***PLUMBUM METALLICUM. The Element. Pb. (***A. W. 206. 39). Trituration. ***PLUMBUM ACETICUM. Acetate of Lead. Sugar of Lead. Pb. (C2H3O2)23H2O. Trituration. ***PLUMBUM CARBONICUM. Carbonate of lead. Pure White Lead. Plumbic Carbonate. Pb. CO3. Trituration.
Clinical
*Amaurosis. *Anaemia. Anaesthesia. Aneurism. *Anhidrosis. Appendicitis. Asthma. *Atrophy. *Bone, *exostoses *on. Brain, softening of, tumour of. Bright’s disease. *Colic. *Constipation. Cystitis. *Depression of spirits. Diplopia. Dropsy. Dysmenorrhoea. Dysuria. Emaciation. *Epilepsy. *Epulis. *Eyes, *inflammation of. Ganglion. Gout. Haemoptysis. Haemorrhoids. *Headache. Hernia, Strangulated. Hyperaesthesia. Hypopion. *Ichthyosis. Intermittent fever. *Intestines, *obstruction of. Intussusception. Jaundice. *Jaw, tumour of. *Kidneys, affections of, granular. Liver, affections of. Lockjaw. Locomotor ataxy. *Melancholia. Metrorrhagia. *Myelitis. Nephritis. *Numbness Esophagus, stricture of. *Paralysis, diphtheritic, agitans. *Perichondritis. Proctalgia. *Progressive muscular atrophy. Prolapsus ani sciatica. Spine, diseases sclerosis of, tumour of. Spleen, affections of. Stricture. *Tabes mesenterica. *Tobacco habit. Tongue, paralysis of. Typhlitis. Umbilicus, abscess of, hernia of. Uric-acidemia. Vagina, spasm of. Vaginismus, *Veins, *varicose.
Characteristics
*Plumbum, the *Saturn of the Alchemists, has been proved by Hartlaub, Trinks, Hering, and Nenning. To their symptoms have been added those of numberless cases of poisoning among workers with lead and painters, symptoms from drinking lead-contaminated waters, from the use of lead in cosmetics, and from cases of suicide. In the old school metallic lead was seldom used, being considered inert, but Boerhaave gave it internally reduced to an impalpable powder for leucorrhoea, dysentery, syphilis, and gout (Teste). In the form of plaster and “Goulard water” the salts of lead have been largely used as external applications in skin diseases, vaginal and urethral injections, and much injury has not infrequently resulted, especially form repelled eruptions. The effect of the three preparations of lead enumerated above have all been included in the Schema, as no attempt has ever been made to keep them separate, nor has any specific difference been noted. Among painters and lead manufacturers the best-known symptoms are the colic and drop-wrist. In addition there are set up conditions of kidney irritation with albuminuria, ending in granular degeneration with attendant heart hypertrophy, optic neuritis, and blindness. There is an excess of uric acid in the blood of persons under the influence of lead, and actual gouty deposits and gouty attacks have been observed. In one case of lead poisoning I saw there was chronic enlargement of the knees and contraction of the lower limbs, completely crippling the patient. In another case there were small aneurisms almost all over the body. In those who have drunk lead-contaminated water the effects vary in intensity according to the amount of contamination and duration of exposure. When the poisoning has been going on insidiously for years a state of anaemia is set up, with dry, inactive, scaly skin, and invertebrate constipation *Tunzelmann (*B. J. H., xxxii. 17quoted *C.D.P., where a full collection of cases may be found) reports a number of cases of acute poisoning from drinking water containing lead: (1) a cook, ill three weeks. Unable to retain any food on stomach, constant nausea, and even when no food was taken frequent vomiting of greenish watery fluid, worse night. Skin yellowish, conjunctivae decidedly yellow. Tongue furred, coat at back very yellow, horrible taste, foetor of breath, bowels confined. Extreme debility. *Hydrast. 3 gave great relief, but three months later the hands became paralysed, which led to the testing of the drinking-water and the discovery of lead. (2) Youth, age 12, had bronchial catarrh with loose cough and consolidation of left apex. As soon as the poisoned water was stopped he rapidly got quite well. (3) An elder brother had haemoptysis, coughing up half a pint of blood. Nothing was found wrong with the lungs beyond slight feebleness of respiration at apices. Three months later, after a day’s rowing, the haematemesis returned with epistaxis. Now distinct dullness was found at right apex. Rapid recovery followed stopping the water. Caspar (*C. D. P.) relates the case of a pregnant young woman who swallowed three ounces of white lead on October 8th. The first symptoms set in some hours later with vomiting. Next morning she was found suffering from inflammatory pain and jaundice. The evening of the 10th she gave birth to a seven-months’ child, and died the following morning. The autopsy revealed: Features relaxed, skin dirty yellow. Bloody, frothy ichor escaped from nostrils in large quantities, and from genitals, saturating the bed, the mouth also, from which the tongue point protruded, was full of it. Abdomen distended and of stony hardness, genitals swollen and discoloured, brain markedly bloodless, pleura contained 8 oz. Of bloody fluid, lungs distended, filled with frothy, decomposed blood, heart empty, very soft, dirty brown, trachea dark cherry-colour. Pectoral muscles very soft, brown, the blood exuding from them being greasy. Liver dirty brown, very soft, spleen filled with black, tar like blood, both kidney very soft and full of blood. Blood in vena cava black, tar-like. Women who work with lead frequently abort, women who do not work with lead but whose husbands do, abort in even greater proportion. Children born under these conditions are frequently idiotic or epileptic. According to Teste, *Plumb. is *particularly adapted to adults, males rather than females, particularly to persons of a dry, bilious constitution, with somewhat jaundiced complexion, irascible, hypochondriac, or disposed to religious