Some Landmarks in the History of Lead Poisoning
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COPYRIGHT, 1931 SOME LANDMARKS IN THE HISTORY OF LEAD POISONING By RALPH R. MAJOR KANSAS CITY, KANSAS REPRINTED FROM NEW SERIES, VOL. 3, NO. 2, PAGES 218-227 ANNALS OF MEDICAL HISTORY PUBLISHED BY PAUL B. HOEBER, INC., NEW YORK PAUL B. HOEBER, INC., 76 FIFTH AVENUE, NEW YORK SOME LANDMARKS IN THE HISTORY OF LEAD POISONING^ RALPH H. MAJOR KANSAS CITY, KANSAS of Aegina is frequently sensation unimpaired, at other times held up by the medical his- with involvement of both motion and torian as an example of the sensation. So, whatever Paul’s short- PAULlow state into which the prac- comings, he has left us the first titioner of medicine in the seventh account of epidemic lead poisoning century had fallen, because he fre- that we possess today. This, to be quently apologetically disclaimed any sure, may be only a description of originality and because he constantly what the Ancients also saw but their emphasized that the ancients knew accounts have either not been pre- all of medicine that was worth know- served or are not as yet unearthed. ing and that he was merely their Avicenna, the “Prince of Phy- humble scribe. However, Paul has sicians” some three hundred years, his good points. Few physicians, an- centuries later observed the same cient or modern, have been so modest species of epidemic colic and wrote as to write seven books of medicine that “the paralysis is the crisis of the without claiming any originality, and colic; and to many the sensation Paul, despite his self-effacing attitude, remains, and those who recover, re- did make some solid contributions cover by paralysis, for nature expels to medical science. In his Third this material and brings it to the Book of “De re medica,” he writes exterior.” in a very interesting fashion about an Neither of these writers, however, epidemic of colic which prevailed in expresses the belief that the disease his time. they described was the result of lead. Yet many before Paul I consider moreover a colicky affection, physicians which still becomes violent from a kind were familiar with the effects of lead. of collection of humors, which took its Indeed Nikander, who wrote his “ origin from regions in Italy, moreover Alexipharmaca” in the 2nd century in many other places in Roman territory b.c. describes both colic and paralysis whence it spread like the contagion of a as the result of the ingestion of lead. pestilential plague. Wherefore in many Nikander’s verses on cerussa as trans- cases it passed into epilepsy, to some lated by Euricius Cordus close with: there came loss of motion with sensation unhurt, to many both, and of those who Interdum obrepens oritur cum frigore somnus, Torpet Ianguentia fell victims to the epilepsy, very many iners motus, membra fathiscunt. died. Of those indeed who were paralysed, not a few recovered, for the cause which Sometimes a stealthy stupor comes with a attacked them ended by crisis. chill is The feeble limbs droop, motion becomes slow, This description generally ac- then still. cepted as the first description of lead colic, since our author describes at- Nikander’s verses on litharge were tacks of colic followed by paralysis translated by Jacques Grevin de Cler- of the extremities, sometimes with mont into quaint sixteenth century 219 Some Landmarks in the History of Lead Poisoning French, in the following spirited considered the father of materia, passage: medica, wrote that cerussa “causes hiccough, cough and dryness of the N’ignores ie te pri’, la Litharge mortelle Dont la charge se sied dans Ie ventre, & cruelle Fait autour du nombril enfler & tournoyer Un grand vent tout bruyant, tel que peut essayer & Un homme tourmente par la douleur cachee P A V L I* Que Iui est apportant I’incurable trenchee: j$GI>NETA OP VS DE RE ME* elect niweprimtm mte^rm, Latinita* This verse is too to picturesque te donatum per IO A N N E M a be marred by translation. Sir C V I N T E RI V M Harrington dot John could probably have Andernaem, turned it into equally quaint Eliza- ftorem me bethan English. But the reader with diem* only a passing knowledge of French ADTECTIS IN EVNDEM DO sees here a striking picture of the {{ijjitnis & utilijjimis anno* poor man who has taken litharge only rationibuf ab eodem Ander* net* atis to be tormented by an intense inward elncu.br f pain and the stirring up of a mass of C'VM INDICE COPIOSISSIMO gas which blows out his navel and causes an incurable colic. These passages leave no doubt in our minds that Nikander who has been described as the most ancient medical writer after Hippocrates, knew fijrud Andream Arriuabenum* that lead produced both colic and Venrt.f< D I I * paralysis. He also was familiar with the M X X X X disturbances of lead Fig. i. Title-page of Paul of Aeginas “de re ocular poisoning: Medica.” 