ON THE ACTION 
OP 
WATER ON LEAD PIPES, 
AND 
THE DISEASES PROCEEDING FROM IT. 
BY 
HORATIO ADAMS, M. D., 
OP WALTHAM, MASS. 
PRESENTED TO THE AMERICAN MEDICAL ASSOCIATION, 
AT ITS SESSION OF MAY, 1852. 
PHILADELPHIA: 
T. K. AND P. G. COLLINS, PRINTERS. 
1852. ON THE ACTION 
OF 
WATER OR LEAD PIPES, 
AND 
THE DISEASES PROCEEDING FROM IT. 
The subject referred to your committee embraces two distinct 
propositions—to wit: 1. The action of water on lead pipes; and, 
2. The diseases proceeding from it. A distinct section of the report 
will be devoted to each of them. The committee will proceed to 
consider them in the order above designated. 
SECTION I. 
ON THE ACTION OF WATER ON LEAD. 
On this subject, the committee would report only well-known and 
well-established facts. Though the chemical action of lead and 
water is generally supposed to be involved in much obscurity, the 
well-known facts in this case are sufficient, like well-understood facts 
in other cases of chemical action, to explain whatever may appear 
anomalous. The relations of lead and water having been explained, 
the committee respectfully add such practical remarks as these rela- 
tions seem to demand. 
It may be stated, in the outset, that pure water exerts no effect 
on pure metallic lead. Pure water is never decomposed by pure 
lead. 
By pure water, the committee understand that which is free from 
all uncombined oxygen, acids, and alkaline, earthy, and metallic salts. 
Such water exists not naturally. The effects of natural water in 
relation to lead are alone to be investigated. The action of natural 
water on lead is due to foreign matters contained in water. All 
natural water contains air, acid, gas, and salts. These all exert an 
effect more or less direct on lead. The salts cause water to be hard 4 
ON THE ACTION OF WATER ON LEAD PIPES, 
or soft, and these qualities modify the chemical relations of lead and 
water. The salts in natural water are either neutral or non-neutral; 
the last are all alkaline. The neutral are, sulphate of lime, common 
salt, earthy and alkaline nitrates, and chlorides. The alkaline con- 
sist of hicarhonates of lime and magnesia, sometimes of bicarbonate 
of potash and soda. 
These several substances act, either singly or combined, on lead. 
Single action is generally direct, combined action is always indirect. 
Hence the foreign matters in water may be divided into direct and 
indirect agents. The first class comprises oxygen, chlorine, and 
compounds of sulphur and hydrogen. 
The second class comprises the alkaline, earthy, and metallic salts, 
and organic or inorganic acids. Among the foreign matters, oxygen 
exerts perhaps the most important influence in determining the 
action of lead and water; when absent from water, action will 
rarely occur; its action is primary. With the exception of chlorine 
and hydrosulphurous compounds, no other agents act primarily, and 
direct action always precedes indirect, primary always precedes se- 
condary action. 
Pure metallic lead cannot be put in contact with any direct agent 
in water without being acted on by it, and the results of this primary 
action are oxides, chlorides, and sulphurous compounds of lead. 
The degree of oxidation depends on the amount of common air, 
carbonic acid, and oxidizing agents in the water. If only a small 
amount of air or free oxygen is present, a compound of twTo propor- 
tions of lead to one of oxygen, or a suboxide, is formed. If carbonic 
acid and oxidizing agents are more abundant, then a higher degree of 
oxidation, one portion of lead to one of oxygen, or a protoxide, occurs. 
All natural water contains oxidizing and decomposing agents, which 
readily change the lower oxide into a higher oxide of lead; hence it 
may be said that the result of direct action is the formation of prot- 
oxide, chloride, and sulphurous compounds of lead. 
Water containing hydrosulphurous compounds is never used for 
domestic purposes; hence, practically, the only compounds of lead 
here to be considered are the protoxide and chloride. Bearing these 
principles in view, it is evident that, since all natural water contains 
direct or indirect agents, all natural water acts on lead. The 
result of this primary action is the production of an oxide or chloride 
of that metal. 
The properties of these compounds are highly important. Their 
mere formation could demand no further investigation, did not their AND THE DISEASES PROCEEDING PROM IT. 
5 
behaviour towards the water in which they have been produced give 
that water characters of the utmost importance in its hygienic rela- 
tions. 
Among the most important properties of oxide and chloride of 
lead is their solubility. Both are soluble in natural water. That 
oxide of lead is dissolved by pure distilled water, to the extent of 
about eight grains per gallon, is beyond question. Hence the sol- 
vent power of natural water varies in proportion to its purity. 
If natural water contained only pure, common air, it would dissolve 
as much oxide of lead as would distilled water. Hence, in aqueduct 
service with lead pipe, where natural water flows freely and con- 
tinuously, oxidation and solution of lead will occur. In this view, 
it may be said that the purer the water and the greater its aeration, 
the greater is its action on lead. 
On the other hand, natural water aerated contains carbonic acid. 
This compound, by its behaviour with suboxide of lead, converts that 
into an oxide, and by its combination with this produces carbonate 
of lead. This salt, insoluble in pure water, is readily solved by an 
excess of carbonic acid, or by supercarbonates existing as alkaline 
or earthy salts. No natural water is so nicely balanced in its rela- 
tive proportions of absorbed air, oxygen, and carbonic acid, as to 
form carbonate of lead alone, and hence it may be said that natural 
water necessarily dissolves a portion of the carbonate of lead which 
it has formed. Failing of the due proportion of carbonic acid, so- 
lution ceases. Failing of air, action ceases. 
One may easily understand, then, that, in experimenting in a 
limited quantity of water, the formation and solution of oxide cease, 
and hence, apparently, lead becomes insoluble. It is so actually 
only when retained in that portion of water in which it was originally 
immersed. 
Natural water generally contains organic, or sometimes inorganic 
acids, which convert oxide and carbonate of lead into soluble or in- 
soluble lead salts, while the presence of such acids renders chloride 
of lead more easily dissolved than by pure water. Mutual reactions 
occur among the salts of natural water, whence result products of 
decomposition by which oxide of lead is converted into a salt soluble 
in water, or its contained salts ; the reaction of the per-salts of iron, 
and of nitrates, is, in this view, of the highest importance. The 
influence of salts in causing oxide of lead to be dissolved by water is 
very unequal. Nitrates increase the solubility in a greater degree 
than do other salts. Sulphates and silicates alone do not dissolve 
oxide of lead. Viewed singly, the lead solvent power of salts, com- 6 
ON THE ACTION OF WATER ON LEAD PIPES, 
mon in spring water, is as follows, as determined by Spencer, of 
Liverpool; the highest being first named:— 
Supercarbonate of magnesia. 
“ “ “ lime. 
Chloride “ sodium. 
“ “ magnesium. 
“ u calcium. 
Oxidation of lead and solution of the oxide in water are independent 
of the degree of hardness; hence the hardness being equal, oxidation 
may be very unequal. This seems, however, dependent on the quan- 
tity present of some particular salts, for a large amount of one salt 
renders lead soluble, when a smaller amount renders it insoluble. 
Hence, though the total of hardness may he equal, the solvent power 
may he very unequal. It may, however, be stated generally that 
salts causing hardness usually dissolve oxide of lead. 
It is easy to determine what is the lead solvent power of each salt. 
In this question we deal not with single or individual salts. There 
is an inherent difficulty in determining by experiment what are the 
effects due to the combination of the various salts in natural water. 
Analysis may accurately determine the amount of each salt element 
in water, but the mode in which they exist in combination cannot 
be ascertained. Our arrangement of the union of these elements 
is arbitrary. It is the mode of combination which doubtless influ- 
ences the solvent power of salts. The weight and solvent power of 
each salt having been determined, the total solvent power will not 
be represented by their sum. The mode of combination probably 
varies with the quantity of each salt present in the water; hence 
every variation in the quantity of any one salt alters the lead solvent 
power of the water, and gives to the combined salt elements new 
properties. Hence, it is not improbable that, though analysis may 
detect the same elements in different waters, and as rigorously as our 
means of analysis may permit, apparently in the same proportion, 
yet, a variation in the amount of any one element, too slight to be 
detected, may influence the mode of arrangement of the salts, and 
the lead solvent power of the water. Temperature exerts also a 
marked influence on the mode of arrangement. 
A mode of combination of salt elements of natural water may pos- 
sibly render that perfectly inactive on lead. It is only on this sup- 
position that such a natural water can be admitted to be found. 
But no previous analysis of water for domestic use will allow a 
prediction as to what its exceptions to the usual relations of lead AND THE DISEASES PROCEEDING FROM IT. 
7 
and water may be. That can be determined only by actual aqueduct 
service, continued through a series of seasons, as it is well known 
that the action of water on lead has been intermitted. Hence, water 
apparently free from lead to-day may become charged with that 
metal to-morrow. (See Appendix A.) 
The actual amount of the lead-solving power of any water is of little 
moment. It will become important only when it shall have been de- 
termined what is the minimum of lead which can exist in water, when 
used as a beverage, without detriment to health, a question as yet 
wholly undecided. The committee have yet to learn upon what 
facts, by what experiments this minimum has been placed by those 
eminent chemists, Professors Hoffmann, Graham, and Miller (see 
Keport on the Supply of Water to London, Quarterly Journal of 
Chemistry, No. 16), so high as one-fifty-seventh of a grain of lead 
per imperial gallon of water. “ So minute a trace of lead,” continue 
the above-named chemists, “ remaining in the water could have no 
possible influence on the health;” and they seem disposed to adopt, 
if they do not in fact adopt the opinion of Dr. John Smith, of Aber- 
deen, “ that less than one-twentieth of a grain of lead per gallon 
produces no deleterious effect on the health of those using it for 
dietetical purposes.” 
In numerous cases of well-defined, unmistakable lead disease, which 
have come under the observation of some of the members of the com- 
mittee, the water suspected to be the cause of disease has been che- 
mically examined. While, generally, it may be said that the amount 
of lead in solution would not fall below one-twentieth of a grain per 
gallon, yet, the cases have not been rare, where disease has been 
produced by less than one-one-hundredth of a grain of metallic lead 
per gallon in solution, or one in seven millions of water. One hun- 
dredth of a grain of lead is easily detected by a simple stream of 
sulphuretted hydrogen. Water has sometimes caused disease, under 
the eye of a part of your committee, where this test showed no 
trace of lead; yet, lead was abundantly evident after concentration 
of the water, and the sulphuret thus obtained has been converted 
into salts of lead, which have been again examined to confirm the 
hydrosulphurous test. Small as the amount of lead—less than one- 
seven-millionth of the weight of water—in solution thus appears, the 
committee are disposed to place it still lower. The Tunbridge well 
may be adduced, whose water, flowing through a lead pipe, disordered 
many who drank it; and it contained so minute a trace of lead in 
solution, that some of the most acute and eminent chemists of the 
day, men full of chemical tact and laboratory experience, failed to 8 
ON THE ACTION OF WATER ON LEAD PIPES, 
detect its presence. Happily for the afflicted, lead was at last de- 
tected, the pipe was removed, and health returned. 
The salts of natural water were at one time thought to be protect- 
ive against its lead-solvent power. To a limited degree this is true 
of wTater holding in solution bicarbonate of lime, a deposit of car- 
bonate of lime gradually incrusting the interior of the pipe. But, as 
we have no analysis recorded of the water thus flowing through a 
pipe lime-coated, it is impossible to say whether bicarbonate of lime 
has ever prevented gradual corrosion of the lead. (See Appendix B.) 
The doctrine of protective power has been much extended within a 
few years. It has afforded, and still affords to many minds an 
argument for the safety of water lead-transmitted. This doctrine 
has assumed various phases, which may be reduced to the three fol- 
lowing :— 
1. Protection by certain salts of the “ right kind,” present in water 
in a limited proportion, or by salts artificially introduced for the pur- 
pose of producing compounds of lead known to be insoluble in pure 
water. In the latter case, the pipe filled with a solution of the pro- 
tective salt must be left closed for some months to allow a protective 
coat to be formed. 
This may be called the Edinburgh doctrine, having been promul- 
gated and advocated by Dr. Christison, of that city. 
2. Protection by the formation of an insoluble coat of suboxide of 
lead after a few days, or at most a few weeks contact with water. 
This may be termed the Boston doctrine. It was there adopted as 
the ground of safety of using lead service pipes for lake water ; forti- 
fied as it was by the belief that the inhabitants of other cities, using 
river or lake water lead-transmitted, had been protected from lead 
disease by the formation of an insoluble coat. 
3. Protection by the presence of a limited amount of carbonic 
acid present in the water, forming insoluble carbonate of lead. 
This is the latest, and it may be termed the London doctrine. 
It is assumed by the eminent professors of chemistry named above, 
as the ground of their belief, that the present distributing lead pipes 
in London may safely be continued if that metropolis should here- 
after be supplied from the newly proposed sources with a constant 
supply of soft water. 
The advocates of protection seem not to have duly considered that 
their several protective coats, however insoluble in pure water, are 
decomposable and soluble by the salts contained in natural water. 
The Edinburgh doctrine has been practically abandoned by its author. AND THE DISEASES PROCEEDING FROM IT. 
9 
The Boston doctrine has been disproved by the results of analysis of 
water at present flowing through the lead service pipes earliest laid 
down by the city authorities. The London doctrine is yet to be 
proved, but its authors admit that an excess of carbonic acid will dis- 
solve the coat of carbonate, and thus the water will be rendered 
deleterious if the solved lead exceeds one-twentieth of a grain per 
gallon. 
The whole doctrine of the protective power by the formation of an 
insoluble, impervious coat on lead by the action of the impurities of 
water, is set aside by the fact that, however this coat may be formed, 
lead transmitting water is constantly dissolved. No limit of time 
has yet set bounds to this action. 
This is the lesson of experience taught by the erosion of lead 
pipes and cisterns. It is the result of experiment that, where no per- 
ceptible action is visible, chemical examination detects lead in solu- 
tion. Without going into details, by adducing evidence on these 
points, by citing the statements which within a few months have been 
made to learned associations by scientific men, or to parliamentary 
committees by practical plumbers, of the ceaseless corrosion of lead 
by water, the committee would remark, that the doctrine of pro- 
tection is no longer tenable on scientific or practical grounds. Still 
it is a doctrine which has many advocates, and exerts an influence on 
many minds, which is much to be deplored viewed as a question of 
public hygiene. 
This influence can be destroyed, not by reason, scientific argu- 
ment, or practical experience of the erosion and destruction of lead 
pipe, but it will be counteracted— 
1. When a substitute for lead of some material which, while it has 
all the practical working advantages of lead, will be equally cheap. 
It is a question of price, which always determines and will determine 
the preference for lead. This consideration with the many will con- 
tinue the use of lead, however little faith may be placed in the 
doctrine of protective coating. 
2. This doctrine will gradually be overthrown by the numerous 
cases of disease occurring where lead-transmitted water is used. 
These cases will be marked in proportion as the knowledge of lead 
malady, so much misunderstood, becomes more general and search- 
ing. 
No argument for the safety of lead-transmitted water, founded on 
the absence of lead malady, ought to be admitted, which does not 
add to the non-occurrence of disease the fact that the pipe is not 10 
ON THE ACTION OF WATER ON LEAD PIPES, 
acted on, and that the water repeatedly, and under all circumstances 
examined, has never shown the presence of lead. Such pipes and 
such water are unknown to your committee; and they would, there- 
fore, proceed to lay before the Association the facts they possess 
which prove the danger in the use of lead for transmitting and con- 
taining water, by the diseases which the use of lead-water has caused. 
SECTION II. 
ON THE DISEASES WHICH PROCEED FROM THE USE OF LEAD-WATER. 
This is by far the most important, and most difficult part of the 
duty assigned to your committee; one which they approach with 
much diffidence, feeling, as they do, their inability to do justice to a 
subject so fraught with evil to their fellow-beings as they conceive 
this to be; one, too, which, for its elucidation, requires a more 
thorough research than the limited opportunities of observation fall- 
ing to their lot have enabled them to bestow upon it. They will, 
however, lay before the Association such facts as they have been 
able to collect, feeling that they have hut just entered upon a subject 
which they hope those who have a wider field of observation may, 
ere long, more fully develop. 
Science has not probably yet revealed all the diseases which pro- 
ceed from lead taken into the human system. Several serious dis- 
eases, however, at the present time, are well understood to have 
their origin in the absorption of this poison, -while others, scarcely 
less severe and distressing in their character, have not as yet been 
definitely proved to be thus produced, although many of them 
have fallen under strong suspicions of having a saturnine origin. 
Several of these, as some forms of dyspepsia, neuralgia, and rheu- 
matism, from their well-known resemblance to other forms of lead 
disease, have been so classed by many very intelligent and observing 
physicians. 
The earlier writers considered lead colic as the only form of dis- 
ease produced directly from the introduction of lead into the system. 
All other forms of lead disease were considered by them as subor- 
dinate to, or consequent upon, this. Their descriptions of even this 
were often vague and indefinite. Later authors have given more 
accurate descriptions of saturnine colie, and some of the character- 
istics of several of the other forms of lead disease; but even they 
considered all these as dependent upon colic. And nowhere among AND THE DISEASES PROCEEDING FROM IT. 
11 
their writings do we find them well and distinctly described. In 
short, the pathological conditions of the system under which they 
were developed, were evidently not understood. 
Tanquerel, a quite recent French writer, whose work on this sub- 
ject should be in every physician’s library, was the first to present 
to the public the true pathology of these diseases. After a patient 
and accurate research of eight years, at the Hospital of Charity, 
where nearly all the lead-diseased workmen in Paris and its environs 
resort for relief, and where every facility for the examination of the 
patients of this vast establishment was freely extended to him, Tan- 
querel laid before the public the result of his researches. His 
examinations were made on a class of patients contracting disease in 
the numerous lead manufactories in and about Paris. The poison 
was introduced into the system by the absorption of the numerous 
inhaled particles of lead which are constantly floating in the atmo- 
sphere of those vast establishments, or from particles swallowed in 
the drink, food, &c., of the workmen. He classes lead diseases, so 
far as he has observed them, under four distinct and well-determined 
forms, viz., colic, arthralgia, paralysis, and encephalopathy. 
These affections, he considers, have an independent existence, and 
have no real or necessary relation except their common origin. 
That lead, taken into the system in continued small doses, becomes 
a cause of disease, is a fact too well established at the present day to 
require notice. Chemical analysis has pointed out one source of this 
evil, which, till recently, has been, if not overlooked, not properly 
appreciated, viz., the use of leaden conduits for water for domestic 
purposes. Yet many well-informed physicians, even at the present 
day, are not roused to a sense of its dangers, and probably will not be, 
until the frequency of disease caused by it, attended often by a fatal 
termination, but still oftener by loss of muscular power, which ren- 
ders life almost a burden, has spoken in tones too loud to be passed 
unheeded, and under circumstances too afflictive to be longer re- 
sisted. 
Lead introduced into the system, from whatever source, may mani- 
fest its presence in various ways, before any of the usual forms of 
disease ultimately produced by it become apparent. These mani- 
festations Tanquerel calls “primary effects of lead” And accord- 
ing as the person is more or less exposed, or imbibes a greater or 
less quantity of it, will these “ primary effects” become more or less 
strongly developed. 
These premonitory symptoms are rarely all produced in any one 12 
ON THE ACTION OF WATER ON LEAD PIPES, 
individual; yet when a person has been exposed, for instance, to an 
atmosphere highly charged with lead, or has been drinking water 
impregnated with it for any great length of time, most of these effects 
will become apparent; showing that the system is highly charged 
with lead. On the contrary, where a person less susceptible is ex- 
posed to the same influences, or a person of the same susceptibility 
is exposed to milder influences, these manifestations will be developed 
only after a longer exposure, and often then in a much milder degree. 
The presence of these primary manifestations will often enable the 
physician to decide on a correct diagnosis, when, without them, he 
may be left in doubt as to the cause and character of the disease 
before him. They are common to all lead diseases, and generally 
enter largely into the physiognomy of each of them. 
The first of these premonitory symptoms which we shall notice is, 
the discoloration of the teeth and gums. This is generally the first 
to show itself, and is the one most certain to follow the applica- 
tion of lead in any form to the mucous membrane of the mouth. 
Says Tanquerel, “ The first and most frequent symptom of the pre- 
sence of lead in the system is a very peculiar discoloration of the 
gums and teeth. That portion of the gums nearest the teeth, to the 
extent of one or two lines, generally assumes a bluish or slate gray 
colour. The rest of the gums often presents a very light bluish-red 
colour, which insensibly disappears in the rosy tints of the mucous 
membrane which covers the other portions of the mouth. Some- 
times the slate colour tints the whole extent of the gums, and even 
spreads to the entire mucous membrane of the mouth.” 
In a majority of cases, that portion of gums nearest the teeth, 
to the extent of one or two lines, will be found the only part showing 
the blue slate colour—this discoloured portion of the gums is in time 
absorbed, leaving the edges very blunt, and the necks of the teeth 
denuded; which portion of the teeth assumes a decidedly brownish 
colour, contrasting strongly with the natural yellow or greenish tint 
of the crown. 
This colouring matter is the sulphuret of lead, and is formed by 
a change of chemical affinities ; when food, which always contains 
more or less sulphur, is masticated, some portions of it adhere to the 
roots of the teeth. A species of decomposition very soon takes 
place, and sulphuretted hydrogen is formed, which at once combines 
with any particles of lead that may be taken into the mouth, and 
forms sulphuret of lead, which is deposited on the gums and teeth 
precisely where the sulphuretted hydrogen was evolved. 
(See Tanquerel, Primary Effect of Lead.) AND THE DISEASES PROCEEDING FROM IT. 
13 
The next most frequent manifestation of lead is the lead taste, 
breath, and odour. Those who have been long exposed to the in- 
fluence of lead often complain of a sugary, styptic, and astringent 
taste. The breath has also a peculiar fetid odour, which it is not 
easy to describe, but which can never be confounded with any other, 
by one who has ever been obliged to experience its effects: it is as 
marked as the mercurial breath, but is unlike it, and may be called 
the “ lead breath.” 
The sense of smell is often affected; persons who have been much 
exposed to the influences of lead soon experience a smell of metallic 
lead ; they seem sometimes to smell their own breath. 
