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Moeschlin S. The clinical picture and therapy of lead poisoning. Zeitschrift fur Unfallmedizin Berufskrankheiten 51. 1958; 2:129-149. (1936) [This is a long paper in which the author gives an account, with many references, of Pb poisoning as it occurs and is treated at the present time. Although Pb poisoning has become much less common, typical cases of it still occur but many of these remain undiagnosed. The account deals with the ways in which Pb is absorbed into the body and the sources of the poison in industry with mention of TEL in engine exhausts. The mode of action of Pb particularly on the blood and nervous system, and the amounts of Pb found in the blood serum and the urine, are described. Clinical symptoms and signs are considered at length with an account of methods used for the analysis of the urine for porphyrins and of the blood for cellular changes. There is a discussion of the significance of the findings of these examinations. Specific and symptomatic therapy in cases of Pb poisoning is described at some length, with particular reference to the value of Na citrate in some circumstances and of CaNa2EDTA. Particular attention is given to the latter, which though very powerful in bringing about rapid excretion of Pb may have adverse effects. These have been recorded by other workers, and have been experienced in the author's practice. It is recommended that EDTA should be used in doses lower than those that have often been employed. The recommended treatment for adults is: not >20 mg of EDTA/kg of body weight given by drip infusion or not >2.0 g orally daily for 3 days, then 3 days' pause. This sequence may then be repeated 5-10 times according to the clinical picture. This treatment must be carefully controlled by urine examinations and stopped at once if marked albuminuria is found.
The author comments that although the industrial worker is so well shielded from exposure to Pb, it is a tragedy that in Switzerland ~300,000 kg of Pb derived from TEL in gasoline are annually exhausted into the atmosphere. In the course of time this Pb may exert its toxic action on the general population.

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