Chapter I: Front Matter

Transcriber’s Notes

Text printed in italics has been transcribed _between underscores_,
bold face printed text =between equal signs=. Small capitals have
been replaced with ALL CAPITALS.

Literature references are numbered and listed per chapter at the
end of the chapter, footnotes (indicated by letters in square
brackets) will be found directly underneath the paragraph, table or
illustration to which they refer.

More Transcriber’s Notes may be found at the end of this text.

LEAD POISONING AND LEAD ABSORPTION

INTERNATIONAL MEDICAL MONOGRAPHS

_General Editors_ { LEONARD HILL, M.B., F.R.S.
{ WILLIAM BULLOCH, M.D.

_THE VOLUMES ALREADY PUBLISHED OR IN PREPARATION ARE:_

=THE MECHANICAL FACTORS OF DIGESTION.= By WALTER B. CANNON, A.M.,
M.D., George Higginson Professor of Physiology, Harvard University.

[_Ready._

=SYPHILIS: FROM THE MODERN STANDPOINT.= By JAMES MACINTOSH, M.D.,
Grocers’ Research Scholar; and PAUL FILDES, M.D., B.C., Assistant
Bacteriologist to the London Hospital.

[_Ready._

=BLOOD-VESSEL SURGERY AND ITS APPLICATIONS.= By CHARLES CLAUDE
GUTHRIE, M.D., Ph.D., Professor of Physiology and Pharmacology,
University of Pittsburgh, etc.

[_Ready._

=CAISSON SICKNESS AND THE PHYSIOLOGY OF WORK in Compressed Air.= By
LEONARD HILL, M.B., F.R.S., Lecturer on Physiology, London Hospital.

[_Ready._

=LEAD POISONING AND LEAD ABSORPTION.= By THOMAS LEGGE, M.D., D.P.H.,
H.M. Medical Inspector of Factories, etc.; and KENNETH W. GOADBY,
D.P.H., Pathologist and Lecturer on Bacteriology, National Dental
Hospital.

=THE PROTEIN ELEMENT IN NUTRITION.= By Major D. MCCAY, M.B., B.Ch.,
B.A.O., M.R.C.P., I.M.S., Professor of Physiology, Medical College,
Calcutta, etc.

=SHOCK: The Pathological Physiology of Some Modes of Dying.= By
YANDELL HENDERSON, Ph.D., Professor of Physiology, Yale University.

=THE CARRIER PROBLEM IN INFECTIOUS DISEASE.= By J. C. LEDINGHAM,
D.Sc., M.B., M.A., Chief Bacteriologist, Lister Institute of
Preventive Medicine, London; and J. A. ARKWRIGHT, M.A., M.D.,
M.R.C.P., Lister Institute of Preventive Medicine, London.

=DIABETES.= By J. J. MACLEOD, Professor of Physiology, Western
Reserve Medical College, Cleveland, U.S.A.

_A Descriptive Circular of the Series will be sent free on
application to the Publishers:_

LONDON: EDWARD ARNOLD

NEW YORK: LONGMANS, GREEN & CO.

INTERNATIONAL MEDICAL MONOGRAPHS

_General Editors_ { LEONARD HILL, M.B., F.R.S.
{ WILLIAM BULLOCH, M.D.

LEAD POISONING AND
LEAD ABSORPTION

THE
SYMPTOMS, PATHOLOGY AND PREVENTION,
WITH SPECIAL REFERENCE TO THEIR
INDUSTRIAL ORIGIN AND AN ACCOUNT OF THE
PRINCIPAL PROCESSES INVOLVING RISK

BY

THOMAS M. LEGGE, M.D. OXON., D.P.H. CANTAB.

H.M. MEDICAL INSPECTOR OF FACTORIES; LECTURER ON FACTORY HYGIENE
UNIVERSITY OF MANCHESTER

AND

KENNETH W. GOADBY, M.R.C.S., D.P.H. CANTAB.

PATHOLOGIST AND LECTURER ON BACTERIOLOGY, NATIONAL DENTAL HOSPITAL
APPOINTED SURGEON TO CERTAIN SMELTING AND WHITE
LEAD FACTORIES IN EAST LONDON

LONDON
EDWARD ARNOLD
NEW YORK: LONGMANS, GREEN & CO.
1912
[_All rights reserved_]

GENERAL EDITORS’ PREFACE

The Editors hope to issue in this series of International Medical Monographs contributions to the domain of the Medical Sciences on subjects of immediate interest, made by first-hand authorities who have been engaged in extending the confines of knowledge. Readers who seek to follow the rapid progress made in some new phase of investigation will find therein accurate information acquired from the consultation of the leading authorities of Europe and America, and illuminated by the researches and considered opinions of the authors.

