- markable in the muscles which supply the thumb and fingers; and in
every case which I have seen the extensors suffered more than the flexors. The paralysis is hardly ever complete, except perhaps in the extensors of the fingers. When it is considerable, the position of the hands is almost characteristic of the disease. The hands are constantly bent, except when the arms hang straight down by the side; they dangle loosely when the patient moves; he cannot extend them, and raises one arm with the aid of the other. The palsy is attended, according to Tanquerel, with diminished heat in the parts, and feeble pulsation in the arteries which supply them. There is seldom any loss of sensation in the affected parts. But the paralysis sometimes affects the nerves of the other senses. Thus two cases of paralysis of the nerves of vision have been related by Dr. Alderson of Hull;[1] and Tanquerel says this affection is not uncommon in Paris, and is attended with dilated and immovable pupils. The latter author also once met with deafness in the same circumstances.—Patients affected with lead palsy usually complain of racking pains in the limbs and arms, digestion is feeble, and trivial causes renew the colic. From this deplorable condition it is still possible to restore the sufferer to health, chiefly by rigorous attention to regimen. But he too often dies in consequence of a fresh attack of colic as soon as he returns to his fatal trade.
The lead palsy, however, does not always come on in this regular manner. Sometimes the primary stage of colic is wanting, so that the wasting of the muscles and loss of power are the first symptoms. I have seen a characteristic example of the kind in a sailor who had been employed for a month in painting a vessel. He had great weakness and wasting of the arms and hands, particularly of the ball of the thumb; but except a tendency to indigestion, costiveness, and transient slight pain of the belly, he had suffered no previous disorder of the intestines. I have seen the paralytic affection confined to the extensors of one hand in a compositor, and Dr. Chowne met with a similar affection of both hands in a gas-fitter.[2] Dr. Bright observed palsy without colic in the case of a painter three times in the course of seven years.[3]—In like manner, according to Tanquerel, the neuralgic affection may occur severely without any precursory colic; and the same author has witnessed both coma and convulsions in the same circumstances.
Colica pictonum, with the collateral disorders specified above, is the only disease which has been distinctly traced to the operation of lead insidiously introduced into the body. But many other disorders have been ascribed to its agency. Boerhaave seems to have imagined that consumption might be so induced; and Dr. Lambe thought that to this cause may be traced the increased prevalence of "scrofula, phthisis, dropsy, chronic rheumatism, stomach complaints, hypochondriasis, and the host of nervous complaints which infest modern life."[4] These conjectures are wholly destitute of foundation in fact.
