Document QgLNr6V1OKBqdJpKBJ5RQ6LO4

aC ersi J** w fe; M* ;I se Is O 8 ** & 8 I O sm5r MOu r O' f #&! IrtHa+* 8$ ft!* *OJS & ef <* fi** g*0+ bC5* Is sI 10* H 1! &! 8 p> tfg*** i td 8f ta o H iOtt B mind i s too a c tiv e to alios? sleep* ad th at when a r dream -like s ta te in which a l l kinds o f grotesqu The attempt to sleep i s more fa tig u in g than to rem Haases. Anor&xls. sad VoKjtlpg:* These symptoms sa m in g . & sickening t a s t e , not describeA as met& development o f these symptoms. Such an Individua p o sitiv e aversion , though as the dqy g o es on he fe and w ith r e lis h in the oveaing. However, m atta c p recip ita ted a t cay time by the odor o f te tr a e th y je c tio n s! odors* T ertlro and Headache. N either o f these aro pro something approaching these, in the form o f a d u ll complained o f . O ccasion ally, however, the vertigo !dig;c u lir "eaksegg. Borne degree o f weakness i s a very p e r sist eat eom plaint. I t does not appo^r u w e ll sta b ilised , and appears to be due in most o Itch in g o f th e skin i s an ocoasioual dis The above symptoms are unvaryingly acca P allor* This i s so uniform as to be im d estru ctio n , but ratheap to a gen erally inadequate Bounced f a l l in blood pressure* S^mag^3L-Bio^ij rm m m * She blood p They represent among the most r e lia b le d ia g n o stic * J I *n I1 % 3 5 M & I % I I< Is I Ii (Ti ta 38 * ri 4 ! 4* & 1v*ota>i -0 a S ri I g I0 1 I? 1 5 <9 -0 aI 14 1 0 *& I s g a a *Cr-34 a g #. % f*Bf* a8 a aOAr4 i * 3 i J 3 iO S * * S3 PS a :Ga ** a * JS o %U aXi -S !1 Xi I O fi toa $ ISi 3 3 OCri, *O4 Oi g d si s s t ** i 5 e; exposure over a etisidersble period o f lisas {months in the blood picture* in a d d ition to the above sysgit in a few such oases a lso * Here ca refu l examination sio n a l stip p led erythrocyte* w ithout the dim inution erythrocytes* She leucocyte count in such & e sse i increased one or two thousand above the previous m abnorm alities in the blood picture tend to disappea exposure and the in stig a tio n o f ibo rs p e u tle m aeare In more severe ea ses the sympt-OKs are or and anorexia are e sp e c ia lly proacunoed h ith the is weakness on exertion* and the Erhnorrsal blood press prominent s y s te m * t'hs p ersisten ce o f t h is con d it the chronic fa tig u e o f low grads infect!crus d isease however* a l l the symptoms disappear, am no resid u a In acute eases* a cen tral nervous system cB een titl ohar& cterietic o f the condition The p a t in a conetsnt s ta te of excitem ent* which rssy progre him maniacal (Ho ease o f the w r ite r 's has present ca ses have been seen by him* Observations made on sefce of co so le t cuesa} The mania resem bles an a lc o i t the v ictim ta lk s con stan tly end i s in constant f the point o f attaci& tg him His struggling to esca strain ed or quieted in some fashion* hs i s lik e ly t p ossible* oven to leaping out o f an upper wisdom* n 0 consideration o f th e yaptom end eigne tog e t tor w ith one hand, atch poisoning m y not s a fe ly be excluded b sign s considered character! Stic o f ordinary lead pois o f the item s which go to malae up the c lin ic a l asp ect t i c o f i t a lo n e, The conditions which o ffe r the g r e d ifferen tia l diagnosis are tuberculosie, sy p h ilis, ch sub-acute o in a s itie , cafi other chronic I s f e c t io .e w it fin d in g o f sig n ifica n t q u a n titie s o f lead in the urin certa in d iffe r e n tia l point