Another premonitory symptom of lead disease is what has been 
called lead jaundice. “ When lead jaundice,” says Tanquerel, 
“ exists in the greatest degree, the skin is of a foul, earthy, yellow 
tint; if the disease is less severe, it appears of a pale, slightly ash 
yellow. This colour appears more decidedly in the face than else- 
where, though the skin of the body and limbs is also discoloured, but 
in a less degree. This pale yellow, generally united with a very 
marked bluish discoloration, may be observed very decidedly in the 
white of the eye. The urine is of a dull yellow colour. Nitric 
acid does not show that play of colours indicated by Berzelius as a 
proof of the presence of bile. The excrements are of a very decided 
fawn yellow colour. The serum of the blood presents a slight yellow 
reflection, but the yellow colour has no tinge of green.”—Page 21. 
The discoloration of the skin in lead diseases is not from the ab- 
sorption of bile. The liver performs its functions as usual, as is 
shown by the absence of bile in the urine, and its presence, in the 
usual amount, in the excrements. It is produced by the presence of 
lead in the system, precisely in the same way that nitrate of silver 
produces a change of colour in the skin, when used internally for any 
great length of time. 
Lead emaciation very soon follows the jaundiced appearance just 
noticed, and, like it, does not show itself till the system is highly 
charged with the poison. “ This emaciation, though general, is at 
first most strongly marked in the face, which becomes wrinkled, and 
presents the expression of premature old age. These wrinkles give 
an expression of sadness to some faces.” (Tanquerel.) 
The pulse is generally soft, small, and compressible, and the beats 
are rather diminished than increased in frequency. 
These primary manifestations of lead are, as has already been 
stated, common to all the known lead diseases ; they are not neces- 14 
ON THE ACTION OF WATER ON LEAD PIPES, 
sary precursors of either of them, and may not always be found with 
them, as, for instance, when disease is produced in persons of ex- 
treme susceptibility after a short exposure ; but their presence, or 
the presence of either of them, may be considered as a certain indi- 
cation of the presence of lead in the system, although no marked 
form of disease may, as yet, have shown itself. They generally 
occur in the order in which they have been described. The discolor- 
ation of the teeth and gums is of much the most frequent occurrence; 
the next in the order of frequency are the taste, breath, and odour; 
lead jaundice and emaciation soon follow ; the altered pulse will be 
less frequently observed than either of the others. 
It is rare that all these premonitory symptoms are present in any 
one individual. Should they be so found, lead disease, in some form or 
other, may be expected soon to follow. On the other hand, any one 
of them may be present for a long while, before the individual will 
show any signs of well-marked lead disease. 
In the following condensed description of lead diseases, your com- 
mittee have drawn freely from Tanquerel’s elaborate work on that 
subject. In his descriptions of these diseases, he has left, on most of 
the leading points, but little to be desired. When practicable, his 
language has been used, and credit accordingly given. 
Lead colic is the most frequent form of lead disease, and is the one 
most generally known, and perhaps the best understood. The functions 
of the digestive, urinary, and circulatory organs, are changed by it. 
It rarely attains immediately its greatest height, yet this may occa- 
sionally happen; generally it is preceded by certain morbid phe- 
nomena in the cavity of the abdomen. The patient first feels a 
weight in the epigastrium ; dull, fleeting colic pains in the stomach, 
increased by eating, and sometimes attended by nausea and eructa- 
tions ; appetite diminished or entirely lost; bowels, previously free, 
soon become restricted ; the urine flows with some difficulty, and oc- 
casionally with a slight feeling of pain. Patients remain tormented 
with these comparatively slight abdominal disturbances for several 
weeks, sometimes months, when suddenly the pain acquires more in- 
tensity, and returns at shorter intervals, and soon the disease becomes 
completely developed. 
Pain is the first and most distressing symptom of lead colic. It 
is generally situated about the umbilicus ; sometimes it occupies the 
epigastrium, but rarely the hypochondria or the iliac fossae. “ These 
regions seem only to be the centres from which the flashes of pain 
radiate to other parts of the abdomen.” AND THE DISEASES PROCEEDING FROM IT. 
15 
This colic pain is generally marked by a twisting sensation about 
the navel; the parietes of the abdomen are retracted, or drawn in- 
wards, which causes the patient to experience a sense of compression, 
as if a weight was laid upon the abdomen. The pain, at first light 
and transient, at intervals becomes more severe; the intervals of 
comparative ease varying from a few minutes’ duration to occasionally 
as many hours. As the attack increases in severity, the patient be- 
comes the victim of the greatest anguish; his whole countenance is 
disturbed, and he utters the most heart-rending cries, and frightful 
screams and groans. He becomes restless, constantly changing his 
position, in the vain hope that the change may give him some relief. 
Most of these sufferers rub their bowels or compress them with 
pillows, cushions, crickets, &c., and sometimes girt themselves firmly 
with a strap or cord. It would be almost impossible to describe all 
the various positions these patients assume, or the means to which 
they often resort for relief, during a severe attack of colic. The 
severe exacerbations of pain are generally more frequent, and also 
more violent, by night than by day; it is not unusual to see a patient 
comparatively easy during the day, when, as the night approaches, 
he is reminded by the returning pains that the agony of the pre- 
ceding night is fast gathering upon him. 
In mild cases of colic, the pain is not always developed by the 
same exhibition of suffering. The patient is often able to lie quietly 
in bed, but generally his countenance, even here, is indicative of 
more or less distress. The severe pain is almost always relieved by 
pressure. Constipation generally attends lead colic; sometimes diar- 
rhoea, but this is rare. It is the opinion of Tanquerel that pain 
always precedes constipation. The patient is often harassed with a 
kind of tenesmus, or a constant feeling as if he were about to have 
an evacuation, but his greatest efforts are unavailing, and serve 
only to fatigue him. Nausea frequently attends colic, and some- 
times vomiting; both these accidents are most frequently observed 
when the pain is seated about the epigastrium; pressure, though it 
relieves the pain, generally increases the nausea. The tongue is 
usually moist, with a light coat along the centre extending to the 
root. It is sometimes swollen. The appetite is always impaired, 
and if food be taken, it always aggravates the distress. There is 
also considerable thirst, and drinking freely often relieves, but some- 
times increases the suffering. The urinary and genital organs are 
often considerably affected. If the attack is severe, the urine will 
be scant, and micturition more or less painful. The testicles of the 16 
ON THE ACTION OF WATER ON LEAD PIPES, 
male, and the uterus and vagina of the female are often the seat of 
severe pain. 
Respiration is rarely perfectly tranquil; it is usually accelerated 
during the continuance of a paroxysm of pain, but as the pain is 
relieved, the respiratory movements soon resume their normal fre- 
quency. The voice is often somewhat husky and stifled. 
The pulse, at the commencement of the attack, is generally slower 
than in health ; but as the disease advances, or if purgative medicines 
have been freely administered, it becomes more frequent, and is often 
intermittent. “ This increased frequency of the pulse,” says Tan- 
querel, “must not be mistaken for febrile action; fever does not 
exist in lead colic, unless it be complicated with some other disease. 
In simple colic, the temperature of the skin is not affected.” 
The countenance, in lead colic, is changed. In the face there are 
strong muscular contractions, indicating great acuteness of suffering; 
it is impossible to describe the hurried changes of expression which 
crowd upon each other in rapid succession; yet, once seen, this pe- 
culiar and ever-changing physiognomy can never be mistaken; it 
seems, of itself, almost sufficient to denote the disease. 
Such are the phenomena attendant on lead colic. It can hardly 
be expected that all these manifestations of the disease will be pre- 
sent in any one case ; but a sufficient number of them, together with 
the premonitory symptoms before described, will generally be found 
to enable the physician to form a correct diagnosis. 
As to the seat and nature of lead colic, pathological anatomy has 
revealed no lesion to which all the phenomena it presents can be 
referred. It is certainly characterized by functional derangement of 
all the organs to which the great sympathetic nerve is distributed; 
but, as no organic lesion is known to exist in these organs, and from 
the resemblance of the symptoms to neuralgia of other parts, we are 
naturally led to the conclusion that the disease is a neuralgia of 
this great nervous centre. 
Tanquerel supports the same view, and says: “ Lead colic is a neu- 
ralgia of the great sympathetic nerve; and according as such or such 
nervous plexus becomes a kind of centre for the lead excitability, 
whence lines of irritation radiate, such and such forms of colic ap- 
pear ; thus, as the coeliac, mesenteric, hypogastric, or renal plexus 
is the seat of neuralgia, epigastric, umbilical, hypogastric, or renal 
colic will be manifested.” 
This, we are aware, is assuming that the great ganglionary system 
is the source of both feeling and motion in the abdominal organs. AND THE DISEASES PROCEEDING FROM IT. 
17 
Most modern authors, as Andral, Grissolle, Ranque, and others, sup- 
port this view, both as it regards the functions of this nerve, and 
also, that lead colic is a neuralgia of this great nervous centre. 
Bichat, also, in speaking of certain colics, essentially nervous, and 
independent of any affection of either of the coats of the intestines, 
says: “ These colics are evidently seated in the nerves of the semi- 
lunar ganglions. They are real neuralgias of the nervous system of 
organic life.” 
There is, probably, no disease which has, from time to time, been 
treated with a greater variety of therapeutic agents than lead colic 
—almost every form of treatment has had its advocates, and pro- 
duced its cures. Our limits will only permit us to give them this 
passing notice. We must confine our remarks to the modes of treat- 
ment which experience has proved to be most successful in the removal 
and prevention of the disease under consideration. 
The first thing to be done, in all cases, is the removal of the cause, 
where it can be ascertained. This is indispensable to a permanent 
cure. If it be allowed to continue in operation, a relapse may be 
expected soon to follow any relief which may be obtained, however 
perfect for a time it may seem to be. Cathartics are most to be 
relied upon for the removal of lead colic. These, however, may 
often be materially aided by the occasional use of other remedies, as 
will be presently noticed. Croton oil, first recommended in the 
treatment of this disease by Dr. Kinglake, is the form of cathartic 
usually employed. The best mode of administering it is to add one 
drop to two teaspoonfuls of castor-oil, with a little lemon juice, or 
in a tablespoonful of some demulcent drink. We consider the former 
the most efficacious mode of administration. Should this dose fail 
to produce evacuations in from four to six hours, it should be re- 
peated, and in three hours after the second dose, if necessary, be 
followed by an active enema. This course should be continued till 
free catharsis is produced. “To obtain all the advantageous results,” 
says a distinguished author, “ it should be prescribed at least three 
days in succession, even when the first dose has produced wonders. 
No fear need be felt of producing inflammation of the intestinal 
mucous membrane; it has never been known to occur.” 
When croton oil disagrees with the stomach, other cathartics will 
be naturally suggested, as castor-oil alone, Seidlitz powders, &c. &c. 
At the South and West, physicians usually administer calomel in 
this disease; they consider the patient as safe when ptyalism is pro- 
duced. But the experience of your committee leads them to the 18 
ON THE ACTION OF WATER ON LEAD PIPES, 
conclusion, without denying the power of this remedy, that the 
cathartic mode of treatment is much the more efficacious, and is much 
less expensive to the constitution than the treatment by calomel; it 
also gives relief much sooner, and is free from the distressing annoy- 
ance of a sore mouth. Sulphuric lemonade has, with many physi- 
cians, been extensively used in the treatment of lead colic. Dr. 
Gendrin, physician to the Cochin Hospital, has used it perhaps more 
extensively than any other physician. With him, he says, it has 
rarely failed to remove the disease in six or seven days. Other phy- 
sicians have not generally had the same success in the use of this 
remedy. Some doubt, others even deny altogether, its curative 
powers. There can be no question, we think, that it has often been 
successfully used, though it may not have been so speedily efficacious 
as some other medicines. As a preventive, there can be no possible 
doubt of its powers. 
Supersulphate of alumina and potass (alum) has been recom- 
mended, in lead colic, by several distinguished physicians. Kapeler 
administered it, in demulcent draughts, to the extent of from one to 
three drachms per day, and asserts that it always cures, however 
intense the colic. 
Dr. Macgibbon, physician to the Charity Hospital, New Orleans, 
in a communication in the New Orleans Medical and Surgical 
Journal, recommends that half an ounce of alum be dissolved in one 
pint of lemonade, one-half of which is taken at a time, the remainder 
in three hours. In this form, he says, it acts as a gentle cathartic, 
and, without ascribing to it any specific effects, thinks it may be a 
very useful addition to the treatment of lead diseases. 
The same success has not always attended the use of this remedy 
by many other physicians. This, like the last-named remedy, forms 
a part of the chemical treatment, from which so much was at one 
time expected, on the supposition that there would be a chemical 
combination formed which would convert any particles of lead in the 
system into an insoluble sulphate. 
The expectations of the advocates of this mode of treatment have 
certainly not always been realized; yet a degree of success has been 
attained, which would not warrant us in discarding these remedies as 
wholly inefficacious either in the cure or prevention of lead diseases. 
Both may be considered as valuable adjuncts to the course of treat- 
ment already recommended. 
Recourse has often been had to bleeding, in the severer forms of 
lead colic; but the general conclusion of most observers is, we be- AND THE DISEASES PROCEEDING PROM IT. 
19 
lieve, that the disease is not materially shortened by it. If lead colic 
be complicated with any inflammatory affection of the abdominal 
organs, bleeding should, of course, be at once resorted to, in order to 
arrest it; after which, the appropriate treatment for colic should be 
immediately adopted. 
Morphine can be used with great advantage in relieving pain and 
distress. It is not safe to rely upon it alone for the removal of the 
disease; but, as a palliative, it is of great value, and often a free 
dose of it will completely relieve, not only the pain, but that ex- 
tremely irritable state of the stomach which is so frequent an attend- 
ant on this disease, and enable the patient to get a quiet sleep. It 
also allays the spasmodic contractions of the intestinal canal, and, 
when judiciously administered, does not appear to retard the opera- 
tion of cathartics, but, on the contrary, serves sometimes to facilitate 
their action. 
The several anaesthetic agents, as ether and chloroform, will also 
be found of great value in relieving the extreme suffering attendant 
on the severe forms of this disease. 
The alimentary canal should be kept freely opened, by the daily 
use of either castor or croton oil for several days, or until all symp- 
toms of colic shall have entirely ceased. Demulcent drinks should 
be used freely during the treatment. When lead colic is complicated 
with other diseases, it will become necessary to modify the treatment. 
If the several complications are of an acute form, they must be sub- 
dued before the treatment of colic is commenced, each complication 
receiving its appropriate treatment. Should the complication be of 
a chronic character, the treatment for colic should be immediately 
commenced, avoiding as much as possible that which would tend to 
increase the chronic malady. Sometimes colic may be complicated 
with other lead diseases, in which case the treatment might also re- 
quire some slight modification. 
Arthralgia is the next most frequent form of lead disease. “ It 
is characterized by pain in the limbs, without swelling or redness.” 
The pain is constant, but subject to exacerbations; motion generally 
increases it, but gentle pressure diminishes it. The patient is often 
seized with severe cramps in the affected parts, on making any mo- 
tion. There are also great hardness and tension of the muscles in the 
diseased parts. The pain in the limbs is most frequently seated in 
the course of the flexor muscles; all parts of the limbs, trunk, and 
head may, however, at times, become the seat of it; it is often felt 
in the large articulations, while the smaller articulations of the hands 20 
ON THE ACTION OF WATER ON LEAD PIPES, 
and feet are rarely affected. The pain is often very sharp, darting, 
or flashing. During the short intervals of comparative relief which 
occasionally occur, the patient often complains of a feeling of numb- 
ness in the affected parts. The lower extremities are more often 
the seat of this affection than the upper, and it more often com- 
mences in the night than in the day, but is not exclusively limited 
to either. It is, in short, nothing more than the spasms and cramp 
pains of lead colic, affecting the limbs instead of the abdomen. 
Pathological anatomy has developed no organic alterations charac- 
teristic of this form of disease. The functional alterations which 
attend it are seated in those organs which derive their sensibility 
from the nervous spinal system. The exalted sensibility of these 
parts, then, must be referred to an alteration of the nervous fibres 
communica.ting with them; showing that the disease is purely a 
nervous lesion revealed only by its symptoms. 
This disease will almost always yield to the daily use of the warm 
sulphur bath for the space of one week. The best mode of preparing 
the bath is to add six ounces of the sulphuret of potash to four pailsful 
of warm water. The patient should remain in it from half to three- 
quarters of an hour. Should this fail to remove the disease speedily, 
recourse should be had at once to the cathartic course recommended 
in lead colic. 
Paralysis is of less frequent occurrence than arthralgia, but is 
oftener seen than encephalopathy. According to Tanquerel, “ the 
paralysis produced by lead preparations may consist in the loss of 
motion only, in parts at once enjoying both motion and sensibility. 
In other cases, on the contrary, the sensibility only of these same 
parts is affected, and they are rendered unfit to receive impressions 
from external bodies, the power of motion being unimpaired. The 
first kind of paralysis is called the paralysis of motion, or simple 
lead paralysis; and to the second is given the name of anaesthesy.” 
These two kinds of paralysis may be combined, so that the parts 
affected may have neither motion nor sensibility. 
Lead paralysis is generally preceded by a sense of weakness, 
debility, and numbness in the parts about to be affected by it; the 
diseased muscles soon lose their contractile power, and are not read- 
ily called into action, but when once roused into action, will often 
suddenly give out under it. The disease rarely attacks suddenly; 
and is generally partial, occupying only one or more sets of muscles; 
it is rarely complete, embracing all the muscles of a limb. Except 
where it is complete, paralysis always seizes first on the extensor AND THE DISEASES PROCEEDING FROM IT. 
21 
muscles of the limbs. This fact we are unable to explain, but it is of 
very great importance in the diagnosis of the disease. This pheno- 
menon is the opposite of what takes place in arthralgia, where the 
region of the flexor muscles is the seat of pain. The skin generally 
has a pale, livid hue, sometimes yellow, earthy, dry, and shrivelled; 
there is also a marked sensation of coldness in the paralyzed parts. 
The paralyzed muscles soon lose their plump and rounded appear- 
ance, and rapidly diminish in volume. This is rendered more 
apparent by the flexor muscles retaining as they do their full and 
plump appearance. 
Paralysis sometimes seizes upon the muscles of the trunk. When 
the intercostal or abdominal muscles are the seat of disease, their 
functions, so essential to the maintenance of life, are performed with 
the utmost difficulty. 
There can be no doubt that the nervous influence destined to be 
transmitted to the paralyzed muscles has from some cause been inter- 
rupted. “It is difficult,” says Tanquerel, “to point out exactly the 
seat and nature of a disease when deprived of the light of patholo- 
gical anatomy. Here, as in all purely nervous diseases which leave 
no traces in the parts where they had their seat, pathological ana- 
tomy shows, at least, that this disease ought not to be attributed to 
organic lesion. Each muscular fibre possesses the power of contract- 
ing by the influence that the nerves transmit to it. The seat of the 
disease must then be sought for in the nervous system.” There can 
scarcely be a doubt that some part of the spinal nervous centre is 
altered in lead paralysis; this again is revealed, not by anatomy, but 
by the symptoms only. 
Treatment of Paralysis.—Here, as in other forms of lead disease, 
the greatest variety of treatment has at different periods been 
adopted. We shall follow our original plan, and notice only such 
as experience has proved to be of value. 
The sulphur hath is frequently employed in paralysis with marked 
good effect; the temperature should be about milk-warm, and the 
patient should remain in it from three-fourths of an hour to an hour. 
This will produce a glow and feeling of general heat. The baths will 
induce a copious perspiration, a fine cutaneous eruption, attended by 
a general itching. This state of things will soon exhaust the patient; 
the baths consequently should never be continued for a long time. 
Electro-magnetism is a valuable remedy when properly used. The 
shocks should be conveyed through the paralyzed muscles only; if 
passed through the entire limb, it will generally do more harm than 22 
ON THE ACTION OF WATER ON LEAD PIPES, 
good, exciting the sound more than the diseased muscles. One pole 
of the battery should be placed at the origin, the other at the inser- 
tion of the muscles about to he acted upon. It should be used daily 
from ten to twenty minutes, according to the ability of the patient to 
hear it. 
Strychnine.—This alkaloid is the most potent remedy we possess 
for the removal of lead paralysis. It, together with electricity, 
seems to keep the diseased muscles as it were alive or excited, and 
prevent that dormant state which soon results in a rapid diminution 
of their volume. If this artificial life in the muscles can he kept up 
at intervals for a few months, or till the system is cleansed from the 
lead introduced into it, we may reasonably expect the disease to he 
eventually removed. 
The best mode of administering it is in the form of pills contain- 
ing one-twelfth of a grain each. The dose should be one pill, given 
once a day, increasing each dose by one pill, till a sufficient num- 
ber be taken to produce a slight spasmodic action in the muscles. 
This dose (whatever it may be) should be repeated daily. In a few 
days, the patient will begin to move slightly the diseased muscles. 
The immediate effects of this remedy are generally very disagreeable 
to the patient, producing a tension of the muscles, and as this sub- 
sides a feeling of exhaustion. Frequently the patient will be very 
unwilling to proceed with it. Your committee believe, however, if 
the remedy be judiciously given, and persevered in for months, that 
the disease will generally yield.* 
Encephalopathy, according to Tanquerel, is a distinct form of dis- 
ease arising from the noxious influence of lead upon the animal 
economy, which would seem to depend immediately upon some lesion 
of the brain. It embraces all the various forms of cerebral affections 
which have been observed to arise from lead poisoning. The same 
author considers that it requires the absorption of a larger propor- 
tion of lead particles to induce this disease than is requisite for the 
production of colic, arthralgia, or paralysis. He establishes four dis- 
tinct forms of cerebral affection: 1, delirium; 2, coma; 3, convul- 
sions; and 4, a combination of delirium, coma, and convulsions. 
In the first of these forms of disease, delirium is the leading fea- 
ture ; it either assumes the peculiar restless, talkative character of 
delirium tremens, or the more violent symptoms peculiar to acute 
* For the particular effects of strychnine, see the case of J. S. Copley Greene in a 
subsequent part of this report. AND THE DISEASES PROCEEDING FROM IT. 
23 
meningitis. Two varieties have been described, viz., quiet delirium 
and furious delirium. In the former of these, the patient is gene- 
rally quiet, with his features and eyes immovably fixed, with rather 
an astonished air; the countenance is sometimes composed and 
thoughtful; at other times, the eyes are turned upwards, and the 
whole expression is that of ecstasy; when spoken to, the answers are 
at first sensible, but soon the ideas rapidly succeed each other with- 
out apparent connection. The patient is by turns either gay or sad, 
loquacious or silent. He will be in a constant state of restlessness, 
tossing his arms, and throwing off the clothes, and trying to get out 
of bed. Sometimes he will be affected with a light trembling, chiefly 
in the arms and face, and experiences a hallucination of sight and 
hearing which at times greatly harasses him. 
