children of drinking water through leaden pipes; , Journ. de Pharm., 1845, effects of 300 grains of Carbonate of lead, in a man, suffering from heartburn; , Melion, Prag. Vjs., 1845 (Frank's Mag., 3, 612), a girl took 1 ounce of the Acetate; , Rumpelt, Diss., Dresden, 1845 (Œst. Zeit. f. Hom., 3, 205), general effects; , Evans, Lon. Med. Gaz., 1846, 1, p. 997, worker in lead; , Gœringe, Prov. Med. and Sur. Journ., 1846, 1 ounce of the Acetate, in a girl; , same, in another girl, same quantity; , Chowne, Lancet, 1847, 1, p. 173, from sleeping in a newly-painted room; , Schonemann, Journ. de Kinderkrankheiten, 1849, poisoning of children by water containing lead; , same; , same; , De Mussey, Dublin Med. Journ., 1849, p. 405, effects of water from leaden pipes, in thirteen persons; , Banks, Lancet, 1849, 1, 478, poisoning of about five hundred persons by thirty pounds of lead mixed with eighty sacks of flour; , Leboucher, poisoning of a girl by the Acetate, Journ. d. l. s. Gal., 2, 597; , Curie, Clin. Lectures, N. W. J. of Hom., 1850, p. 23, worker in lead; , Pluskal, same, poisoning by lead from a charge of shot in the leg (no local trouble); , Murphy, Br. and F. Med.-Chir. Rev., 1852, 2, 258, effects of chewing lead; , Orfila, Toxicologie, working in lead; , same; , Thouvenet, from Orfila, effects of about 1/2 ounce of the acetate, in a woman; , Robertson, Lancet, 1851, 1, 202, about twenty girls poisoned by water from a leaden cistern; and , same, individual cases; , Capello, Bull. Gén. de Thérap., 1851, a man was accustomed to chew leadfoil; , Challiss, Trans. Am. Med. Ass., 1852, p. 197, effects of water from leaden pipes; , same; , Garrison, same reference, effects of water through leaden pipes; , same, on himself; , Adams, ibid., same cause; , Howe, ibid., same cause; to , same; , Crosby, ibid., same cause; to , same; , Birdwell, ibid., same cause; and , same; , Dalton, same; and , same; , Stimson, same; and , same; , Dr. Francis Black, general effects, Appendix to Br. J. of Hom., 1; to , various authorities cided by Black, l. c., lead poisoning; , Anderson, Am. J. Med. Sc., 1853, worker in lead; , same; , same, effects of water drawn through leaden pipes; , same; , Eichmann, Gaz. des Hôp., 1854, poisoning of two children by sucking enamelled cards; , Spengler, Med. Cent. Zeit., 1854, effects of a solution of 1/2 ounce of the Acetate, in a man; , Addison, Med. Times and Gaz., 1856, p. 643, worker in lead; , Cabot, Bost. M. and S. J., 1856, p. 21, vol. liv, effects of water from lead-lined tanks; , Buck, Bost. M. and S. J., 55, 428, effects of water from leaden pipes; , Hyde Salter, Lancet, 1857, 1, 649, effects in a compositor; , Boufils, L'Union Méd., Feb., 1857, a boy poisoned by cider containing lead; , Muller, Zeit. f. V. Oest., 1857, 1, 49, thirteen persons poisoned by water from lead pipes; , Sieveking, Med. Times and Gaz., 1857, 1, 163, effects in a plumber; , Jachimowiez, Zeit. f. V. Oest., 1857, 2, 418, woman, worker in lead; , Leudet, ibid., workers in lead; , Leared, Med. Times and Gaz., 1858, 1, 295, effects of 1 ounce of the Acetate; , Kingsbury, N. Y. J. of Med., 1859, water from leaden pipes; , O'Connor, Dubl. Med. J., 1859, case of a plumber; , same; , Mattei, Gaz. des Hôp., 1860, No. 62, poisoning of a married woman; , Addis, Lancet, 1860, 1, 33, 3/4 pint of Goulard's Ext., in a girl, aged twenty-one; , Chambers, ibid., worker in lead; , Rees, ibid., from water containing lead; , Johnson, ibid., effects of scouring pewter pots; , Schotter, Virchow's Archiv., 1859, effects of frequent application of a leaden plate to the hair (covering the head with a sheet of lead at night, so that only a small portion of the face was uncovered); , Moore, Br. and F. Med.-Chir., Rev., 1861, 2, 382, painter; , Falconer, Br. Med. J., 1861, 464, plumber; , Fouquet, Wien. Med. Woch., No. 11, 1861, 1 ounce of Acetate, in a man for spasmodic dysuria; , Boreland, Bost. M. and S. J., 1862, 66, 453, by water from a leaden tank; to , Ollivier, Archiv. Gén. de Méd., 1863, workers in lead; , Reynolds, Lancet, 1863, 2, 507, a man, with phthisis, took 4 grains of Acetate daily for twenty-seven days; , Gonzales, El Criterio Med., Jan. 1864 (Am. Hom. Rev., 4, 551), from pickles kept in a glazed jar; , Ward-cousins, Med. Times and Gaz., 1864, 2, 279, from use of lead cosmetics; , ibid., p. 569, worker in lead; , Wilkshire, Lancet, 1864, 2, 67, painter; , Memorabilien, 1864, p. 245, worker; , ibid., from holding type in his mouth; , Fleming, Br. Med. J., 1865, painter; to , workers in lead, ibid.; , Garrod, Lancet, 1866, 1, 345, plumber; , Marmisse, Gaz. des Hôp., 1866, No. 25, exposed to fumes of lead; , same, poisoning; , Bowditch, Bost. M. and S. J., 1867, 76, 37, a boy aged eight, effects of drinking water through leaden pipes; , Wilks, Lancet, 1867, 1, 9, from water through leaden pipes; , Clapton, Med. Times and Gaz., 1868, 2, 611, worker in lead; , same; , same; , effects of inhaling steam from leaden pipes; , worker; , painter; , same; , Murchison, Lancet, 1868, 2, 215, painter; , same; , same, cleaning pewter vessels; , same, painter; to , Hitzig, Studien ueber Blei-vergift, Berlin, 1868, effects in workers in lead; , Gubler, Med. Times and Gaz., 1869, 2, 7, in a plumber; , same, in a painter; , Woodman, Med. Times and Gaz., 1869, 1, 222, in a worker; , same; , same, in a painter; , same; , same, from cider containing lead; to , Lafont, sur le Tremblement Saturn., Paris, 1869, effects on workers in lead; , Delaine, l'Hahnemannisme, 1869, poisoning, in a girl; , same, worker in lead; , Dalton, Bost. M. and S. J., 44, 356, in a child, from water drawn through leaden pipes; , Duroziez, Gaz. des Hôp., 1869, No. 143, painter; to , same, workers in lead; , Garrod, Lancet, 1870, 2, 781, worker in lead; , Johnson, Br. Med. J., 1870, 2, 325, worker (glazed cloth); and , Bial, Die Chron. Blei-vergiftung Diss., Berlin, 1870, workers in lead; , Taylor, Lancet, 1870, 1, 428, several cases of poisoning by beer containing red lead; , Baker, Trans. Obstet. Soc. of London (Br. J. of Hom., 29, 709), a woman, in the habit of washing the clothes of her husband who worked in lead; , same, painter's wife; , Paul, Archives Gén. de Méd. (B. J. of Hom., 1871, 707), a woman worked cleaning type; , same, histories of eighty-one cases; , Hoyne, U. S. Med. and Surg. J., 1871, p. 171, lead poisoning; , same; , Lancereaux, Gaz. de Paris, 1871 (S. J., 154, 146), general effects; , Nankivell, Hom. World, 6, 80, from bathing a wound with Goulard's lotion for several days; , Schneller, S. J., 153, 318; and , Kersch, Memorabilien, 1872, p. 289, two children, poisoned by holding pieces of lead in the mouth; , Riemer, Corr. Bl. f. Schw., 1872, p. 17, chronic poisoning; , Hollis, Br. Med. J., 1872, 1, 154, worker in lead; , same; , Townsend, Phil. Med. and Surg. Rep., 1873, p. 33, worker; , Lewis, Med. Times and Gaz., 1873, 1, 84, workers; , Leidersdorf, All. Wien. Med. Zeit., 1873, painter; , same; and , Wurt. Corr. Bl., 1873, workers in lead; , Smith, N. Y. Med. J., 1873, from water drawn through leaden pipes; , Bottentint, l'Union, 1873, worker; , Browne, Lancet, 1873, 2, 146, painter; , same; , Samuelsohn, Monatsbl. f. Augenheilk., 1873, worker in lead; , Brown, Hahn. Month., 9, 88, from cosmetics containing lead; to , Gaffky, Ueber d. ursachlichen zusamunhang zwischen chron. Blei-intox. und Nieren-affect. Diss., Berlin, 1873, workers in lead; , Roque, in Mouvement Med. (M. H. Rev., 17, 119), observations on a series of selected cases; to , Elgnowski, zur casuistik d. Blei-lähmungen Diss., Berlin, 1873, workers in lead; , Bouchardt, M. Hom. Rev., 17, 504, observations; to , von Tunzelmann, Br. J. of Hom., 32, 17, cases of poisoning by well water containing lead; , Malassez, Gaz. Méd. de Paris, 1874, observations in a large number of cases; to , Manouvriez, Recherches clin. sur l'intox. Sat., Paris, 1874, effects in workers in lead; , Earle, Am. J. Med. Sc., 1874, p. 279, a family poisoned by water containing lead; , Shearmann, Practitioner, 1874, from drinking rain water from a leaden roof and leaden cistern; , same; , Danjoy, N. Y. J. of Hom. (from the French), 2, 210, workers in lead; , Lancereaux, ibid., workers; , Ollivier, ibid.; to , De Cours, De l'Hemi-anestésie Saturnine, Thèse, Paris, 1875, workers in lead; , Waldo, Am. J. Hom. Mat. Med., 9, 48, in a painter; , Halma Grand, Thèse, Paris, 1875, workers; to , Renant, De l'intox. Saturnine, Paris, 1875, in workers; , same, in mothers; , same, in fathers; to , same in workers in lead; , Bucquoy, Gaz. des Hôp., 1875, No. 90, worker; , Johnson, Med. Times and Gaz., 1875, 2, 233, cosmetic containing lead; , Moreau, Empoisson. aigu par le Plomb, 1875, Paris, suicide of a woman by the Extract. Saturni; , Dowse, Lancet, 1875, 1, 545, painter; , Norris, Lond. Med. Rec., 1875, p. 277, from using a cosmetic containing lead; , same; , Popp, Bay. intell. Bl. (Am. Hom. Obs., 12, 47), in a worker; , Berridge, Med. Invest., N. S., 1, 101, in a painter; , same, a child swallowed some white lead; to , Remak, zur Pathogenese der Blei-lähmungen Diss., Berlin, 1875, workers in lead; , same, in a girl from use of cosmetics for five months; , same, another case; , Knott, Lancet, 1876, 2, 531, from beer that had remained over night in a leaden pipe, taken every morning for three years; , Pepper, Phila. Med. Times, 1877, 148, a packer of litharge; , Franziska Tèburtius, Inaug Diss., Zurich, 1876, a painter; , Turnbull, Edin. Med. J., April, 1877, a boy swallowed a bullet; , Hardenhewer, Berlin Klin. Woch., 1877, lead poisoning treated by Jaborandi; , Frank, Deutsch Archiv. f. Kl. Med., 16, 3; to , Da Costa, Med. and S. Rep., 1867, in workers; , Milner, N. O. Med. and S. J., 1873, effects of water from leaden pipes; , Tompkins, Virginia Med. Rec., 1874, p. 14, a girl, aged twenty-five, took 1 drachm of Acetate of lead three times first day, and once second day recovery; , Corson, Canada Lancet, 1874, p. 141, effects of water from leaden pipes; , Williams, ibid., p. 69, in a painter; and , Fearnside, Liverpool Med.-Chir. J., 1848, effects of drinking water from a leaden cistern; , Orr, Ranking's Abstract, 32, 195, a worker in lead; , Jones, Lancet, 1867, 1, 4 painter; , Gubler, Med. Times and Gaz., 1869, 1, 531, general effects; , Neftel, Centralbl. f. Med. Wiss., 1868, effects in three women; , Maschka, Wien. Med. Woch., 1871, poisoned by the Acetate; , Ramskill, Br. Med. J., 1875, 1, 559, twenty-five, workers in lead; , Johnson, Med. Times and Gaz., 1875, 2, 233, from cosmetics, in a woman; to , Dowse, Med. Times and Gaz., 1876, 1, 357, three female workers in lead; to , Pauvert, De la Colique de Plomb., Thèse, Paris, 1877, workers in lead; , Reich, S. J., 176, 11, poisoning of a child by leather containing lead; , Ledetsch, Wien. Med. Presse, 1877, from preserves kept in a badly-glazed jar; , Raymond, Gaz. de Paris, 1876; and , Brochin, Gaz. des Hôp., 1875; , Lepine, Gaz. de Paris, 1875, worker; , Boucheret, Hurbain and Leger, Archiv. de Phys., 1877, p. 424, worker in lead; and , Johnson, Chicago Med. J. and Exam., 1877, two girls used a cosmetic which contained lead; and , Richardson, Boston Med. and Surg. J., 1877, p. 379, workers in lead.

