Lead Poisoning Essay

INDEX SL. NO. | CONTENTS| PAGE NO:| 1. | INTRODUCTION| 1-2| 2. | LEAD| 3| 3. | PREPARATIONS OF LEAD| 4-6| 4. | LEAD POISONING| 7| 5. | SOURCES OF LEAD| 8-9| 6. | WHY LEAD IS HARMFUL? | 10| 7. | ABSORPTION,DISTRIBUTION AND ELIMINATION| 11| 8. | RISK FACTORS| 12| 9| SIGNS AND SYMPTOMS| 13-17| 10. | FATAL DOSE AND FATAL PERIOD| 18| 11. | COMPLICATIONS| 19| 12. | TESTS AND DIAGONOSIS| 20| 13. | TREATMENT AND DRUGS| 21-22| 14. | POST MORTEM APPEARANCE| 23| 15. | MEDICO LEGAL IMPORTANCE| 24| 16. | PROPHYLAXIS| 25| 17. | AYURVEDIC VIEWS| 26-29| 18. | CONCLUSION| 30| 19. | REFERENCE| 31-32| 20. BIBLIOGRAPHY| 33-35| INTRODUCTION Ayurveda Ayurveda can be defined as a system, which uses the inherent principles of nature to help maintain health in a person by keeping the individual’s body, mind and spirit in perfect equilibrium with nature. Ayurveda is a Sanskrit term made up of two words ‘ayu’ and ‘veda’. ‘Ayu’ means life and ‘veda’ means knowledge. The term ‘Ayurveda’ thus means ‘knowledge of life’. According to ancient Ayurveda scholar Charaka, ‘ayu’ comprises the mind, body, senses and soul. Ayurveda is an intricate medical system that originated in India thousands of years ago.

The main aim of this system is to protect illness, heal the sick and preserve life. The fundamentals of Ayurveda can be found in Vedas, the ancient Indian books of wisdom. Agadatantra Agadatantra is one of the eight branches of Ayurveda which explains about visha along with its properties, action, fatal dose, detection, symptoms shown by intake of visha and its treatment measures. The word ‘agadatantra’ is derived from the combination of two words, Agada and Tantra. Agada means the medicaments which are used as an anti dot to combat the morbid condition.

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Tantra means science through which the positive health of an individual is preserved. As regards origin of visha, Lord Shiva describes the visha as a result of the churning of the milk ocean by devas and daityas using the serpant king Vasuki as the rope of churning. Lead poisoning Lead poisoning (also known as plumbism, colicapictonium, saturnism, Devon colic, or painter’s colic) is a medical condition caused by increased levels of the heavy metal lead in the body. Lead is a ubiquitous metal that has been used by humans for more than 3 millennia. Its toxic effect on humans is well documented in history.

As with other metals, the soluble compounds of lead are more poisonous than lead itself, except when lead is in the volatile state. Lead may obtain access to the body by inhalation, by ingestion or by absorption from the skin or mucous surface. The primary effect of lead is to cause spasm of the capillaries and arterioles. The toxic effects results from fixation of lead in certain tissues such as the brain and peripheral nervous system. LEAD Lead is one of the first metal known to man, the references of which are abundantly available in vedic literature also. It is the commonest metal involved in chronic poisoning.

It has been widely used during the last 2000 years for domestic, industrial and therapeutic purposes. It is distributed throughout the earth crust. It is abundant in soil and is poison in both metallic form and salts. Physical appearance: It is heavy, soft, and steel-grey. Salts are variously coloured. PREPARATIONS OF LEAD Lead Acetate-Pb(C2H3O2)2. 3 H2O Lead acetate is commonly called sugar of lead or salt of Saturn. It occurs in white masses of acicular crystals, slightly efflorescent and having a sweet, astringent taste. It dissolves in water, forming an acid solution.

It is also soluble in glycerine and alcohol (90%). It looks very much like loaf sugar. It was used to sweeten wine in old days. Lead Subacetate-Pb2O(C2H3O2)2 Lead Subacetate is the chief constituent of Gouldard’s extract(liquor plumbi subacetatis), which is colourless liquid with a sweet, astringent taste and alkaline reaction. The extract contains about 42. 5% of lead subacetate. Lead Carbonate-PbCO3 Lead carbonate is a white, crystalline powder, almost insoluble in water, but soluble in dilute acids. In the form of a basic carbonate or white lead (PbCO3)2PbH2O, it is extensively used as a pigment in oil painting.

