640 POISONS : THEIR EFFECTS AND DETECTION. [§ 815 . 
the Jacob’s Hospital, Leipzig, forty-four patients (or about 31 per cent.) 
suffered from colic. Arthralgia—that is, pains in the joints—is also 
very common ; it seldom occurs alone, but in combination with other 
symptoms. Thus, in seventy-five cases of lead-arthralgia treated at 
Jacob’s Hospital, in only seven was pain in the joints without other 
complications, fifty-six being accompanied by colic, five by paralysis, 
and seven by other affections of the nervous system. The total per¬ 
centage of cases of lead-poisoning, in which arthralgia occurs, varies from 
32 to 57 per cent. 
Paralysis, in some form or other, Tanqueril 1 found in 5 to 8 per cent, 
of the cases, and noticed that it occurred as early as the third day after 
working in lead. The muscles affected are usually those of the upper 
extremity, then the legs, and still more rarely the muscles of the trunk. 
It is only exceptionally that the paralysis extends over an entire limb ; 
it more usually affects a muscle-group, or even a single muscle. Its 
common seat is the extensors of the hand and fingers ; hence the expres¬ 
sion dropped-wrist,” for the hands droop, and occasionally the triceps 
and the deltoid are affected. The paralysis is usually symmetrical on 
both sides. Although the extensors are affected most, the flexors nearly 
always participate, and a careful investigation will show that they are 
weakened. If the paralysis continues, there is a wasting and degenera¬ 
tion of the muscle ; but this is seen in paralysis from any cause. The 
muscular affection may cause deformities in the hands, shoulders, etc. 
Anaesthesia of portions of the skin is generally present in a greater or 
less degree. A complete analgesia affecting the whole body has been 
noticed to such an extent that there was absolute insensibility to burns 
or punctures ; but it is usually confined to the right half of the body, 
and is especially intense in the right hand and wrist. 
§ 815. The older writers recognised the toxic effect of lead on the 
nervous system. Thus Dioscorides speaks of delirium produced by lead, 
Aretaeus of epilepsy, and Paul of iEgina refers to it as a factor of 
epilepsy and convulsions. But in 1830 Tanqueril first definitely de¬ 
scribed the production of a mental disease, which he called “ lead 
encephalopathy .” This he divided .into four forms—(1) a delirious 
form ; (2) a comatose ; (3) a convulsive ; and (4) a combined form—com¬ 
prising the delirious, convulsive, and comatose. Dr Henry Rayner, 2 
and a few other English alienists, have directed their attention to this 
question ; and, according to Dr Rayner’s researches, the number of male 
patients admitted into Hanwell Asylum, engaged in trades such as 
plumbing, painting, and the like, is larger in proportion to the number 
1 Tanqueril des Planches, Traite des Maladies de Plomb, Paris, 1839. Tanqueril’s 
monograph is a classical work full of information. 
2 See an important paper, “ Insanity from Lead-Poisoning,” by Drs H. Rayner, 
Robertson, Savage, and Atkins, Journ. of Mental Science, xxvi. 222 ; also a paper 
by Dr Barton, Allgemeine Zeitschrift f ur Psychiatrie, xxxvii H. 4 , p. 9 . 