MIND

• Delirium, 39, 53, 85 , etc.
• Most violent delirium, with screaming and running about the room, succeeded the epileptiform spasm, 94.
• Delirium, resembling the most frightful kind of madness, and impelling them to tear themselves and bite their own fingers, 171.
• Furious delirium, resembling delirium tremens, 476.
• Raging, alternating with quiet, delirium; the former came in paroxysms; no fever, 170.
• Delirium, with violent raging, so that he had to be put into a strait-jacket, with hallucinations of vision, 444.
• Raging delirium, 46.
• Furious delirium, 305.
• Violent delirium, at night, 35. [10.]
• Violent delirium set in and continued for some days. As the delirium declined, the mind did not recover its clearness and integrity, on the contrary, his sensations and perceptions were vitiated and erroneous. Various morbid ideas took possession of him, and some of them remained, and continued to manifest themselves for many months after his apparent restoration to health, 561.
• The delirium tranquil during the day, furious at night, 305.
• Complete rage, 28.
• Delirium, with bewildered expression, 35.
• Delirium, with very violent convulsions, 96.
• During the third day of delirium, he was awake, sometimes quiet, sometimes violent, but almost totally irrational. Pulse, 80; skin rather hot, 191.
• Delirium, for three days (in a previous attack), 222.
• Delirium, with trembling of the tongue and hands, 578.
• At times delirious, 276.
• Nightly delirium, alternating with sopor, 235. [20.]
• He was at times delirious, very restless, and manifested great concern for his affairs, 279.
• Delirium, alternating with sopor, 237.
• Tranquil delirium, 305.
• Appeared to be rapidly recovering, when he was suddenly seized, about 11 A.M., with furious delirium, attended at intervals, by general spasms. It was astonishing to see him, who, three hours before, could only pronounce with difficulty a limited number of words, whose voice was weak, and whose utterance was faint and drawling, now talking incessantly, and pouring forth shouts, screams, and abuse against all who approached him. His voice was loud and clear. His delirium turned chiefly upon the idea that . His muscular strength was increased to such a degree, that, with one hand, he could lift all his mattresses at once with the greatest ease. He left his bed, and walked about briskly, knocking against every obstacle at random. His face was flushed; his eyes sparkling and fierce. At last a strait-waistcoat was put on him, which heightened his fury. Pulse, 65; heat of body rather increased. The delirium lasted about half an hour, when it was succeeded by coma, during which he lay stretched out and motionless, with closed eyes and somewhat pale face. Strong stimulation could only draw forth a few unmeaning grunts. An hour later, the delirium suddenly returned, to be followed again by coma, and thus, all that day and night, the opposing conditions alternated, .

Make haste and get up ." His limbs were tremulous. His constant efforts to get out of bed made it necessary to put him in a strait-waistcoat; he struggled hard against it, screamed, howled, uttered threats; became red with passion, and tried in every way to break loose; called out to the passers by and begged them to set him free. During the day, he was sometimes quiet and silent; sometimes furious at the thought of being tied. He was never sleepy. Fancied, at times, that he heard delightful music, which soothed his sorrows, 187.

• His utterance is drawling, difficult and frequently broken; so that he talks like a child who has not learned to speak plainly; instead of " oui ," for example, he says " ui ." Sometimes he cannot get hold of the right word; then he frets and worries himself, and now and then becomes quite desperate. This difficulty seems to be met with chiefly in the case of substantives ; with adjectives, the intellect and organs of speech deal more easily, 195.
• His colic was almost cured, when the nurses and his fellow-patients observed that his intellect was affected, and that he wandered in his speech, but to so slight an extent, that the aberration escaped the notice of the medical attendants. He lay quiet, with closed eyes, as if in a peaceful sleep; when pinched as hard as possible he showed no sign of sensibility. When the fingers, hands, forearms, or arms were placed in any position, and left unsupported, they remained there for a few seconds, then oscillated a little, and fell back on the bed. This experiment was repeated several times, with the same result. The body was rigid, so that he could not be made to sit upright, and his attention could not be aroused for a moment. Suddenly he began to make a great variety of the most expressive gestures, at first with one arm only, but soon the other arm, the legs, trunk, head and face, all took part in these movements, which were performed in co-ordination, and seemed to express the same idea. Every moment he appeared to be possessed by the most dissimilar and grotesque conceptions, which he embodied in this way. At the same time he cried out, and tried to speak, but was prevented by the liquid in his mouth. If, at this time, he was gently pinched, he showed by an abrupt movement, that he felt acutely. The upper limbs no longer remained fixed in any position they were placed in; they were too stiff to be moved at all. After the movements had lasted some minutes, they were succeeded by a state of absolute quietude, and he lay just as he done before they commenced; then they began again, to be again followed by a period of repose, and so on, in alternation. Now, he indicated, by a significant gesture, that he desired to eat and drink; now he suddenly spouted the ptisan, which he had been holding in his mouth, all over the surgeon in attendance. Then came an interval of quiet and unconsciousness, during which his limbs remained in any position they were made to assume. Next was witnessed a series of the most expressive gestures, although he kept his eyes shut, and uttered not a single word. Their significance is constantly varying; sometimes they seem to indicate rage, sometimes despair, sometimes entreaty, sometimes the most profound meditation. At last he suddenly opened his eyes, called for drink; then seemed to fall asleep again while swallowing his ptisan, but is easily aroused by being spoken to; then he opened his eyes fully, began to talk about his mother, and while rambling volubly from one incoherent idea to another, still answered questions rationally. Left to himself, he talked incessantly, followed up an idea for a minute or two, and then left it for another. At one time he became much agitated, tried to get up, addressed the doctors, abused them, tried to strike and bite the nurses when restrained; and at last, shouting and struggling, was put into a strait-waistcoat. On the second day of the delirium, he was lying quiet, with eyes half open. Soon he aroused completely, began to talk very fast, and at first answered questions rationally. But after conversing a few minutes, his thoughts became confused, and he began to ramble and talk to himself. By attracting his attention again, he could be brought back to the original topic, then got off the track again, and so forth; so that his talk was a mixture of sense and nonsense. He was frequently influenced by the most grotesque delusions; he fancied that a cavalry regiment was about to fall upon him; or that he was in the presence of his employer, who was finding fault with him. His face looked rather wild; at times he bursts out laughing. His head was full of notions. He recollected very well what happened a month or more ago; but could not call to mind things that occurred only a few days before his delirium set in, .