It is also used as a ointment. Children who suck and bite painted toys white lead suffer from poisoning. Lead Nitrate-Pb(NO3)2 Lead nitrate is a crystalline, poisonous salt, soluble in water, and is used in calico printing. Lead Sulphate-PbSO4 Lead sulphate is a heavy, white powder, insoluble in water and is therefore supposed to be non-poisonous, but cases of poisoning have occurred from sucking yarn coloured white with this salt. Lead Chromate-PbCrO4 Lead chromate is a bright yellow, insoluble powder, known as chrome yellow is used as a pigment. Fatal cases of poisonous have occurred from the use of weet meats coloured with this salt. Joseph Uttar also reports 3 cases of chronic poisoning from the use of tobacco snuff adulterated with lead chromate as a colouring agent. Lead chloride-PbCl2 Lead chloride occurs as white, needle-shaped crystals, sparingly soluble in cold water, but more so in boiling water. When heated in contact with air, it is converted into an oxy chloride, which is employed as a white pigment, known as Pattison’s white lead. The yellow oxy chloride obtained by heating lead oxide and ammonium chloride is known as Cassel yellow which is used as a pigment. Lead Iodide-PbI2

Lead iodide is a tasteless, odourless, bright yellow powder, slightly soluble in cold water, but readily soluble in boiling water. Lead Sulphide (Galena)-PbS Lead sulphide is naturally found in the form of cubic crystals, but is sold in the bazaar in a powder form as surma in place of sulphide of antimony which is used as a collyrium for the eyes. Lead Monoxide (Litharge, Masicot, Mudrasang)-PbO Lead monoxide is a pale brick-red or pale orange scaly mass, very slightly soluble in water, but readily soluble in nitric and acetic acids. It is a constituent of Emplastrum plumpy (diachylon plaster).

Quacks use monoxide as a remedy for syphilis. It is also commonly used by painters and glaziers, and is a constituent of certain hair dyes. Lead Tetroxide (Red Lead, Minium, Sindur/Metia Sindur)-Pb3O4 Lead tetroxide is a scarlet, crystalline powder which varies in colour according to its mode of preparation and is employed as a pigment. It is insoluble in water but partially soluble in nitric acid. Lead Tetra-Ethyl-Pb(C2H5)4 Lead tetra-ethyl is a readily absorbing, highly toxic, liquid soluble, heavy, oily liquid, somewhat volatile at the ordinary temperature. It has a specific gravity of 1. 2 and has a peculiar sweetish odour. It is insoluble in ether and hot or cold water, but soluble in alcohol and acetone and miscible in all proportions with fats and oils. It breaks in sunlight with the formation of crystalline lead triethyl hydroxide which, in the presence of a halogen, forms lead triethyl. Lead tetra-ethyl is added to petrol to prevent ‘knocking’ and the mixture, known as ethyl petrol or ethyl gasoline, is used as a fuel for motor cars. It is absorbed either by inhalation or through the intact skin and acts as a dangerous poison to persons engaged in the manufacture of lead tetra-ethyl.

However, investigations in England and in the United State of America have shown that drivers of cars using this fuel are not likely to be affected, if the amount of lead tetra-ethyl does not exceed 1 part in 1300 parts by volume, or 650 parts by weight of petrol. Some absorption of lead may be noticed in the employees handling the fuel in garages and stations, but the effect is slight. However, the finding of more lead in the blood of traffic police officers or persons from large city results from absorption from motor exhaust is not quite clear.

Another source of poisoning is amongst those engaged is cleaning large empty petrol tanks used for storing ethyl petrol. LEAD POISONING Lead poisoning (also known as plumbism, colicapictonium, saturnism, Devon colic, or painter’s colic) is a medical condition caused by increased levels of the heavy metal lead in the body. Lead interferes with a variety of body processes and is toxic to many organs and tissues including the heart, bones, intestines, kidneys, reproductive and nervous systems.