In the second variety, the eyes are widely opened, menacing, 
furious, or haggard; the features are contracted; the patient cries, 
shouts, swears, tears his garments to pieces, bursts through the re- 
straints by which he wTas confined, and, in short, is in a state of com- 
plete and raging insanity. The delirium is sometimes accompanied 
by spasmodic contractions of the muscles of the face, distortion of 
the eyes, chattering of the jaws, twitching of the tendons, or tremors 
of the limbs. Notwithstanding all this nervous disturbance, by sud- 
denly fixing the attention on some very simple question, a rational 
answer will occasionally be obtained. The progress of both these 
varieties of delirium is of inconceivable irregularity, varying from 
instant to instant, without order; but when it is about to terminate 
favourably, a long, deep sleep supervenes, at the close of which, a 
complete change is observed, often an unexpected amelioration. 
The second, or comatose form, is characterized by coma, more or 
less profound. Tanquerel distinguishes two varieties of this form, 
according as the coma exists simply, or as it is combined with low 
delirium. In the former variety the patient is immovable, the limbs 
drawn up, the eyes closed, or half closed; he utters occasionally some 
heavy groans, turns in his bed, opens his eyes only to close them 
immediately, and is not easily roused from the comatose state in 
which he is plunged. 
In the latter variety, there is a partial rousing from the comatose 
state, during which the eyes are opened, and a few unintelligible 
words are uttered, and a degree of restlessness manifested. “ These 
two varieties of comatose encephalopathy,” says Tanquerel, “ show 
themselves alternately or isolated, during all the course of the dis- 
ease, and observe no order in their appearance or disappearance.” 24 
ON THE ACTION OF WATER ON LEAD PIPES, 
In the convulsive form of this disease, Tanquerel distinguishes five 
varieties: 1. Partial convulsions, in which the face, or one side, or 
one or more of the limbs, are agitated bj repeated quick shocks; or 
there may be spasms of longer or shorter duration. These symp- 
toms may coexist with delirium and somnolency, or with cephalalgy, 
more or less intense. 2. General convulsions. The cerebral disturb- 
ance, in this variety, may often be attributed to the violence of the 
colic or arthralgiac pains. The convulsive shocks extend to the whole 
body, affecting the face and superior extremities most severely; dis- 
tinguished from epilepsy by the consciousness being partially retained; 
patients can often relate, in part, what they have experienced during 
the fit. Reason generally returns after a quiet sleep. 3. Epilepsy; the 
most common form in which cerebral disturbance from the deleterious 
effects of lead evinces itself. The paroxysm lasts from two to thirty mi- 
nutes, and in no case have any traces of an aura epileptica been detected. 
When the attack is light, the patient suddenly falls, deprived of reason 
and general sensibility; he does not speak, but sometimes utters groans, 
and is but lightly convulsed. The more violent attacks are character- 
ized in the following manner : “ Immediate loss of reason, the globe of 
the eye turned up, the head immovable, the face suddenly injected, and, 
in an instant, the florid red colour changes to the paleness of death. 
Some convulsive movements pass through the limbs, and the body is 
stiffened; soon these symptoms acquire a prodigious increase; the 
hand is clenched, and the thumb turned convulsively within; violent 
spasmodic shakes agitate the whole body. Respiration is modified 
by the convulsive state of the muscles of the breast; it becomes 
short, interrupted, jerking, noisy, and afterwards stertorous; a foam- 
ing saliva, often bloody, is thrown out with noise and difficulty.” 
4. Epileptic convulsions. In this variety, the convulsive contractions 
are less energetic than in epilepsy; usually, there is no foaming at 
the mouth, or stertor; the spasms are almost continuous, and may 
last from one to twenty-four hours. 5. Catalepsy. The appearance 
of a patient, under this variety, is that of a person in a tranquil 
sleep; he gives no sign of sensibility or feeling when pinched or 
even burned, and it is impossible to awake him, or fix his attention. 
If the fingers, hand, arm, foot, or leg be placed in any position, 
constrained or easy, they are fixed for some seconds or minutes, then 
shake a little, and fall upon the bed. This state alternates with one 
in which there is some restlessness of motion and return of sensation. 
“ After some hours, or entire days of alternations of repose and rest- AND THE DISEASES PROCEEDING PROM IT. 
25 
lessness, the patient suddenly opens his eyes, feels physical wants, 
and asks to eat or drink.” 
In the fourth form of encephalopathy, there is a combination of 
all the symptoms occurring in the three other forms; it presents the 
type of the disease. The utmost irregularity prevails in the various 
combinations. Tanquerel gives the following as the most usual and 
most regular: “ The patient is, at first, taken with delirium, some- 
times so light that the physician does not recognize it; at the end of 
some hours, or one or two days, an attack of epilepsy supervenes, in 
consequence of which, the patient becomes drowsy for some minutes ; 
then he seems to awake, and talks all day; delirium, tranquil or 
furious, is then more decided than before the fit of convulsions; the 
same day, the night following, or the next day, one or more attacks 
of epilepsy supervene again. After each fit, the drowsiness is more 
profound and long; it is interrupted only for an instant, by a half 
waking for some minutes, during which the patient murmurs some 
wrords, then sleeps again. If the epileptic fit is renewed often, coma 
becomes very profound, then death takes place. In the contrary 
case, the patient seems to wake suddenly from his drowsiness, after 
some hours, or a day.” 
The encephalic nervous system seems to be the seat of this disease. 
All the pathological phenomena belonging to it point to alterations 
in the encephalon. Pathological anatomy, which has shed so much 
light on all organic affections, has revealed nothing satisfactory con- 
cerning lead encephalopathy. If there are organic changes in the 
brain, they are too subtile to be appreciated by our senses, even with 
the aid of the microscope. 
Of the treatment of encephalopathy, Tanquerel says: “At pre- 
sent, the best means known, for preventing the fatal termination of 
encephalopathy, is the expectant method. The physician who wit- 
nesses such violent accidents of the brain, with difficulty resists the 
desire of prescribing some treatment, in hopes that it will do no harm, 
and may, perhaps, prevent a fatal termination; it is painful for him 
to fold his arms before the disease, but experience is the greatest of 
masters; the facts referred to are sufficiently conclusive to persuade 
every practitioner that the best mode of treatment, to oppose to one 
of the most formidable diseases to which man is subject—lead ence- 
phalopathy—is that pursued at the “ Charity” by Rayer; that is, the 
expectant method, of which diet and diluted drinks form the basis.” 
In giving this brief description of lead diseases, their seat and 
nature, together with the modes of treatment which experience has 26 
ON THE ACTION OP WATER ON LEAD PIPES, 
shown to be most successful, it may, perhaps, he considered that the 
committee have gone beyond the strict limits of the subject committed 
to them. Their object has been to lay before the Association the 
means of comparing at once the cases which will be reported, arising 
from the use of lead water, with the well-established forms of lead 
disease. 
Under this view, your committee feel that the deviation (if it be 
considered one) will be excused. 
From what has already been stated, it appears that, in the present 
state of science, all known lead diseases are referable only to altera- 
tions in the brain and nervous system; and that pathological ana- 
tomy reveals no organic changes whatever that can account for the 
phenomena of these diseases. Where anatomy fails to demonstrate 
disease, we are naturally led to the only resource left us to ascertain 
its seat and nature; viz., observation and reasoning on the symptoms 
it presents. When we find, then, the functions of any organ altered, 
without any cadaveric lesion to explain the phenomena observed 
during life, we are at once led to look for the cause to the source 
from which these organs derive the power of performing their several 
functions. Following this course of reasoning, we are directly led 
to the nervous system and the brain, as the ultimate seat of all lead 
diseases. 
Chemical analysis has given us more positive results than patho- 
logical anatomy. It has demonstrated not only the presence of lead 
naturally in the human system, but that it exists in much larger 
quantities in persons who die of lead diseases than it does in those 
who die from any other cause. Lead, in such cases, has been found 
in undue quantities in all the tissues of the body, and also in the 
blood itself; consequently, it must pervade every part of the system. 
Its poisonous effect is manifested in a remarkable degree in the 
brain and nervous system. This is demonstrated by the functional 
changes in these parts; as has already been shown, in the derange- 
ment of the functions of all the organs to which the great sympathetic 
nerve is distributed, as in lead colic; by functional alterations of the 
organs which derive their power of motion and feeling from the 
spinal nervous system, as in arthralgia and paralysis; also by a dis- 
turbed state of the brain in encephalopathy. 
Lead diseases induced by drinking lead-transmitted water do not dif- 
fer in their general character from the same disease produced by other 
forms of lead exposure. In their course, they are often complicated 
with each other; for instance, colic is often found in connection with AND THE DISEASES PROCEEDING FROM IT. 
27 
arthralgia, sometimes with paralysis, and even with encephalopathy. 
Most of the cases, which will he reported by your Committee, 
present some of these complications. In fact, it is unusual to find 
a well-defined case of any form of lead disease unaccompanied by 
symptoms of some other form of disease, produced by the same poison. 
The following case is one in point: While it presents most of the phe- 
nomena of colic, those of arthralgia and paralysis are displayed in a 
very marked form. 
It occurred in the person of a distinguished scholar and eminent 
divine, Rev. Dr. Lamson, of Dedham, Mass. The case is reported 
as drawn up by the patient himself, who, in describing his own feel- 
ings, has given an admirable delineation of the extreme suffering, 
the depressed nervous feelings of a person afflicted with lead disease. 
Dr. Stimson, a distinguished physician in Dedham, informs your 
Committee that, in 1836, water was brought to the village from a 
spring upwards of half a mile distant, through leaden pipes, and dis- 
tributed from them, through small service pipes of the same material, 
to most of the houses in the place. Dr. Stimson further states 
“ that the Rev. Dr. Lamson was the first person who became dis- 
eased from drinking the water. It was used in his family both for 
drinking and culinary purposes. His case was one of the most 
interesting that occurred, was very insidious, and for a long time 
baffled the skill of other physicians besides myself. The cause of 
his severe illness was finally detected by accident. One day, when 
at his house, his wife asked me to taste their water, said it had a 
sweetish taste, and brought me a pitcher full that had stood over 
night. (The aqueduct water was not received at my house.) I 
observed on its surface a scum of leaden colour, resembling drops of 
lead; it had decidedly a sweetish taste. I had two bottles of it, one 
drawn early in the morning, to obtain the water that had remained 
in the pipes over night, and the other taken some time after, and 
sent to a chemist to be analyzed; saying, if lead was found in solu- 
tion, we should no longer be in doubt as to the cause of her husband’s 
illness. The chemist analyzed the water, and found it to contain 
lead in solution.” 
Rev. Dr. Lamson, in a letter addressed to the chairman of your 
Committee, says:— 
“ My dear Sir : In compliance wuth your request, I will describe 
to you, so far as I can now distinctly recall them, the symptoms and 
history of the disease or diseases under which I suffered, some years 
ago, from the introduction, as I confidently believe, of lead into the 28 
ON THE ACTION OF WATER ON LEAD PIPES, 
system, by means of water brought in lead pipes. I cannot, after 
the lapse of several years, determine the precise point of time when 
my attention wTas drawn to the malady which, most insidious in its 
approach, afterwards developed itself in so strange a manner. 
“ I am not positive as to any decided traces of a diseased state of 
the system before the early part of the summer of 1838; though I 
have an impression that the sensations I am about to describe com- 
menced the preceding summer. 
“ The first symptoms which I can recall (I now speak of my first 
attack) are a peculiar uneasiness or moderate pain in the bowels, 
with a sort of feeling that there was required, or would be some action 
of them, but no effect of the kind ordinarily followed, or could be 
induced by a natural effort. Yet there was at that time no violent 
constipation. This uneasiness, or these sensations, were not con- 
stant, but grew in frequency, the pain gradually creeping round to 
the lumbar region, when it became fixed and constant; by degrees, 
however, diffusing itself over the system, particularly the lower limbs. 
I do not recollect any pains in the head. But by the middle or 
latter part of the summer of 1838 I became greatly debilitated, yet 
was without fever, the pulse not elevated. An uneasiness or pain in 
the lumbar region now caused me continual suffering. I had a feel- 
ing of great misery; could walk hut a few steps without wanting to 
stop and sit down ; and if I did so, it was a great effort to rise again. 
I had a sense of constant lassitude or weariness, and an indisposition 
to motion. I was perplexed by the symptoms. The least fatigue— 
and all motion fatigued me—aggravated the suffering. 
“ I have now a very vivid recollection of going, with two or three 
friends, to pass a day or two at Nantasket Beach. This must have 
been late in July or early in August. We went out in a boat, and I 
well remember my sufferings as 1 lay listless in one end of it, trying, 
by various changes, to put myself in a posture of some ease, which I 
could not succeed in doing. I remember distinctly the question 
asked me by one of my companions: ‘Are you in pain?’ I was 
scarcely able to get home. We rode from the Beach to Dedham in 
a carryall. I remember the difficulty I had in supporting myself, 
holding on, as I could, by different parts of the carriage. As soon 
as I reached home, I threw myself on a bed, and sent for Dr. 
Stimson. 
“ The bowels had now become wholly inactive, and it was, I think, 
two days, at least, before they could be moved, and then very im- 
perfectly. During this time I was in a most restless state, day and 
night. There was no sharp pain, but a constant, dull, gnawing pain, 
more particularly in the lumbar region and bowels, and a tired feel- 
ing in all the limbs. I was every moment changing my position, 
seeking ease, but not, for a moment, finding it. I would get out of 
bed every little time, and sit in a chair, or attempt to walk the room; 
but it was all the same. There was no relief to be had. After the 
bowels had been effectually stirred, I found myself in a degree re- AND THE DISEASES PROCEEDING FROM IT. 
29 
lieved. From this time, the duties of my pulpit were suspended. I 
gradually gained, however. I now kept out as much as possible.” 
In the latter part of August, Dr. Lamson went to the sea-shore, 
and, about the 20th of September, to Eastport and the Provinces; 
and subsequently travelled, by easy stages, through the interior of 
Maine and New Hampshire, reaching home in the autumn. After 
this he walked, or rode on horseback, a distance of ten to twelve 
miles every day. Exercise did not now fatigue, but seemed to in- 
vigorate him, so that he entered his pulpit and preached on Thanks- 
giving Day. “ This, you will recollect,” the Dr. continues, “ was in 
the latter part of November of 1838.” 
“I went through the next year very well, keeping up my system 
of out-door exercise so far as my duties allowed. In the latter part 
of winter, or early in the spring—I think it was Avinter—I had an 
attack, mainly in the left side, apparently in the intercostal muscles. 
From this I recovered in no long time, and went on till late in the 
spring of 1840. Then, and in the early part of summer, I had a 
return of the old symptoms described as occurring in 1838; only 
with this difference, that the development of the disease Avas much 
more rapid. I went through the same process of active medicines, 
injections, &c., before the boAyels could be stirred. I became more 
debilitated than before, the countenance assuming, in a more marked 
degree, the peculiar earthy yelloAV described by M. Tanquerel. 
“ Then came on the pure arthralgic pains. They seemed to be deep, 
as if in the very bone, and were seated more particularly in the flexor 
muscles, as the inside of the elbow-joints and the joints of the knees. 
“ Soon after, that is in July, there commenced a trembling of the 
fingers, which soon passed into decided paralysis, the paralysis in- 
creasing for about three weeks. This paralysis was in the extensor 
muscles of the fingers, wrist, forearm, and arm of both the upper 
limbs; the lower limbs, with a slight exception I shall hereafter no- 
tice, not being affected. My arms, when left to themselves, hung 
loose and dangling at my sides, as if turning on a pi\rot. Using only 
one at a time, I could elevate them only in a slight degree. I could 
not get my hand to my chin or mouth. 
“But what puzzled me at the time was that there were certain mo- 
tions which I could perform; for example, placing the palm of one 
hand against the back of the other, I could get them to my face, the 
flexor muscles of the hand, which were not paralyzed, being thus 
brought into action. So, too, I could draw on my boots almost as 
well as ever, the same muscles acting. If my arms were elevated to 
a right angle with the body, the palm of the hand being turned doAvn- 
ward, the whole hand fell at the wrist, hanging loose as a piece of 
cloth, and the will had no more power over it. I could not, without 
help, raise the hand in the least, nor so much as one of my fingers, 
in the slightest degree. When I took a tumbler to drink, I clasped 30 
ON THE ACTION OF WATER ON LEAD PIPES, 
it with both hands fully spread, and could so get it to my lips. When 
I ate, I rested my right arm, below the elbow, on the edge of the 
table, and grasping the wrist with the left hand, and then bringing 
my mouth down to within three or four inches of the table, I could get 
the food to it. The backs of the hands became prominently arched; 
the fingers, when left to themselves, became bent and half shut, the 
natural consequence, I suppose, of loss of power in the extensor 
muscles. The rotatory motion of the arm was entirely lost, a fact to 
which my attention was directed when they attempted to assist me to 
put on my coat. 
“I tried all I could to exercise the poor lame muscles, but all 
fatigue, that is, all use of them, seemed to be attended with injury. 
They had totally lost their contractile power. The abdominal 
muscles were similarly affected, though not in the same degree. If 
I had any, it was only a very slight power over them, which gave me 
great trouble when an action of the bowels was needed, though they 
could at this time be readily moved by medicine. 
“All the while there was more or less of arthralgic pain, more 
particularly at this period in the inside of the knee-joints. 
“ The pain seemed to have no connection with the paralysis, and 
was greater in the parts not paralyzed than in those which were. 
The intercostal muscles on the left side were now affected; for months 
I could not sneeze ; the moment the process began it was arrested by 
these muscles. The sensation was a very unpleasant one. 
“We were at this time entirely in the dark as to the nature of this 
disease ; my physician seemed perplexed at the very extraordinary 
character of the symptoms. 
“I got doAvn to Nantasket Beach, and passed four weeks there 
with some slight benefit; that is, I became in a trifling degree less 
debilitated. I could not but remark at the time that, whenever I 
left Dedham for a few days, I gained a little strength, but relapsed 
on my return, an effect which I afterwards ascribed to drinking the 
water, as I at the time used no other. I recollect asking myself 
at the time, what could be the cause ? Was it the atmosphere of the 
place ? That seemed an insufficient solution of the problem. At 
this time I had some appetite ; I could eat enough, in fact, and in 
general with a tolerable relish. I had no constant thirst, though I 
felt thirsty at times, especially in the afternoon, or when unusually 
fatigued. I had little or no fever, though at one time a highly 
nervous pulse. 
“I have spoken of the loss of the power of motion in certain 
muscles, or their loss of contractility. The sensibility of the mus- 
cles or nerves, with a slight exception, was not impaired, but the 
reverse. This sensibility became intensely acute. There was a 
soreness or peculiar tenderness in all my flesh. Sitting in a common 
wooden chair and leaning back, the parts of the chair seemed to 
penetrate to the very bones. The exception referred to was a small 
muscle in the inner part of the left thigh; I never ascertained its 
name. There was a spot of three or four inches in length, and two AND THE DISEASES PROCEEDING FROM IT. 
31 
or three in breadth, which had lost its sensibility. There was, at 
times, a sensation of a peculiar and unpleasant kind at the bottom 
of my feet, a sort of burning, which I used to relieve, when in bed, 
by drawing up the covering, and pressing the soles of my feet firmly 
against the foot board, which produced a cool and agreeable sensa- 
tion. I had also, at times, a violent pain in the back between the 
shoulders, rather nearer the right than the left shoulder, which I 
would relieve by getting on my bed, and lying flat on my back, 
bringing as much pressure to bear on the part affected as I could. 
This method mitigated the pain before a long time. In a multitude 
of ways, I was a great sufferer; but the brain I did not think was 
affected, and I do not now think that it was. There was no appear- 
ance of encephalopathy.” 
Soon after Dr. Lamson’s return from the beach, the latter part of 
August, he was induced to visit the Sulphur Springs of Virginia. 
The journey was with great difficulty performed. He remained 
about two weeks at the White Sulphur, and about the same length 
of time at the Hot Mineral Springs. Returning by the way of 
Washington, he reached home after an absence of about six weeks. 
To resume the narrative. “About this time I heard some talk of 
lead as the probable cause of my disease, and attention was directed 
to the water. It was at this time, or a little before, I think, that 
Dr. Stimson expressed a conviction, or an opinion, that lead might 
be, or was, the cause. I did not myself think that it could be so, 
and, in fact, at first treated the suggestion rather lightly. I remem- 
bered to have heard it stated, at the time the pipes were laid, that 
the water being soft and pure would not act on lead. I had, there- 
fore, rested secure. I did not then know what I afterwards ascer- 
tained from reading, that the pure and spring waters were quite as 
likely as others to act on lead. It happened, however, that about 
this time a volume, treating of mineral poisons, being mainly an 
epitome, I think, of Dr. Christison’s work, was put into my hands. 
Some symptoms, which he described as those of lead disease, caused 
me to pause and reflect. About ten days or a fortnight after this, 
we heard the result of the first chemical analysis of the water drawn 
from my branch-pipe. This analysis was made by Prof. Webster, 
of Cambridge. He found the water decidedly impregnated with 
lead; enough so, in his opinion, seriously to endanger the health 
of those who should habitually use it. He found acetate of lead, 
and, I think, carbonate. A quantity of the water was afterwards 
sent for analysis to Dr. Hayes, and with the same result. 
“At this time I was very slightly improving, as I thought. Still I 
could not be quite sure that the paralysis was leaving me, or was, in 
fact, essentially better. I may say that I had yet remaining some 
little scepticism as to the nature and cause of the malady. But the 
last vestige of it was soon to be put to flight. 
“I received from Paris the two volumes of Tanquerel on diseases 32 
ON THE ACTION OF WATER ON LEAD PIPES, 
occasioned by lead; the work subsequently so faithfully translated 
and abridged by my friend Dr. Dana. I fell to reading it with 
great eagerness, and there I found all my symptoms minutely and 
accurately described, under the heads of arthralgia and paralysis. 
