Page:Treatise on poisons in relation to medical jurisprudence, physiology, and the practice of physic (IA treatiseonpoison00chriuoft).pdf/439

 ordinary colic; and it is consolatory to know, that a first attack, taken under timely management, is for the most part easily made to terminate in that favourable manner. In such circumstances it rarely endures beyond eight days. But it is exceedingly apt to recur, if, for example, the patient expose himself to what in ordinary circumstances would cause merely a common colic or diarrhœa; and if he returns to a trade which exposes him again to the poison of lead, the disease is sure to recur sooner or later, and repeatedly, unless he observes the greatest precautions. In one or other of these returns, sometimes even in the first attack, the colic is not succeeded by complete recovery, but gives place to another more obstinate and more alarming disease. This secondary affection is of two sorts. One, which occurs chiefly in fatal cases, is a species of apoplexy. The other, which does not of itself prove fatal, is partial palsy.

In violent and neglected cases of colica pictonum, the colic becomes attended in a few days with giddiness, great debility, torpor, and sometimes delirium; as the torpor advances the pains in the belly and limbs abate; at length the patient becomes convulsed and comatose, from which state very few recover. Tanquerel, who is unnecessarily minute in subdividing the various affections produced by the poison of lead, distinguishes four kinds of affections of the head, coma, epilepsy, delirium, and a combination of all these. A very rare termination allied to that now described is sudden death during the colic stage, without any symptom which would lead one to suspect its approach. A case of this kind has been related by M. Louis. His patient, five minutes after talking to the attendant of his ward, was found at his bedside in the agony of death; and no cause for so sudden a death could be found on dissection. Somewhat similar was a case which occurred in 1838 at the hospital of La Charité at Paris. A man labouring for three days severely under the colic stage of the disease, began to breathe stertorously soon after straining at stool, and died in three hours. In a case which occurred to Dr. Elliotson death was owing to concomitant perforation of the stomach, a concurrence which was probably accidental, but which was also once observed by Dr. Copland.

In cases, on the other hand, which have not been neglected, and particularly when the attack is not the first, the departure of the colic often leaves the patient in a state of extreme debility, which by and by is found to be a true partial palsy, more or less complete. This affection is sometimes present before the colic departs, but is apt to escape notice till the pain abates. Occasionally it supervenes on a sudden, but more generally it is preceded by a sense of weariness, numbness and tremor of the parts. The palsy is of a peculiar kind. It affects chiefly the upper exremities, and is attended with excessive muscular emaciation. The loss of power and substance is most re-*