The Nature of the Primary Renal Lesion Produced by Lead

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Abstract
To 36 guinea pigs PbCO3 was given per os in small gelatine capsules. The initial dose was 0.03306 gm., followed by 0.03637, 0.06309, 0.075945, and 0.0909 gm. The first general symptom shown by the animals after 4-5 doses of 0.036 gm. PbCO3 was increased sensitivity and excitability. Attacks of convulsions and symptoms of colic usually began after a total of 0.2-0.4 gm. per os had been given in 5-6 subsequent days. Some animals died in these attacks. Animals receiving a smaller amount of poison during this period, and survivors, began to lose weight and to show anemia, poikilocytosis, anisocytosis, normoblasts and basophilic granules in red blood cells. Later the animals became very emaciated. They died usually in convulsions with cramps in their extremities, opisthotonos or emprosthotonos. In the grave stages of the illness the animals were very weak, showed delirium, weakness and paralysis, first in hind legs. Urine of the animals dead after 3-5 gm. of lead showed albumin, few leucocytes, several epithelial cells, and considerable triple phosphate crystals and amorphous salts; but never was blood found in the urine. In the later period of the experiment the animals became within certain limits immunized against the PbCO3, so that they continued to live even though 2-4 times the original dose was given. The following are the conclusions the earliest lesions in the guinea pig kidney due to PbCOs poisoning are moderate paren-chymatous and fatty degeneration, without any microscopical lesions of the blood vessels. These early renal epithelial lesions, providing that no other etiological factor can be found, are the only lesions up to 6 months'' duration of the experiments and when PbCO3 in a-mounts between 0.5 and 6 gm. has been given. Both the time and amount of Pb required to bring on these changes are conditioned somewhat by individual variation. After 6 mos. and when more than 6 gm. of PbCO8 has been given, there begins, first in the cortex, a slight proliferation of the interstitial connective tissue which toward the end of the 7th mo. and when the total, amount of PbCO3 given is over 7 gm., leads to secondary contracted kidney.
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