Below are the main rubriks (i.e strongest indications or symptoms) of Plumbum Metallicum in traditional homeopathic usage, not approved by the FDA.
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586, John F. Luck, M.D., Med. Record, vol. xiv, 1878, p. 158, J. F., aet. fifty-one years, after a protracted debauch, took 3 ounces Acetate in water; 587, Dr. M. Bernhardt, Berlin, Klin. Woch., June, 1878 (Lond. Med. Rec., July, 1878, p. 281), a case of lead palsy (cause not given); 588, same, ibid., J. W., aet. twenty-nine years, has been a painter sixteen years.
After sleeping three hours he awoke feeling tolerably well; was about the village during the day, and only suffered from slight colic. I was summoned twenty-four hours after he had taken the poison and found him pale, anxious; pulse 58, feeble; temperature 97° F.; abdomen tense and retracted. He had vomited three pints of fluid matter containing blood and shreds of mucus; ejection black from change of Acetate to lead sulphide; six hours after vomiting, persistent, copious, without straining; prostration extreme; hands and feet numb; calves of legs cramped; pulse 50; no dejection; no urine voided since taking the Lead abdomen hard and nodulated; colic pains constant, particularly severe and burning at pit of stomach; general tremor of body; unable to stand on account of vertigo; urgent thirst; delirious. Four hours after (after Ol. ricini, Ol. tiglii, etc) bowels had moved freely, dejected matter similar to that vomited, plus small quantity of scybala. Four hours later had passed 4 ounces of Highly-colored urine; blue line distinct along edge of gums; greatly prostrated; vigilant; delirious (potomania?),
A. T., aet. forty-nine years, is a ruddy, healthy looking woman, and, excepting the paralysis of her left arm, considers herself well. The smallness and flatness of the left shoulder as compared with the right are very striking; the acromion projects forwards, and between it and the head of the humerus there is a furrow in which the index finger can be laid; the entire left upper arm is thinner than the right, especially on the flexor aspect; the forearm is overextended on the humerus and cannot be flexed by any effort of the patient. If you tell her to bend her left arm, she swings the whole limb upwards over her shoulder, and then the forearm falls of its own weight on the humerus. The arm bent by this means can be actively extended. If we partially bend the forearm upon the upper arm, and then ask patient to continue the movement, by a great exertion she is able to do so, but this is effected by the flexor carpi ulnaris and flexor digitorum profundis, which can be seen and felt to contract. Supination of the left forearm is not possible; if the arm be passively supinated pronation is readily effected. The movements of the left hand and fingers are in every respect free; the hand is a little curved and the skin bluish red, but no oedema or eruption is present; there is no atrophy of the interosseous or thenar muscles; the arm can be raised from the shoulder in spite of the visible atrophy, and the clavicular fibres of the deltoid can be seen to contract; adduction, internal and external rotation, and drawing of the arm are all well performed, although the last is not quite so perfect as on the right side; the right arm is quite normal, except a distinct atrophy of the ulnar side of the extensor aspect of the forearm, which is associated with inability to completely extend the fingers, the basal phalanges of the thumb and index finger being alone perfectly extended, the remainder persisting in a state of half flexion in spite of the strongest voluntary efforts, the middle and ungual phalanges of the same fingers being, however, as perfectly flexed and extended as in health. She feels a certain subjective sense of weight in the left arm. Electrical examination gives the following In the right arm the muscles all react well to direct and indirect stimulation, except the extensor communis digitorum, which does not extend the three fingers above mentioned; the extensor capri radialis reacts more feebly than normal, although its contour is prominent. In the left arm the deltoid reacts only near its origin from the clavicle; the biceps and both supinators are absolutely without reaction; it is questionable whether or not some intact fibres of the long supinator exist in the upper arm where it is covered with fat. All the muscles of the arm, forearm, and hand react to both direct and indirect stimulation. Placing the electrode at the point mentioned by Erb, as that from which it is possible to stimulate both the biceps and long supinator together (at the exit of the fifth and sixth cervical nerves between the scaleni), gives a marked reaction of the muscles in question on the right side, but remains without effect even, with much stronger currents on the left. With the anode of the constant current on the neck, and the cathode on the right deltoid, a feeble contraction occurs with twenty-two cells, while on the left side thirty cells produce only a quick twitching of the clavicular fibres, the bulk of the muscles remaining unexcited; with thirty-three cells the remainder of the left deltoid reacts. The left biceps does not contract, the right contracts with thirteen cells. By stimulating the right radical nerve with twenty cells, there is short quick movement in the index finger and thumb. The muscular fibres of the extensor communis, from the three outer fingers of the right hand, do not react to direct or indirect stimulation. All the muscles of the left arm, innervated by the radial nerve, contract with twenty cells, except the supinators. We have in the case before us paralysis and atrophy of the deltoid, the biceps, and brachialis anticus, as well as of both supinators on the left side, and a part of the fibres of the extensor communis digitorum of the right side,
After several attacks of colic one night, without any affection of the sensorium, paralysis of both hands and fingers supervened; the shoulders and the upper arms remained freely movable; extension of the forearm on both sides was free; equally flexion of the forearm on the upper arm; the first interosseous space was not only sunken, but there was decided atrophy of the ball of the thumb, and on both sides the interosseous spaces were sunken, and the interosseous muscles were atrophied and incapable of function, so that the lateral movements of the fingers and the extension of the middle and ungual phalanges were not possible; the hypothenar eminences were also diminished in both hands; there was also paralysis of the muscles supplied by the radial nerves on both sides, and of some of those supplied by the median and ulnar nerves. But these undoubtedly interesting phenomena pass into the background when we consider the result of electrical exploration. With the induced current of the muscles supplied by the radial nerve on the left (the less affected) side, only the extensor carpi ulnaris and supinator longus react, but very feebly; all the other muscles remain unaffected, and these by direct and indirect stimulation. On the other hand, the muscles supplied by the ulnar and median nerves on the left side contract very forcibly to both direct and indirect stimulation, but the adduction of the interosseous and thenar muscles was very feeble, or almost nil. The same, only more marked in failure of reaction to the induced current, is the case on the right side; even with the strongest currents the supinator longus, a muscle which usually remains intact in lead-poisoning, scarcely displays its contour, and in the feeblest outline the tendons of the extensor carpi radialis longus et brevis display themselves, but without producing any corresponding movements. It is remarkable that muscles which have their functions quite unimpaired, and are used at will by the patient, and of the action of which he has never complained, should react either not at all, or only in the smallest degree to the strongest induced currents. This is the case for both the deltoids (except the clavicular portion), for the biceps and brachialis internus. With the constant current the deltoid, biceps, supinator longus, and the extensors of the hands and fingers of both sides, with strong currents (thirty to forty elements), give only fibrillar twitchings; in fact we have in the paralyzed, as well as the unparalyzed muscles, the most marked degenerative reaction,
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