I could hardly persuade myself that it was possible for one who had 
not felt the symptoms himself to describe them with so much minute- 
ness and truth. All mystery now vanished with regard to the nature 
of the disease. I can never feel more certain of any fact whatever, 
than I was, and am still, that all my suffering came from the use of 
water conveyed in lead pipes. 
“ It was impossible, as it appeared to me, to doubt it. I know the 
power of incredulity, but there are cases in which incredulity itself 
must yield. I deem this one of them. 
“ Still my recovery was exceedingly slow ; I could perceive no 
change from day to day; but from week to week I flattered myself 
that I could. Electricity was tried, but without any perceptible ad- 
vantage. 
“ Time and the open air, in which I kept as much as possible, and 
nourishing food, seemed to me to do the work. The pains gradually 
left me, and the muscles became strengthened, and returned to their 
normal state. 
“ The arms, which had become greatly emaciated, and the wrists 
and hands, were the last to be restored. By the 1st of January, 
1841, I was able to enter my pulpit, and go through the services. 
But I had then a very imperfect use of my hands ; I could write a 
little, but my chirography looked like that of a very old man. 
My pen would jump and go all sorts of ways, and was tremulous. 
In the course of the winter I improved gradually, but for some years 
occasionally felt the effects of the disease, particularly in the wrists. 
“ The above is a simple narration of facts and sensations as they 
now rise up to my memory, I have many times regretted that I did 
not write a description of my case at the time. I have done it now, 
at the request of your Committee, and in the hope of benefiting my 
fellow-beings. You will excuse the length of my communication, 
and believe me, 
With sentiments of great respect, 
Very truly yours, 
(Signed) A. LAMSONA 
It appears, from the remark on this case by Dr. Stimson, that the 
patient early presented the peculiar jaundiced appearance, already 
described as one of the primary effects of lead poisoning. He says, 
“ It occurred in an early stage of the disease, while he was suffering 
under arthralgic and neuralgic pains. Not only the face, but the 
entire surface of the body became as yellow as in common jaundice 
from occlusion of the biliary duct; at the same time, the dejections 
contained a sufficiency of good yellow bile. This colour was more AND THE DISEASES PROCEEDING PROM IT. 
marked in the face than on the surface of the body, and had a more 
dirty, earthy-yellow tint than common jaundice. After it left, the 
complexion had a pale, dingy, leaden hue, similar to others who had 
become diseased by the reception of this mineral. Another pecu- 
liarity was a paralysis of the abdominal muscles to such a degree 
that he could make no effort to expel the contents of the bowels ; 
this took place much later ; we had, therefore, much difficulty in 
keeping the bowels open.” 
“ There was another person in Dr. L.’s family who became dis- 
eased, and presented symptoms similar to his, but of less severity ; 
a coloured female domestic, who had drank the water for eighteen 
months. Her symptoms were arthralgic and neuralgic pains about 
the trunk and extremities, impaired appetite, loss of flesh, with a 
peculiar anxious and distressed countenance, and constipated bowels ; 
was obliged to leave her place, in consequence of her indisposition; 
after she left, she soon began to mend, and in a few weeks regained 
her usual flesh and health.” 
It appears also, from the Doctor’s report, that many other cases 
occurred similar to the one above; for many of the inhabitants con- 
tinued to drink the water, although warned that it contained a 
deadly poison, until they began to feel the evil effects of it, when it 
was abandoned. Most of the cases recovered after the water was 
discontinued. 
The following cases we give in Dr. Stimson’s own language :— 
Lead Arthralgia with Paralysis.—“ April 18, 1849. I was called 
to visit a patient in a neighbouring town—a Miss Mayhew, aged 
about 14 years. The following history of her case I received from 
her mother and the attending physician. She had been confined to 
her bed for several weeks with what they supposed to be chronic 
rheumatism. It came on gradually, without fever, with severe pains 
in the inside of her upper and lower extremities, more particularly 
about the inner angle of the elbow and knees; then about the loins 
and chest. The mother said she had pains all over her ; sometimes 
they appeared more severe in one place, and sometimes in another; 
but when moved she complained of its hurting her everywhere; 
that she was very nervous, unwilling to be touched, or have anything 
done for her; much depressed in spirit, and unwilling to see any 
one. Nothing she had taken had done her any good ; she had con- 
tinually been growing worse and worse; her appetite was very poor, 
and she had lost much flesh; and her bowels were constipated from 
the morphine she had been obliged to take to get any sleep. 
“ The first thing that attracted my attention, as she lay curled up 
in the bed, was that specific physiognomy peculiar to persons poisoned 34 
ON THE ACTION OF WATER ON LEAD PIPES, 
by lead. Skin cool; pulse moderate, soft, and feeble; much ema- 
ciation. It was difficult to make a thorough examination, she was so 
fearful it would put her in pain; for, when still, she said she was 
comparatively easy. On gently moving the limbs, both upper and 
lower, I found it was the flexor muscles that caused the pain on mo- 
tion ; the abdomen was small; the muscles were rather firm, not soft 
and pliable. The fingers of one of the hands were curled up into the 
palm, and I could not persuade her to move them. She breathed 
naturally, and I could discover no disease of the heart or lungs. I 
suspected the disease was caused by lead; that somehow or other it 
had penetrated the system. I questioned the parents about their 
water, whether it came through leaden pipes; and was informed that 
it did. It was brought, they said, some distance to the house for 
washing, as the water was very soft, and their well-water was hard. 
They had generally used their well-water for drinking and for culinary 
purposes; but their well had been out of order the last six or eight 
months, and the water from the aqueduct had been used constantly 
during that time for all domestic purposes. This water was fre- 
quently used in the family while the well was in order, as it came 
into the house and was so handy; but oftener they thought for cook- 
ing than for drinking. These facts confirmed my diagnosis. I gave 
my opinion that the disease was lead arthralgia, caused by the aque- 
duct water, and advised an immediate discontinuance of it. 
“ August 29, 1849. Saw her again; her parents brought her to 
Dedham; she remained here a week under my care. Her general 
health had much improved; she had gained in flesh and strength; 
suffered little or no pain; slept without anodynes; appetite good; and 
the countenance had recovered its normal expression. The extensor 
muscles of one of the upper and one of the lower extremities of the 
same side were paralyzed* When she raised the arm, the hand hung 
pendulous from the wrist. Pronation or supination could neither be 
performed; the fingers were still drawn into the palm of the hand; 
no one of them, nor the thumb, could be moved in the slightest degree; 
they retained their sensibility. When she walked, she shoved the 
foot on the floor, not being able to raise the toes, which gave her a 
peculiar and unsightly gait. I prescribed strychnine in pills, com- 
mencing with Jjth of a grain, and increasing -Hjth each dose, till she 
felt the tetanic shaking; T42ths produced the desired effect. The next 
day she slightly moved the forefinger. She continued to take T4.2ths 
of a grain, every second or third day, for several weeks, with much 
benefit. I did not see her again till the summer of 1850. She then 
was quite fleshy, her health good, had entirely recovered the use of 
her foot, could walk or dance without any perceptible difference in 
the movement of her limbs. She could rotate the lower arm and 
hand, and move it in all directions, as well as the other, but could 
not straighten the fingers ; the thumb had also recovered perfectly. 
She played on the piano, using the knuckles of that hand, instead 
of the extremities of the fingers, with a facility that surprised me. 
Whether she will ever be able to use these fingers, time alone must AND THE DISEASES PROCEEDING FROM IT. 
35 
determine. She could not the last time I heard from her, six months 
since.” 
Lead Paralysis with Encephalopathy.—“ J. Guild, aged fifty-four, 
a resident of this village, engaged in mercantile pursuits, of rather 
feeble constitution; had always been able to attend to his business; 
had never been severely ill previous to May, 1847, when he was 
attacked with pleurisy, which terminated in eifusion into the left 
pleura. In about two months, the water was absorbed, and he 
gradually recovered such a degree of health, that he returned to his 
business in the latter part of the following July. His system was shat- 
tered by his long sickness, and his health never so good afterwards 
as before. Early in March, 1848, he began to falter, complained 
of being easily tired, walked feebly, said he had no pain, and could 
not imagine what ailed him; thought he might have more water in 
the chest, and wished me to examine him. I did so, by auscultation 
and percussion, and was satisfied there was no disease about the 
chest, and could discover none anywhere about him. His pulse 
was feeble, his appetite failing, and flesh declining; but what caused 
his indisposition, at that time, I could not divine. A few days after 
this examination, strabismus supervened; one eye turned in toward 
the nose, and he could not roll it out; the external muscle of the 
eye was paralyzed. He could see as distinctly as ever with either 
eye separately; but, whenever he looked with both, the object ap- 
peared double. He continued about his business several weeks after 
this, much in the same state, though rather declining ; he had some 
slight pains about the chest at times, and was apprehensive his old 
difficulty would return, and wished me to examine his chest fre- 
quently, which I did, but could discover no disease there. 
“ I advised him to take a journey; he did, to the Sulphur Springs, 
in New York; he remained absent but a short time, feeling too un- 
well to be from home. Soon after his return, he complained of 
numbness in his fingers ; it soon increased to such a degree that he 
was unable to button his clothes ; and soon after this, there was evi- 
dently paralysis in the extensor muscles of the arm. The coun- 
tenance began to put on that expression so peculiar in all who suffer 
from lead disease. I was satisfied that lead had penetrated his 
system in some way ; but how ? The aqueduct did not come to his 
house or store ; he believed it unhealthy, and never used it. He had 
his store painted and grained in the inside; the workmen were a 
fortnight doing it, in the month of March; he Avas in the store every 
day, with the doors and windows closed, while they were about it. 
The strabismus occurred during this time. Did he inhale the poison 
of lead in a sufficient quantity to cause the disease ? I thought not, 
as the earlier symptoms appeared some weeks previously. On fur- 
ther inquiry, I learned that the water he drank and used for culi- 
nary purposes came from his well through leaden pipes. We had 
two junk bottles of the water, one from the pump, and the other 
from the well outside the leaden tube, sent to Dr. Hayes, a distin- ON THE ACTION OF WATER ON LEAD PIPES, 
guished chemist, formerly of Roxboro’, now in Boston, for analysis. 
Lead was found in both bottles, but less in No. 2 than in No. 1. 
How long the leaden pipe had been in the well could not be cer- 
tainly ascertained; they were sure it must have been in a number of 
years, probably five or six; no one else of the family had suffered 
from it. We were now fully satisfied the cause of the disease was 
discovered. 
“ The patient was put under the treatment recommended by Tan- 
querel; viz., sulphurous baths and pills of strychnine. The baths 
were prepared by putting five ounces of sulphuret of potash to each 
bath ; they were taken six days in succession, then omitted ; gr. i of 
strychnine was made into twelve pills, beginning with one, and in- 
creasing one every day, till the tetanic shakings were produced ; 
four pills generally affected him, and caused as severe shakings as 
he was willing to bear, continuing two or three hours before they 
entirely ceased. This course was interrupted, then again repeated, 
as long as it was thought best, without apparent benefit; at any 
rate, he gradually grew worse, with the exception of the pains about 
the chest; they were better. The paralysis increased in the ex- 
tensor muscles of both the upper extremities, and soon after, one of 
the lower was so severely affected, that he could neither dress nor 
feed himself, nor walk without assistance. The debility and ema- 
ciation increased, also the tremor ; the complexion, a pale dirty 
white, and the physiognomy peculiarly marked. His spirits greatly 
depressed; if a neighbour called to see him, would burst into tears, 
and be unable to speak, for some time. This state of mind appeared 
in all the severe cases; the stoutest hearts seemed to succumb, be- 
come passive and non-resistant. Bowels constipated, readily moved 
by medicine ; pulse normal, but feeble. 
“ He continued with little alteration till early in October, when 
encephalopathy supervened ;* he became delirious during the night, 
talked incoherently ; countenance wild and staring. This continued 
ten or twelve days; at times, would talk rationally, and answer 
questions correctly, then wander and be quite insane. After the 
affection of the brain terminated, his general appearance was much 
as it had been previously, only more debilitated. He continued 
from this time gradually to sink, and became very much emaciated 
before his death, which took place January 2, 1849.” 
We have selected but two of Dr. Stimson’s many cases of the well- 
marked and well-defined lead diseases, which appeared in Dedham, 
Massachusetts, a few years since; so common were these diseases, at 
one period, that they might have been considered in the light almost 
of an epidemic. 
But as soon as the inhabitants were convinced that they were 
* The chairman of your Committee first saw this patient, in consultation, on the 
last day of September, 1818, when he began to show some symptoms of the approach 
of encephalopathy. AND THE DISEASES PROCEEDING FROM IT. 
37 
caused by the use of lead water, most of them abandoned it, and the 
great frequency of the disease disappeared. 
But some of them were sceptical, and continued to use the aque- 
duct water, and were unwilling to believe in the poisonous quality of 
it, until forced to do so by their personal experience in the diseases 
caused by it. 
The Doctor himself, at a subsequent period, suffered a severe at- 
tack of arthralgia in his lower extremities, from using water drawn 
from a well through a lead pipe. 
His wife also had an attack of paralysis in the lower extremities, 
which prevented her from walking; she could not rise from her chair 
without taking hold of something and pulling herself up; she was 
also unable to raise her toes from the floor. The disease continued 
to increase till the cause was discovered and removed; since which 
the Doctor has had no return of the pain, and his wife has gradually 
recovered the use of her limbs. His case had some points of pecu- 
liarity ; the pain always came on in the night, was seated in the in- 
side of his knees and legs, and seemed to him as if it extended to 
the marrow of the bones, and was always relieved by pressure. 
The Committee regret that their limits will not allow them to give 
the Doctor’s minute description of these two cases entire. 
The following cases, communicated by letter to your Committee 
by Dr. Challiss, of Moorestown, Burlington County, New Jersey, 
will show, that the liability to disease does not always cease imme- 
diately on abstaining from the cause. One case of colic occurred 
two months after the patient ceased to drink the water; and the case 
of paralysis did not show itself till three months after the use of the 
water had been discontinued. The first case of colic was alsp at- 
tended by some symptoms of encephalopathy. 
“ The family of William Clark commenced making domestic use of 
water, transmitted through lead pipes, on March 20, 1851; with the 
exception of his son George, who commenced in September, 1850. 
George, who was a man of robust and plethoric constitution, was 
taken with colica pictonum, April 3, 1851, and after a severe illness 
of three weeks, convalescence commenced. Lancinating pain in the 
bowels and severe cephalalgia were the prominent symptoms. He 
was at times delirious, very restless, and manifested great concern 
for his affairs. But, as soon as ptyalism was produced, the severity 
of the symptoms abated. But, before leaving this case, I would 
state that, in the September following, he had another attack, and 
died under the care of a homoeopathic physician; the only case, out 
of five, in this family, that was treated homoeopathically, and the 
only one that died. April 7, 1851, Mrs. Clark, who is old and 38 
ON THE ACTION OF WATER ON LEAD PIPES, 
anemic, was taken, and did not fully regain her health until June 
12, 1851. Her symptoms were, in character, the same as her son’s, 
but not so acute. Susan (the daughter), who is a young woman, of 
ruddy countenance and full habit, was taken May 3,1851. She did 
not remain ill after May 15. The onset of the disease, in this case, 
was threatening, but the recovery wras rapid. The symptoms were, 
in the main, the same as in the preceding cases. 
“ William Clark was taken October, 1851, with paralysis of the 
left arm, but which, in about four weeks after I began the treatment, 
was restored to use. For the particulars in regard to this case, I 
would refer you to the January number of the New Jersey Medical 
Reporter, (from which we gather the following facts: ‘ The appear- 
ance of the patient was very much changed from what it w'as a short 
time previous. His countenance was pale and sunken, his expres- 
sion melancholic. That vivacity which was a marked feature of his 
character was gone, and sadness and silence sat enthroned.’) 
“ He was able to make flexion and extension but to a slight de- 
gree ; but, what is singular, the grasp was as perfect, and as strong 
as in health. The condition of the left side wms involved in great 
obscurity. To the touch, that part, extending from the false ribs to 
the crista ilii, and from the dorsal vertebrae to the left rectus muscle, 
presented a hard and indurated feel. The hardened mass lay imme- 
diately beneath the skin, and could be traced only to the muscular 
system. His general system was not at all deranged. This attack 
came on three months after the water, which had poisoned his family, 
had been discontinued for domestic purposes.” 
The following cases are extracted from a letter addressed to the 
Committee by Dr. J. T. Garrison, of Swedesboro’, West N. Jersey:— 
“ In the autumn of 1847, Mr. C. laid a train of one-inch lead pipe 
from his residence to a spring about a mile distant, for the purpose 
of conveying the water from it to his house and barns. The spring 
being on a hill which was more elevated than the buildings for which 
the supply was intended, no machinery was required to impel the 
water through the pipes; it made its way along them, by its natural 
gravitation, into large wooden tanks provided for it in the kitchen 
and cattle yard. When the spring was very low, as sometimes 
happened in warm weather, the pipes were but partially filled by the 
current, room being thus left for the entrance of air into the unoc- 
cupied space. I cannot ascertain the exact time at which the water 
was first used by the family more nearly than that it wras in the latter 
part of the summer, or the first of the autumn ; but from this time 
it was used constantly; and, as it was esteemed peculiarly pure and 
good, none other was ever employed for culinary purposes or drink- 
ing. The cattle and horses wTere also supplied exclusively from the 
same source. 
“There wTas no illness in the family during the winter of 1847; 
nor the spring of 1848, until the middle and latter part of May, 
when several members of the family began to complain of feelings AND THE DISEASES PROCEEDING FROM IT. 
39 
of uneasiness in the abdomen, with pains over the body generally, 
accompanied by constipation in some, and in others by tenesmus and 
small bloody stools. Mr. C. himself was especially affected, and 
became gradually worse, suffering from violent colic pains, with unre- 
lenting constipation, until June 20th, 1848, when we were called on 
to visit him. Dr. Garrison (senior), who first saw the case, found 
him in excruciating pain, which was located near the umbilicus; it 
never left him for a moment, and seldom even remitted decidedly ; 
this was attended with intense retraction of the integuments of the 
abdomen towards the spine, and a hard knotty feeling of the muscles 
in various places over its surface. 
“ The bowels had not been moved for five days previous to the 
visit, although there was a frequent and urgent tenesmus; his pulse 
was rapid, his skin hot, his countenance anxious, his tongue furred, 
and his gums fringed along their edges with the strongly marked 
blue line, said to be pathognomonic of the presence of lead in the 
system. His stomach was also disordered; so much so as to induce 
a frequent desire to vomit. 
“ The peculiarity of the symptoms, joined to a knowledge of the 
facts above mentioned, respecting the water which he wras in the 
habit of using, left no doubt of the nature of his ailment. He was 
treated by bleeding and the administration internally of calomel and 
opium, followed by senna and salts, cream of tartar, and jalap, and 
other purges, which were, however, one and all rejected; nor was 
the constipation overcome until the morning of the third day of our 
attendance, when it was effected by the use of croton oil, assisted by 
enemata. After this, he gradually improved, and on the tenth day 
(June 30th) was decidedly convalescing.” 
“ Mrs. C. and several of the children had also been suffering in a 
similar manner, though not so severely; and, on examination, we 
found the gums of six others of the family distinctly marked with 
the blue line along their edges; but, by suspending the use of the 
water, and some slight medication, they were soon made quite well. 
Since this time, the family have entirely discontinued the use of this 
water for cooking and drinking; but the cattle and horses have been 
allowed to take of it freely, and as yet without any injury to their 
health that is notable.” 
A gentleman from New Hampshire called to consult the chairman 
of your Committee, a few months since; but, being absent, he did not 
see him. Soon after this gentleman’s return home, he sent by a 
friend a bottle of water to be analyzed, and the following history of 
his own and his wife’s case—two very well defined cases of arthralgia, 
accompanied by slight paralysis of the muscles of the extremities. 
It is quite remarkable that he should have noted most of the pro- 
minent symptoms of the two diseases above mentioned. The water 
contained traces of lead, sufficient, in all probability, to produce the 
state of the system which he describes. They had no suspicion that 40 
ON THE ACTION OF WATER ON LEAD PIPES, 
lead poison was the cause of their troubles until this was suggested 
to them bj a friend, who had known something of the effects of it 
in other instances. 
We give the letter in his own language, which is eminently 
descriptive of the diseases from one not familiar with the phraseology 
of medical science : — 
“ In 1843, we began to use hard water, drawn through heavy, one 
and a-half inch lead pipe ; in 1851, renewed the pipe, the old being 
very badly corroded, in fact, eaten through in several places. At 
the time we began to use the water, Mrs. G. and myself were in 
good health and spirits; previous to which, neither of us had laboured 
so hard as we have since; both of us have been troubled, more or 
less, during the whole period since 1844, with numbness in our hands 
and arms. Mrs. G. for most of the time has been in good health 
and spirits, has generally slept well; the exceptions are, the numb- 
ness, before mentioned, and more particularly in 1850-51, was much 
troubled with lame, weak, and painf ul limbs, particularly in her 
knees; she is now nearly recovered in this particular; yet she is, 
from numbness or something akin to it, now frequently unable to 
write, sew, or knit. We discontinued using the water in August 
last. 
“ My own case is substantially as follows: In the first place, I 
have drank very freely of the Avater, particularly in warm weather; 
it is quite cool, and I have indulged copiously in the luxury, and, as 
a general thing, my health and spirits have been bad; generally 
wrorse in autumn, often down or very near it at this season ; better 
in the winter. My back has been lame, weak, and painful; my 
knees and legs at times nearly useless, or in other words extremely 
feeble ; very troublesome dreams almost nightly; generally restless ; 
on rising in the morning, often (not always) completely enervated, 
with neither energy, strength, nor courage ; depressed exceedingly ; 
stirring about, however, soon, in a degree, remedies the difficulty. 
“ In 1849-50, I was greatly troubled with pain in my leg; fre- 
quently awoke in the night in most intense agony; a sudden jump, 
with hard rubbing, would very soon cause relief. 
“ I also had thirty or forty sores, something like boils, on the back 
of my thigh and above ; ‘ push boils’ in the commencement, but they 
enlarged and discharged very much. My teeth began to work loose 
and come out before I left Boston; they, however, went rapidly after 
I came here; the last that were firm, say four or five, the dentist 
took away in 1849. 
“ I have described my feelings as nearly as I can ; you will bear 
in mind the hard work, and also the ages, being now fifty-four and 
fifty-six.” 