1542. Falso modo ante oculos rerum simulachra videtur. tongue, the extremities become lan- False images ofthings only are seen before the guid, the mind gives way, the limbs eyes. arc paralysed,” and Galen very ex- Indeed Nikander might well be plicitly warned against drinking water called the poet laureate of lead colic. that ran through lead pipes, which But this term would fail to do justice caused those who drank it to be sub- to his pharmacological or poetic tal- ject to intestinal disorders. Vitruvius ents, for he wrote verses not only remarked that “water is much health- about lead but about many other ier from clay pipes than from lead poisons. Nikander was praised by pipes: since it seems to be poisoned Cicero, imitated by Ovid, but Plutarch by the lead, for white lead is formed was unkind enough to say that his from it: this moreover is said to be works had nothing poetical about harmful to the human body.” them except the meter and that his Paracelsus, in his works Das Neudte style was bombastic and obscure. Buck in der Artzney (“de Contrac- Many other authorities were also turis”),das istvon krummen und lahmen familiar with certain features of lead Gliedern (the ninth book of thera- poisoning. Dioseorides, who is usually peutics, “de Contracturis,” that is Annals of Medical History 220 concerning crooked and lame mem- remedies the people sometimes rose bers) speaks of Von Ursprung der up against him and made things so Contractur die auss der Colica ent- unpleasant that he was forced to seek another location. Another physician in those distant NICANDRI times who has left us a good account POET AE ET MEDICI AJU of a case of lead poisoning Jean Alcxiphdrmci was tiquifinti Thtridcd cr m Fernel of Amiens. We remember him uerfturedaftd,per EVfUClVM Cordum,Mcdicm* as a patriotic Frenchman who, smart- ing with resentment because syphilis IDEM IN EADEM. was so universally called the morbus Contrdquosqjfudsmorfus iftusqj mcdtUt gallicus or French disease, insisted Nic&ndriru, fdcro cArmine Mufrdocct, that it be called the Disease of Prtterqudmdir* liuentu uulncrdlingu*, Venus or the venereal disease, as lUudnullapotefimccrc curamlm- Jacques de Bethencourt had suggested. Erg) quis hdnc dubitctpciorcm dicercpcjlcm» In his treatise “de Iuis vcnereae” he um que totus cunfta Q hubet ucnouliber* records the following history: A painter of Anjou, thirty years of age, of a good and sound constitution, noticed for the first time in 1557, that his fingers were heavier than usual, that they were numb and difficult to move; after several days he felt them contract and move convulsively, finally the affec- tion was progressively aggravated, until the fingers remained flexed and could not be fRAN C O F OR DIAE Apui Cbr& extended. Moreover, the affection fimm Egcnclphw* reached the hands and arms, and so by the chilling nerves Fig. 2. Title-page of Nikanders “Theriaca of the and tendons, & Alexipharmaca.” 1532. Translated by Euricius filled with a thick humor, they became Cordus. heavy, trembling and numb. Soon after he experienced the same trouble in his springt an Handen und Fiissen aus- feet, and walking became impossible. getheilt (concerning the contracture However, he had very little pain in his that comes from the colic distributed feet, nor in his arms and hands. The poor to the hands and feet). Paracelsus, who fellow, as if he had not had already as one of his critics remarks “in the enough ills, saw a symptom appear much midst of the most incomprehensible more serious and much more painful; for jargon, sometimes writes intelligibly” an acute and unbearable pain now evidently in the course of his wander- attacked his stomach and hypochondrium ings saw and studied lead colic. It and extended throughout his abdomen. did not let has also been pointed out that Para- This pain up during the day or night, it was attempted but in vain celsus who was very fond of prescribing to ease it with clysters, hot applications, lead as a remedy, may have himself baths and other remedies. caused many of the cases he saw. Indeed this may explain in part the Fernel attributed the attack to circumstance that when he located in cinnabar, a mercurial pigment which a town and began dispensing his the painter constantly wiped off his 221 Some Landmarks in the History of Lead Poisoning brushes with his fingers. Later authors, tered references by physicians to lead however, have seen in this account the colic, it was Francois Citois who first description of a typical case of paint- established its right, as it were, to be ers’ lead colic with paralysis and have Nicander.