- pleasant symptom except slight colic, which seldom came on till after
the fourth dose.[1] I have often given it in divided doses to the amount of eighteen grains daily for eight or ten days, without remarking any unpleasant symptom whatever, except once or twice slight colic. Van Swieten even mentions a case in which it was given to the amount of a drachm daily for ten days before it caused any material symptom.[2]
Yet facts are not wanting to prove that acetate of lead in an improper dose will produce violent and immediate effects. The symptoms are then either those of simple irritation, or more commonly those of inflammation united with the peculiar spasmodic colic of lead, and sometimes followed by convulsions and coma, or by local palsy.
In one of Sir George Baker's essays there is an instance of immediate and violent symptoms having been caused by a drachm taken twice with a short interval between the doses. The subject was a soldier who took it in milk to cure a diarrhœa. Five hours after the first dose he was seized with pain in the bowels and a feeling of distension round the navel. After the second these symptoms became much more acute; and he was soon after seized with bilious vomiting, loss of speech, delirium, and profuse sweating, while the pulse fell down to 40. He recovered, however, with the aid of diluents and cathartics.[3]
A case which proved rapidly fatal has been related in a French journal. A drummer in a French regiment, who was much given to drinking, stole some Goulard's extract, and drank it for wine. Neither the first symptoms nor the dose could be ascertained. On the second day he was affected with loss of appetite, paleness, costiveness, and excessive debility; on the third day he had severe and excessive colic, drawing in of the belly, loss of voice, cold sweats, locked jaw, and violent convulsions; and he expired before the evening of the same day. The morbid appearances will be mentioned in their proper place. Sugar of lead was detected in the stomach.[4]
In both these instances the disorder excited partook very much of the character of the spasmodic colic which is caused by the gradual introduction of lead into the body; and in the last the whole course of the man's illness was very like that of the worst or most acute form of colica pictonum. But in another example which came under my own notice, the symptoms were more nearly those of ordinary irritation,—namely, vomiting, burning, and pricking pain in the throat, gullet, and stomach, with trifling colic subsequently; but the patient recovered in two or three days. The quantity taken was supposed to exceed a quarter of an ounce. So, too, in a case which occurred to M. Villeneuve of Paris, the symptoms were chiefly vomiting and purging, with faintness and some convulsions. His patient swallowed intentionally above an ounce of acetate of lead in solution.