It interferes with the development of the nervous system and is therefore particularly toxic to children, causing potentially permanent learning and behaviour disorders. Symptoms include abdominal pain, head ache, anaemia, irritability, and in severe cases seizers, coma, and death. Lead is toxic to everyone, but unborn babies and young children are at greatest risk for health problems from lead poisoning their smaller, growing bodies make them more susceptible to absorbing and retaining lead. SOURCES OF LEAD Lead used to be very common in gasoline and house paint in the U.

S children living in cities with older houses are more likely to have high levels of lead. Although gasoline and paint are no longer made with lead in them, lead is still a health problem. Lead is everywhere, including dirt, dust, new toys, and old house paint. Unfortunately you can’t see, taste or smell lead. Lead is found in: * House paint before 1978. Even if the paint is not peeling, it can be a problem. Lead paint is very dangerous when it is being stripped or sanded. These actions release fine lead dust into the air.

Infants and children living in pre-1960’s housing (when paint often contained lead) have the highest risk of lead poisoning. Small children often swallow paint chips or dust from lead-based paint. * Toys and furniture painted before 1976. * Painted toys and decorations made outside the U. S. * Lead bullets, fishing sinkers, curtain weights. * Plumbing, pipes and faucets. Lead can be found in drinking water in homes containing pipes that were connected with lead solder. Although new building codes require lead-free solder, lead is still found in some modern faucets. Soil contaminated by decades of car exhaust or years of house paint scrapings. Lead is more common in soil near highways and houses. * Hobbies involving soldering, stained glass, jewellery making, pottery glazing, and miniature lead figures. * Children’s paint sets and art supplies. * Pewter pitcher’s and dinnerware. * Storage batteries. Children get lead in their bodies when they put lead objects in their mouth, especially if they swallow the lead object. They can also get lead poison on their fingers from touching a dusty or peeling lead object, and then putting their fingers in their mouth or eating food afterward.

Children also can breathe in tiny amounts of lead. WHY IS LEAD HARMFUL? When the body is exposed to lead-by being inhaled, swallowed, or in a small number of cases, absorbed through the skin-it can act as poison. Exposure to high levels of levels of lead in a short period time is called acute toxicity. Exposure to high levels of lead in a short period of time is called chronic toxicity. Lead is particularly is particularly dangerous because once it gets into a person’s system, it is disturbed throughout the body just like helpful minerals such as iron, calcium and zinc.

And lead can cause harm wherever it lands the body. In the blood stream, for example, it can damage red blood cells and limit their ability to carry oxygen to the organs and tissues that need it, thus causing anaemia. Most lead ends up in the bone, where it causes even more problems. Lead can interfere with the production of blood cells and the absorption of calcium that bones need to grow healthy and strong. Calcium is essential for strong bones and teeth, muscle contraction, and nerve and blood vessel function. ABSORPTION, DISTRIBUTION AND ELIMINATION Lead is absorbed through the skin and all mucous surfaces.

Lead and its inorganic salts are absorbed through respiratory and gastrointestinal tracts, but oil soluble organic compounds are absorbed even through intact skin. After absorption it is distributed mainly in the skeleton and small quantities are present in the viscera and body fluids. Under conditions of abnormal exposure, the lead content of bones, the liver, blood and urine may be raised markedly. The metabolism of lead runs parallel to that of calcium. Conditions which favour the deposition of calcium in the bones also favour the deposition of lead.

Conversely, stored lead is mobilised and returned to circulation by conditions which remove calcium from the blood. A large portion of lead ingested daily in food passes unabsorbed in the faeces, and this masks that which is eliminated from the tissues. In normal persons, the faecal content of lead is 0. 4mg/day and urinary content is 0. 08mg/l. RISK FACTORS People most at risk of harmful effects from lead in their body include: * Babies and children under 6 years of age. Infants and young children are more likely to be exposed to lead than are older children.