HEAD

• Vertigo.
• Vertigo, 20, 21, 47, 56 , etc. [220.]
• Vertigo, almost immediately; everything seemed to tremble and whirl before her, 268.
• Vertigo, immediately, 274.
• Frequent vertigo, 28.
• Vertigo, and intoxication in the head, 46.
• Vertigo, on stooping or on looking up (eighth day), 5.
• Vertigo and convulsions, 326.
• An attack of vertigo, of short duration, 384.
• One patient had vertigo and convulsions several times, 266.
• Often suddenly seized with slight attacks of vertigo, 492.
• Frequent dizziness (second day), 268. [230.]
• A dizzy feeling, vanishing in the open air (after two hours and three-quarters), 4.
• Attacks of giddiness, 566, 567.
• Giddiness frequently, when stooping, 269.
• General Head.
• Trembling of the head, 92.
• Head turned to the right, its rotation to the left being prevented by paralysis of the sterno-cleido-mastoid muscle of that side, 114.
• Heaviness of the head, 429, 449, 479, 483, 485, 486.
• Heaviness of the whole head, especially in the occiput, with slight stitches in the sinciput (after two hours), 2.
• Heaviness of the head; it falls forward (after two hours and a half), 4.
• Heaviness in the whole head, except in the occiput, with slow stitches in the sinciput, 2.
• Heaviness of the head; it falls forward (after two hours and a half), 4.
• Heaviness in the whole head, except in the occiput, with slow stitches in the sinciput, 2.
• Head heavy, without real pain, . [240.]

EYE

• Objective.
• Eyes swollen, painful, 35.
• Eyes wide open, fixed, and hard, 173.
• Eyes wide open and fixed, 181, 186.
• Sometimes the eyes are half open, sometimes kept wide open, but generally they are closed; when opened, they are wild-looking or fixed, looking nowhere in particular, 201.
• Generally a fixed look, 153, 566.
• Eyes fixed, and at times wild-looking, 195. [330.]
• Eyes staring, 360.
• Eyes wild and rolling, 315.
• Eyes wild, 186.
• Eyes rather wild, 188.
• Eyes at times wild and shiny, 499.
• Eyes glistening and protruding, 248.
• Eyes brilliant, and projecting from their orbits (after one hour), 256.
• Left eye quite transparent; iris slightly contracted by artificial light, 168.
• Eyes unnaturally prominent, 562.
• Protruding eyes, 235, 253. [340.]
• Eyes hollow, and surrounded by blue rings, 122.
• Eyes hollow and quite dim, 120.
• Eyes sunken, 240, 278, 432.
• Eyes hollow, and surrounded by blue rings, 176.
• Blue color around eyes, the rest of the face having a decided dingy-yellow color, 222.
• Blue rings around the eyes, which are somewhat sunken, 519.
• Hypopium, 43.*
• Convulsive twitching of the muscles of the eyes and in the hands, 575.
• Frightful distortion of the eyes, 56.
• Twitching of both eyes (after two hours and three-quarters), 4. [350.]
• Squinting, 168, 432.
• Strabismus; one eye turned in toward the nose, and he could not roll it out; the external muscle of the eye was paralyzed; he could see distinctly as ever with either eye separately, but when he looked with both the object appeared double, .

EAR

• Tension in the region of the right ear and the corresponding cervical muscles (after two hours and a half), 4.
• Right arm painful; sensitive to pressure; lancinations from the shoulder towards the bend of the elbow, 486. [500.]
• Tearing in the region of the right ear, after dinner, 4.
• A fine stitch extending into the lobule of the right ear (after one hour), 4.
• Boring in the right ear, after dinner, 4.
• Transient pains within the left ear and in the meatus auditorius, 3.
• Tearing deep in the right ear (after half an hour), 4.
• Tearing deep in the left ear (after two hours and a half), 4.
• Sticking tearing within the right ear, whence it extends to the concha (after three-quarters of an hour), 4.
• Sticking in the right ear, while standing, in the forenoon, 4.
• Scratching in the right ear, as from a spear of grain (after a quarter of an hour), 4.
• Hearing.
• Great sensitiveness to slight noise, 96. [510.]
• Hearing, which for some time has been entirely lost in the right ear, is to-day duller than usual, 476.
• Difficult hearing and numbness, 20.
• Dulness of hearing since exposure to cold, 269.
• Very hard of hearing, especially on the right side, 527.
• Frequent sudden, transient diminution of hearing, in the evening, 4.
• Impaired hearing in right ear, 488.
• Hearing much diminished on the left side, 528.
• Weakness of hearing, 433, 483.
• Difficulty of hearing, 429.
• Hardness of hearing in right ear, 481. [520.]
• Hard of hearing in the left side, 450.
• Partial deafness, 134.
• Deafness of right ear, 487.
• Deafness, especially on the right ear, worse at times, 471.
• Vanishing of hearing, .

NOSE

• Objective.
• Erysipelatous inflammation of the nose, 3.
• Sneezing (after seven hours), 4.
• Constant irritation and ineffectual sneezing (after three-quarters of an hour), 4.
• Hæmorrhage from the nose during the convulsions, 429.
• Habitual and profuse epistaxis, 511.
• Nosebleed with the second attack of spitting blood, 463.
• Frequent bleeding of the nose, 237. [540.]
• Frequent copious epistaxis, 235.
• Oozing of blood from the nostrils (fourth day), 246.
• Fluent coryza, with watery mucus, soon disappearing (after three-quarters of an hour), 4.
• Fluent coryza without sneezing (third and fourth days), 2.
• Fluent coryza, in the afternoon, lasting an hour, 4.
• Water runs from the nose, during dinner, 4.
• Much tenacious mucus in the nose, that he, however, cannot blow out, is only able to draw it backward through the posterior nares, where most of it seems to be accumulated (second day), 2.
• Mucous membrane of the nose dry, 575.
• Subjective.
• Stoppage of the nose, 5, 450.
• Sensation of stoppage in the nose, she is unable to blow it (third day), 4. [550.]
• Pain in the tip of the nose, 3.
• Sharp drawing pain in the right ala of the nose, and in the upper lip, 305.
• Painful tearing in the septum of the nose in the right side (after five hours), 4.
• Itching of the left nostril, relieved by scratching, in the afternoon, 4.
• Smell.
• Very bad odor from the right nostril, much less from the left, 497.
• Horrible smell, 28 . [Effect of large doses.]
• Sense of smell almost lost in the right nostril; less diminished in the left, 523.

FACE

• Countenance wild looking, 197.
• Frequent sardonic smiling, 190. [560.]
• Look confused, 35.
• During the colicky attacks, the face was expressive of the utmost anxiety, 213.
• Most anxious countenance (after five hours), 107.
• Face expressive of extreme anxiety and suffering, 209.*
• Countenance anxious and sunken, frequently of a peculiar livid hue, 267.
• Peculiar anxious and distressed countenance, 302.
• Face haggard, skin yellow, sclerotic coat of a yellowish tinge, 583.
• Anxious expression, 73, 113, 240 , etc.*
• Melancholy expression; he seems aware of his situation, and to be silently imploring pity, 174.
• Expression sad and melancholic, 340. [570.]
• Languid look and woe-begone countenance, 318.
• He has a heavy stupid aspect, 356.
• The face has a very stupid expression, 182, 195.
• Expression of the face quite peculiar, almost stupid, 153.
• Astonished stupid look; patient appears as if ecstatic; risus sardonicus; the patient has a sad, melancholy look, and weeps. Patient gives no satisfactory answer as to the state of his expression, 305.
• Face stupid, 509.
• Expression rather dull, 170.
• Aspect vacant and stupid, 360.
• Expression of face and eyes decidedly dull, 200.
• The expression was of dull, heavy, unremitting pain, 446. [580.]
• Countenance expressive of pain, 98.
• Countenance entirely changed, and expressive only of extreme pain, which even prevents him from answering when spoken to; the application to his abdomen of a vessel of hot water is scarcely felt, 214.
• The whole expression of the child was that of one suffering from pressure upon the brain, 432.