The cases which follow fell under the immediate observation of 
Dr. Dalton, a member of your Committee from Lowell, Mass.:— 
The case which I shall first describe strongly illustrates the in- AND THE DISEASES PROCEEDING FROM IT. 
41 
tractable character of lead affections, so long as the cause remains 
unsuspected, and in continued operation, and also how liable this is 
to be overlooked by even the most sagacious members of the pro- 
fession, in the absence of suspicious circumstances. 
“ E. M. Read, a mason, 35 years of age, married, of a fine consti- 
tution, and in the enjoyment of perfect health, removed from one of 
the factory boarding-houses (supplied with water, for domestic pur- 
poses, through a wooden pump) to a residence on Gorham St., Chapel 
Hill, in 1836. His health remained good until the early part of 1839, 
when he began to have attacks of colic, with constipation, attended 
with a disagreeable sense of heat in the bowels; loss of flesh and 
colour—his skin assuming a yellowish dingy aspect; pains in his lower 
limbs, with a sense of weakness, stiffness, and numbness, with frequent, 
indeed almost daily, attacks of colic. Eructations ; loss of appetite, 
with all the variety of dyspeptic symptoms. Naturally cheerful, his 
spirits became depressed, and he became very nervous. These symp- 
toms, which came on very insidiously and gradually, in the course of a 
few months were much aggravated, and from their frequent return, 
after partially yielding to active cathartics, alteratives, bitters, &c., 
became alarming. 
“ The treatment, which relieved in the early stages, failed to be of 
any benefit as the case advanced. Practitioner after practitioner was 
consulted, with equally unsatisfactory results. The costiveness be- 
came constant, while cathartics and even laxatives aggravated his 
sufferings; colicky pains recurred almost daily, and he suffered from a 
sense of stricture, as if a cord were drawn permanently tight around 
his body at the navel. 
“At this juncture, he consulted Dr. James Jackson, and remained 
a week under his care, in Boston; by him, leeches were applied 
twice freely to his abdomen, and with immediate, but transient relief; 
in a few days, the pains, &c., returned, and leeches were ineffectually 
repeated. Dr. Jackson dissuaded from the further use of medicine, 
advising him to a strict course of diet, and such as was calculated to 
produce a soluble state of the bowels, without resort to purgatives. 
This course was strictly followed, but the disorder remained substan- 
tially unaltered. 
“ No inquiry or reference, up to this time, was made by any one, 
as to the true cause of the difficulty. Some five or six months pre- 
viously to his own ill health, the health of his wife and of his only 
daughter had become impaired; the former suffering from frequent 
attacks of colic, pain in the limbs, nausea, vomiting, numbness and 
stiffness of the lower extremities—the latter, from spinal irritation, 
dyspepsia, fetid breath, and convulsions.* 
* In about a year after their removal to Ch. Hill, Mr. R.’s son, a child about two 
years old, began to be affected with anomalous symptoms in his bowels, terminating, 
after a few weeks’ illness, in fatal disorder of the brain, which, at the post-mortem ex- 
amination, exhibited, however, no tangible traces of disease. The father feels a con- 
viction that the child owes its death to the influence of lead in the water of the house, 
which, he says, constituted its constant beverage. I did not see the case. 42 
ON THE ACTION OF WATER ON LEAD PIPES, 
“About this time, similar cases, in this same neighbourhood, had 
occurred; and several in my own practice. The result was a sus- 
picion as to the true cause; which was at once confirmed by chemical 
examination of the water in the wells, which was found to be supplied 
to all the families in that portion of the city through lead pipe, in 
some cases several hundred feet in length; of course no time was 
lost in substituting other material for lead in supplying the family 
of Mr. R. ; which example was very soon followed in the case of the 
other sufferers. 
“From this time, Mr. R.’s symptoms began to mitigate; the attacks 
were less and less severe; and, although his recovery has been slow, 
he is now in the enjoyment of nearly the same amount of health as 
when he first removed to the district. His wife and daughter also 
soon recovered.” 
Similar cases, of a more or less pronounced character, continued to 
occur in this, as well as in other parts of our city, all of which were 
traced to the use of water impregnated with lead; not a small number 
of them terminating fatally, either before the cause was detected, or 
from an obstinate incredulity on this subject, which prevented its 
removal at a sufficiently early stage of the affection to admit of 
recovery. But, eventually, this incredulity was overcome; lead pipes 
were generally removed; block tin or iron substituted—and forth- 
with the intractable character of the disease disappeared; protracted 
cases began to permanently mend; new ones became less frequent, 
and finally very rare, occurring only now and then, here and there, 
where the avarice of a landlord had refused to listen to the voice of 
humanity, by submitting to the trifling expense required in the ex- 
change of the material above mentioned. When cases did occur, they 
were at once identified, and the cause being immediately removed, 
recovery began, and was soon established, with very little, and in 
some cases with no medication. In one of the cases above alluded 
to, the water for the uses of the family was brought through a lead 
pipe more than 400 feet in length; scarcely one of its members, 
domestics, or visitors, however transient their stay, escaped attacks of 
disease, bearing evident marks of their saturnine origin; the visitors 
being attacked with nausea, vomiting, constipation, and colic; the 
more permanent members with the same as well as with the more 
severe and dangerous symptoms; yielding but imperfectly to treat- 
ment as long as the cause remained undetected, but recovering rapidly 
and permanently so soon as this was removed. One of these cases 
terminated in complete paralysis of both lower extremities, which 
eventually disappeared under the use of strychnine. 
Although, as I have above intimated, there were here and there AND THE DISEASES PROCEEDING FROM IT. 
43 
cases of the affection in other localities within the city, yet by far 
the larger number, and most severe ones, took place in that portion 
of Lowell embraced by what is called Chapel Hill; a fact readily 
explained by its peculiar geological structure, abounding in those 
chemical agencies which, in their various plays, act with energy upon 
lead, producing either soluble compounds, or suspending it in indi- 
visibly diffused particles, throughout the water ; these, prevailing 
less abundantly elsewhere, the affections under consideration were 
less, both in amount and severity. In a very large majority of 
the cases, the suspected water was subjected to appropriate tests, by 
competent chemists, principally by Dr. Dana, and invariably found 
charged, in a greater or less degree, with the noxious principle. 
The following letter, from a manuscript lecture of the late Dr. 
Howe, of Billerica (having allusion to one of the fatal cases which 
he saw, in consultation with Dr. Bartlett, and which occurred in the 
Chapel Hill district), may not be without interest:— 
“ In the year 1836, I owned a house in Lowell; the water sup- 
plying it was drawn from the well through lead pipe some forty feet 
long ; my patient was a man of a broken-down constitution—he 
sickened and died. During his illness, I saw him occasionally in 
consultation with Dr. Bartlett, his attending physician. The case 
exhibited some peculiarities ; the symptoms were obstinate and un- 
yielding ; and from them I was induced to fear that our patient was 
suffering from the use of the water. Without expressing my appre- 
hensions to the physician or friends, I determined to ascertain whe- 
ther the water might not be contaminated with lead; the pump 
forthwith got out of order, and would not go at all. I procured 
privately, through a friend, two junk bottles of water, drawn from 
the same well, and in the same manner: one bottle contained water 
which had stood in the pipe over night—this I marked No. 1. 
“ The other bottle was filled directly fresh from the well—this I 
marked No. 2. Both bottles were sent to Dr. Jackson (C. T.) to be 
analyzed, &c. 
“In due time, he wrote me that bottle No. 1 contained lead in 
sufficient quantity to enable him to reduce it to the metallic state; 
that bottle No. 2 contained some traces of lead, but in much smaller 
quantity than No. 1. 
“We then, without assigning any reason for so doing, immediately 
removed the pipes from the well, and introduced wooden pumps in 
their places. 
“ On the 2d July, 1842, I was called in consultation with Dr. II. 
of Lowell, to visit a young lad belonging to a respectable family in 
that place; it was a case of real Devonshire colic, attended with 
symptoms too clearly defined to be mistaken by any medical prac- 
titioner ; one other member of the family was suffering at the same 44 
ON THE ACTION OF WATER ON LEAD PIPES, 
time, but under a milder form of the same disease. The boy died in 
a day or two after I saw him.” 
In the following case, although the symptoms were unmistakably 
those of arthralgia and colic of lead, I was for a long time baffled in my 
attempts to ascertain the fact, in consequence of my patient’s want 
of good faith towards me ; who, either because he had no belief him- 
self in the poisonous qualities of lead, or from a fear of the expense 
which might be involved in the acknowledgment, concealed from me, 
not only the important fact that the well water used in his family 
was drawn through some twenty feet of lead pipe, but also the 
far more important one, that, about a year previously, he had caused 
the water from a neighbouring hill to he brought into his tannery 
through lead pipe, a distance exceeding two thousand feet; which 
water, in consequence of its “ superior freshness, coldness, and 
sweetness,” he had been in the habit of drinking when about his 
work; of course, he was warned against a repetition of his error, 
and, since his recovery, has enjoyed perfect health, having become 
himself convinced of the true origin of his complaint. 
“ H. T., aged forty-five, a tanner; after suffering for several weeks 
from pains in his limbs, shoulders, neck, face, and head, attended 
with costiveness and abdominal distress, was seized on Nov. 26, 
1850, with violent colic, when I was called to him. I then learned 
that, for several weeks before the onset of the above train of symp- 
toms, he had loss of flesh and appetite, frequent nausea and occa- 
sional vomiting, and the skin had become sallow and dingy. I found 
the abdominal walls drawn in and perfectly rigid; pulse weak, and 
but little quickened; little or no feverish action, indeed his skin 
was rather inclined to be cool. Although naturally patient of suf- 
fering, he was importunate, nay, clamorous for relief, uttering him- 
self in terms of agony far stronger than his general appearance and 
symptoms seemed to warrant; active and frequently repeated ca- 
thartics alone afforded him any satisfactory relief, the distress re- 
curring the moment the bowels ceased to be kept in a perfectly soluble 
state. The effects of opiates were transient; sulphuric acid drinks 
were freely used, and, after a fortnight (the active symptoms having 
been subdued), sulph. quinine and other tonics were administered.” 
In the following case, the patient was but littld inclined to ac- 
knowledge the habit to which his repeated attacks of the character- 
istic symptoms were mainly due. 
“Alva Eaton, aged forty-four, carpenter, has generally had good 
health ; in 1848, had severe typhoid fever, from which his recovery, 
though protracted, was perfect. 
“ In the of 18—, he entered the Lowell machine-shop, and 
continued in the enjoyment of his ordinary health, until the fall of AND THE DISEASES PROCEEDING FROM IT. 
45 
1851, when he began to suffer from “ rheumatism” of the back, hips, 
and lower extremities; his knees became weak and stiff, making 
locomotion painful, particularly the going up and down stairs ; to 
these were occasionally added colicky pains, which repeatedly con- 
fined him several days at a time, partial recovery following the use 
of cathartics, sweats, liniments, &c., self-prescribed and administered. 
“In August last, an attack of these symptoms, under an aggravated 
form, attended with rending, twisting pains about the umbilicus, 
shooting through to the back and down the limbs, and with obstinate 
constipation, nausea, and vomiting, compelled him to call in medical 
advice. In my absence, Dr. D. attended him, and, after repeated 
and long-continued cathartics, the severity of the symptoms gave 
way, and an imperfect recovery took place in about three weeks. 
His appetite, however, did not return. Some pain in his bowels, 
weakness and stiffness of lower extremities, with dull pains in the 
back of his head, extending upwards from the spine, remained; the 
true nature of his case having been overlooked, the cause was unsus- 
pected, and of course allowed to continue in operation. He, however, 
went to work, when, after the lapse of about five weeks, another 
attack of equal severity with the last took place, with which he was 
confined about ten days, taking as a cathartic, principally, castor-oil 
and calomel; the last producing a slight constitutional effect. Get- 
ting out, he continued at his work until Jan. 11, when he began 
again to complain of abdominal pains, and, on the 5th, was seized 
with all the symptoms marking his previous attacks—yielding, as 
did the last, and under similar means, in about ten days. As strict 
inquiry elicited no source of the suspected poison within the family, 
we were forced to the conclusion that it was derived from the white 
lead, with which, to prevent rusting, the pieces of iron machinery 
were smeared, previously to being packed in boxes, to be sent away, 
it being his principal employment to perform this duty. 
“ Before he got out from this last attack, however, the much more 
probable cause was ascertained to be his habit of stopping at a beer- 
shop, on his way to and from his work, and indulging in potations of 
that villanous compound, which was drawn through lead pipe. At 
any rate, he has since abstained from this habit, and has remained, 
ever since, entirely free from any vestige of his former symptoms.”* 
The case of which I will now proceed to give a brief account 
came under my notice recently, and occurred in the persons of two 
families, occupying a house in the extreme north-western part of our 
city, quite removed from the locality of those already detailed. 
“I was called to Mrs. R. on Friday, Jan. 9th of the present year, 
and found her labouring under symptoms of approaching abortion, 
of which, however, she was not aware, inasmuch as (she said) her 
* For another case of lead disease, viz., the dropped wrist, which was traced to its 
causes only after the most thorough inquiry, see Watson’s Lectures, Philad. edition, 
page 811: the case of Mary Ann Davis. 46 
ON THE ACTION OF WATER ON LEAD PIPES, 
present sufferings were only an aggravation of what she had suffered 
for many months. She was thirty years old, the mother of one child, 
and considered herself now advanced about four and a half months; 
abortion took place in two or three hours; size of foetus justifying 
this estimate. She then gave me the following history: Having, 
previously, always enjoyed good health, in January, 1850, gave birth 
to her first child—got up well, and continued in good health during 
the whole period of lactation, weaning her child on the last of Sept., 
1851. About the third week in October,began to experience a “tired,” 
heavy feeling of pain in her lower limbs, particularly her knees; the 
same pain was soon felt about the navel and in the groin, giving the 
sensation of a cord pulling down, and extending to the very lower 
part of the bowels; soon a similar pain was felt in the shoulders, 
back, arm, hands, fingers, feet, and toes, particularly over the tops 
of the feet and hands. She suffered the characteristic nausea of 
pregnancy for the first two months, none afterwards, until Dec. 31, 
when she was seized with vomiting, with an increase of all the symp- 
toms just named, until it closed with abortion. 
“ Has occupied the same house for a year and a half, and used the 
water from the well until a fortnight since. After her confinement, 
the pains in her limbs, &c., disappeared, and at the present time she 
is quite well. 
“ Mrs. B. and four adult children, three girls (one married) and one 
boy, occupied the lower story of the same tenement, where they 
have lived for four years. 
“Mrs. D., the married daughter, aged 23, without children; 
enjoyed good health until about last October, when she began to 
have dull, aching, heavy pains in her feet, which gradually extended 
to her legs and bowels; in December, was seized with severe pain in 
the stomach, radiating thence to both groins, striking down both 
limbs, particularly the left; also a dragging pain from the chest, as 
if a string was stretched from it to the groin; severe nausea and 
vomiting, with obstinate constipation, nervous restlessness, thirst, 
coldness of feet, cold chills, frequent desire to pass urine—which was 
painful; urine often high-coloured, and depositing a lateritious sedi- 
ment ; pains also in the back, hips, and down the spine, extending 
occasionally up the neck to back part of head ; also in hands and feet, 
and numbness of the same; loss of flesh, with dirty yellowish colour 
of skin and eye. 
“ Mrs. D. called for medical advice about Dec. 1, but obtained only 
partial relief; it being difficult to persuade the family that their ill- 
ness was caused by the water. This, however, she consented, after 
a while, to give up; was put upon a course of sulphur and sulph. 
acid; and, after one or two relapses, began permanently to mend. 
“ I found her, on the 14th Jan. last, as follows : Pulse 88, soft; skin 
has a dry feel; tongue slightly coated with white ; gums, where they 
run up between the teeth, bluish, but no regular distinct line; appetite 
good; sleep quiet; bowels regular; has now occasionally attacks of 
pain in the bowels and limbs, but, on the whole, is much improved AND THE DISEASES PROCEEDING FROM IT. 
47 
within the last fortnight. March 19, has now scarcely any remains 
of former symptoms. 
“ Thryphena B., sister of the above, has suffered precisely in the 
same way, hut less in degree, commencing about the same time; but, 
supposing her symptoms owing to long confinement and over-work 
at her business (factory harness-making), went into the country in 
Sept, and returned, after a month’s absence, relieved of her pains, 
stiffness of limbs, &c.; but, after a few weeks’ residence with her 
mother, had a return again of all her symptoms—was put under 
same treatment as her sister, and with similar results, carefully ab- 
staining from the suspected cause. She is now (March 15) quite 
well. The blue line, at first much more marked than in Mrs. D., 
still continuing perfectly distinct. 
“Amos B., the son, has, within the last two years, had repeated at- 
tacks of lead colic pains in both arms; numbness and stiffness of lower 
limbs, so that frequently he was not aware when they touched the 
ground; dysuria; blue line well marked, which still continues at this 
date (March 15), although he has been quite well for two months, and 
has not used the water since. 
“ Sarah B., aged seventeen, youngest member of the family, went 
away to school in June last; similar temperament and constitution 
with the above; has never had any symptoms, however, of lead dis- 
ease, and the gums are entirely unstained. 
“ Mrs. B., the mother, aged fifty-eight, has frequently suffered from 
arthralgic, colicky pains, and costiveness ; blue line marked ; has been 
decidedly in better health, since she omitted the use of the well water, 
than for several years.” 
The water, for all domestic purposes, was supplied to both families 
from the same well, through lead pipe. Dr. Dana, at my request, 
tested the water, and found it highly impregnated with lead. 
In my own practice, I have never met with any cases of decided 
encephalopathy. In consultation, I have seen two or three; one, Dr. 
Huntingdon’s patient of this city, and one at Manchester, N. H., 
under the care of Dr. Josiah Crosby: the former proved fatal; the 
latter, a very interesting case, recovered. I trust, through the polite- 
ness of these gentlemen, you will be put in possession of detailed 
accounts of both cases.* 
Several deaths among children, from affections of the brain at- 
tended with symptoms of an anomalous character, were, by the 
attending physicians, ascribed to the agency of lead water, taken as 
drink; but no post-mortem examinations were had, and I have not 
been able to obtain reliable reports of the cases. 
* Two cases have been received from Dr. Crosby. No account of the other case 
has yet been received. 48 
ON THE ACTION OF WATER ON LEAD PIPES, 
The two following well-defined cases were received by your Com- 
mittee, from Dr. Josiah Crosby, of Manchester, N. H. 
“Albert Taylor, thirty-eight years of age, of good constitution, and 
of very industrious temperate habits, an iron-worker in the repair- 
shop on the Amoskeag Corporation, in Manchester, N. H.; moved 
into a new tenement belonging to the company in the autumn of 
1849. 
44 The water to supply his family was drawn through a lead pipe, 
inch in diameter, and 75 feet long, from a well 5 feet diameter, 
having 20 feet of water and nine lead pipes of the same dimensions 
as his, reaching to the bottom. His family consisted of himself, 
wife, and one child. * 
“ The water on this corporation, generally, was not good, being im- 
pregnated with iron, some of it largely—but was generally denomi- 
nated hard. This well was an exception; the water was much softer, 
and considered excellent to drink. Mr. Taylor was very fond of 
water, drinking nothing else, and drank very freely, and with so 
small a family they probably did not generally pump all the water 
from the pipe before using it. 
“In January, 1850, Mr. T. began to complain of constipation, colic, 
and pain in the limbs and thorax; with loss of appetite and occasional 
vomiting. During this month and the two following, he was under 
my care, and a part of the time at his work, but too sick to attend 
to his business much of the time. In April, he went into the country; 
after a few weeks he returned very much improved, and went 
again to his Avork in the shop; in a short time he began to feel all 
his former difficulties return upon him, and so he continued through 
the first year of his residence in this tenement. Up to this time, his 
disease had been considered by his friends as resulting from his long 
confinement to the shop. 4 The shop is killing him!’ was the lan- 
guage of all his shop-companions, notwithstanding I had expressed 
my opinion strongly that it was lead in the water. 
“ In August, the colic and neuralgic pains in the thighs, arms, and 
thorax had become so severe that he was unable to sleep much at 
night, groaning and twisting himself continually; had but little 
appetite, and, when food was taken, it would produce great distress 
and frequently vomiting—so much so, that he often took no supper. 
44 In September, he painted all the lower part of his house, and 
remained in it with his family during all the operation of painting 
and drying. This seemed to produce an explosion, and his disease 
was soon and fully developed; all the symptoms were greatly aggra- 
vated; he had three forms of the lead disease—colic, paralysis, and 
arthralgia, all at the same time—having now, for the first time, the 
addition of paralysis of the sphincter of the bladder, which allowed 
the urine to pass guttatim. His case now became alarming; he could 
take but little nourishment, and this was often rejected ; got but little 
sleep, and this never quiet—always disturbed; often getting out of 
bed, and wishing to go home ; sometimes not recognizing his family; AND THE DISEASES PROCEEDING FROM IT. 
49 
thought they were conspiring to kill him ; almost daily vomiting of 
a green, bilious fluid; the pain in the head, thorax, inside of the 
arms and thighs, was at times so intense as to produce furious 
delirium; his bowels all this time were very costive, and not moved 
but by powerful cathartics; when quiet, he would lie on either side, 
generally on his left, with his thighs pressing against the abdomen; 
taking no notice of anything about him, unless roused by pain or an 
attendant; the pupils were largely dilated; pulse 45 to 50; about 
fifteen inspirations in a minute; urine very scanty, four to six ounces 
in a day, and high coloured; gums very blue. 
“ In December, he had four fits; two at intervals of several days, 
and the other two on the same day. The emaciation was extreme; 
the parietes of the abdomen seemed glued to the spine, with no elas- 
ticity ; I could grasp the curvature of the spine in the hand, and take 
hold of the descending aorta with the thumb and finger. 
“ This case wTas so severe, and continued so long, it would make a 
long chapter to give the treatment in detail. I shall therefore only 
mention those means which seemed to afford the most relief; cathar- 
tics, warm bath, in which was dissolved the sulphuret of potassium, 
and anodynes were the remedies which had the most control over the 
neuralgic pains, both of the colic and arthralgia, which I consider 
the same, and requiring the same treatment. 
“ The cathartics which I found best adapted to this case were 
castor and croton oils ; sometimes they were administered separately, 
and sometimes combined. I think they afforded more relief when 
given together. 
