Abstract
In investigations undertaken by one of us (S.S.K.) it was found that sodium citrate in dilute solution exerts a powerful solvent effect on tertiary lead phosphate, 1 that citrate removes lead ion from solution by the formation of a soluble complex of extremely low dissociation, 2 and that the administration of sodium citrate to lead poisoned rats produced a significant increase in the excretion of lead. 1 The junior author (T.V.L.) independently observed that in a case of plumbism receiving potassium citrate incidental to a chloride excretion test there was a sharp drop in the blood lead level and a rise in the urinary output of lead. (Chart I, No. 7.) These observations led to the present study of the effects of the administration of sodium citrate in plumbism.
Six cases of lead poisoning seen at the Philadelphia General Hospital since August, 1940, provided the basis of this study.∗ All presented clinical evidence of mild to severe lead intoxication and all had abnormally high lead concentrations in whole blood on admission. Each adult received from 2 to 4 g of sodium citrate and the children from 1 to 2 g by mouth 3 times daily. Blood lead concentrations and, in 3 cases, urinary lead excretions were determined before and at intervals during the course of treatment by the method of Letonoff and Reinhold 3 slightly modified. 4
The results are presented in Chart I. There was a rapid disapearance of toxic symptoms without untoward reactions in every instance and the blood lead concentration fell to normal or nearly normal levels, (normal range as determined by this method is from 0 to 0.05 mg lead per 100 g of whole blood). Urinary excretion studies gave variable results with a trend toward increased urinary excretion of lead during treatment.
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