MOUTH

• Teeth.
• Violent grating of the teeth at night, with frequent waking (first day), 2. [750.]
• Grinding of the teeth, 339.
• Hard chattering of the teeth, as in violent ague, 223.
• Usually, in cases of saturnine discoloration of the gums, the teeth are dark brown at their bases or necks, while their edges are of a lighter brown, with a shade of yellow or green. This appearance should not be mistaken for the ordinary deposit of tartar. The incisors and canines are most liable to this discoloration, but it may occur on all the teeth, though they are seldom affected in an equal degree. When the process of gingival absorption has resulted in a loss of substance, the discoloration of the teeth becomes more decided. The teeth thus affected finally deteriorate; they become brittle, break off, decay, and fall out long before the usual time. The coloring matter adheres firmly to the osseous substance of the teeth, with which it appears to combine, so as to be detached with difficulty, as is the case also with that of the gums, 117.
• In general, when the blueness of the gums is very decided, the discoloration of the teeth is also strongly marked, and vice versâ, 117.
• The discoloration of the teeth and buccal mucous membrane, by contact with lead molecules, may take place in five or six days, or after months or even years of exposure, the time varying in different classes of workmen, 117.
• Teeth in a very bad condition, all brown, and most of them broken, 219.
• Characteristic saturnine discoloration of the teeth and gums, 195.
• Teeth and gums discolored, 161.
• Most of the teeth destroyed, blackish; deep, slate-colored border on the gums; oxygenated water caused a whitish track of sulphate of lead, 220.
• Teeth and gums black, 90. [760.]
• Teeth black with the lead line on the gums, 498.
• Teeth black, 39, 121, 123 , etc.
• Teeth black at their necks, 175.
• All the teeth black, especially the incisors and canines, 208.
• Teeth black; partly destroyed, 215.
• Teeth black, and mostly destroyed, 225.

THROAT

• Hawking of sourish mucus (after half an hour), 4.
• Hawking up of a sourish sputa, 306.
• Mucus is expectorated from the throat with easy hawking, it is frothy like saliva, transparent, lumpy, and in yellowish-green tenacious masses (first day), 3.
• Very tenacious mucus, 49. [1080.]
• Choking, when swallowing, 258.
• Choking sensation in throat (after one year), 261.
• Sensation of dryness in the throat, in the morning, 5.
• Dryness of throat (after five hours), 107.
• Roughness of the throat, with somewhat hoarse voice (fourth morning), 4.
• Rawness of the throat (after six hours), 4.
• Swollen sensation in the throat, that obliges frequent swallowing, and does not disappear (after two hours), 4.
• Swollen sensation in the throat, on swallowing, with retching (fourth day), 4.
• Constriction of the throat, 21 . [From large doses.]*
• *Constriction of the throat, 3, 43 ; (fifth and sixth days), 47, 56. [1090.]
• The patient continued to suffer from constriction of the throat for three months after the poisoning, rendering deglutition difficult, associated with general muscular feebleness, 253.
• Spasmodic constriction of the throat, 93.
• Sense of constriction about the throat and epigastrium, 267.
• Violent constriction of the throat, 253.*
• Sensation as though the foreign body in the throat slipped downwards, afterwards tearing in the right scapula (after two hours and a half), 4.
• Sensation as of a foreign body in the right side of the throat, with a sulphurous odor; the sensation afterwards extended towards the ear and lasted a long time, 4.
• Sensation as if something in the throat moved suddenly up to the base of the skull and thence to the left orbital region, where it became a sticking; while smoking (first day), 3.

STOMACH

• Appetite.
• Great appetite, in the evening (first day), 3.
• Sensation of violent hunger in the throat, extending down to the stomach, returning after eating (third day), 5.
• Excessive hunger, he eats an unusual amount (after five days), 5.
• Great hunger; eating a biscuit considerably aggravated the pains, and caused vomiting, 224.
• Great desire to eat bread and biscuits the whole time; occurring even an hour after a meal, also late in the evening and early in the morning, 3.
• Sensation of hunger and nausea, in the evening before going to sleep (sixth day), 5. [1130.]
• Appetite generally craving, 236.
• Appetite indifferent, 341.
• Appetite poor, 499, 522 ; (after one year), 561.
• Appetite very poor, 303.
• Diminished appetite (second day), 4, 133, 302, 331, 512.*
• Appetite much diminished, 521.
• Loss of appetite before the colic, 214, 222.
• No appetite nor thirst, 194, 198.
• Loss of appetite, for two months, 535.
• Loss of appetite and sleep, 29. [1140.]
• *Loss of appetite, 16, 18, 19, 21, 23, 27, 35, 46, 48 , etc.
• Great loss of appetite, and even aversion to food, 468.
• Complete loss of appetite, 446, 473, 474.
• Almost complete anorexia; perhaps some malacia, 519.
• Anorexia, , , , etc.

ABDOMEN

• Hypochondria.
• Liver enlarged, 519.
• Out of one hundred and eighty cases, four died of cirrhosis of the liver, 329.
• Liver contracted, 574.
• Spleen large, extending below the margin of the ribs, 437.
• Diseased spleen, 39.
• Morbid sensitiveness of the splenic region, 471.
• Hepatic region sensitive to pressure, but the liver is not enlarged, 485.
• Liver sensitive to pressure, and somewhat hypertrophied, 475.
• Spleen and kidneys also painful on pressure, 485. [1430.]
• Pain in the region of the spleen, 474.
• Pain in the liver, 484, 488.
• Dull pains in the liver, 3.
• Constant pains in the hypochondria, aggravated by touch, 91.
• Sensation of heat and burning in the liver and spine (after three-quarters of an hour), 84.
• Tearing in the left hypochondrium posteriorly toward the back, where it became a sticking, in the afternoon, 4.
• Sticking pressure in the hepatic region, 3.
• Persistent sticking pain in the hepatic region, first anteriorly, then posteriorly, 3.
• Slight pain in the region of the spleen (second day), 2.
• Stitches in the right hypochondrium (after one hour and a half), 4. [1440.]
• Stitches in the right hypogastrium, in the afternoon, 4.
• Stitches extending inward in the left hypochondrium, somewhat relieved by rubbing, but returning worse than ever, at last disappearing of themselves, frequently during the day (after one hour), 4.
• Stitches in the left hypochondrium, relieved by rubbing (after two hours), 4.
• Stitches in the left hypochondrium, extending backward (after one hour and a half), 4.
• Umbilicus and Sides.
• Cuplike depression at the umbilicus, 208.
• Prominent swellings could be seen and felt at the umbilicus and hypogastrium, evidently formed by an aggregation of the intestinal folds, and disappearing when the acute pain subsided, .

RECTUM AND ANUS. [1860.]

• When a finger was introduced into the rectum during the paroxysms, the sphincter ani, and the bowel as far as it entered, closed forcibly upon it; during the intermission this was not the case, 220.
• A finger passed into the rectum is forcibly compressed by the sphincter and bowel. Injections cannot be retained more than five minutes; they are rejected hurriedly, 237.
• Weight in the rectum, 350.
• Much pain on evacuating bowels, 79.
• It seems as though he would evacuate a thin stool, but he does not, immediately, and also later (first day), 3.
• Violent efforts to evacuate, producing hæmorrhoids, 309.
• Frequent tenesmus, 120.
• Tenesmus, 347.
• Tenesmus of the rectum and bladder, 136.
• Difficult defecation, 120. [1870.]
• Frequent and urgent tenesmus, 262.
• Itching in the hæmorrhoids; the anus is retracted, 3.
• (All the hæmorrhoidal troubles disappear), 3.
• Itching and burning pain in the perineum and neck of the bladder, 55.
• Prolapsus of the anus, 44.
• Constriction and drawing up of the anus (introtractio ani), 12.
• The anus was violently constricted and drawn up, 11.
• Difficulty in passing the finger into the anus; the sphincter contracting during the paroxysms, 128.
• Some cutting colic and cutting in the anus, during a soft stool (sixth day), 5.
• Crawling and fine sticking in the rectum (after two hours and a half), 4. [1880.]
• Burning in the anus during stool, 4.
• The anus is drawn inward, 20.
• Tenesmus in the anus, 4.
• Tenesmus of the anus, which seems shrunken in; contracted on itself, 217.
• Pressing-boring pains and tenesmus in the anus, 253.
• Formication in the anus, 183.
• Desire for stool and a watery evacuation (second forenoon), .

STOOL

• Diarrhœa.
• Troublesome and constant diarrhœa, at times accompanied with a good deal of abdominal pain, and sometimes with very much tenesmus; after various remedies, the bowels still acted three or four times a day, the stools being quite liquid; no blood was passed, but mucus sometimes, 461.
• Dysentery, 33 . [From the internal use of white lead.]
• Dysentery, 57 . [From drinking water that had stood in a leaden vessel.]
• Violent bloody dysentery, fever, incessant cutting in the stomach and abdomen, violent eructations, so that everything seemed changed to gas, 43 . [After the excessive use of sugar of led in gout.]
• Dysentery, 48.
• Frequent purging of yellow fæces, with pain (third to sixth day), 4. [1900.]
• Diarrhœa, 44, 185, 198, 529.
• Uncontrollable diarrhœa, in rare cases, 28.
• Diarrhœa, with rumbling in the abdomen, without pain, for two hours, 1.
• Very profuse discharge from the bowels, 93.
• More or less decided diarrhœa, in some cases, 35.
• Diarrhœa, whenever he had lead-colic, and at no other time, 222.
• Evacuates the bowels in bed, 200.
• Diarrhœa, before the colic, 214, 222.
• Frequent offensive diarrhœa, 29.
• Purged once freely (after three-quarters of an hour), 330. [1910.]
• Some occasional diarrhœa, 275.
• Diarrhœa, with paroxysms of colic; the evacuations were watery, and contained much mucus, 342.
• Involuntary evacuations just before death, 329.
• Diarrhœa, succeeded by constipation, 476.
• Three stools this morning, without his having taken medicine; the evacuations are mostly liquid, 222.
• Two stools, since 5 A.M., 201.
• Very copious stool, in the morning, 135.
• Bloody stools, with tenesmus, .