“ I consider the warm bath with sulphuret of potassium a remedy 
of the greatest value in relieving the pains. Immersing the patient, 
and also the local application of the solution with flannels, applied 
hot to the bowels, thighs, arms or thorax, whenever the pain is most 
severe, and friction with the same solution, was of great service, the 
patient expressing great satisfaction from its use. 
“ The whole catalogue of anodynes was tried; morphia was the 
best, and the only one that accomplished much. Chloric ether was 
applied to the head externally, and was also inhaled with benefit. 
“The paralysis, so far as manifested in destroying the action of the 
sphincter of the bladder, was more readily overcome than any other 
symptom in the case. Strychnine internally administered, in doses 
of from one-sixteenth to one-twelfth of a grain, three times a day, 
restored the action of the sphincter in about three weeks, so that 
the patient could control his water. 
“ In this case, I could do nothing specifically for the encephalopathy. 
The patient was so reduced, we could only support as much as possible 
his strength by nourishment, wine, brandy, cider, &c.; expecting 
daily that death would terminate the case; but, notwithstanding the 
extreme prostration and emaciation, Mr. T. has perfectly recovered, 
and enjoys at this time as good health as ever. He was away from 
his business six months. 
“ On the 8th of August, 1851, I was called seventeen miles into 50 
ON THE ACTION OF WATER ON LEAD PIPES, 
the country to see Mr. W., thirty-five years of age, naturally of 
robust constitution, corpulent, temperate, of active business habits, 
(farmer, and deputy sheriff), who had been confined to his house and 
bed for several weeks with what was considered “liver disease,” ac- 
companied by yellow skin, severe colic pains, and extreme costiveness 
and vomiting ; pulse slow ; urine scanty ; gums very blue; neuralgic 
pains in the limbs and back, and sleepless nights. 
“On inquiry, I learned that he had never been able to get a good 
supply of water at his house, on account of a ledge of granite, which 
came very near the surface of the ground, on which his buildings 
stood; and that two years before he had sunk a well twenty-two rods 
from them, and had drawn the water that distance through a lead 
pipe, by a pump in the house, for all household purposes ; that it took 
five minutes smart pumping to bring fresh water from the well. This 
explained the whole difficulty; the diagnosis was clear, and the treat- 
ment too; a supply of pure water, cathartics of croton and castor- 
oil to remove costiveness, and anodynes to abate the pain, constituted 
most of the treatment, and the patient soon began to improve, and 
ultimately recovered perfectly. 
“From observations made in the management of a large number of 
cases, I am of opinion that all cases, not complicated with other and 
older diseases, would recover—perhaps not quite so soon—but would 
in a few weeks recover, by discontinuing the use of water drawn 
through lead pipes. 
“I have related this case to show how nearly some forai£ of lead 
disease may simulate other and very common diseases, produced by 
very different causes. Here were exhibited all the symptoms of a 
severe case of jaundice, accompanied by severe colic; and would 
have been speedily cured by the treatment that had been adopted, 
had it been the production of common causes. It was only necessary 
to withhold the lead to effect the cure. 
“ I understand the opinion has been recently advanced, by some 
of high medical authority, that there is no such specific form of dis- 
ease as that called ‘Lead Disease,’ not even in painters, and that the 
blue margin of the gums is not evidence of the presence of lead in 
the system; that it is shown in cases where the disease could not be 
attributed to lead. Now my belief is that we have had in this city 
more than a hundred cases of disease, the product of lead taken 
into the stomach by using water for drinking and cooking that was 
drawn through lead pipes. 
“ I consider the fact as well settled as any fact can be; as certainly 
as that the contagion of smallpox will produce the genuine small- 
pox. 
“I have found blue gums in a large proportion of cases exhibiting 
the colic and arthralgic symptoms, and in every case of paralysis 
and encephalopathy. I do not consider its presence always necessary 
to settle the diagnosis of a case, but always sufficient to settle it 
when it is present. I think I have never seen, certainly never 
noticed such blue gums in any case, where it could not be attributed AND THE DISEASES PROCEEDING FROM IT. 
51 
to lead. I have seen the blue lines present in several members of 
the same family at the same time, when only one manifested the 
symptoms of the disease; and by changing the water the blue has 
disappeared in every one so affected. This has been the result 
always.” 
The following are the only two, of numerous cases, brought under 
the observation of the chairman of your Committee, either as attend- 
ing or consulting physician, which he proposes to introduce at this 
time. lie has preferred to lay before the Association those furnished 
from other reliable sources from different parts of the country. By 
so doing, the fact has been shown that the diseases in question have 
not been confined to a limited space, nor to a small number of 
observers. All the cases reported, except those designated as coming 
under the observation of the Committee, have been furnished in 
answer to the circular issued by them in the early part of December 
last. 
I was called, in October, 1851, to see A. C., aged 32, of rather 
slender constitution. It appeared that, about three months previous, 
he had an attack of pain in the abdomen, which was relieved by 
evacuations. This was followed by an uneasiness, nearly constant, 
in the bowels, constipation, and by occasional attacks of pain, like 
that just described, but less severe ; this uneasy sensation led the 
patient constantly to hold on, or press his hands upon the bowels. 
The skin had a sallow, dingy appearance ; the white of the eyes was 
quite yellow. These symptoms had led his friends to believe his 
disease was jaundice; there was loss of appetite and flesh, his spirits 
were depressed, tongue lightly coated, breath offensive, pulse 76, 
small; his whole physiognomy was precisely that indicative of lead 
poison. On examining the mouth, found the points of the gums, 
which project between the teeth, stained blue. The urine was rather 
more coloured than natural, but on examination (subsequently made) 
did not present that peculiar play of colours with nitric acid, said to 
be indicative of the presence of bile ; the excrements were rather 
darker than usual, showing a sufficiency of bile. I did not hesitate 
to pronounce it a case of lead poisoning, from some source or other. 
On inquiry, I found that he had been drinking lead water for some- 
thing more than two years. The treatment consisted in regulating the 
alimentary canal, which was done with a moderate amount of medi- 
cine, and abstaining entirely from the use of the water. In one week, 
his countenance began to clear up; the distressing sensations about 
the bowels were soon mitigated, and finally entirely relieved in about 
three weeks ; had no attack of severe pain after the discontinuance 
of the water; remained well since, a period of five months. 
This case is reported as showing a well-marked case of lead 
poisoning ; its physiognomy could never have been mistaken by any 52 
ON THE ACTION OF WATER ON LEAD PIPES, 
one who had ever been familiar with lead maladies. More of the 
premonitory symptoms were present than are usually observed in any 
one case, viz., the blue gums, the fetid breath, the jaundiced appear- 
ance of the skin and eyes ; yet no one of the four forms of lead 
disease laid down by Tanquerel was ever well developed. 
The intelligent and reliable record of the following case was fur- 
nished me by the patient himself, who is a gentleman of wealth and 
education, and a graduate of the Boston Medical School; but he has 
never entered upon the practice of the profession. He was under 
my immediate observation during the continuance of the treatment, 
and at my request he kept a daily record of his own case. 
Dr. Adams:— 
My Dear Sir—At your request, I write down what I recollect of 
the state of my health before your treatment of me for lead paralysis, 
in the summer of 1848. My health had not been very good for 
many years, but my strength failed more perceptibly during the two 
years previous to that summer; and, in the winter previous, I felt 
an increasing unwillingness to make any physical exertion, and great 
listlessness. This was made evident in working the foot-treadle of a 
lathe, which had furnished me exercise for three or four years. I 
could not keep at work long, and found, on comparing myself with 
others, that I was unable to turn it so fast as they. 
I spent three months of that winter in Boston; our rooms being in 
the fourth story, and the staircase long and rather steep, I never 
went up without fatigue, and often sat down to rest. I remember, 
too, an uncertainty in going down, and more than once slipped (as I 
then thought) and should have fallen, but for the banister. 
In the latter part of March, being in the saddle, my horse fell with 
me, and my shoulder was dislocated. Had I been as vigorous as 
formerly, I could have held him up, but I felt conscious that I could 
not brace myself up from the stirrups. 
I recovered the use of my arm, and we returned to our home in 
Waltham towards the end of April; from which time to the first of 
July, it became still more evident that my lower limbs were failing. 
On one occasion, I started to run a short distance, and fell forward 
flat; my legs seemed not to obey the will. Two or three times, while 
standing or walking on the smooth floor, my knees suddenly bent and 
I fell. I fell repeatedly while dressing. And during that spring I 
complained, after an hour’s drive in a gig, of a cramped feeling in 
the thighs—so uncomfortable that I seldom drove in any vehicle in 
which I could not stretch the limbs straight. 
All these symptoms I detailed to you on the evening of the last 
day of June, and added that I began to feel a numbness over the 
left thigh and buttock, with a diminished sensibility. 
You inquired about the water used in the house, and I told you 
that that for cooking passed through 140 feet of lead pipe to the AND THE DISEASES PROCEEDING FROM IT. 
53 
kitchen-pump, and that I had used it for nine years: that for some 
months past I had made my breakfast of crushed wheat, which, after 
soaking in water all night, was put on to boil the first thing in the 
morning, and probably the water which lay in the pipes all night 
was used for this purpose. The drinking water chiefly used was 
brought through 40 feet of lead pipe from another well to another 
pump. 
You then said that you believed that I was suffering from lead held 
in solution in this water, and asked me to let you have some of it in 
the morning for analysis. On the following day I called on Dr. James 
Jackson, to ask him about other matters, and before I left his study I 
told him of the symptoms I had detailed to you, and also of the opinion 
that you had expressed, Dr. Putnam being present. He said that 
it might be so, and that he had great respect for your judgment; but 
that he had not observed in his practice any case of paralysis of the 
lower limbs from lead which had not been preceded by some affection 
of the other parts of the body, particularly colic.* He examined my 
spine thoroughly, with Dr. Putnam, and found no evidence of disease 
there. Still he recommended, as a matter of prudence, the applica- 
tion of twelve leeches to the lower part of the spine, and to be 
followed by a blister on the same spot; which was accordingly done. 
The next day (the first of July) you took for examination two 
phials of water, the first pumped that morning from both pumps. 
On being tested with sulphuretted hydrogen, that from the kitchen- 
pump became very dark; and, after standing till the next day, looked 
like ink and water. That from the other pump was coloured, but less 
highly. I discontinued the use of both waters from the first of July. 
The day after my blister had been drhsaed, I called on Dr. Jack- 
son again, and took with me the phial of blackened water, at the 
sight of which, he confessed that he believed that your opinion was 
well founded, and that he thought I might safely omit the treatment 
for disease of the spine. 
I remark in this connection, though anticipating a little, that ano- 
ther gentleman, equally eminent in his profession, examined my spine, 
a few weeks afterwards, to whom I had also mentioned your diagnosis, 
and though he found no tenderness in any spot, he suggested the 
application of caustic to the lower part of the spine. 
For two, or perhaps three weeks, I walked every day a little for 
exercise, though with great and increasing difficulty. A spasmodic 
working of the feet from side to side troubled me, and they would 
often draw back out of the shoes. I was unable to draw on a boot. 
While sitting still, the legs would insensibly draw back on the thighs, 
till the feet got entangled under the chair. This involuntary draw- 
* The experience of Dr. Jackson on this point differs from that of the chairman of 
yonr Committee. Of 11 cases of lead paralysis falling under his observation, in 6 
paralysis was the first form of lead disease observed; and in 5 cases it was seated in 
the lower extremities. 
Out of 102 cases of paralysis observed by Tanquerel, 89 were not preceded by any 
other form of lead disease; and in fifteen only was it seated in the lower extremities. 54 
ON THE ACTION OF WATER ON LEAD PIPES, 
ing back of the leg made it very difficult to go up stairs. I recollect 
that the last time I went up (Aug. 10), a man held the foot on the 
first stair, while a person behind assisted me to rise so as to place 
the other foot on the next stair; and then the man would hold that 
foot in place, or it would certainly have drawn back so as to have 
thrown me down. While going down stairs, I straightened the whole 
limb before planting the foot upon the next step, and, with the help 
of a man and the banister, could get down safely. But on the 
11th August my bed was moved to the lower floor, and I did not 
attempt the stairs again till the 25th October. 
The numbness, before spoken of, affected the right limb a day or two 
after, and soon extended over the whole of both limbs, from the but- 
tocks to the toes; and, for a long time, I so lost the sense of feeling 
in them, that I had no consciousness where the feet were, unless I 
saw them: for many weeks I did not know whether one foot touched 
the other in bed. There was also an unnatural coldness of the lower 
limbs, uncomfortable to myself, and perceptible to the touch of others. 
I wore my warmest winter clothing all summer, and always had a 
blanket shawl over my lower extremities, even the hottest days, when 
taking my drive, which I did almost every day that summer. In the 
house I used an India-rubber water cushion to sit upon, and had it 
filled with warm water every day. Since my recovery, I have felt 
more warm than before the crisis, and have especially observed that 
my feet are not so cold as formerly. 
It was very perceptible to me, as well as to yourself and others, 
that the glutei muscles on the buttocks, and the large extensor on 
the front of the thigh, were greatly wasted; while the biceps and 
flexors, from the trochanter the ilium to the tibia, were unusually 
strong and active, indeed, in a constant state of contraction; and I 
suffered much from cramp in this muscle, and in different muscles of 
the leg and sole of the foot. And when I found that Tanquerel lays 
down a principle, established by facts, that, in lead paralysis, the ex- 
tensor muscles are always weakened and more or less wasted, while 
the flexor muscles continue in their usual vigour, I was convinced of 
the correctness of your diagnosis. 
The difficulties in the different motions, as before described, agree 
with this law: I could not run, because I could not throw forward 
the leg, nor push forward, by straightening out the foot and rising 
on the toe. The foot drew back on the stair, and the leg drew up 
under the chair, because one set of muscles was more vigorous than 
the counteracting set. And, in walking, the foot would twist about 
and draw out of the shoe, and the muscles of the sole contract even 
to a painful cramp, because there was no balance of power. 
On the 6th August, I began a daily minute of the symptoms and 
the treatment which I kept till the second week of November. 
From the 8th of August to the 25th, I could not get up out of my 
chair without assistance, nor stand alone even on crutches. On the 
28th, I raised myself erect by placing my hands on my knees and 
let myself down again pretty well. AND THE DISEASES PROCEEDING FROM IT. 
55 
Aug. 29. Walked with ease and confidence on crutches without 
other help. 
Sept. 14. Manifest improvement in walking and standing; since 
two or three weeks, I can do many things alone that I could not do 
without help. Indeed, until a short time before this date, I was 
quite unable to put on my clothes, or to wash myself, or to undress, 
without help. 
16th. Walked round the garden with a cane (discarding the 
crutches), and holding upon another person’s left shoulder with my 
left hand, bearing almost all my weight upon my legs. 
Same day, in the house, walked about a dozen steps entirely alone, 
without crutches or cane, and back again. 
17th. Walked about alone on crutches more than I have done 
any day for many weeks. Glutei muscles said to be very per- 
ceptibly enlarged, especially the left. 
18th. Could stand while I washed my face and hands without 
taking hold and without help, which I have not done for five or six 
weeks at least. 
) Jfiih. Walked out of doors on crutches, without other help. 
21 st. Walked half a mile with my wife and a cane; carried a 
lighted candle in my left hand from one room to another, using cane 
with right hand. 
24th. Went to church in Boston in the afternoon, not much 
fatigued. 
Oct. 1. Went to church in Boston all day; not more fatigued 
than other days. In the morning, took my douche standing, for the 
first time. 
2d. Played two games of billiards, one hundred each, and beat 
both. 
19th. Walked a mile with my wife and a cane. 
20th. Walked a mile with cane only. 
25th. Out of doors on my feet with a cane only, for three hours, 
besides driving myself in a wagon about four miles. 
During the following winter I walked every day, and often from 
four to eight miles with a cane, but I have not ridden on horseback 
with confidence till this winter, and, even now, have not a very firm 
seat. I can walk as fast as I ever did, but am very awkward in my 
movements in a room and in running. I cannot walk a single plank 
steadily. I never go down stairs now without taking hold of the 
banister, if there is one, or resting on a cane. If I attempt to walk 
in the house in the dark, without a cane I totter; out of doors with 
a cane, I am unsteady. While washing my face in a wash-bowl, my 
eyes being shut, there is a tendency to draw back; and to this day, 
I never for a moment forget the existence of the flexor muscle on the 
back of the thigh ; it is, indeed, developed out of proportion to the 
other muscles, and seems to be in a constant state of contraction, and 
this I believe to be the principal cause of the unsteadiness and awk- 
wardness that remains. 
I have, from time to time, very sharp neuralgic pains, which I 56 
ON THE ACTION OF WATER ON LEAD PIPES, 
first felt in the winter of 1846-4T, owing, I believe, to the state of 
the stomach ; but it is a singular fact that they are always seated in 
the lower limbs, though not limited to the joints, nor to any particu- 
lar spots. 
There is one fact which I have omitted; the bladder was very 
much weakened. It was slow in recovering, and has not yet its 
full natural power. 
The treatment was chiefly the use of strychnine and of electro- 
magnetism. With the last I began early in July, applying it to the 
whole limb from the buttocks to the foot, putting on the metallic 
slipper. The effect was not good, for it increased the spasmodic 
action of the limb, and especially of the foot. But afterwards, on 
applying the wires to the extremities of the weakened muscles, and 
under the influence of strychnine, I found a happy result; for it 
stimulated them into action without affecting the healthy muscles. 
Early in August, I read Dr. Dana’s translation of Tanquerel’s invalu- 
able work, and proposed to you to try the effect of strychnine, and 
with your approval I began, I believe, on the 2d or 3d day of August, 
first with a pill of one-sixth of a grain, the next day a pill morning 
and evening of one-sixth grain each, and on the 6th one-third of a 
grain in the morning and one-sixth at night. The effect of the first 
dose which I took was very similar to that of electro-magnetism, 
particularly the feeling in the foot; it was like the rapid succession 
of little electric shocks in the foot, with a sort of creeping sensation 
through the limb. The larger dose on the 6th, I took at ten A. M.; 
at noon, the muscles about the mouth twitched spasmodically; at 
half past two P. M., there were very strong contractions of the 
muscles of the lower limbs till three o’clock. Twitchings about the 
mouth continued till between four and five, whenever I attempted 
to speak. 
On the 7th, I took half a grain. 
On the 8th, I took two-thirds of a grain at ten minutes past ten 
A. M. In twenty minutes I began to feel light-headed, with great 
difficulty of breathing, which led me to suppose that I was fainting. 
I laid myself flat on my back on the floor, and got no relief. I raised 
myself on end, which caused a strong convulsion. The man-servant 
took me up to lay me on the sofa, and, while in his arms, there was 
a powerful spasm of all the muscles of the body (as it seemed to me), 
intensely painful for a moment; this subsided on being laid down. 
I could hardly breathe while the head was down; breathed a little 
easier on being bolstered up. I found that I was instinctively rais- 
ing the shoulders at every inspiration. Sensibility was extreme; 
so much so, that the resting of a fly suddenly on the nose caused a 
spasm, which lifted the whole body from the sofa, arched up, as in 
locked-jaw cases. The same convulsion was caused by any one 
touching me unexpectedly. A person who came into the room and sat 
down opposite to me, caused such a commotion in my whole frame 
that I was obliged to request that she would go out. The pulse was 
eighty-four, intermitting about every tenth stroke. Great twitching AND THE DISEASES PROCEEDING FROM IT. 
57 
and jerking of the muscles round the mouth. I could speak only in 
a whisper. The jaws were held tight together, so that, even after 
some time, it was very difficult to get a little water into the mouth; 
after I got it into the mouth, I swallowed it. Occasionally there was 
involuntary gritting of the teeth. Pain in the nape of the neck very 
severe, so that a man’s whole force was exerted in pressing against 
it. At eleven A. M., I began to inhale chloroform; from two to 
four full inspirations at a time, repeated as often as the spasms 
became more violent. This acted like a charm; it kept the spasms 
under, relieved the breathing, and, in an hour or two after first 
taking it, the intermission of the pulse entirely ceased. The symp- 
toms continued, though gradually diminishing, till between two and 
three o’clock. At a quarter before four, I was able to sit up and 
eat some dinner, and between five and six o’clock, I took a drive in 
the carriage. 
My minute in the evening was, excepting weakness, not much worse 
than the few last days. The pill to-day was from a new parcel of 
strychnine and fresh made. The next day I took one-third grain in 
the morning and one-sixth grain in the evening, and I continued the 
same dose until the 31st, except the evening pill, which I took only 
two or three times. Twice, during that month, I took five-twelfths of 
a grain with symptoms similar to those on the 8th, but much less 
violent. In both instances, I found great relief from chloroform. 
During the rest of the treatment, I took usually, during the month of 
September, one-sixth of a grain daily, and until the 9th of October; 
from which day till the 9th of November, I used daily one-third or 
one-fourth of a grain, and twice only one-half of a grain, omitting 
it for a few days when very much reduced. The electro-magnet- 
ism was applied generally three times a day, once to the glutei 
muscles for half an hour, and twice to the extensors of the thighs, 
one-quarter of an hour each. 
On the 7th and 9th, I took a sulphurous bath at 98°, three-quarters 
of an hour each time. But it reduced my strength so much that it 
was given up. I took daily a dose of flowers of sulphur. I con- 
tinued the use of strychnine till Nov. 9 ; and, in the following winter 
and spring, I used it for a short time, at three different periods only, 
twice in pills as before, and once sprinkled on a blistered surface; in 
both methods with effects similar to those before experienced. While 
under its influence, there is much more vigour in the lower limbs, but 
I observe nothing similar in the upper extremities. It affects my 
general health to such a degree that I have not the resolution to per- 
sist long in the use of it again. 
The result of my experience of it is, that it has more effect on the 
weakened than on the healthy muscles, though it does not act ex- 
clusively on them. I observed this especially as I began to gain 
control over the limbs. I could feel at every step that I had a power 
over the glutei muscles and the extensors on the front of the thighs 
which I had lost. Under full doses of strychnine there was a feeling 
of great tenseness and rigidity, and an indescribable sensation of 58 
ON THE ACTION OF WATER ON LEAD PIPES, 
compression of the whole limb. I speak of them on the 31st August, 
in my journal, as feeling stiff and hard almost as iron. When under 
the full influence of the medicine, I usually slept a heavy, lethargic 
sleep, from which I was roused, every now and then, by a sudden 
jerk of the lower limbs, as if an electric shock had passed through 
them. The spasmodic motions of the foot gradually diminished, after 
a week or two from the first dose, and disappeared towards the end 
of August. 
