PLUMBUM.
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. ► (Hot or cold drinks), Pains. ► (While eating),
Drawing sensation in œsophagus. ► (Eating a biscuit), Pains; nausea. ► (After eating),
Pressure in stomach; pain; colicky pains; fish; offensive flatus; soup,
tearing in eyelids. ► (After any excess), Debility. ► (Mental exertion),
Tremor. ► (After
fatigue), Tremor of hands; tremor. ►
(Food), Colic. ►
(Inspiration), Stitches in left side
of chest; pressure of left side of chest; sticking in left mamma. ► (When
intoxicated), Tremor. ► (Laughing). Pressure on left side of chest;
stitches in left lumbar region. ► (Looking up), Vertigo. ►
(While lying), Drawing in hip-joint;
throbbing in calves. ► (During micturition), Burning. ► (Motion),
Lancinations in face; anxiety about chest; lancinations in lumbar
region; pain in joints; pain through paralyzed limbs; cramps in forearm;
pains in lower limbs; pain in forepart of thigh; pain in knees, calves,
and soles of feet; pains. ► (After motion), Weakness. ► (Moving eyes), Pressive pain above eyes. ► (Moving head),
Pressure in occiput. ► (Moving right arm toward left), Sticking in
right hip. ► (Moving limbs), Cramps. ►
(Pressure), Pain in spleen and
kidneys; oppression in region of heart; anxiety about chest;
lancinations in lumbar region; pain in mammary region; pain through
paralyzed parts; pain through extremities; pains in forearm, elbow, and
axilla; pain in arms; pain in lower extremities; pain in knees and soles
of feet. ► (Pressure
on hypogastrium), Pain. ►
(Firm pressure on abdomen), Pain at
umbilicus. ► (When pressing at stool), Cutting about navel.
► (Respiration),
Pain in wall of thorax. ► (During rest), Contraction of muscles of sole
of left food. ► (Rising from recumbent position), Pain in
abdominal muscles. ► (Running), Palpitation of heart. ► (While sitting),
Stitches in inner side of left knee; heaviness and weariness of feet. ► (After sitting
down), Sticking in right costal region. ►
(While smoking), Sensation in
throat. ► (While
standing), Head dull and heavy; stitch in left groin;
sticking beneath right arm; stitch in back; tearing in lumbar region;
pains from soles to hips; tearing in left knee; sticking in right knee. ► (During stool),
Burning in anus; cutting colic, and cutting in anus. ► (Stooping),
Vertigo; giddiness; pain in lumbar region. ►
(Swallowing), Swollen sensation in
throat. ► (After
swallowing liquid), Abdominal pains. ►
(Talking), Pain in pimples on
tongue. ► (Touch),
Pain in hypochondria; pain in abdomen. ►
(Turning head sideways), Tension in
nape of neck. ► (Turning body backwards), Stitches in right
side of body. ► (At twilight), Prostration. ► (Vomiting),
Pain in umbilical region. ► (When anything goes wrong), Trembling. ► (Walking),
Rapidly, rush of blood to chest; shortness of breath; loss of power in
lower extremities; pains from soles to hip; pain in middle of left
thigh; stitches in right thigh. ► (Warmth of bed), Pain in large joints; pain in
leg; pain in knees and soles of feet. ►
Amelioration. ► (Morning), After eating soup, heaviness in
forehead. ► (Forenoon),
When walking in the open air, short-sightedness. ►
(Night), All Symptoms. ► (Open air),
Dizziness; sleepiness. ► (Hot-air bath), Head symptoms. ► (Cold water),
Cramps. ► (Eating),
Pain in upper abdomen. ► (Emission of flatus), Griping about navel;
pain in abdomen. ► (Food), Faintness. ►
(Friction), Pain in renal region;
pain in knees and soles of feet. ► (Lying on abdomen), Colic. ► (Motion),
Contraction in muscles of sole of left foot; tearing in two first toes
of left foot. ► (Moving knee back and forth), Sticking. ► (During
pregnancy), Colic. ► (Hard pressure), Pain in epigastrium; pain
about umbilicus; pain in abdomen; colic. ►
(Gentle pressure), Pain in forearms,
elbows, wrists; pain in lower limbs. ►
(Pressure with flat of hand), Pain
in abdomen. ► (Pressure), Pain in head; griping pain in
lower part of head; pain in renal region; sticking in lumbar region;
pains in bends of elbows; pain in knees; pain. ►
(Raising foot), Contraction in
muscles of sole of left foot. ► (Rising and sitting erect), Sticking in left
lumbar region. ► (Rubbing), Pain in stomach; stitches in left
hypochondrium; sticking in left side of chest; stitches in right side;
tearing in nape of neck; sticking in small of back; tearing in right
ring and middle fingers; sticking in left leg. ►
(Scratching), Itching on left upper
lid; itching of left nostril; itching on coccyx. ►
(Standing), Pressure in occiput. ► (Swallowing
saliva), Dryness at root of palate. ►
(Warmth), Pain in abdomen. ► (Warmth of bed),
Lancinations on knees. ► (Walking), Sticking in right costal region;
weariness in hands and feet; sticking in region of right hip; pain in
legs.
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 left side, and a part of the fibres of the
extensor communis digitorum of the right
side, [587]. ►
After several attacks of colic one night, without any affection of the
sensorium, paralysis of both hands and fingers supervened; the shoulders and the upper arms remained freely movable;
extension of the forearm on both sides was free; equally flexion of the
forearm on the upper arm; the first interosseous space was not only
sunken, but there was decided atrophy of the ball of the thumb, and on
both sides the interosseous spaces were sunken, and the interosseous
muscles were atrophied and incapable of function, so that the lateral
movements of the fingers and the extension of the middle and ungual
phalanges were not possible; the hypothenar eminences were also
diminished in both hands; there was also paralysis of the muscles
supplied by the radial nerves on both sides, and of some of those
supplied by the median and ulnar nerves. But these undoubtedly
interesting phenomena pass into the background when we consider the
result of electrical exploration. With the induced current of the
muscles supplied by the radial nerve on the left (the less affected)
side, only the extensor carpi ulnaris and supinator longus react, but
very feebly; all the other muscles remain unaffected, and these by
direct and indirect stimulation. On the other hand, the muscles supplied
by the ulnar and median nerves on the left side contract very forcibly
to both direct and indirect stimulation, but the adduction of the
interosseous and thenar muscles was very feeble, or almost nil. The same, only more marked in failure of
reaction to the induced current, is the case on the right side; even
with the strongest currents the supinator longus, a muscle which usually
remains intact in lead-poisoning, scarcely displays its contour, and in
the feeblest outline the tendons of the extensor carpi radialis longus
et brevis display themselves, but without producing any corresponding
movements. It is remarkable that muscles which
have their functions quite unimpaired, and are used at will by the
patient, and of the action of which he has never complained, should
react either not at all, or only in the smallest degree to the strongest
induced currents. This is the case for both the deltoids
(except the clavicular portion), for the biceps and brachialis internus.
With the constant current the deltoid, biceps, supinator longus, and the
extensors of the hands and fingers of both sides, with strong currents
(thirty to forty elements), give only fibrillar twitchings; in fact we
have in the paralyzed, as well as the unparalyzed muscles, the most
marked degenerative reaction, [588].® 2000
Article