Amidst the press and rush of modern research, and the multitude of papers published in many tongues, it is necessary to find men of proved merit and ripe experience, who will winnow the wheat from the chaff, and give us the present knowledge of their own subjects in a duly balanced, concise, and accurate form.

This volume deals with a subject of wide interest, for lead is dealt with in so many important processes of manufacture--in the making of white lead; pottery glazing; glass polishing; handling of printing type; litho-making; house, coach, and motor painting; manufacture of paints and colour; file-making; tinning of metals; harness-making; manufacture of accumulators, etc.

The authors bring forward convincing evidence, experimental and statistical, in favour of the causation of lead poisoning by the inhalation of dust. This makes prevention a comparatively simple matter, and the methods of prevention are effective, and will contribute greatly to the health of the workers and the prevention of phthisis, which is so prevalent among lead-workers. Exhaust fans and hoods, or vacuum cleaners, for carrying away the dust formed in the various processes--these are the simple means by which the dust can be removed and the workers’ health assured.

LEONARD HILL.
WILLIAM BULLOCH.

_September, 1912._

AUTHORS’ PREFACE

Progress in the knowledge of the use of lead, the pathology of lead poisoning, and the means of preventing or mitigating the risk from it, has been rapid of late years, and has led to much legislative action in all civilized countries. The present is a fitting time, therefore, to take stock of the general position. We have both, in different ways, been occupied with the subject for several years past, the one administratively, and the other experimentally, in addition to the practical knowledge gained by examining weekly over two hundred lead-workers.

The present treatise takes account mainly of our own persona experience, and of work done in this country, especially by members of the Factory Department of the Home Office, and certifying and appointed surgeons carrying out periodical medical examinations in lead factories. The book, however, has no official sanction.

We are familiar with the immense field of Continental literature bearing on legislation against lead poisoning, but have considered any detailed reference to this outside the scope of our book, except in regard to the medical aspects of the disease.

Most of the preventive measures mentioned are enforced under regulations or special rules applying to the various industries or under powers conferred by the Factory and Workshops Act, 1901. Occasionally, however, where, in the present state of knowledge, particular processes are not amenable to the measures ordinarily applied, we have suggested other possible lines on which the dangers may be met. We have not reprinted these regulations and special rules, as anyone consulting this book is sure to have access to them in the various works published on the Factory Acts.

The practical value of the experimental inquiry described in Chapter VI., and the light it seems to throw on much that has been difficult to understand in the causation of lead poisoning, has led us to give the results in detail.

One of us (K. W. G.) is responsible for Chapters I., III., and V. to XI., and the other (T. M. L.) for Chapters II. and XII. to XVII.; but the subject-matter in all (except Chapter VI., which is the work entirely of K. W. G.) has been worked upon by both.

Our thanks are due to the Sturtevant Engineering Co., Ltd., London; Messrs. Davidson and Co., Ltd., Belfast; the Zephyr Ventilating Co., Bristol; and Messrs. Enthoven and Sons, Ltd., Limehouse, for kindly supplying us with drawings and photographs.

_September, 1912._

CONTENTS

CHAPTER PAGE

I. HISTORICAL--CHEMISTRY OF LEAD 1

II. ÆTIOLOGY 7

III. SUSCEPTIBILITY AND IMMUNITY 27

IV. STATISTICS OF PLUMBISM 44

V. PATHOLOGY 62

VI. PATHOLOGY--_Continued_ 81

VII. SYMPTOMATOLOGY AND DIAGNOSIS 110

VIII. EXCRETION OF LEAD 127

IX. THE NERVOUS SYSTEM 140

X. CHEMICAL INVESTIGATIONS 165

XI. TREATMENT 184

XII. PREVENTIVE MEASURES AGAINST LEAD POISONING 199

XIII. PREVENTIVE MEASURES AGAINST LEAD POISONING--_Continued_ 221

XIV. PREVENTIVE MEASURES AGAINST LEAD POISONING--_Continued_ 230

XV. DESCRIPTION OF PROCESSES 242

XVI. DESCRIPTION OF PROCESSES--_Continued_ 265

XVII. DESCRIPTION OF PROCESSES--_Continued_ 288

INDEX 305

LIST OF PLATES

FACING
PAGE

PLATE I. 92

PLATE II. 93

PLATE III. 95

PLATE IV. 276

LEAD POISONING AND LEAD ABSORPTION