URINARY ORGANS

• Kidneys and Bladder.
• Three years previously, the patient had been in the hospital with albuminuria and casts in the urine, but when discharged these symptoms had disappeared; at that time he had no brain symptoms except headache; on this occasion, the urine, which was retained in the bladder and had to be drawn with a catheter, contained albumen and a large number of casts; two days subsequently there was anuria, trismus, opisthotonos, convulsions followed by loss of mind; during the attack the tongue was badly bitten, the pupils contracted and indolent; on the following days the amount of urine, in spite of treatment (an infusion of squills), 600 and 700 c.cm.; the urine for twenty-four hours contained 17 grams of urea; the patient did not have another spasm, though he suffered from most violent pains in the upper and lower extremities ; after this the amount of urine increased, the urea rose to 39 and 41 grams, the albumen diminished, the pus disappeared and the mind became free, but after about two weeks he was seized with erysipelas, from which he died, 548 . [The post-mortem showed a very easy separation of the suprarenal capsules, the upper surface of the kidney granular, the parenchyma very moist, the cortical gray, somewhat reduced in size, the malpighian corpuscles not distinct, the pyramids gray. Under the microscope the kidneys presented an exquisite picture of interstitial nephritis in a rather early stage; the cortical substances especially presented in both transverse and vertical sections, great cellular hyperplasia and increase of interstitial connective tissue , though the process was not equally diffused; while frequently the whole field was occupied by small cells of connective tissue with scarcely a trace of uriniferous tubes, other sections exhibited the tubercles of normal size and configuration, but separated by abnormally broad septa of connective tissue ; the glomeruli presented varying characters, some normal, others atrophied to fibrillar knots of connective tissue, and others in all possible stages of degeneration . The substance of the pyramids was less affected than the cortical; the growth of connective tissue was here much less pronounced, and in many places was not noticed at all; the tubes were for the most part denuded of epithelium. The small arteries of the kidney showed no remarkable change; in the transverse section was seen a very broad zone of connective tissue; hyperplasia thickening of the walls and contraction of the calibre of the vessels were not noticed. The intertubular capillaries in both the cortical and tubular portions of the kidney were excessively filled; in the latter there were numerous spots of hæmorrhages into the urinary canals, and here and there the cativies of the urinary canals were found stopped by old plugs, and by some calcareous concretions. The liver showed analogous changes of . The heart showed inflammatory connective tissue growth, with chronic myocarditis; in some places very broad septa of small-celled connective tissue was formed between single muscular fibrillæ. (Microscopic examination of other parts of the body cannot be detailed here. -T. F. A.]

symptoms appeared and ceased coincidentally with the appearance and cessation of the albuminuria, 493. [2070.]

• Large quantity of albumen in her urine, the sp. gr. being only 1010; when she began to recover the albumen gradually diminished in quantity, as I discovered less lead in the urine , and at last totally disappeared, 492.
• Albumen was present in the urine; the albuminuria was either merely temporary, ceasing by the tenth day, or it was continued up to and after the patient's dismissal from the hospital. Lead was discovered several times in the urine, 495.
• Four cases in which albuminuria existed during life, and nephritis was found after death; three of them were chronic, one comparatively recent, 494.
• Urine heavily albuminous, without any œdema (in several cases), 348 . [Autopsy showed the kidneys smaller, the surface granulated, the cortical substance dark-yellow, and atrophied.]
• Urine very heavily loaded with albumen, containing epithelial casts (and traces of lead), 347.
• Urine albuminous, containing numerous cells from the kidney, 344.
• The urine contained a trace of albumen, 418, 569.
• Urine very albuminous, 429, 504, 509, 523.*
• Urine albuminous, sp. gr. 1024, scanty, dark brown, 420.*
• The urine contained a large amount of albumen; 150, 000 grams of urine contained 12 grams of urea, 581. [2080.]
• Urine very albuminous, diminished in quantity to 1/2 litre in twenty-four hours, sp. gr. fell to 1009, 429.
• Urine yellowish-brown, acid, clear, sp. gr. 1030, albuminous, containing numerous granular cylinders; after treatment, principally with Croton oil, the albumen gradually disappeared from the urine, though the sp. gr. remained high (no sugar), 449.
• Later, the excretion of albumen in her urine has been gradually increasing, the sp. gr. being always under 1010, and often as low as 1002, with a very minute quantity of urea, 492.
• Urine albuminous, containing numerous isolated cells from the kidney, 345.
• Urine albuminous; sp. gr. 1010, 429.
• Urine albuminous, , , , , .

SEXUAL ORGANS

• Male. [2130.]
• Peculiar weakness of the genitals. (H. and T.) [From Plumbum muriate.]
• Slight jerking in the spermatic cord, in the morning; in the afternoon, stitches in the place where it leaves the abdomen (first day), 3.
• The pains return by paroxysms, during which they are quite severe, extending all along the spermatic cord into the left testicle, which then appears retracted; between the paroxysms the colic is slight or, in general altogether absent, 127.
• Frequent erections, with spasmodic retraction of the testicles, and even with emissions during the colic, 109.
• Erections in the morning, 5.
• Flaccidity of the penis, 30.
• The penis is as painful as the abdomen, 215.
• The patient experiences a sensation as if the penis were tied at its root or along its course with a cord, 305 . [Attributed by Stoll and Dance to sudden contraction of the urethra.]
• Biting on the frænum preputii, and emission of semen. (H. and T.) [From Plumbum muriate.]
• Violent inflammatory swelling of the scrotum and penis, with violent inflammatory Dysuria constipation, delirium, and on the ninth day, gangrene of all these parts, followed by death on the tenth day, 47 . [From the external use of aqua Goulardi for gonorrhœa and phimosis.] [2140.]
• Constriction of the scrotum, so that at times the testicles were drawn up into the inguinal canal, with the most fearful pains in the small of the back, scrotum, and intestines, 326.
• Constriction of the scrotum, 46.
• Soreness of the skin of the scrotum and thigh wherever they touched, after the perspiration, 3.
• Great swelling of the testicles, 25 . [From the external use for spermatorrhœa.]
• Swelling of the testicles, 72.
• Retraction of the testicles at times, 46.
• During the paroxysms both testicles were forcibly retracted, 210.
• During the paroxysms the right testicle only rose toward the inguinal ring, 220.
• Constriction of the testicles, 35.
• Tension in the testicles, 9. [2150.]
• The pain in the testicles was somewhat relieved by suspending them with the hands, .

RESPIRATORY ORGANS

• Spasm of the respiratory organs, 20.
• Constriction of the larynx, 46. [2200.]
• Dry mucus in the upper part of the trachea, that he could loosen only with difficulty, and not without some pain in the chest, with whistling in the upper part of the chest on inspiration (second day), 2.
• Intense general bronchitis, 140.
• Voice.
• Rough voice, with hacking cough, 12.
• Rough, hoarse voice, 12.
• Voice hoarse, almost toneless, 451.
• Voice hoarse, 258.
• Voice nasal, 527.
• Voice toneless, hollow, 545.
• Voice loud, 190.
• Voice a good deal altered, and the tones of the voice much impaired, 228. [2210.]
• The voice has lost much of its resonance, and is weak, like a woman's; articulation is impeded and sometimes even incomplete, 142.
• Voice panting, stifled; he can scarcely make himself heard, 219.
• His voice is weaker than usual, 195.
• Voice very weak, 174.
• His voice (which had been a little weak for some days previously) began to fail him one evening while he was reading aloud, 401.
• Voice weak and dull, 537.
• The voice is weak and husky, 356.
• Voice became very weak, talking very difficult, 273.
• Voice very weak, with imperfect utterance (tenth day), 240.
• The voice had partly lost its strength and resonance, 144. [2220.]
• Voice feeble, 254, 278.
• Voice weak, 146.
• For three or four months she noticed that with each return of the catamenia her voice became noticeably weaker, until it became merely a faint whisper, in which state it remained a period of six years and a half. Even a short conversation caused great fatigue of the muscles of the chest. This was at once explained by the laryngoscopic examination, which showed that there was not the slightest approximation of the vocal cords on attempting to speak, and the glottis remaining widely open; a large volume of air was required to be forced through it in order to produce the faint whisper above mentioned. This demanded an effort of the expiratory muscles, which was very fatiguing, .

CHEST

• Suppuration of the lungs, 42, 45.*
• The lungs were well distended during the respiratory period; the thorax expanded, and all of the respiratory muscles seemed to be active. The violent ingress of the air, and the violent efforts to get it, muffled the vesicular murmur, which could only be heard at the close of the respiratory period, and was louder than normal, and accompanied with more or less of mucous râles. Percussion sounds were usually resonant, except in the region of the heart and liver. A few days previous to the death of the patient, the lungs were evidently greatly congested, and he finally died with a gush of blood from the mouth, containing large coagulated clots, 556.
• On examining his chest I found evidence of consolidation in the left apex, and appearance of its commencing in the other; there was no râles, moist or dry, and very little cough; while the poisoned water was being used there was scarcely any rising of the upper left chest on inspiration (the respiration being very harsh, almost bronchial; soon after pure water was used, the chest began again to expand, and the respiration became puerile), 462.
• The condition of the left side was involved in great obscurity. To the touch that part extending from the false ribs to the crista ilii, and from the dorsal vertebræ to the left rectus muscle, presented a hard and indurated feel. The hardened mass lay immediately beneath the skin, and could be traced only to the muscular system, 280.
• At the apex of the lungs bronchial respiration was heard, 439.
• Weak action of the lungs, especially the left; distinct shade of dulness in the right apex (the left being the first affected), 463.
• Labored movement of chest and diaphragm, 385. [2310.]
• Two out of one hundred and eighty-four died of gangrene of the lungs; two of tubercles of the lungs, 329.
• At one time the friction of the muscles of the chest was so loud, that combined with other symptoms, I had great difficulty in satisfying myself that she had not pleurisy, 492.
• Accumulation of phlegm on chest, 566.
• Rush of blood to the chest, when walking rapidly (fifth day), 5.
• Symptoms resembling angina pectoris, 306, 310.
• Tightness of the chest (fifth and sixth days), 47.
• Great oppression of the chest, and anxiety, 99.