The general effects of the medicine I found very remarkable. Under 
its full influence, the pulse was usually 96; never observed lower than 
84, and in two hours it would fall to 64 and 60. There was also a 
tendency to intermit, though never so frequently as on the 8th of 
August. 
The breathing became difficult, and this appeared to be caused by 
a contraction of the diaphragm, as shown by the extreme difficulty 
of breathing, while flat on the floor, and, when raised, by the action 
of the shoulders and intercostal muscles. 
There was always more or less twitching of the muscles about the 
mouth, particularly on attempting to speak, eat or drink. Pain in 
the nape of the neck was caused by the larger doses only. 
There was always great nervous sensibility, amounting, sometimes, 
to a sense of distress impossible to describe. All these effects be- 
came more violent under the slightest mental excitement. After a 
long use of strychnine, the system seemed to run down, the appetite 
diminished, costiveness increased; and constant headache, stupor, 
lassitude, and weakness were produced. 
I cannot conclude, without an expression of my sincere gratitude 
to you, for discovering the true cause of my complaint, and for your 
unwearied attention and kindness in the treatment of it. Nor can I 
refuse to recognize that, under the blessing of our Heavenly Father, 
you have been the instrument of saving my life. For, had I been 
treated for disease of the spine, without a suspicion of lead, I can- 
not but think I should have sunk under it. 
I am truly and gratefully yours, 
J. S. COPLEY GREENE. 
Waltham, April 12, 1852. 
There are two points in the treatment of the preceding case 
worthy of particular notice: 1st, the fact that the administration of 
the strychnine was continued, with but slight interruption, for a 
period of three months, in doses of sufficient magnitude to produce 
some twitching of the muscles, generally slight, but sometimes severe. 
2d. The fact that, in the application of electro-magnetism, the 
stream was carried through the diseased muscles only, by placing one 
pole at the origin, the other at the insertion of the muscles to be 
acted upon. When the whole limb received the shock, no beneficial 59 
AND THE DISEASES PROCEEDING FROM IT. 
effect was produced; the well and diseased muscles being equally ex- 
cited by it. 
The committee have shown the action of water on lead pipe, and 
they have also endeavoured to show the nature and character of 
some of the diseases produced by the domestic use of such water; 
and reported cases illustrative of the subject. They will now pre- 
sent some additional facts in support of these views, and add some 
brief comments on the more important statements and conclusions 
recorded in the foregoing pages. 
It has been shown that natural water, when brought in contact, 
always acts on lead, and that the various theories of the cessation of 
action, after a certain length of time, are not true, and are in no case 
supported by the facts of Jlfc Cochituate water, drawn* 
through lead pipes laid four years ago, continues, at this time, to pre- 
sent very notable traces of lead. In New York, the Croton water, 
even at the present day, drawn from leaden hydrants put down ten 
years since, is impregnated with lead, and your Committee are credibly 
informed that diseases which can only be ascribed to this poison are 
not of unfrequent occurrence in that city. Dr. George H. Kings- 
bury has published, in the JV. Y. Journal of Medicine for May, 1851, 
four cases of obscure disease fairly attributable to the use of Croton 
water drawn from lead service pipes. We make the following quota- 
tion from his report:— 
“ Since the introduction of Croton water into the city, cases simu- 
lating lead colic have occasionally been met with; yet, in the absence 
of the usual and well-known causes of that disease, and the seeming 
improbability of a sufficient amount of lead poison being held in 
solution by Croton water from passing through lead pipes, the symp- 
toms have usually been ascribed to other causes or left altogether 
unaccounted for.” 
In two of the cases reported by Dr. K., the patients suffered re- 
peated attacks of lead disease, before the true cause was suspected; 
when suspected and removed, there was no return of disease. 
In New Orleans, the inhabitants appear to have suffered more from 
lead diseases than those of any other large city within the knowledge 
of your Committee. According to Dr. Fenner, who has published two 
elaborate reports—one in 1850 and another in 1851—the first on 
epidemic colic in New Orleans in the summer of 1849; the second, 
on lead poisoning, in the same city, in 1850—it appears that colic 
was epidemic during both the summers of 1849 and 1850, and that 
it presented the appearance of lead colic, which led Dr. Fenner to 60 
ON THE ACTION OF WATER ON LEAD PIPES, 
investigate the cause of it. From this investigation he came to the 
conclusion that it was mainly due to lead poisoning, derived from 
three different sources, viz., soda fountains, where this beverage is 
drawn through lead tubes, and the hydrant water of the city, which 
is delivered through lead service pipes, which were put down in 1837, 
and the cistern water, which is collected from the tinned roofs of the 
houses.* Lead has been frequently detected by him in all these 
different varieties of water. 
According to Dr. Fenner, the colic of 1849 bore a close resem- 
blance to lead colic, and was frequently attended or followed by 
rheumatic pains, as they were then denominated. The disease was 
not inflammatory, but was generally considered a neuralgic affection. 
It appears, by the report on lead poisoning in New Orleans, that 
the same disease again prevailed during the warm season of 1850. 
There were admitted, during this year, into the Charity Hospital of 
that city, 137 cases of colic, of which 51 cases are recorded as colic, 
and 83 as colica pictonum, and 3 as bilious colic. A large proportion 
of these cases occurred between the first of May and the last of 
October. It also appears, by the same report, that some other 
diseases, known to proceed from lead poisoning, were very prevalent. 
According to Dr. Simond’s statistics of mortality in the city for the 
same year, the number of deaths from apoplexy were 115, from 
congestion of brain 101, from epilepsy 16, convulsions 354, from 
paralysis 19. Of these, 403 occurred in the summer and autumn, 
and only 202 during the winter and spring; corresponding in this 
particular with the cases of colic. The above-named diseases, accord- 
ing to Tanquerel, are often produced by lead poisoning; and all lead 
diseases are more common in warm than in cold weather. Of the 
354 deaths from convulsions, 330 were children. It is not unfre- 
quently the case that the first development of disease among children 
from lead poison is in the form of convulsions. 
Dr. Fenner, in a letter addressed to the chairman of your Com- 
mittee, in speaking of the diseases of New Orleans in 1851, says :— 
“I am decidedly of opinion that encephalopathy, arthralgia (vulgo, 
rheumatism), neuralgia, and paralysis, arising from lead poisoning, 
prevail in this city to a considerable extent. In our large Charity 
Hospital, in the year 1851, the number of cases admitted for the 
various affections that are known sometimes to arise from lead 
poisoning are as follows: viz., colica pictonum 72, bilious colic 17, 
colica convulsiva 1, apoplexy 19, epilepsy 12, amaurosis 3, con- 
* The so-called tin used for covering buildings is made mostly of lead. AND THE DISEASES PROCEEDING FROM IT. 
61 
gestion of the brain 19, convulsions 9, paralysis 29, neuralgia 17, 
rheumatism 358. 
“ Knowing that the exposure to lead is very great in this city, I 
have no doubt that it had the chief agency in the production of a 
large majority of the above cases. The colics marked bilious were 
precisely like the painter s colic; and a large number of those marked 
colica pictonum did not occur among painters. The congestion of 
brain cases may have arisen from a variety of causes. The convul- 
sions occurred mostly among adults, and I have no doubt mostly 
depended on lead poisoning.” 
In support of this opinion, he adds:— 
“ In one patient, immediately after recovery from convulsions, the 
wrist-drop paralysis supervened, establishing the character of the 
disease. Other cases like this have been observed at this hospital; 
as also cases of colic and convulsions, which could not be indubitably 
traced to lead, but which yielded alone to the treatment appropriate 
to lead poisoning. 
“ Neufhlgia prevails in this city to a great extent, and lead may 
certainly have something to do with it. As to rheumatism, it is 
certainly very remarkable that it should prevail here chiefly in the 
warmer portions of the year, as I have shown in my report.” 
Many other very interesting facts are to be found in Dr. Fenner’s 
reports, and your Committee regret that their limits will not allow 
them to extract more freely. The Dr. has performed a good service 
both for the profession and the community in which he resides, and 
if they do not both profit by his researches, he certainly will have the 
satisfaction of having early pointed out the impending danger. 
In Cincinnati, as appears by a letter from R. Jay Kittredge, M. D., 
published in the Southern Medical Reports, vol. i., lead diseases are 
not unfrequently met with, although often treated under another 
name, and that notable quantities of lead are found in the water 
drawn through lead pipes. 
Your Committee sufficient evidence has been adduced to 
show the continued action of water on the lead pipe through which 
it passes. 
The next point your Committee will notice is the great difference 
in the length of the exposure of individuals to lead influences before 
disease is developed—varying from a few weeks to something more 
than nine years. This may in part be owing to the intensity, or 
degree of strength of the poison introduced into the system. Ex- 
tremely minute quantities may be taken for a great length of time, 
before there will be sufficient accumulation to produce disease. The 
minuteness of the quantity of poison in water, which may in time 62 
ON THE ACTION OF WATER ON LE£D PIPES, 
produce disease, cannot be limited; less than 1-lOOth of a grain per 
gallon has been known to produce it. The chairman of jour Com- 
mittee has now under his care a case of paralysis of the muscles of 
the forearm, hand, and fingers of one limb, produced bj lead water, 
where no trace of the metal could be detected by the most delicate 
tests, till the water had been concentrated fifty per cent. By the 
tests above used, l-100th of a grain of lead per gallon can be detected 
in natural water. 
But this discrepancy in the length of exposure before disease is 
produced may be mainly owing to difference of susceptibility in the 
exposed. This difference of susceptibility is due, no doubt, to 
different degrees of constitutional vigor or energy; and it is possible 
that this may in some cases be so great as to render the individual 
comparatively impregnable to the action of this poison. Dr. Dana, 
in his report on this subject to the City Council of Lowell, makes 
the following apposite remarks:— • 
“The constitution is only a greater or less degree of vital force. 
Life is vital force, manifested under the control of a higher influence; 
the nervous influence, it may be, too spiritual for the cognizance of our 
senses. The vital force is as much a power as is electricity, magne- 
tism, light, and heat. All agents act chemically on the tissues of the 
living animal body, as they would upon dead matter. Their agency 
is limited and controlled by the vital force. If that is strong, so 
much less is their action. One man differs from another, as a horse, 
for instance, differs from a man. A horse may take daily, for weeks, 
several grains of arsenic, without other effect than a softer and more 
silky skin. In this sense of the constitution, a difference, in degree 
only, of that agent called vital force, it is found by experience that 
the young, the delicate soonest succumb under the effects of lead 
drank in their daily drink, and like the dews of heaven, descending 
on all, the gentlest and fairest feel the chill which soon closes in 
death.” 
There is in the community, and even among medical men, an 
unwillingness to admit that this poison is productive of much evil; 
they urge the exemption of a certain portion of those exposed, either 
entirely or in a very great degree, from the injurious effects of this 
poison, as an evidence that these are, in all the supposed cases, imagi- 
nary. The same argument might be used with equal truth against 
the existence of malaria, or the poison of most epidemic or contagious 
diseases, inasmuch as but a small portion of those exposed become 
actually infected. Cholera scarcely decimates the community among 
whom it finds its victims, and influenza, even, leaves many untouched 
in its less partial course. Another ground of scepticism has been the AND THE DISEASES PROCEEDING FROM IT. 
fact, that cases, having the features of the affections attributed to 
the agency of this metal, are occasionally met with, in individuals, 
not yet suspected of being exposed to its action. But when we reflect 
to ■what a variety of purposes, connected with domestic life, this 
metal has been put, through which it may be insidiously introduced 
into the system, such cases may all ultimately prove (as many of them 
have already been proved) to be mere apparent exceptions. It is 
well known, that the oxides of lead enter largely into the composition 
of the glazing of earthen and stoneware. It is readily acted upon 
and dissolved by acids; hence, whatever articles to be used as food, 
which contain acids, are kept in these vessels, must act upon this 
glazing, and be more or less liable to produce the peculiar symp- 
toms of this poison. Numerous cases in point could be cited, but 
we will only mention one which occurred some two or three years 
ago in Ohio. The following account of it is gathered from a letter 
addressed to your Committee, by Dr. E. C. Bidwell, of Keen, Ohio. 
It appears that a cheap kind of earthenware came into use in a 
certain section of Ohio. Soon afterwards, a very strange disease 
made its appearance, and was variously denominated Dutch belly-ache, 
dry cholera, &c. Many deaths occurred from it before its character 
was understood. Dr. Bidwell says:— 
“ A case occurring in my practice which I had determined to be 
of saturnine origin, although unable to indicate the source of the 
poison, I soon afterwards ascertained it to be precisely similar to the 
disease which had become endemic in that locality.* This led me to 
make such an examination as immediately satisfied me that the lead 
employed in the glazing of the earthenware was the true cause of 
the alarming disease.” 
The following extract of a letter, recently received from Dr. Mason, 
of Billerica, strikingly verifies the difiiculty, under certain circum- 
stances, of identifying the cause of the disease. 
“ When I practised in Dedham, I attended upon the family of Mr. 
Mark Guild, whose wife and mother seemed to me to be clearly 
poisoned by the long use of lead. I communicated my suspicions to 
them, but they denied that they were at all exposed to the use of that 
article. They drew their water from a well, and used no lead utensils 
in the family. There was a small mine of very pure lead in the 
vicinity, which had been opened a few years before, but was then 
deserted. This mine was afterwards reopened by a company on 
speculation, and the grounds explored around. The result of the 
* Dr. Bidwell did not live in the immediate vicinity of the diseased neighbourhood. 64 
ON THE ACTION OF WATER ON LEAD PIPES, 
exploration was that this well was found to have been dug through 
rock containing a portion of the lead vein.” 
It is to he hoped that the profession will soon become so familiar 
with the diagnostics of lead diseases, that they will be able to recog- 
nize them with more certainty than is now generally done, and treat 
them with their appropriate remedies, although the source of the 
poison may not be detected. In many other forms of disease, we 
prescribe in full confidence of our diagnosis, although the causes 
producing them may remain hidden from our view. (See Appen- 
dix C.) 
The several members of your Committee have not unfrequently 
met with cases of chronic disease, which have for months, and in 
some instances years, been unsuccessfully treated for neuralgia, 
dyspepsia, jaundice, and more especially rheumatism; which they 
were compelled to believe had their formation in this poison received 
in some unsuspected way into the system. Such cases have gene- 
rally yielded to appropriate treatment for lead maladies, particularly 
if the source of the poison could be discovered and removed; and in 
some instances where this could not be done, the patient has been 
removed to some other place of residence, when convalescence imme- 
diately, ensued. 
The different forms of lead disease, as laid down by Tanquerel, 
are often complicated with each other, and sometimes with other dis- 
eases. They are also very insidious in their approach, often creep- 
ing on very slowly, the symptoms for weeks, and in some instances 
months, indicating no very definite form of disease. At other times, 
the attacks are sudden. This is oftener true of encephalopathy 
than any other form of lead disease. 
We must, for a moment, call attention to the remarks already 
made on the seat and nature of lead diseases. It was shown that 
lead poison produced an alteration in the brain and nervous system; 
that pathological anatomy, however, revealed no organic lesions; 
but that functional changes existed in the organs to which the fibres 
from the several nervous centres were distributed; hence, the varied 
seat of disease, as the different nervous centres were affected. But 
why, when the nervous spinal system is affected, for instance, sensi- 
bility should at one time be exalted, as in arthralgia, or entirely lost, 
as in anaesthesia, or the power of motion destroyed, as in paralysis, 
is not revealed to us. Under this view of the seat and nature of 
lead disease, we shall cease to be surprised at the variety of forms 
under which it presents itself. AND THE DISEASES PROCEEDING FROM IT. 
65 
In a manuscript lecture of the late Dr. Howe, before alluded to, 
in his quaint way, referring to the question under consideration, he 
remarks:— 
“ A large portion of the symptoms produced by lead in small quan- 
tities is saddled on to that everlasting pack-horse, called rheumatism. 
This rheumatism passes with ‘the world’s people,’ as a noun of 
multitude, and affords a name which is vastly convenient for a host 
of indescribable twinges, darts, pangs, and girds, for which no names 
have been provided. Besides colic, minute quantities of lead, taken 
internally, will produce an almost infinite variety of symptoms, such 
as numbness of the hands and feet, swelling and pain in the finger- 
joints, pain in the back and limbs, slight convulsive twitchings of the 
face or eyelids, over which the patient has no control, and a multi- 
tude of others, varying in different subjects, and at different periods 
of life. These symptoms are sometimes so very tardy in their 
development, and come often in such a ‘questionable shape’ that 
the connecting link between cause and effect is often lost, and the 
disease prescribed for under mistaken impressions; for instance, a 
child becomes indisposed, is peevish and fretful; the eyes become 
heavy, it starts in its sleep, or has a convulsion fit. But what is the 
cause of all this ? Why, to be sure, they will say, ‘ the child has 
taken cold,’ or, ‘it is feverish,’ or, ‘it has canker,’ or, ‘it is 
teething,’ or something else; but not a word is said about 
sugar-plums, peppermint, or candy. Nobody mentions the nicely 
painted doll, the trumpet, or the whistle; but each of these is orna- 
mented with lead, which is liable, in various ways, to be decomposed 
and swallowed by the child; and it is well known that exceedingly 
small quantities of this metal produce the very symptoms just de- 
scribed. Let me entreat you, as you value the present and future 
health of your children, to protect them against the poisons of the 
‘ toy-shop.’ ” 
If, then, such a variety of symptoms is due to, and so large a 
number of the organs of the body become deranged by the agency 
of this poison, which in such a number of ways may be unconsciously 
received into the system, it is not strange that errors of diagnosis 
should be often committed by those of the profession to whose atten- 
tion the subject of lead disease has not been presented. 
Those practitioners who are persuaded that most of the chronic 
ailments to which flesh is heir are due to “deranged liver” will 
readily find confirmations strong of this prejudice in the sallow, 
dingy complexion, yellowish conjunctiva, constipated bowels, and 
pains in the sides and shoulders, which attend some cases of the 
affections we are considering. These patients will feel that their 
difficulties are more than half cured when they are pronounced to 
be “ very bilious 66 
ON THE ACTION OF WATER ON LEAD PIPES, 
Neuralgia and spinal irritation will, with those whose indolence 
cannot brook the labour of a cautious diagnosis, embrace a large 
portion of them, and this the more readily, since the resemblance is, 
in some of the cases, very strong, and particularly will this error 
obtain in regard to those in whom the two diseases (as often 
happens) unfortunately coexist. But even these complicated forms 
will, to an instructed eye, and under a searching analysis, become 
perfectly transparent. 
Those imbued with the Broussaisian doctrine of “ gastro-enterite” 
will not fail to find their dogmas confirmed by the irritable state of 
the stomach and bowels, tenderness on pressure over the epigastrium, 
and frequently recurring stitches and pains, emaciation and deranged 
secretions, which constitute the livery of some forms of this protean 
affection; and forthwith the sufferer must be subjected to an ever- 
lasting succession of leeches, rubefacients, ptisans, and enemas, and 
to a shadowy nutriment, embraced in the fearful phrase diete ab- 
solute. Some cases within the observation of at least one member 
of the Committee have been mistaken for, and treated as subacute 
or chronic peritonitis, though we think this error can scarcely be 
committed, except by those whose diseased imagination compels them 
to detect a latent fire, ready to burst out, momentarily, into open 
conflagration, whenever tenderness on pressure (no matter how small 
the amount) can be made to coincide with abdominal pain. One or 
two such cases from histories received, on being summoned to hurried 
consultations, near the closing scene, led to more than a suspicion 
that they had been brought to a fatal consummation by the sangui- 
nary proceedings of one of these graduates of the Sangrado school 
of medicine; a post-mortem in one of them betraying not the 
slightest trace of preceding inflammation, the other not being ex- 
amined. 
The pains in the back and loins, and the occasional dysuria, will, 
in some cases, lead the observer strongly to suspect nephritis; and 
in some others, he can hardly persuade himself that his patient is 
not labouring under an attack of gravel. And these cases will yield 
their obscurity only to the most vigilant scrutiny and careful inquiry. 
To the unsuspicious or inexperienced observer, the disturbed con- 
dition of the digestive organs constituting the more prominent de- 
rangements in some lead affections at a certain stage; dyspepsia, in 
all its protean varieties, will at once be suggested, and a corre- 
sponding treatment, without reference to the true cause, be adopted. 
Cases of diseased brain, within our knowledge, have gone on to a AND THE DISEASES PROCEEDING FROM IT. 
fatal termination without a single suspicion as to their true origin, 
and, of course, with the omission of a most essential condition of 
recovery in all diseases, viz., removal of cause, which, with the light 
thrown upon these affections from the luminous pages of Tanquerel, 
wmuld at once have been recognized as cases of encephalopathy, and 
possibly have been guided to a fortunate termination. 
Besides the above, for which affections arising from the poison of 
lead have been mistaken, we cannot but feel the strongest conviction 
that there are many anomalous and unnamed derangements and 
symptoms, which are met wdth by all physicians, which will hereafter 
be traced to lead as their cause, but which now, in consequence of 
its unsuspected agency, often baffle the most scientific, and in other 
respects the most judicious treatment, and consign their victims to 
year after year of suffering and decrepitude throughout a long life, 
or bring it to an early close, in an unexpected and unexplainable 
manner. 
We have been struck with the immediate evidence of commencing 
convalescence which most cases exhibit on the cause being removed. 
Even the protracted and the more severe ones, which before this 
seemed to be only in a slight degree mitigated by the use of means 
employed, would at once, in the improved complexion, diminished 
pain, and more especially in an unwonted cheerfulness of manner and 
elevation of spirits, inspire both patient and physician with a confi- 
dence that certain immediate relief and ultimate recovery might now 
be relied upon. A buoyancy and elasticity of the feelings would 
begin at once to be manifested, which never were witnessed during 
the continued exposure to the cause, even when, by the treatment, 
the rest of the symptoms were most decidedly softened. In many 
instances, a conviction seemed immediately to be produced on the 
mind of the patient that his convalescence was now certain to be 
established. It was equally surprising how rapidly this array of 
symptoms was reproduced by a few weeks of renewed exposure to 
the unsuspected cause. 