monomania. (But children are by no means excluded. I have seen apparently hopeless cases of marasmus in infants with large, hard abdomens and extreme constipations cured with *Plumb., usually in 3rd trituration of the metal or the acetate.) Teste mentions the following cases as having been successfully treated by him with *Plumb. (1) Chronic cystitis. (2) Stricture after gonorrhoea. (3) Tenacious salivation (mercurial), worse in damp weather, saturating pillow in sleep. (4) Excessively painful retraction of testes and penis, which seemed to re-enter hypogastrium (consequence of sexual excesses and repelled tetters). (5) Nightly bon pains (after failure of *Mercurius, &c.). (6) Pulling and pressive chronic headache in forehead, worse by mental labour, intolerable in company. (7) Mental derangement from syphilis with obscure paralysis of right arm, paroxysms of religious monomania, erotism without erection, periodic fever without sweat, cramp-like retraction of abdomen from time to time. (8) Nervous disease characterized chiefly by wandering pains in limbs, spasms of facial muscles, paroxysms of screaming, fright without cause, sudden fainting in passing from one room to another or entering a room full of company. (9) Marsh intermittent with quotidian or double tertian type, especially when splenic region is painful to touch. In such cases, says Teste, neither *Arsenicum nor *Chi. Can be compared to *Plumb. These cases bring out some of the keynotes of *Plumb., and chief among them is: *Retraction and sense of *retraction. “Violent colic, sensation as if abdominal wall were drawn back by a string to the spine.” Actual drawing in of abdominal wall were drawn back by a string to the spine.” Actual drawing in of abdomen in frequently present and is characteristic. The cheeks are retracted, sunken. Excessive and rapid emaciation. In the same category with colic are: Cramps, spasms, convulsions, paralyses, tremors. Frohling (*A. H. Z., cxxxii. 68 *Amer. *Hom., xxii. 422) relates the case of N. farmer, 46, who was taken ill in November, 1893, with attacks of colic with vomiting and extreme constipation, action only obtained by large enemata. Had been constipated in former years but without illness. Opium had given only temporary relief. After December, 1893, vomiting was rare, but colic increased in intensity up to February, 1894, when Frohling saw him first, and found him *wasted, to a skeleton, abdomen drawn in, appetite bad, felt ill, mind somewhat affected, unable to give sensible answers to questions. *Constant urgent call to stool, only small, hard, black balls passed. Liver dullness only heard from upper border of sixth to upper border of seventh rib. Lead poisoning was suspected, but as no evidence of it could be found *Plumb. 6 three times a day was prescribed. In six days colic attacks were less frequent, and less severe, two stools passed without enema, mind clearer. Improvement continued in all respects, and in fourteen days N. was able to leave his bed, to which he had been confined since November. By the middle of March he made an hour’s journey to see Frohling, and was hardly recognizable, he had gained so much flesh, and his liver was found of normal size. Wing field (*M. H. R., quoted *Amer. *Hom., xxi. 426) reported two characteristic cases: (1) Mrs. D., 50, no children, sparely built, very nervous, constipated fifteen years, takes a teaspoonful of Cascara extract every other night. Tongue coated with yellowish white fur. Has constant headaches, and after each motion is thoroughly exhausted, and has to lie down the rest of the day. *Plumb. 6x gr. iii. twice a day. In two days bowels commenced acting naturally. In three weeks headaches gone, tongue clean, much less nervous. (2) Miss M., 25, florid, has boils appears on face and arms, and chronic constipation. The constipation had been a trouble since she was twelve years old. Slight spinal curvature. Tongue furred, occasionally has headaches. Suffers much at menstrual periods. *Plumb. 6x twice daily at once relieved the constipation, and soon the boils disappeared. Patient soon felt quite well. Arriage (*La Homoeopatia, No. 9, 1893, *H. M., xxix. 190), of Mexico city, reports the case of a woman, 73, seized with symptoms of intestinal occlusion, violent colic, nausea, obstinate constipation, meteorism, complete anorexia, and no fever. *Nux relieved the colic, and then *Plumb. 12, and later 13, gradually brought about recovery in four days. Nash cured a severe case of post-diphtheritic paralysis in a middle-aged man. The leading symptom was *excessive hyperaesthesia could not bear to be touched anywhere, it hut so. *Plumb. 40 m (Fincake), a single dose, cured. Nash tells of a man, 70, attacked with severe pain in abdomen, and finally a large, hard swelling developed in ileo- caecal region, *very sensitive to contact or least motion. It began to assume a bluish tint, and on account of his age and weakness the man’s life was despaired of. But his daughter, the wife of a medical man, found the symptoms in *Raue under *Plumb., in the chapter on Typh. and *Plumb. 200 cured. Anaesthesia is as strongly marked as the hyperaesthesia of *Plumb. The excessive emaciation of *Plumb. and the action on the spine make it a remedy of the first importance in progressive muscular atrophy. Among the spasms are: Vaginismus, spasm of uterus and expulsion of its contents, sensation as if there was not room enough for foetus, spasm of bladder, of oesophagus, strangulated hernia. Clonic or tonic convulsive movements of limbs from cerebral sclerosis or tumour. Epilepsy preceded by vertigo, sometimes sighing, followed by stupid feeling. (In a case cured by Skinner, after a fit the head turned to the right. There was worse 8 to 9 a.m.) Paralysed parts lose flesh. Progressive locomotor ataxia. Restlessness, lassitude, faintness. Sensation in abdomen at night
