Plumbum metallicum

Lecture LX — Plumbum and Stannum

Plumbum Metalucum.

( Belladonna, Platina, Nux vomica, Cuprum, Opium.

Plumbum. < < Opium.

( China. ^ ( Alumina.

The symptoms of Plumbum, or lead, may be studied from its main property, that is, its tendency to cause contraction of muscular fibre, both voluntary and involuntary. It will cause this contraction of muscles, and it will also cause contraction of the bloodvessels, because it affects the involuntary or non-striated muscular fibres. The first symptom that usually follows poisoning by lead, whether taken by the stomach in small doses, as in case of drinking water impregnated with it, or whether by inhalation, as in the case of painters, is lead colic, and this consists of horrible griping cramp-pains, with retraction of the abdominal walls, making the abdomen concave rather than convex. There is understood to be spasm of the recti muscles; as these are contracted, of course they draw the abdominal walls in. Pain radiates in all directions, generally following the course of the nerves, sometimes causing delirium when extending to the brain, dyspnoea when involving the chest, retraction of the testicles when extending in that direction, and violent cramps in the legs when reaching the nerves there. With this colic there is obstinate constipation, and in some cases, even stercoraceous vomiting.

The colic is antidoted by Alumina, Alume?i, Platina, Opium, Nux vomica, Arsenicum, Colocyntk, Sulphuric acid, Zincum, or Belladonna, and is prevented by alcohol.

Next the symptoms of Plumbum that are of a paralytic character. The first characteristic symptom here is wrist-drop from paralysis of the extensor muscles of the wrist. This Plumbum has cured when it has arisen from other causes than lead-poisoning. This paralysis extends to other parts of the body, always involving extensor muscles in preference to flexors. There appears on the border of the gums a blue line, known as the gingival line of lead poisoning. It is caused by the sulphur that exists in the tartar on the teeth combining with the lead in the bloodvessels, and forming a deposit of insoluble sulphide of lead. As I have said, the paralysis extends and involves other parts of the body, and then it is characterized by atrophy of the affected parts, which is therefore due to true organic changes. Thus you find Plumbum indicated in paralysis from disease of the spinal cord when that nervous structure has undergone fatty degeneration or sclerosis. Plumbum suits very nicely that disease known as multiple cerebrospinal sclerosis. It is indicated by this symptom: tremor, followed by paralysis.

We often find Plumbum indicated in paralysis with contracture. Progressive muscular atrophy may also call for Plumbum. Plumbum tends to produce non-development of the uterus. We may, therefore, find it indicated in cases of tendency to abortion. The foetus in utero increases in size, but the muscular fibres of the uterus do not develop in proportion, hence the uterus is no longer able to accommodate the growing foetus and abortion ensues.

Sometimes we find Plumbum indicated in delirium, very much like that of Belladonna; the patient bites and strikes at those near him; but it differs from that of Belladonna in this: there is tremor of the head and hands, and yellow mucus collects about the mouth and teeth. The delirium, moreover, alternates with colic, which is not the case in Belladonna .

Other cerebral disturbances from lead-poisoning are not common, but still the following may be met with: insomnia, severe headache, either occipital or frontal, with or without vertigo; noises in ear; disordered vision; diplopia; amaurosis; contraction of pharynx, though liquids are swallowed in gulps and greedily; mind weak, morose, and sad; preceded by albuminous urine.

Plumbum has frequently caused epilepsy. The characteristic symptoms which indicate it are paralytic heaviness of the legs before the attack, and paralysis and prolonged snoring sleep afterwards. It is especially indicated in convulsions from cerebral sclerosis or tumor. In constipation you may use Plumbum when the retraction of the abdomen already mentioned is present, and when there is marked spasm or contraction of the sphincter ani. There is urging to stool, and the patient complains of a sensation as though a string were drawing the anus up into the rectum.

It may be mentioned in passing that Baryta carbonica has a colic with retraction of the umbilicus like Lead. Thallium has the same symptom as an accompaniment of violent lancinating pains through the stomach and bowels, following each other rapidly like electric shocks. This remedy has relieved the fulgurating pains of locomotor ataxia. In its action on the kidneys Plumbum produces granular degeneration or cirrhosis of those organs. There is very little dropsy or albuminuria, but a marked tendency to uraemia and consequent convulsions.

Stannum.

( Causticum.

Stannum. \ Phosphorus, Sulphur.

Sepia, Pulsatilla, etc.

\ V Pulsatilla.

f Exhaustion.

Paralysis.

Nerves. < .

bpasms.

^ Neuralgia.

Mucous membranes.

Fevers.

Organs.

Stannum is a drug that has not many symptoms; hence it can be disposed of very quickly. Its complement is Pulsatilla. The Stannum patient is usually sad and lachrymose, just like Pulsatilla. Crying usually makes the patient worse. This low-spiritedness is found in the lung troubles for which Stannum is your remedy. This is rather different from the usual mental state of consumptives, who, you all know, are generally hopeful, almost to the last hour of life. Stannum is particularly indicated when they are low-spirited, hence it is rarely indicated in true tuberculosis. The woman for whom Sta?mzim is indicated is also nervous and weak; so nervous, irritable, and weak is she, that she becomes anxious and has palpitation of the heart, even from so little exertion as giving directions concerning her household affairs. She complains of a sensation of goneness in the stomach and chest. This nervous exhaustion is exhibited in various ways; it is particularly induced when the patient goes down stairs, more than when ascending. She feels as if she could not walk down stairs, or as if she had not sufficient strength in her limbs. This exhaustion may be exhibited in another way: the patient does not complain much about walking, but on trying to sit down she fairly drops into the chair. This is not an imaginary symptom. You will meet it in uterine affections.

In the mental symptoms you may compare Stannum with Natrum mur., Pulsatilla, and Sepia. Natrum mur. has melancholy, sad, weeping mood, but consolation seems to aggravate. On trying to comfort him, he becomes enraged.

The Pulsatilla patient is of a mild, tearful, yielding disposition. She rather likes consolation. She has scanty, delayed menses, while