The beats of the heart were tumultuous, rapid, and resonant, 519.

• Itching and sticking pains in both breasts; the left breast suppurated about the nipple and discharged for six days a somewhat serous water, after which it remained well; in the right breast there developed an induration extraordinarily large, occupying the whole substance of the breast, firmly adherent towards the outer portion, of a livid color, extending upward and outward over the whole periphery of this swelling, with here and there red streaks, together with violent pains in the swelling, that extended to the arm and affected its use; after being opened it discharged a large quantity of thin and corrosive matter, and after several days the swelling entirely disappeared, 1 . [Immediately following the application of lead ointment to a tetter-like rash of both hands, in a girl twenty-one years old; the rash disappeared on the twelfth day.]
• Sticking below the right breast (after five hours), 4.
• Sticking in the left mamma on inspiration, in the afternoon, 4.
• Sticking in the left mamma (second day), 4.
• Sticking beneath the mammæ (after five hours), 4.
• Sticking beneath the left mamma, near the sternum, in the afternoon, 4.
• Two stitches in and beneath the mammæ, lasting an hour, in the morning in bed, disappearing after rising (third day), 4. [2370.]
• Stitches deep in the right mamma, not disappearing after rubbing (second day), 4.
• A fine stitch in the left mamma, afterwards in the right (after six hours), 4.
• Somewhat violent stitches below the right breast, extending into the right scapula (after one hour and a half), 4.
• Stitches deep in the female breast, 305.

HEART AND PULSE

• Prominence of the præcordial region; it gives a dull sound on percussion, over the space of three inches square, 168.
• The præcordial region is shaken by the hurried and irregular beats of the heart; they seem as if stifled, on auscultation, but there is no abnormal sound, 217.
• Pressure in the præcordial region, 238.
• Jerking in the præcordial region (after half an hour), 4.
• A stitch in the præcordial region on inspiration, then anxiety, with mounting of heat and redness into the face, soon disappearing (after six hours), 4.
• Heart measures 15 by 20 centimeters; the beats can be noticed over the whole surface of the heart and in the epigastric region; violent pulsation in the jugular veins, which are enormously distended, pulse very small and rapid, associated with oppression and œdema of the limbs; the heart-sounds are very difficult to distinguish, consisting of indefinite double friction-murmurs, 414 . [Autopsy showed the heart large, hypertrophied (not dilated), firm, and resistant; the right auricle large, the tricuspid valves present numerous thickenings, the orifice measures 15 centimeters; the left auricle presents an opaline surface, the mitral orifice measures 115 millimeters; the aorta enlarged, atheromatous.] [2380.]
• Heart dilated 12 by 14 centimeters; four beats are heard instead of two; associated with a pulse of 84, vibrating as in insufficiency of the aorta; moderate beating in the carotids, 406.
• The heart measures 10 centimeters in length, 15 in breadth; the heart-sounds noticed over a larger surface than normal; the valvular sounds are wanting; instead there is a double bruit , very rough, rasping, which is transmitted along the carotids, 405.
• Heart very much enlarged, the apex in the sixth space; the murmur at the apex diminishing in intensity along the aorta, 417.
• The heart measures 11 by 12 centimeters; chlorotic sounds very marked, pulse 80 and feeble, 411.
• The heart measures 9 by 14 centimeters; the heart-sounds are redoubled; the second sound rude, changed in character; it resembled a pericardiac sound. The chlorotic murmurs are considerable, 413.
• Heart measures 11 by 16 centimeters; the sounds are sonorous; at one point, however, there can be recognized a little murmur in the second sound of the heart, 412.
• Heart measures 11 by 12 centimeters; there is double rough blowing sound, which is transmitted along the carotids, associated with swelling of the limbs and albuminuria, .

NECK AND BACK

• Neck.
• Paralysis of the cervical muscles, 104.
• Tension in the nape of the neck, more on the right side, extending into the ear, on turning the head sideways (after four hours and a half), 4.
• The neck is stiff; the head is kept almost motionless, 132.
• In the neighborhood of the last cervical and first dorsal vertebræ pressure causes a rather severe pain (point of hyperæsthesia), 528.
• The pains are also felt in the neck, walls of the chest, back and loins, 132.
• Tearing in the nape of the neck, disappearing on standing and rubbing it, after which it appeared in the left shoulder, when it disappeared of itself (after five hours), 4.
• Back.
• Weakness of the back and lower extremities, 65.
• Weary feeling in the back, hardly amounting to pain, 457. [2590.]
• Back lame, weak, and painful, 297.
• "Rheumatism" of the back, hips, and lower extremities, 283.
• "Spinal irritation," 301.
• Neuralgic pains in the back, 291.
• Pains in the back, hips, and down the spine, extending occasionally up the neck to back part of head, 287.
• Pains in the muscles of the back, 531.
• Dorsal.
• Dorsal region of spine tender on pressure (after one year), 261.
• Pains between the shoulders (after three-quarters of an hour), 84.
• Pain as if sprained in right scapula (after a quarter of an hour), 4.
• Tearing in the lower portion of the right scapula (after two hours), 4. [2600.]
• Tearing in the right scapula, with a feeling as of something living in it that rose up; afterwards burning in the abdomen, and then again sticking in the right scapula (after two hours and a half), 4.
• Violent tearing in the right scapula (after two hours and a half), 4.
• Burning in the tip of the left scapula (after one hour), 4.
• Sticking and burning in the right scapula (after two hours and a half), .

EXTREMITIES

• (Dilated veins on both legs and on the feet; on the upper third of the outer surface of the right arm there is a large serpentine varicose vein, and on the patella a large patch of varicose veins), 377 . [The patient suffered from these veins for a long time, and bad worked thirty-seven years in the factory.]
• Œdematous swelling of the extremities, 70.
• Has suffered from gout in the hands and feet, 359.
• The limbs lie slightly flexed, and are never contracted; when raised, they immediately fall back again, 178.
• Lay always with the limbs drawn up, 265. [2640.]
• Usually the legs are kept flexed upon the thighs, and the forearms upon the arms, while the body is doubled together. This seems to be the easiest position, 132.
• Convulsions of the limbs, 46.
• The upper and lower extremities trembled, and the extensors of the former were paralyzed, 439.
• Tremor of the legs and hands, especially the right, 484.
• The limbs tremble much less when they are resting against anything, 401a.
• The whole arm trembled so much that he could not carry a glass to his mouth. The lower limbs became similarly affected, in the evening. The oscillations quick and uniform, 396.
• Tightness and spasms in the extremities and hands, 250.
• Spasmodic flexion of the arms and legs, so the dorsal surfaces of both hands rested upon the chest, lasting a quarter of an hour, and followed by gradual relaxation, until the arms hung by the side; after a few hours the spasm was renewed, 339.
• Numbness of extremities increased day by day, and there was an incessant trembling, worse at times, especially the upper extremities, in which the paralysis of the extensor muscles was manifest, particularly in the right hand, which could not grasp or hold any object, 350.
• Convulsive movements of the extremities, 235. [2650.]
• Sudden attack of violent convulsions in the upper and lower limbs, 138.
• Tremor, first in the left lower then in the left upper extremity, with pain and difficulty in moving, 154.
• Constant trembling of all the limbs, 173.
• Tremor and convulsions of the limbs, 171.
• Slight trembling of the limbs and face, .

After the persistence of this state for some time, the muscles of the arm became painful, 560.

