Unusual Case of Lead Poisoning.—Three months before the onset of foot drop, the patient had suffered an attack of lobar pneumonia and had been very ill. Many years previous to this, he had had occasional attacks of "rheumatism.'' With the exception of the rheumatism he had not been ill for 16 years. This sickness had been an unusually severe attack of lead poisoning which he had developed while working "in a sheet lead factory" where he had been foreman. After repeated attempts to continue his work there he had been obliged to resign a very lucrative position and discontinue this kind of work. He had had "colic" so severely that the physician in charge had despaired of his life and had expected him to die. Recovery had been tedious and he had never been well since. Still in the last years he had not shown symptoms of lead poisoning and had considered his ill health clue to rheumatism.
It was difficult to imagine this present foot drop to be directly clue to "leading" sixteen years ago, and the history of his past illness was again reviewed. Special inquiry was made of the attack of pneumonia, which condition the present trouble has so closely followed. Apparently he had had a frank attack of lobar pneumonia but said that the physician in charge thought the lung had not returned to its normal erudition, and that he had taken medicine for some time after he was up and about. He was asked to describe this medicine which he did as follows: "The medicine was bitter drops, made my nose run as though I had the hay fever, and I took ten drops after each meal. The medicine formed a white scum over the neck of the bottle and turned the label brown." The explanation of the case seemed clear to Lazell. The lead deposited sixteen years before in some insoluble form in the bones, had been thrown into solution by the iodids given for an unresolved pneumonia and acute lead poisoning had resulted. The patient was given a good prognosis, saturated with sodium iodide and made a complete recovery. 1
In many forms of chronic rheumatism, and in certain affections of the osseous system, due to a syphilitic taint, iodide of potassium is of the greatest service; and its value in the treatment of chronic lead-poisoning is not so generally known, even in the medical profession, as it deserves to be. The iodide of potassium dissolves the compounds of lead with albumen, fibrine, fcc, which abound in the body in chronic lead-poisoning; and these dissolved compounds are excreted by the kidneys. In these cases, lead may often be detected in the urine, almost immediately after the administration of the iodide. This salt has a similar action in chronic mercurial poisoning, and cases are recorded of mercurial salivation having come on during the use of iodide of potassium, in consequence of the liberation of mercury, which had been previously fixed in the system. 2
1 The Journal of the American Medical Association. Volume 55, 1910
2 Chambers's Encyclopaedia, Volume V, 1931