In conclusion, your Committee will only add that the settled con- 
viction to which their labours, in preparing this report, have conducted 
them, is this: that it is never safe to use water drawn through lead 
pipes, or stored in leaden cisterns for domestic purposes, and that 
any article of food or drink is dangerous to health which by any 
possibility can be impregnated with saturnine matter. It may pos- 
sibly be done in some cases with impunity, but it is impossible to 
predetermine the cases of safety where so many are fraught with 
danger (see Appendix D). 68 
ON THE ACTION OF WATER ON LEAD PIPES, 
APPENDIX. 
(A.) 
Some anomalous cases of apparent non-action of water on lead, 
derived from the absence of disease, are occasionally observed. 
They must be considered as exceptions to the general rule, but 
nevertheless are as important to be known, in the search after truth, 
as the more numerous facts establishing the general unsafety of the 
use, for domestic purposes, of water transmitted through lead pipe. 
The following letters, addressed to your Committee, from highly 
respectable sources, are of this character :— 
Dr. J. C. Dalton— 
My dear Sir: Although Amherst Plain is well known to some of 
the Committee of the American Medical Association appointed to 
investigate the subject of the action of water on lead pipes, it may 
not he entirely foreign to the purpose to give some account of the 
natural location, soils, &c. 
The Plain has a light sandy soil, hut well cultivated is capable of 
affording very good early gardens. As you ascend the higher 
ground, the soil becomes richer—a dark, reddish loam soil—higher 
still, not quite so deep a soil, and coarser—above this, a mixed clay 
soil. And all these are well stored with New Hampshire granite. 
The house I reside in stands on the margin of the higher ground 
—I purchased, and moved into it, I think, in 1808. The next 
summer was a dry season, and, to my disappointment, I found my 
well without water. This induced me to think of an aqueduct. On 
searching for springs, I found one 25 rods from my buildings-— 
another 60 or 80 rods distant. 
In 1820, a company was formed for bringing the water from my 
springs, and also from the springs in the hills on the other side of the 
road, to the Plain, in lead pipes; 20 or 25 families engaged to take 
the water. An equal or larger number have continued to he sup- 
plied by this aqueduct to this time. Other aqueducts, since laid 
and in lead pipes, supply a number of families in the neighbourhood; 
yet the degree of health, according to the number of inhabitants, is 
as good as it ever has been—the bills of mortality show as few 
deaths. 
I have been a practising physician, in this town, for nearly fifty 
years. When I came here, the number of inhabitants was between 
sixteen and seventeen hundred—and the number has varied but 
little to this day. There has been an increase in the village, hut AND THE DISEASES PROCEEDING FROM IT. 
69 
tlie outer parts of the town have lost, and portions have been added 
to other towns adjoining. Statistics show the average number of 
deaths, per year, for all this time, to he about twenty-six—varying 
some seasons, when epidemics have prevailed. 
In 1820, wThen the lead pipes were first laid, and for several years 
afterwards, there was much solicitude felt by many, lest we should 
all be poisoned. Newspapers and other publications often brought 
frightful stories of the bad effects of water drawn through lead. 
The physicians of the place have been often called upon for their 
opinions on the subject—in fact, we have ourselves felt considerable 
anxiety respecting it. There are now two physicians here besides 
myself. But no case is known, in which disease has been produced 
by using water brought through lead pipes. 
I am myself familiar with the effects of lead on the human system. 
Soon after I came to Amherst, I was called to visit, professionally, 
the family of a house-painter. I found some strange and painful 
neuralgic complaints; much resembling those named in the questions 
proposed by your committee. Colic, pains in the limbs and joints, 
partial paralysis, also appeared. Some of the family died from 
these diseases; the father died from a violent paralytic shock. I 
have witnessed other like cases among house-painters. Until late 
years, it should be remembered, painters ground and mixed their 
own colours. 
The water, brought in our aqueduct, is very pure; it is good to 
drink—good for all domestic purposes—good for medicinal purposes 
—the best, I think, I ever used, except distilled water. Another 
proof of its purity is that, where the pipes have burst, as they 
frequently have, from the pressure of the water, there has been no 
appearance of corrosion on the inside the pipe—it was clean and 
smooth. 
And now, my dear sir, after making as fair an investigation into 
this subject as is in my power, I am constrained to say that I 
have never seen nor heard of a single case of disease, in this place, 
which, I think, can fairly be attributed to any of the five points or 
Questions put forth in the circular of your Committee. 
I am, dear sir, 
Respectfully yours, 
(Signed) M. SPALDING. 
Amhekst, N. H., Feb. 18, 1852. 
Reading, Pa., Dec. 19, 1851. 
To Drs. Adams, Dana, and Dalton, Committee of the American 
Medical Association “ On the Action of Water on Lead Pipes.” 
Gentlemen : To your circular on the above subject, I would 
reply that the city of Reading, containing 16,000 inhabitants, is 
situated at the foot of the South Mountain, on the edge of the great 
limestone belt that traverses the whole State from north-east to 
south-west. It has been supplied with spring-water since 1821, 
derived from the South Mountain, composed of a formation 1000 70 
ON THE ACTION OF WATER ON LEAD PIPES, 
feet thick, consisting of a very compact, silicious rock. All the 
water from this formation, which is very abundant, is nearly as pure 
as distilled water. It is introduced in the ordinary way, through 
iron main-pipes, hut nearly all the service pipes are lead. 
I have practised medicine in this city for a period of twenty years, 
and can safely say that I have never noticed any facts that led me 
to suspect the prejudicial agency of lead, derived from this source, 
although my attention has been attracted to the subject for twelve 
or fifteen years. 
I have conferred on the subject with my brother, Dr. Isaac Hiester, 
and Dr. Otto, both of whom practised in this city long before the 
introduction of the water, and have been in active practice ever 
since; and they both fully corroborate my own experience. 
I have the honour to be your most obedient servant, 
(Signed) JNO. P. HIESTER. 
New Bedford, March, 1852. 
Db. Dalton— 
Dear Sir: I received your circular of the 29th of January, and 
regret that I have not been able to answer it before. Having little, 
if anything new to aid you in your report, I have not considered 
it of much consequence. 
There have been only three families in this city that have ever 
had any disease arising from water drawn through lead pipes; and 
in them it manifested its effects in the common form of lead colic. 
Two of the families w’ere under the care of the late Dr. Alexander 
Read, of this city, and recovered, except a child three or four years 
old, in which the disease (as I now learn from the mother) probably 
terminated in marasmus, and proved mortal. 
The other family was under my care. The father, a strong, athletic 
man, had a severe attack of lead colic, after drinking water, drawn 
through lead pipes, for four months. The water had not been used 
from the pipes for several months before they commenced using it 
this time. He had been suffering severely with colic pains several 
days before I was called. On examining him, his features had that 
peculiar shrunken appearance, together with blueness of the gums, 
&c., which we only meet with in lead diseases. On inquiry, I ob- 
tained the above history, which left no doubt as to the cause of dis- 
ease. I treated him in the usual manner, with cathartics, opium, 
and calomel, bleeding both general and local pro re nata ; he soon 
recovered, and has never had any attack since. Every member of 
the family had an attack of the disease before he recovered, and all 
happily recovered, and have never had any disease since that could 
he attributed to lead. 
Painters formerly were peculiarly obnoxious to lead diseases, when 
they were in the practice of grinding and sifting the oxide of lead 
hy hand. But I think it is seldom met with since this operation has 
been done by machinery. We have a number of men, in this city, AND THE DISEASES PROCEEDING FROM IT. 
71 
who, when apprentices to the painting business, and ground their 
lead, contracted the disease, and are now frequently suffering severe 
attacks of arthralgia; but I have not met with a case of encephalo- 
pathy that I supposed to be produced by lead alone. 
There is one subject I will take the liberty to suggest to you ; if 
it meets with your approbation, I will thank you to present it to the 
American Medical Association, and get a committee appointed to 
investigate the cause of anemia, complicated, with the puerperal 
state, sore mouth, &c., and the most successful mode of treatment. 
It is a disease that is hardly recognized by any of our standard 
authors, and few of the journals of the day have noticed it. Dr. 
Hale, some twenty years ago, published an article of much merit at 
that time; since which, I have seen but little, but hope that some 
one will have something useful to offer us on the subject. It is a 
very formidable disease in its worst form, often consigning the 
mother of several children to an early grave. It rarely occurs in 
first pregnancies. 
I am, with much respect, yours, truly, 
(Signed) PAUL SPOONER. 
N. B. This city contains 18,000 inhabitants; on inquiry of the 
plumbers, I find (in their opinion) that from one-half to five-eighths 
of the wells in. this city have lead pipes in them, and the above cases 
are all that have ever occurred in this city. There is little doubt 
that water, in some places, contains substances that oxidize the lead, 
rendering it dangerous to use for domestic purposes, more than in 
others, and which can only be detected by chemical analysis ; or that 
lead, of an inferior quality, has been used. All which is respectfully 
submitted by yours, 
P. S. 
Dr. Adams— 
Bear Sir: In answer to your inquiries in relation to my experi- 
ence as to diseases produced by drinking water which has passed 
through lead pipe, I answer briefly : After thirty years’ experience, 
I am led to believe that, under certain circumstances, disease will 
certainly occur from its use; while, under other circumstances, which 
to me are inexplicable, it may be used freely, for an indefinite period, 
without producing any perceptible unfavourable results. 
Three miles from my residence there is a factory village, the 
boarding-house of which has been supplied for more than a quarter 
of a century with water passing from eighty to a hundred rods 
through lead pipes, supplying the wants of about a hundred indi- 
viduals ; and although I have been a constant practitioner in that 
neighbourhood for that period, I have never known a single instance 
of disease produced by lead. In other parts of the town, the use of 
water, passing through lead pipe, has produced disease which could 
readily be traced to the absorption of lead into the system. I will 
refer to two cases. Miss P. suffered from colic, for three years, at 72 
ON THE ACTION OF WATER ON LEAD PIPES, 
frequent intervals, from using water passing through lead pipe, with- 
out suspecting the cause. Being absent from home one year, drink- 
ing other water, she was entirely exempt from it for that time; on 
her return home, she again drank the water of the house, and again 
suffered severely from colic. 
The cause being now ascertained, the use of the water discon- 
tinued, she was entirely free from it until more than three years after; 
while boarding in a house where lead pipe was used, she had another 
violent attack. Since then, for four years, she has, by abstaining 
from the cause, remained free from the disease. 
The second case is as strongly marked. Mr. B., whose family 
consisted of himself, wife, and three children, in 1840, used water 
from a well about one hundred feet from his house, which passed 
through lead pipe; in June of that year, four of the five became 
dangerously sick from colic; the husband first, then the wife, and 
soon after, two of the children. The cases were distinctly marked, 
severe, and yielding with great difficulty to the usual remedies ; on 
recovery, the use of the water was discontinued, and for the last 
eleven years, they have had no repetition of the disease. 
What the peculiar properties of water, in different localities, are, 
by which it acts upon lead, I do not know; but that water, passing 
through lead pipe, in some places is perfectly innocuous, while in 
others it is poisonous, is certainly true; and it is worthy of our 
deepest study to ascertain all the facts in the case. 
Yours, truly, 
(Signed) JOSIAH BARTLETT. 
Concord, Mass. 
(B.) 
Since the foregoing report was prepared, the Manchester Guar- 
dian of April 24, 1852, an English paper, has been received, from 
which we make the following extract. It proves the fallacy of the 
opinion, advanced by some chemical authorities, “ that certain inso- 
luble deposits are soon made upon the inner surface of lead pipe, 
by which the water transmitted through it becomes, in a very short 
time, safe to be used as a beverage, and for culinary purposes — 
Poisoned Water. 
To the Editor of the “ Manchester Guardian — 
I am sorry to trouble you again on this subject, but should feel 
obliged, if you would allow me space for a few remarks in reference 
to the action of water upon metallic lead. Mr. Pountney, whose 
communication appeared in last Saturday’s (Guardian, seems to have 
the common impression that water brought into contact with lead 
ceases, after a time, to exert any solvent influence upon it. There 
is no doubt that the new lead is much more readily acted upon by 
water than that which has been long exposed, ip consequence of the 
metal becoming partially coated with the insoluble salts of lead, espe- AND THE DISEASES PROCEEDING FROM IT. 
73 
cially the sulphate, as you have remarked.—But that such coating 
is very partial, may he abundantly proved. A lady, who has been 
in the occupation of premises, situated within three hundred yards of 
the Royal Infirmary, for more than twenty years, has, during the 
last three years, been repeatedly under my treatment for painful 
dyspepsia, and occasional impairment of the senses. Her recovery 
was always protracted, and at no time satisfactory, until after a cer- 
tain time she spent in the country or at the seaside. In January of 
this year, she experienced a recurrence of the old train of symptoms 
in an aggravated degree, with the addition of loss of sensation and 
impaired power of motion of the right hand, and the right leg and 
foot. I, on this occasion, for the first time, suspected the real cause 
of her indisposition. The water she had constantly used for four or 
five years past was found to contain lead. The mode of its impreg- 
nation is briefly as follows: There was, in the back premises, raised 
on a galley, a cistern about five feet in depth, and half that measure 
in diameter, made entirely of lead. This vessel had formerly been 
used for holding rain-water. But rain-water, in consequence of the 
immense quantity of soot carried down and mixed with it, having 
become useless, the pipe conducting it from the house top was direct- 
ed into the common sewer, and the cistern thenceafter served for the 
reception of the town’s water. This alteration was made about five 
years ago, since which time the lady and her domestics have never 
been in health until recently. The lady’s niece, who occasionally 
resided with her, had repeatedly suffered loss of power of both hands, 
with other disturbances, on which account she had been removed to 
her parent’s residence, where her health was restored. 
Now the water supplied by the old Manchester Water-Works was 
exceedingly hard ; Mr. Stone informs me that it possessed this quality 
to the amount, in chemical language, of sixteen degrees. When the 
finger was dipped into it and removed, the skin was scarcely moist- 
ened, but appeared as if that member had been previously coated with 
oil, so that the water left it almost dry. Water of this degree of 
hardness exerts less action on metallic lead than any other, and 
yet it had sufficient solvent power on the old lead cistern, notwith- 
standing that the cistern had been previously exposed to the action 
of a still more solvent fluid for ten or twelve years, to acquire poison- 
ous qualities. Mr. Stone has examined old lead pipes which have for 
years been in use for conveying the water in question, and has found 
them deeply penetrated, and even perforated, from within outwards, 
with a multitude of holes made in process of time, by the corroding 
agency of water. 
The water at present supplied to us by the corporation is much 
more pure than that derived from the old source; although it varies 
from time to time, in consequence, probably, of the old reservoir at 
Beswick being occasionally made use of. The latter ought to be 
dispensed with as soon as possible. The water we at present receive 
possesses about five degrees of hardness; but in the reservoirs at 
Woodhead, not nr re, as I am informed, than two or three degrees. 74 
ON THE ACTION OF WATER ON LEAD PIPES, 
The purest waters exert the most powerful solvent action on lead. 
Distilled water, for instance, dissolves it freely ; the next to this is 
rain-water; and the water supplied from the Woodhead reservoirs 
produces a speedy chemical change in virtue of the very quality 
for which it is most prized. 
Water possessing more than sixteen degrees of hardness appears 
to become possessed of more solvent properties, and when this 
quality (hardness) exists in still higher degree, its chemical agency is 
nearly equal to that of pure water. This important fact, not hith- 
erto published in books, is entirely due for its discovery, so far as I 
know, to Mr. Stone’s investigations. 
Water, also, which contains any considerable amount of hydro- 
chloric salts, as that referred to in my former letter, acts very 
readily on lead. 
I remain your obedient servant, 
J. W. 
(C.) 
We cannot refrain from introducing here an extract from a letter 
of Dr. E. C. Bidwell, of Ohio. It contains facts and suggestions of 
much value. 
“ One advantage which I hope to result from the labours of your 
Committee, and the publication of your results, will be, to make the 
various forms of disease caused by lead to be more readily recog- 
nized by the profession, whatever the source of the poison, and even 
when no source is discoverable. This is certainly a desideratum, 
and it would seem to be not impracticable. We do not deny a case to 
be intermittent fever, because we do not know of the patient’s expo- 
sure to miasmatic influences. 
“The poison is wide-spread. It has manifold uses in the arts, and 
we are brought into contact with it in a hundred different forms in 
the every-day walks of life. It cannot, therefore, but be a frequent 
cause of disease. I have no doubt at all that, if the diseases that 
spring from it had been susceptible of accurate diagnosis years ago, 
hundreds of mysterious and mistreated cases would have been under- 
stood and cured. The ‘bilious rheumatism’ of some old doctors, for 
example, was always a mystery to me; now I think I understand it; 
at least I am sure I never had a case of the kind that was not caused 
by lead. I doubt not that, if we were more perfectly acquainted 
with the pathogmetic effects of lead—and of various other drugs, as 
well—many anomalous and inexplicable complications or sequelae of 
diseases, in the treatment of which we have employed it, would be- 
come perfectly intelligible. The effect upon therapeutics of an 
improved diagnosis could not but be beneficial. 
“ With a brief allusion to another point, which may be worthy of your 
attention, I will close this communication. An infant at the breast 
had been for a short time with his mother, in a room where newly- 
painted articles were kept; the mother was often in the room, and AND THE DISEASES PROCEEDING- FROM IT. 
75 
sometimes painted there; but the infant was never there but on the 
single occasion, and then did not touch the paint. A few days sub- 
sequent to this occasion, he was taken with characteristic symptoms 
of lead poisoning, the diagnostic blue line on the gums included. 
He continued to be affected with the disease, with remissions and 
relapses alternating, for a period of two months; after which, his 
recovery was progressive, although slow. 
“The question arising here, upon which I confess my own mind 
laboured at the time, is, whether the single brief exposure of the 
child was sufficient to account for the repeated attacks which he 
suffered for so long a period; or were it not more probable that he 
‘ sucked the poison with his mother’s milk,’ thus having it renewed 
day by day, the mother herself escaping the disease by the elimina- 
tion of its cause through the lacteal secretion. This view is sup- 
ported by the analogy of the ‘milk sickness,’ so destructive in some 
parts of this State. In this disease, in animals called the ‘trembles,’ 
milch-cows escape, while other animals not giving milk are trembling 
and falling, and dying around them; but those wdio use the milk of 
these apparently healthy cows, or its products, experience the disease 
in its utmost violence. 
“ Acting upon this view, in the above case, I early directed the 
child to be weaned; but after a brief trial, it was thought impracti- 
cable by the tender-hearted mother, and the attempt wTas abandoned. 
“ I then put her upon a course of medicine, as if herself affected 
with the disease; but am unable to say with certainty, how much 
effect this treatment had.” 
(D.) 
Since the completion of this report, the following note has been 
received from Dr. Dana, a member of the Committee. Comment on 
its character and importance is unnecessary. 
Dear Doctor : I have been reading a thesis just published (1852) 
in Paris, by Dr. Guerard, Mddecin de I’Hdtel Dieu—“Du Choix et 
de la Distribution des Eaux dans une Yille”—in which he (Dr, G.), p. 
75, gives the following as the most remarkable fact of lead-poisoned 
water, related by M. Henri Gueneaude Mussy: “ During many days, 
this clever practitioner misunderstood the character of the symptoms 
which he had observed.” If so distinguished a pupil of the school of 
Paris has, for one moment, mistaken the true nature of like accidents, 
we may believe that lead-poisoning has, in a multitude of cases, been 
produced by lead reservoirs, and has run through its various stages, 
ending in death, without its cause ever having been suspected. 
In 1848, after some months’ residence at Claremont, many mem- 
bers of the family of Louis Philippe were attacked with symptoms of 
lead-poisoning. Violent colic, nausea, vomiting, with obstinate costive- 
ness first appeared; later, jaundiced skin, nervous disturbances, 
simulating hysteria; the whole surface of the skin became so very 
morbidly sensitive, that the slightest touch produced in the sufferers 76 
ON THE ACTION OF WATER ON LEAD PIPES, ETC. 
cries and tears. The vital force always diminishing^the progressive 
emaciation, the deep cachectic coloration of the skin, &c., caused the 
liveliest inquietude in M. Gueneau de Mussy, who, after vainly using 
purgatives, resorted to antispasmodics, to preparations of iron, sul- 
phur, &c., from which better results were obtained. Other residents 
at the chateau were equally, but not so severely attacked. 
Finally, out of 38 persons, 13 were poisoned, one-half of whom 
presented the blue line on the gums, and spots of the same colour on 
the mucous membrane of the mouth (membrane buccale). This line 
and these spots were, in many persons, the only trace of the action 
of poisoning matter (matiere toxique). To what cause shall be 
attributed these symptoms ? 
The analysis of the water used at Claremont for domestic and 
culinary purposes showed 0.1544 grain (0.01 gramme) of metallic 
lead per quart (litre). But how shall we explain the presence of 
this lead in the water? Hear what M. Gueneau says about the 
changes in the apparatus for distributing the water: “When the 
chateau at Claremont was occupied by its new inhabitants, the water 
was conveyed from a natural cistern, situated near its source (distant 
300 metres, about 975 feet), through lead pipes to a cistern of lead 
placed in the house. This natural cistern was encumbered with 
vegetable and animal remains. It was judged proper to replace the 
natural cistern by an iron cylinder, 6 feet in diameter, by 20 feet 
high, sunk 15 feet in the earth. To this cylinder -was attached a 
lead pipe, which projected some inches within the cylinder; the 
cylinder was closed by an iron cover, pierced with holes to admit 
the air. Nothing is easier,” continues M. Gueneau, “than to ex- 
plain what has happened, under these circumstances. It is known, 
from the researches of Conillet, that lead is positive to iron, and 
especially to cast-iron. The contact of lead and iron favours the oxi- 
dation of the lead, which once transformed into hydrated oxide, will 
soon become carbonated, and dissolved by the excess of carbonic acid 
in the water.” 
As the quantity of lead daily dissolved was inconsiderable, the 
effects which it produced did not show themselves till after a some- 
what prolonged use of the water. 
The practical lesson which M. Gueneau draws from the facts above 
is this : “ That contact, even mediately, between lead and other 
metals, especially iron, should be avoided in the construction of all 
reservoirs, destined for the conservation of water for domestic use.” 
How much better it would be to have said that lead should be 
avoided wherever alimentary water is to be conveyed or stored! 
I consider the above case, in all its details, higlily instructive, not 
only as it regards the insidious nature of lead attacks, but also as 
exemplifying the highly increased danger which arises from attach- 
ing lead pipes to iron mains. 
I am very truly yours, 
(Signed) SAML. L. DANA.