• Rheumatic pains in the limbs and loins, that extend into the knees, 46.
• He had been suffering for three weeks with great pains in all his limbs, especially in the legs and left arm. He still complained of pain and weakness in the left knee, and a week previously this joint had been swollen as well as painful, 377.
• Pain in the joints, especially the knees, 473. [2760.]
• Pain in the limbs during movement and pressure, 481.
• In twenty, pain in limbs or joints, or "all over," 567.
• Pains in the joints and muscles during movement, 470.
• On gently moving the limbs, both upper and lower, I found it was the flexor muscles that caused the pain on motion, 303.
• Pains in the limbs, as if broken, 278.
• Pains in the hands and feet, and numbness of the same, 287.
• Neuralgic pains in the limbs, 291.
• Pains in limbs, shoulders neck, face, and head, 284.
• The slightest pressure aggravated the pains in the extremities, 235.
• Pain in limbs, attended by violent cramps, 230. [2770.]
• No pain or weakness whatever in the right limbs, 153.
• Pain across legs and arms, 228.
• *The pains in the limbs are worse by paroxysms, which are so severe that he cries out; they are somewhat relieved by pressure, but movement increases them, 183.
• *Pains in the extremities, 75, 350, 545.
• Vague wandering pains in limbs, 558.*
• Pain in the joints, 198.
• Dull pain in the extremities, 73.
• *The pains in the limbs were aggravated, at night, 46.
• Pains in the limbs, that rage most violently, at night, .*

SUPERIOR EXTREMITIES

• Both arms, but especially the right, began to feel numb and weak after his third attack of colic. The weakness gradually increased, and in about three weeks a trembling began, at first slightly, but which is now very great. The oscillations, especially of the arm, are uniform in extend, and rapidly performed. He says that the trembling diminishes and increases alternately. It is greatly aggravated after fatiguing work. The legs are not affected in any way. All the movements of the arm are performed naturally; the fingers and forearm can be extended with the greatest ease. Electro-muscular contractility is normal. The force of compression in the right hand, according to the dynamometer, equals 30 kilograms; in the left hand, 45 kilograms. The pulling strength is 70 kilograms. Muscular strength, in this case, is but slightly impaired, 392.
• Trembling of the arms, 451.
• Trembling of the hands, followed by weakness of the third and fourth fingers, so that they could not be fully extended; afterwards the second and fifth fingers became affected, afterwards the wrist, and finally even the shoulders; the arms hung down relaxed; the shoulders and arms were emaciated, especially the deltoid muscles; the balls of the thumbs emaciated; on passive motion of the hands and fingers there were trembling motions of the muscles, also at other times there was exquisite fibrillar twitching; if he attempted to raise the arm, the trapezius and sterno-cleido-mastoid muscles contracted and raised the shoulder as much as three inches, then the pectoral muscles contracted and drew the arm slightly forward; he was, however, able to flex and extend the elbow by means of the biceps and long supinators on the one hand, and the biceps on the other; contraction of all the muscles was very weak; pronation and supination of the hand was possible, with trembling, etc., 542 . [Here follows, in the original the detailed careful examination of the muscles and groups of muscles by means of faradic and galvanic currents, with tables of the exact irritability for each. -T. F. A.] [2800.]
• The whole right arm trembles a good deal. The oscillations are rapid and uniform, with a regular to and fro motion. The tremor persists even after the patient has been told to fix his attention on it, in order to prevent it. There is no decided movement of the fingers per se; it is rather a movement of the whole arm. The left arm also trembles, but in a much less degree, 401a.
• Incoordinate movements of the superior extremities, which consist in an indefinite and irregular series of contractions, and have their set alternately in the extensor and flexor muscles. These oscillations continue in spite of the patient's effort to the contrary. The power of extending the arms upon the posterior portion of the trunk is much lessened. There exists a slight analgesia of the affected members, but not the least paralysis of the extensor muscles of the fingers, .

INFERIOR EXTREMITIES

• Œdema of the lower extremities, 467.
• Complete paralysis of the lower extremities; they seem numb and dead, 40 . [From the internal use of the Acetate of lead.]
• Complete paralysis of the right lower extremity, 278.
• In the lower extremities paralysis of the peroneal muscles and extensors of the toes, 545 . [Completely simulating infantile spinal paralysis.]
• Paralysis in the lower extremity of the peroneal muscles and in the extensors of the toes, 544.
• The right leg is somewhat flexed upon the abdomen, 167.
• The left lower extremity is paralyzed as the right, except that the foot is twisted inwards by the permanent contraction of its "adducteurs flèchisseurs" upon the leg; the latter muscles acting naturally, while their antagonists, the abductors, are paralyzed. Complete atrophy of the tibial region, 161.
• Sudden difficulty in going upstairs; without previous pain, 160. [3230.]
• Loss of power in the lower extremities, while walking (first day), 2.
• At present there is no trembling of the inferior extremities, 400.
• Standing, and much more walking, are impossible. When he tries to stand, the thigh is flexed upon the leg, and the leg upon the foot, so that he falls down; the sole of the foot forms a deep hollow, 141.
• Gait unsteady, 92, 575, 585.
• Gait is weak and tottering from laxity of the knee and ankle-joints, 315.
• Gait became tottering and unsteady, 245.
• One foot began to drag, and soon he could only creep about "on all fours." The hand of that side was also soon affected; he could not button his clothes or cut his food, and was carried up and down stairs. Soon he regained power of his limbs. Again the paralysis returned, and the necessity of creeping, but I think the hand this time was only slightly affected. A subsequent amelioration took place, 365.
• The mother perceived that the gait of the youngest, was awkward, that he frequently tumbled down in crossing the floor, that he staggered and complained that it hurt him to walk, and that his feet pained him, especially the bottoms of them. Soon the other children complained in a similar manner, 241.
• Lower extremities either cramped or partially paralyzed, 267.

GENERALITIES

• Complete emaciation, 21.
• Much emaciated, and looked ten years older than he really was, 219.
• The atrophy becomes general; the patient resembles a walking skeleton, 305.
• Atrophy, 43. [3480.]
• *Emaciation, 23, 166, 180, 287, 292 , 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-made 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, 492.
• 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, 546.
• 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 metacarpo-phalangeal 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 was succeeded after some months by diarrhœa, and she often passed her motions involuntarily, 366.
• Greatly emaciated and very weak, 341.
• On stripping the patient the clavicular and scapular prominences were very remarkable, the deltoid muscles had wellnigh 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 leg. 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, .

[From large doses.], 32

[From the application of White led to an excoriated place behind the ears, in a healthy man.]

• Has had two attacks of epilepsy, 373.
• Suffering from epileptic fits , occurring about once in a fortnight, severe in character, and of three years' duration, 372.
• Ten epileptic seizures in about two years; in which he fell down with a cry; became very pale; there was at first stiffness; then followed contractions. The attack lasted about an hour, and was followed by great prostration. It was accompanied by involuntary urination, 521.
• The paroxysms occurred only every half hour, 220.
• Small spasmodic shocks shoot like lightning over his face and limbs, 188.
• Spasms, 233.
• Violent spasms, 315.
• Tetanic spasms (after two hours), 274.
• Spasms of particular muscles, and in two cases, of the whole body, with delirium, 70. [3630.]
• Epileptiform spasms, 44.
• A series of spasms, and convulsions of various kinds, at first with free intervals, which, however, gradually became shorter and shorter, until the last twenty-four hours the spasms were almost uninterrupted; on the fifth day the patient became comatose, 328.
• Seized three times with what seemed like a tetanic spasm; then came sharp prickings in the hands, the forearm, in the whole lower limb, and then the limbs were stiffened, the jaws were clenched convulsively, 268.
• Clonic spasms of the muscles of the face and extremities, with loss of consciousness, frothing from the mouth, and puffiness of the face (with albuminuria), 429.
• Violent clonic and tonic spasms , with both eyeballs rotated upward, repeated four or five times daily, 432.
• Suddenly seized with convulsions ; the upper and lower extremities were violently thrown into alternate flexion and extension; the body is forcibly and involuntarily shaken; the head bends backward. All sensation is lost, but there is neither frothing at the mouth nor stertor; the face is injected. The convulsions lasted about five minutes. When they cease, he lies quiet and motionless in profound coma, and cannot be stimulated into attention. After this has continued for a quarter of an hour, convulsions again set in, but do not last as long as at first. Thirty-four convulsive seizures were counted within twenty-four hours; between them he was always comatose, .

SKIN

• The skin of the face shines as if oily, and feels oily, 3.
• Skin flabby, 215.
• The skin of the face was changed in texture and appearance, 465.
• Face and most of the body and limbs so thickly covered with white-lead deposit that the color of the skin could not be perceived, 212. [3910.]
• Nearly the whole skin became infiltrated with serum, 235.
• Serous infiltration of the whole skin, 237.
• Skin feels dry, 287.
• The skin is dry and sallow; it is traversed by larger veins, 562.
• Skin dry, cool, 67, 356.
• Dry skin, 237, 257, 258, 278, 491, 492.
• The skin of natural temperature, a little dry, 404.
• Secretion of skin in most cases checked, 267.
• A peculiar discoloration of the solids and fluids of the body; lead jaundice, 117.
• The whole surface of the body is discolored, 23. [3920.]
• Bluish color of the body, 44.
• The hue of his skin generally was of a dusky cerulean character, 340.
• Bluish color of the limbs, 34.
• Redness of the lower extremities, 467.
• Frightful jaundice, and excessive induration of the intestines, 18 . [From the internal use of the Sugar of lead.]
• Obstinate jaundice, 8.
• Very decided general jaundice, 141.
• Severe attack of icterus, of a week's duration, 369.
• The body, the face, and especially the conjunctivæ, have a decidedly jaundiced tinge, 185.
• Jaundice over the whole body, 48. [3930.]
• Jaundice, , , , , , .

SLEEP

• Sleepiness.
• Constant short yawning (after one hour), 4.
• Frequent yawning (after one hour), 4.
• Yawning and stretching (after a quarter of an hour, and one hour and a quarter), 4.
• Yawning, with sleepiness, an hour after dinner, 4.
• Profound drowsiness, 111, 361.
• At times he closes his eyes as if in sleep, but this drowsiness is only momentary, 174.
• Drowsiness, 466, 476, 479, 534. [4020.]
• Sleepiness, 474.
• Frequent inclination to sleep, with dulness of the head, 339.
• Sleepiness, with heat over the whole abdomen and redness of the face (after two hours and three-quarters), 4.
• She could scarcely keep from sleeping, after an hour, disappearing in the open air, 4.
• Sleepy early in the evening; very sound sleep, 4.
• Easy falling asleep while talking and knitting (after two hours and three-quarters), 4.
• Some sleep immediately after a paroxysm, but he is soon aroused by a return of the pain, 127.
• Talking during sleep, without knowing anything of it in the morning (second day), 3.
• Frightful starting up on falling asleep, 46.
• Sleep is pretty good, but he sometimes wakes with a start; he is also awakened whenever he stirs by the acuteness of the pains; nightmare almost every night, 530. [4030.]
• The patient frequently fell into a soporous condition, 235.
• Sopor, 439.
• Sleeplessness.
• Sleeplessness, 119, 121, 123, 128 , etc.
• Entire sleeplessness, 126, 133, 138, , etc.

