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LEAD Action News Vol 2 no 4 Spring 1994.  ISSN 1324-6011
Incorporating Lead Aware Times ( ISSN 1440-4966) and Lead Advisory Service News ( ISSN 1440-0561)
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 The History of Lead part 4

by Christopher Winder

This is the fourth in a series of extracts from Dr Winder's History of Lead, from his book "The Developmental Neurotoxicity of Lead' published bv MTP Press Ltd 1984. Reprinted with kind permission.

Part 1 | Part 2 | Part 3 | Part 4

The Roman Empire

Although its importance initially lay in its close association with silver, lead emerged from the background and assumed a dominant role in the technology of the developing Roman Empire. Amongst other reasons, the Roman invasion of Britain in the first century was launched to exploit the lead [and tin, copper and silver] mines of England, to satisfy the Roman enthusiasm for sanitation and bathing. The Latin word for lead was plumbum, denoting water conduits or spouts; the word plumber is derived from it.

Lead-lined pots were used extensively in cooking, as they prevented the bitterness caused by using bronze containers, imparting a sweet flavour to food. Wine was also prepared in lead-lined containers, specifically because of this sweetening property. The ability of lead to inhibit enzyme activity was well appreciated as a preservative for fruit and wine. Both Cato [De re rustica, cv] and Pliny [Historia naturalis, xiv, 21; translation of Jones and Rackham, 1938-1963] advocated the treatment of wine in leaden vessels. These practices caused considerable contamination of food and drink, and Gilfallen [19661 has proposed the doubtless excessive idea that the fall of Rome was due to endemic lead poisoning.

Together with reports of the use of lead are descriptions of its toxic side effects. These were known to ancient physicians, and the first report is ascribed to Hippocrates [370 BC] who noted symptoms of a metal colic in a metal worker [Jones and Withington, 1923-1931]. However, there is no reason to believe that this colic was due to lead, so that this supposition is based more on recent tradition than fact [for a discussion of the issues involved, see Waldron, 1973]. The first accurate account of lead poisoning is probably that in the Therica and Alexipharmaca [i, 600] of Nicander [2nd century BC], who described symptoms of poisoning by ceruse [white lead] as constriction of the palate and gums, asperity of the tongue, hiccups, a dry cough, nausea, heaviness of the head, unnatural vision and torpor [Major, 1965].

Of the Romans, Vitruvius [1st century BC] mentions that water impregnated with lead was injurious [On Architecture, viii, 31, and noted the pallid appearance of lead workers. Horace [1st century BC] is another of the writers of antiquity to mention the purity of water in relation to lead pipes. In a letter to an old friend, he extolled the virtues of living in the countryside, comparing amongst other things, the purity of town water to fresh countryside water.

Purior in vicis aqua tendit rumpere plumbum Quam quae per pronum trepidat cum murmure rivum?
(Horace Epist., 1, 10, 20-21; translation of Wickham, 1891).

Lead has been used as a remedy for thousands of years. It is mentioned in the Ebers papyrus (1550- 1500 BC), an Egyptian medical treatise. Lead is specified for laying on a wound (for cooling?). Some Egyptian medical recipes were given by later authors, including Dioscorides, Pliny and Galen. Litharge was the 'spuma argenti' of Celsus (1st century BC) who mentioned is as a cooling and cleansing medicine. He also treated ceruse as a poison (De Medicina, v, 27, 15) but recommended it for burns and ulcers (ibid. v, 7,). Pliny (the elder, 23-79 AD) noticed the deleterious effects of exhalations from lead mines (Historia Naturalis, xxxiv, 47, 50; translation of Jones and Rackham, 1938-1963), and Dioscorides (1st century AD), noted the toxic side-effects and some early attempts at industrial hygiene in the Roman shipbuilding industry (De venenis). In his De universa medicina is found the first mention of lead (as the acetate) as a remedy. He also recommends washed litharge as a remedy for ophthalmic problems, unseemly scars, wrinkled faces and refrigerant properties of lead (Goodyer and Gunther, 1934). Galen (138-201 AD) mentions that water conveyed in leaden pipes sometimes causes dysentery (Med Sec. Loc., vii), and expressly says that ceruse ought not to be administered internally (Methodus Medendi iv). For a fuller explanation of roman sources see Scarborough (1969).

With the growth of the Byzantine empire and the transfer of power to the east, Constantinople became the centre of medical knowledge in Europe. The early Byzantine authors tended to paraphrase their Roman predecessors and Oribasius (325-403 AD) and Aetius (early sixth century) both quote many of the Greek and Roman writers. The greatest Byzantine physician is Paul of Aegina (626-690 AD). His report of an epidemic of colic terminating in paralysis is the earliest known description of the clinical picture of lead poisoning (De Re Medica, iii; translation of Adams, 1864-1867). He also had a novel use for lead - 'a plate of lead worn upon the loins restrains libidinous dreams'.

Following the collapse of European culture in the 6th-Sth centuries, medical knowledge and practice became fossilised in the hands of the church. It was only in the expanding Moslem world that intellectual inquiry continued. The early Arabian physicians, such as Rhazes (865-925 AD) and Serapion (9th century) tended to be bound by the authority of the ancients, supplying little or no additional information. The use of lead as a remedy however, was expanded. It was recommended generally as an astringent in fetor of the armpits to restrain sweating, and to dispel extravasated blood. It does not appear to be used internally, although Avicenna (980-1037 AD) mentions its usage in fluxes and ulceration of the intestines (Q'anun, ii, 2, 460; translation of Gruner, 1930). Ibn Baithar (1197-1248 AD) recommended it for diarrhoea, and reported it as being useful in congenital hernia and other complaints around the scrotum.

Although some of these early reports may contain inaccuracies owing to contamination with other toxic metals (notably arsenic, bismuth and antimony), reported symptoms of colic, palsy and paralysis compare favourably with current descriptions.

Part 1 | Part 2 | Part 3 | Part 4

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