They may chew paint chips, and their hands may be contaminated with lead dust. Young children also absorb lead more easily and sustain more harm from it than do adults and older children. * Children living in older homes. Although the use of lead-based paints has been banned since the 1970s, older homes and buildings often retain remnants of this paint. * Children living below the poverty level. Although any child can be exposed to lead, children from low-income families are disproportionately affected, often because they live in older or unrenovated housing. Non-white children tend to have higher rates of lead poisoning. People with lead amalgams in their teeth. Although lead is no longer used to fill cavities in children’s teeth, some adults may still have these fillings. * Pregnant women. Because lead can harm an unborn child, pregnant women or women likely to become pregnant are especially at risk. * Certain adults. Adults who breathe in lead dust while remodelling a home, making stained glass or refinishing furniture are also at risk. SIGNS AND SYMPTOMS Acute poisoning Acute poisoning from the ingestion or inhalation of lead is comparatively rare but it may complicate chronic poisoning.

The manifestations are a metallic taste with burning sensation in mouth, thirst is associated with pain in the abdomen, salivation, tongue is coated and there is offensive odour in the breath, the gums show a blue line which is due to the decomposition of the protein by the liberated hydrogen sulphide gas, constipation is a constant feature, though purging has occurred in some rare cases, when the stools are offensive and dark or black from the formation of lead sulphide, urine is scanty, great prostration occurs with cold, clammy kin and quick feeble pulse, intestinal colic, headache, formication and circulatory collapse. The nervous symptoms develop namely drowsiness, insomnia, headache, vertigo, muscular cramps, convulsions, numbness and occasionally paralysis of the lower limbs. This may be sometimes followed by acute haemolysis and oliguria. The liver and kidneys may be affected. Cerebellar ataxia is common in children in acute lead poisoning. Death may take place in 2-3 days. Most patients recover slowly or develop signs of chronic poisoning. Sub acute

Sub acute poisoning results from the inhalation or ingestion of small amounts of lead. The patient suffers from weight loss, anorexia, and salivation, metallic taste in the mouth, constipation and intestinal colic. Black line in the gums, muscle cramps, tremors, insomnia, muscular paralysis, ataxia, visual and auditory disturbances and hypertension may be seen. Nervous symptoms are prominent, such as numbness, vertigo, dragging pain in the loins, cramps and flaccid paralysis of the lower limbs. Vascular spasm may cause gangrene. Delirium, stupor and coma precede death. Chronic

This results from the continued absorption of lead through respiratory and gastro intestinal tracts and skin. Chronic poison can be seen among persons employed in factories and industries in which lead and its salts are used. Thus it occurs among paint sprayers or burners, compositors, plumbers, pewters, enamel workers, glass blowers, electric light workers, glaziers, lace workers, lead ore refiners, card players etc. it may also result from tinned food contaminated with lead, from drinking water or cider stored in leaden cisterns and from the constant use of hair dyes and cosmetics containing lead.

Chronic poisoning results from a daily intake of 1-2 mg of lead. SIGNS AND SYMPTOMS OF CHRONIC POISONING * Facial pallor: The facial pallor particularly about the mouth is one of the earliest and most consistent sign. It seems to be due to vasospasm. * Anaemia: There may be polycythaemia with polychromatophilia in early stages, but there is anaemia which is associated with polychromasia, punctuate basophilia, reticulocytosis, poikilocytosis, anisocytosis, nucleated red cells (sideroblasts) and an increase in mononuclear cells, whereas polymorphonuclear cells and platelets are decreased.

The anaemia is probably due to decreased survival time of red blood cells and inhibition of haeme synthesis by interference with the incorporation of iron into protoporphyrin. Punctuate basophilia or basophilic stippling means the presence of many dark blue coloured pinhead sized spots in the cytoplasm of red blood cells, due to toxic action of lead on porphyrin metabolism. Reticulocytes and basophilic stippled cells result from the inhibition of 5 pyrimidine nucleotidase, an impaired ability to rid the cell RNA degradation products and the aggregation of ribosome.

Eosinophilia is more common than basophilic stippling. Porphhyrins excreted in urine may be 500 micrograms per day. * Lead line: A stippled blue line, called Burtonian line, is seen on the gums in 50-70% of cases. It appears due to sub epithelial deposit of granules at the junction with teeth, only near dirty or carious teeth, within a week of exposure, especially on upper jaw. It is due to formation of lead sulphide by the action of hydrogen sulphide formed by decomposed food in the mouth. A similar blue line may be seen in case of poisoning by mercury, copper, bismuth, iron and silver. Colic and Constipation: It is usually later symptom. Colic of intestine, uterus, ureters and blood vessels occur in 85% of cases. The colic occurs at night and the pain may be very severe. Individual attacks last only a few minutes, but may recur for several days or weeks. Constipation is usual but diarrhoea or vomiting may occur. * Lead Palsy: It usually occurs late and is seen in less than 10% of cases. There may be tremors, numbness, hyperaesthesia and cramps before the actual muscle weakness. It is commoner in adults than in children, and men are particularly affected.