in c er ta in ease. Howeve diagnosis are liise ly to fee m m in those ca ses in wh cant exposure to te tr a -e th y l lead* 1m m * The treatm ent which has been caployed in ti based upon several co n sid era tio n s, in the absence o f excreted by the poisoned in d ivid u al in the form o f in le a st* I t eecrn obviou s, th e re fo re , that t h is organ converted in to in o rg m io eosapousds o f lead* From t h In the symptomatology o f te tr a -o th y l lead poisoning in g , a r is e e ith e r from & unique d istrib u tio n o f lead d ifferen ce i n th e actu al q u a n tities present in the bo th ese canola ciotae, the treatment o f te t r e - e t l^ l load treatment o f load poisoning o f other types* 00 a s follow s CD Heavy m etals oonfcln w ith sad in ju re liv in (2) She combination o f heavy m etal at tie s o s the presem e o f su ffic ie n t concentrations o f s a lts o a s to resto re the tis s u e to normal p h ysical sta te * a form fo r excretion* |3 j T ^taptoiss o f acid in to x ica tio n and edem poisoning* e sp e c ia lly o f the acute type* may be cce& means* Taut actu al treatment co n sisted o f th e adm Bicarbonate or Sodium C itrate* ilagnesium Oxide* sod su ffic ie n t to Bake end m aintain n eu tr a lity o f th e u mixturo o f such s a lt s are required fo r t h is purpose Magnesium Sulphate was added to the above lie t * give day in order to m aintain a free d iu resis* The bowe secretion o f lea d by means o f sa lin e ca th a rtics* S showed esy evidence o f the developsaant o f acute edem c itr u s fr u it Ju ices mere adm inistered* that th e u se o f opium compounds m d ch lo ra l hydrate insomnia i s an exceedingly dazgerous p ractice) I t was found that a fte r a thorough a lk o lin severity* u su a lly disappearing in a fe e days* The 9900 _g>{ blood pressure also tended to p e r sist* However th o f symptoms6 end so relap se in to p reviou sly severe possible* of course that th is resu lted la rg ely fros eth y l lead* and from the r e s t sad d iv ersio n occasion sad recreation (Hone o f th e se p atien te were put to them was dangerously 111* and a l l o f them maintaine o f bed* ) On the other hsd i t i s probably not w delayed e ffe c ts of e ith e r ordinary load poisoning o poison!r^r has appeared in any o f those cases* Expe study o f th ese p a tie n ts i s to be node the su bject o bat on c lin ic a l evidence clon e the w riter fo o ls ju s s e t hod o f treatment a s th e mast sat ic factory one wh opinion o f the w riter th at the b e n e fic ia l e ffe c ts o sulphate in arsen ic end lead p o iso n ia g ^ a a d Potas explainable m. the b asic o f the p rin cip les above sta e ffe c t may be obtained from th e u se o f l i $ i t n a ta l concentration then these} The e ffic a c y o f th ese t mani acal types o f to tra --eth y l lea d poisoning has no however* th a t in m acute ease o f inorganic lead po symptoms* Such & course o f treatment* vigorously c disappearance o f cereb ral m anifestation s w ith in & p and The R e v e r sa l ' Jour. l a b . and C The A c t iv a t io n o Heavy M etal S a l t s : 1, 736, (Sept.) 1 ( 3 ) W e i s s , H. B. . A M ethod o f T rea P oison in g: J.A.M The P r i n c i p l e s o . C hlorideC P bisdrL ing J.A The T reatm ent o f . A rch, o f T nt, Me (4 ) D e n h i e , C . C . , and McBride, Wm. 1 . : Dermatitis, M er lead Intoxication ( Dec. 27) 1924. ( 5 ) McCord, Carey P . R e p o r t o f C a s e . (September) 1924 ){