FEVER

• Chilliness.
• Chilliness, 350.
• Frequent attacks of chilliness (first day), 274.
• Cold chills, 287.
• Chills several times during the day (first day), 268.
• Chills and fever (with the colic), 516.
• Chills, without heat or sweat before the colic, 217.
• Chilliness, from morning till afternoon, 3. [4070.]
• Chilliness, always worse towards evening, even by a warm stove; head dull, dizzy, with thirst, redness of the face, and soft rapid pulse, over 100; while in bed, external heat with internal chilliness; at last the heat increased, the skin became hot and dry, pulse frequent, without thirst; after midnight, the skin became gradually moist until sweat broke out on the chest, abdomen, and head; after 2 o'clock, sleep with confused dreams; on the next morning, tongue coated, head dull, face pale, and always on rising there is a stitch extending through the head from below upward; this attack was repeated after ten weeks, 3.
• Chilliness, towards evening, even when close to the fire; the head is affected and giddy, thirst, redness of the face, and soft frequent pulse, above 100, 305.
• Shivering, 36.
• Shivering, coldness at the end of the crisis (after about three hours), 268.
• Shivering in all the limbs, 208.
• General coldness, with frequent shivering, which obliged him to be warmly clad and remain near a fire, 350.
• Temperature of the body very low, the skin very cold, 433.
• Sense of coldness of body (ninth day), 240.
• Sensation of coldness, while walking in the house (after one hour), 4.
• Surface of body cold, 113, 120, 266, 303. [4080.]
• Skin cool and dry, 259.
• Coldness immediately, in the open air (after two hours and three-quarters), 4.
• General sensation of coldness, not followed by heat, 35.
• In twelve cases, there was a constant and very strong sensation of icy coldness, both externally and internally, in the paralyzed parts, and especially in the extremities of the affected limbs; this was perceived by others. It was aggravated by the least draught of air which fell on the affected parts, especially in cold weather, .

CONDITIONS

• Aggravation.
• ( Morning ), On waking, discontented; bitter taste; dryness in throat; thirst; early, vomiting; after rumbling in abdomen; colic; cough; in bed, stitches in mammæ; wrists and ankles weak and painful; tearing in left upper arm; after rising, pain in legs; on rising, soreness and tenderness of soles of feet; faintness.
• ( Forenoon ), Sticking and beating in right side of head; jerking tearing in left eyeball; while standing, sticking in right ear; sensation of foreign body in throat; tearing in surface of left upper arm.
• ( Afternoon ), Good-humored; ennui; ill-humored; absorbed in work; stitches in head; headache in forehead; 2 P.M., stitch in left eyeball; coryza; 2 P.M., burning in tip of tongue; tearing in left hypochondrium; stitches in right hypochondrium; stopped sensation in abdomen; stitches in pectoral region; sticking in upper part of sternum; sticking in left mammæ; tearing in right wrist; weakness of lower extremities of lower extremities; jerking in left thigh; flushes of heat and sweat; toward evening, chilliness, warmth.
• ( Evening ), Stitches in head; 9 P.M., stitches in sinciput; roaring in the ears; appetite; eructations of gas; colic; griping in abdomen; pain in extremities; trembling of arms; weakness in upper limbs; tremor of upper limbs; itching.
• ( Night ), Furious delirium; random talking; colic; pain in extremities; pain in arms; pain in calves; the symptoms; warmth.
• ( Open air ), Coldness.
• ( Ascending stairs ), Palpitation of heart; pain in thighs; weariness of knees; weight in knees; pain in right knee; faintness.
• ( Bending toward left side ), Sticking in left lumbar region.
• ( After breakfast ), Eructations of gas.
• ( Cold ), Pain in lower back tooth; colic; pains.
• ( Before colic ), Anorexia; nausea.
• ( After colic ), Frontal headache.
• ( After dinner ), Disinclination to talk; tearing in right ear; boring in right ear; thirst; pulsation in hands and feet; yawning and sleepiness.
• ( Drinking ), Paroxysms; the symptoms.
• ( Excessive drinking ), Tremor.

SUPPLEMENT: PLUMBUM. Authorities.

586 , John F. Luck, M.D., Med. Record, vol. xiv, 1878, p. 158, J. F., æt. fifty-one years, after a protracted debauch, took 3 ounces Acetate in water; 587 , Dr. M. Bernhardt, Berlin, Klin. Woch., June, 1878 (Lond. Med. Rec., July, 1878, p. 281), a case of lead palsy (cause not given); 588 , same, ibid., J. W., æt. twenty-nine years, has been a painter sixteen years.

• After sleeping three hours he awoke feeling tolerably well; was about the village during the day, and only suffered from slight colic. I was summoned twenty-four hours after he had taken the poison and found him pale, anxious; pulse 58, feeble; temperature 97° F.; abdomen tense and retracted. He had vomited three pints of fluid matter containing blood and shreds of mucus; ejection black from change of Acetate to lead sulphide; six hours after vomiting, persistent, copious, without straining; prostration extreme; hands and feet numb; calves of legs cramped; pulse 50; no dejection; no urine voided since taking the Lead: abdomen hard and nodulated; colic pains constant, particularly severe and burning at pit of stomach; general tremor of body; unable to stand on account of vertigo; urgent thirst; delirious. Four hours after (after Ol. ricini, Ol. tiglii, etc) bowels had moved freely, dejected matter similar to that vomited, plus small quantity of scybala. Four hours later had passed 4 ounces of Highly-colored urine; blue line distinct along edge of gums; greatly prostrated; vigilant; delirious (potomania?), 586.
• A. T., æt. forty-nine years, is a ruddy, healthy looking woman, and, excepting the paralysis of her left arm, considers herself well. The smallness and flatness of the left shoulder as compared with the right are very striking; the acromion projects forwards, and between it and the head of the humerus there is a furrow in which the index finger can be laid; the entire left upper arm is thinner than the right, especially on the flexor aspect; the forearm is overextended on the humerus and cannot be flexed by any effort of the patient. If you tell her to bend her left arm, she swings the whole limb upwards over her shoulder, and then the forearm falls of its own weight on the humerus. The arm bent by this means can be actively extended. If we partially bend the forearm upon the upper arm, and then ask patient to continue the movement, by a great exertion she is able to do so, but this is effected by the flexor carpi ulnaris and flexor digitorum profundis, which can be seen and felt to contract. Supination of the left forearm is not possible; if the arm be passively supinated pronation is readily effected. The movements of the left hand and fingers are in every respect free; the hand is a little curved and the skin bluish red, but no œdema or eruption is present; there is no atrophy of the interosseous or thenar muscles; the arm can be raised from the shoulder in spite of the visible atrophy, and the clavicular fibres of the deltoid can be seen to contract; adduction, internal and external rotation, and drawing of the arm are all well performed, although the last is not quite so perfect as on the right side; the right arm is quite normal, except a distinct atrophy of the ulnar side of the extensor aspect of the forearm, which is associated with inability to completely extend the fingers, the basal phalanges of the thumb and index finger being alone perfectly extended, the remainder persisting in a state of half flexion in spite of the strongest voluntary efforts, the middle and ungual phalanges of the same fingers being, however, as perfectly flexed and extended as in health. She feels a certain subjective sense of weight in the left arm. Electrical examination gives the following: In the right arm the muscles all react well to direct and indirect stimulation, except the extensor communis digitorum, which does not extend the three fingers above mentioned; the extensor capri radialis reacts more feebly than normal, although its contour is prominent. In the left arm the deltoid reacts only near its origin from the clavicle; the biceps and both supinators are absolutely without reaction; it is questionable whether or not some intact fibres of the long supinator exist in the upper arm where it is covered with fat. All the muscles of the arm, forearm, and hand react to both direct and indirect stimulation. Placing the electrode at the point mentioned by Erb, as that from which it is possible to stimulate both the biceps and long supinator together (at the exit of the fifth and sixth cervical nerves between the scaleni), gives a marked reaction of the muscles in question on the right side, but remains without effect even, with much stronger currents on the left. With the anode of the constant current on the neck, and the cathode on the right deltoid, a feeble contraction occurs with twenty-two cells, while on the left side thirty cells produce only a quick twitching of the clavicular fibres, the bulk of the muscles remaining unexcited; with thirty-three cells the remainder of the left deltoid reacts. The left biceps does not contract, the right contracts with thirteen cells. By stimulating the right radical nerve with twenty cells, there is short quick movement in the index finger and thumb. The muscular fibres of the extensor communis, from the three outer fingers of the right hand, do not react to direct or indirect stimulation. All the muscles of the left arm, innervated by the radial nerve, contract with twenty cells, except the supinators. We have in the case before us paralysis and atrophy of the deltoid, the biceps, and brachialis anticus, as well as of both supinators on the side, and a part of the fibres of the extensor communis digitorum of the side, .