The muscle groups affected are those most prone to fatigue. Usually the extensor muscles of the wrist (wrist drop; radial nerve is affected) are affected, but the deltoid, biceps, anterior tibial (foot drop), and rarely muscles of the eye or intrinsic muscles of hand or foot are affected. The paralysis is associated with degeneration of the nerve and atrophy of the muscles. Recovery may be complete but is usually slow. * Encephalopathy: Lead encephalopathy, in some form is said to be present in almost every case of plumbism. It is common in children often associated with tetraethyl lead.

The symptoms are vomiting, headache, insomnia, visual disturbances, irritability, restlessness, delirium, hallucinations, convulsions, coma and death. Lead encephalopathy is usually irreversible and about 85% have permanent brain damage. Death occurs in about 25 cases. * Cardio vascular systems and Kidneys: Lead causes vascular constriction, leading to hypertension and permanent arteriolar degeneration. Chronic arteriosclerotic nephritis and interstitial nephritis occur. * Reproductive System: Menstrual derangements such as amenorrhoea, menorrhagia, and sterility of both sexes and abortion are frequent.

Abortion occurs in pregnant women between 3-6 months. * Other systems: They are dyspepsia, anorexia, emaciation, exhaustion, irritability, foul breath, headache, vertigo, loss of hair and drowsiness. Peripheral neuritis is rare. Retinal stippling is noticed by ophthalmoscopic examination showing presence of greyish glistening lead particles in the early phase of poisoning. Wrist-drop in adult with lead poisoning and renal failure FATAL DOSE * Lead acetate- 20 mg * Lead carbonate- 40 mg * Adverse effect on haemopoetic system-10 mg/100 ml. * Neuro behavioural disorders-25 mg/100ml * Tetra ethyl lead-1 or 2 drop FATAL PERIOD In acute poisoning death may occur on 2nd or 3rd day. Acute poisoning is rare and may be followed by chronic poisoning. COMPLICATIONS Exposure to even low levels of lead — 10 micrograms (a microgram is one-millionth of a gram) in a decilitre (1/2 cup) of blood — can cause damage over time, especially in children. The greatest risk is to brain development, where irreversible damage may occur. Higher levels — 25 micrograms per decilitre of blood — can damage the kidneys and nervous system in both children and adults. Very high lead levels may cause seizures, unconsciousness and possibly death.

Complications in children Health problems in children caused by elevated blood lead levels may include: * Anaemia * Decreased muscle and bone growth * Hearing damage * Learning disabilities * Nervous system and kidney damage * Poor muscle coordination * Speech, language and behaviour problems Complications in adults High levels of lead in adults may lead to: * Anaemia * Cataracts * Damage to reproductive organs in men * Digestive problems * High blood pressure * Memory and concentration problems * Muscle and joint pain * Nerve disorders * Pregnancy complications, including miscarriage, preterm delivery and stillbirth

TESTS AND DIAGONOSIS Doctors usually use a simple blood test to detect lead poisoning. A small blood sample is taken from a finger prick or from a vein. Lead levels in the blood are measured in micrograms per decilitre (mcg/dL). An unsafe level is 10 mcg/dL or higher. 1. Haematologic A) Hb estamination (for anaemia) B) Punctate basophilic RBC (more than 200 such cells/cu mm) C) Erythrocyte protoporphyrin (EP) level will be much above normal. D) Blood lead level (more than 25 µg/100 ml) 2. Urine A) Increased level of ALA (amino levulinic acid) B) Lead level (more than 0. 25 mg/litre) 3.

Radiologic A) Opacities in the GI tract. B) Increase in the metaphyseal density of bones. TREATMENT AND DRUGS The Graef Protocol (modified version) A) Severe acute poisoning with encephalopathy: This is a medical emergency and the following measures must be undertaken immediately- * BAL 4mg/kg immediately (in children) * Cranial CT scan: to rule out cerebral oedema. * KUB: to rule out lead chips in GI tract. * For seizers: administer diazepam or phenobarbitone. * Foley catheterization: to monitor urinary specific gravity, sediment, lead level. * CaNa2EDTA 75 mg/kg/day IV infusion. After the initial dose of BAL, repeat the same dose at 4 hourly intervals until blood lead level falls below 40µg/100 ml. Then reduce BAL to 12mg/kg/day in 3 divided doses. * Reduce CaNa2 EDTA to 50 mg/kg/day as condition improves. * Continue the above regimen until the patient is asymptomatic and can tolerate oral chelation with D-penicillamine or DMSA (dimercaptosuccinic acid) B) Severe poisoning without encephalopathy (BL more than 70µg/100ml) * BAL 12mg/kg/day. * EDTA 50 mg/kg/day. * Discontinue BAL when the BL falls below 40µg/100ml, but continue EDTA for 5 more days. Change the oral chelation subsequently which may have to be continued until the BL falls below 15µg/100 ml, or 3 months have been completed. C) Moderate poisoning (BL between 45 and 70µg/100 ml) * EDTA 50 mg/kg/day. * When blood lead falls below 40µg/100 ml, begin oral chelation. D) Mild poisoning (BL 20 to 35µg/100 ml): D-Penicilline 30mg/kg/day in 3 divided doses. Start with 1/4th of the calculated dose. Double this after 1 week. Double again (to full dose) after 1 week. Continue this until the BL falls to less than 15µg/100 ml, or 3 months have been completed.

In addition to the (modified) Graef protocol, the following supportive measures must be instituted as applicable- * Thiamine 10 to 50 mg/kg is said to improve neurological manifestations of lead poisoning. In acute poisoning, or in the event of radiopacities in the GI tract on X-ray, stomach wash can be done. * Lead colic usually responds to IV calcium gluconate. * Correct iron deficiency if present. DMSA for lead removal in both adults and children POSTMORTEM APPEARANCE A blue line along the margin of the gums can be seen. The paralysed muscles are flaccid and show fatty degeneration. The intestines are contracted and thickened.

The liver and kidneys are found hard and contracted. Evidence of tubular necrosis with some intra-nuclear acidophilic inclusion body may be seen. Inclusion bodies may be seen in liver also. The heart may be hypertrophied and there may be atheroma of the aorta and aortic valves. Cerebral oedema, punctuate haemorrhages and proliferative meningitis are present. Bone marrow shows hyperplasia of leucoblasts and erythroblasts with a decrease in fat cells. Segmental demyelination of peripheral nerves may be seen. Eosinophilic intranuclear inclusions may be seen in hepatocytes and cells of the proximal tubules of the kidney.

MEDICO LEGAL IMPORTANCE * Lead in the metallic form is not poisonous, but it is probably acted upon by the secretion of the intestine and may act as a poison after it is absorbed into the system as a salt. * Compounds of lead are poisonous, if they are in a condition fit for absorption, either by the skin, intestines or lungs. * Acute lead poisoning is rare and usually terminates in recovery. Hence it has very less toxicological importance, but chronic poison is more common and is very interesting from a hygienic point of view, as it is regarded as an industrial disease. * Homicidal poison by lead salts is a rare occurrence. Lead is criminally used as an abortificant. It acts by producing tonic contractions of the uterus and causing degeneration of embryonic cell and the chorional epithelium. * Red lead is occasionally used as a cattle poison either alone or mixed with arsenic. * Chronic lead poison is usually accidental. It may occur in children from eating paint on cribs, beds or toys. * Sometimes lead poisoning may occur from lead missiles embedded in the tissues due to gunshot injury. PROPHYLAXIS To prevent chronic lead poisoning in factory workers, the following measures should be taken. Maintenance of proper ventilation in factories. * Maintenance of personal hygiene of the workers and periodical medical examination. * A diet rich in calcium. * Small amount of sulphuric acid in water. * Weekly saline purgative. Home care * Keep your home as dust-free as possible. * Have everyone wash their hands before eating. * Throw out old painted toys if you do not know whether the paint contains lead. * Let tap water run for a minute before drinking or cooking with it. * If your water has tested high in lead, consider installing an effective filtering device or switched to bottled water for drinking and cooking. Avoid canned goods from foreign countries the ban on lead soldered cans goes into effect. * If imported wine containers have a lead foil wrapper, wipe the rim and neck of the bottle with a towel moistened with lemon juice, vinegar or wine before using. * Don’t store wine, spirits or vinegar based salad dressings in lead crystal decanters for long time, because lead can get into the liquid. The health based guideline for lead in drinking water is 0. 1 milligrams per litre (WHO 1993) levels are detected in a supply, alternative supplies or bottled water may be necessary to pro children.

AYURVEDIC VIEW NAGA (LEAD) Synonyms: Nagam, sisam, sisa, nagaka, ashivisha, kuvaduka, kuranga, bhujanga, kuvangam, sindura, karanam, sisaka, vabhra, yogesta, sindurakarana. Names: Hindi – sisa Tamil – kariyam Malayalam – kariyam Kannada – naga Telugu – nagamu, sisam English – lead Latin – plumbum Symbol – Pb Occurrence Nearly all lead ores are produced from mines. Many minerals contain lead, but the principal source of the element is Galena (PbS), a grey metallic ore. In its pure form, galena consists of only lead and sulphur. However, it rarely occurs in such a form in nature.

Instead, most deposits of galena contain some copper, gold, silver and zinc. The other ores of lead include Anglesite (PbSO4) and Cerussite (PbCO3). The occurrence of lead is widespread. It is found in Soviet Union, Australia, America, Canada, Mexico and Peru. In India the lead mines are at Madras, Uttar Pradesh and Rajasthan. Best Naga That sisa dhatu (lead) which melts quickly, which is heavy, the broken surface of which is black and bright, which emits foul smell and the outer surface of which is black, is said to be excellent. The one which has opposite qualities is not useful. Properties of Naga Sisa dhatu is extremely ushna in nature, snigdha and has tikta rasa. It alleviates vata and kapha doshas and eradicates the prameha as well as the diseases evolving from the consumptions of contaminated water. It improves the digestive power and destroys the amavata. 2 Varieties Ayurvedic texts have mentioned two varieties of lead as Kumara and Sabala or Shamala. 3 No description about their individual properties or differences is available. It is not mentioned which variety is superior or inferior and hence, both of them are used. Shodhana

Sisa is melted in an earthen vessel and powder of jata of nirgundi and seeds of renuka (harenu) are added and ground. This mixture then is immersed in the juice of leaves nirgundi. This process is repeated for three times to purify the naga. By administering its bhasma , it can prevent murcha, sphota etc. 4 Marana First of all the purified lead is melted over fire in an iron vessel. To it, 1/4th quantity of each, the ash of the bark and skin of the aswattha (Ficus religiosa) and amlika(Tamarindus indica) is added repeatedly in small amount and the mixture is stirred well with an iron rod.

When the whole lead turns into a solid, powder form, it is transferred into a mortar. Equal quantity of pure realgar is added to it and the mixture is processed with jambira juice or a sour gruel and subjected to heating, by giving a laghu puta. On cooling on its own, the mixture from the sealed saucers is taken out and 1/20th of its part pure realgar is added into it,processed with jambira ( Citrus limonum) and subjected to laghu puta. This procedure is repeated till 60 laghu putas are given. The incineration of lead thus formed is de-relived (nirudha) one. It is also mentioned in the text that when the lead melted in an iron vessel is stirred with the root of palasha (Butea frondosa) for 12 hours, the red colour powder formed, is itself the lead calx. In practice, it is further processed with the decoction of the sticks of palasha and the juice of kumari (Aloe vera) to de-revive it. Evil effect of lead not properly purified and incinerated Lead not incinerated in proper way gives rise to skin diseases, gulma, loss of appetite, urinary flux, excess of phlegm, fever, stone disease, colic and fistula, arthritis, oedema, rigidity of shoulder joint. Remedy One is freed from evil effects of lead not properly incinerated, if one takes incinerated gold with haritaki (? of total in weight) and sugar for 3 days. Swarna bhasma-30 mg With sugar for 3 days Hareetaki churna-1gm Tests Routine tests are performed to assess the quality of naga bhasma. It is also tested for its de-revival (niruthathva). For that naga bhasma is heated in an iron vessel. If it forms into a lead pill, the bhasma is not of good quality and vice-versa. Naga bhasma is yellowish-scarlet in colour. Uses Naga bhasma is used to treat various diseases.

It is a highly esteemed remedy for urinary disorders like dysuria, oliguria and diabetes mellitus. It also works well on genital system and skin diseases associated with oozing and itching. It is used in treating colitis, leucorrhoea, vata diseases, tumours, anaemia, sexual debility and diabetes, especially associated with obesity. Dosage 30 -120 mg. with proper anupana as per disease. Naga rasayana- 375mg Formulations * Vasantakusumakar * Trivanga bhasma * Nagasindura * Chandreswara rasa * Dipika rasa * Nagendra rasa * Lakshmivilas * Ekangavira rasa Mahavatavidhwansa CONCLUSION Lead (Latin plumbum) is an element that has long been known, having been mentioned in the Book of Exodus. Alchemists believed that lead was the oldest metal, and they associated it with the planet Saturn. Native lead occurs in nature, but it is rare. Lead is a bluish-white metal of bright lustre. It is soft, highly malleable, and ductile; it is a poor conductor of electricity. Lead resists corrosion; in fact, lead pipes bearing the insignia of Roman emperors that were used as drains from the baths are still in service.

In addition, lead is used in containers for corrosive liquids (such as sulphuric acid); it may be toughened by the addition of a small percentage of antimony or other metals. Lead environmental pollution is a major health hazard throughout the world. Several mechanisms of lead poisoning have been identified. The most common are pica, industrial exposure, drinking moonshine liquor, inhalation, gunshot wounds, retained lead pellets or particles, and a variety of folk remedies and cosmetics. REFERENCE BIBLIOGRAPHY 1. The essentials of Forensic medicine and Toxicology. Dr. K. S. Narayan Reddy 25th edition-2006 . Forensic Medicine Orient Longman publication 2nd edition P. V. Guharaj, M. R. Chandran 3. Parikhs textbook of Medical Jurisprudence,Forensic medicine and Toxicology-for classrooms and court rooms 6th edition CBS publishers and distributers 4. Toxicology-Ayurvedic perspective Department of Agada tantra Vaidyaratnam P. S. Warrier Ayurveda college, Kottakkal 5. Modern Medical Toxicology W. Pillay. Forewards :Prem Nair, B. M. Hegde Jaypee publication-3rd edition 6. Hand book of Forensic medicine and Toxicology(Medical Jurisprudence) P. V. Chadha Jaypee Brothers Publication-5th edition . Modi’s Medical Jurisprudence and Toxicology 22nd edition, student edition Edited by- B. V. Subbrahmnyan Lexis Nexis, Butterworths publication. 8. A short textbook of Forensic medicine and Toxicology. A. Ramachandran, M. R. Chandran Published by-Rajender. K. Arya All India publishers and distributors Regd. 1st edition-1997 9. Illustrated Agada Tantra Banarus Ayurveda series-56 P. V. N. R. Prasad MD. Ay Chowkhamba Sanskrit series office, Varanasi 1st edition,2009 10. Agada Tantra, Ayurvedeeya visha vijnana Dr. Ayodhya Prasad Achal Chowkamba surabharati publication, Varanasi 11.

Toxicology, Ayurvedic perspective Department of Agadatantra Vaidyaratnam. P. S. Varrier, Ayurveda college kottkal 1st edition January-2000 12. Vishavijnana ,Agadatantra Kaviraj Yugalakishor Gupta, Dr. Ramanath Dwivedi Chowkamba Amarbharati publication, Varanasi 13. Rasa jala nidhi-3 OR Ocean of Indian Chemistry and Alchemy Kaviraj Bhudeb Mookerji Parimal publication 14. Modern medical Toxicology V. V. Pillay Jaypee brothers publication, New Delhi 15. Principles of Forensic Medicine Apurba nandy. M. D. New Central Book Agency(p) ltd. Publishers 2nd edition, reprinted 2003 16. www. google. com


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