Marcus Vitruvius Pollio (c. 80 BCE – c. 15 BCE) wrote:
> 10. Clay pipes for conducting water have the following advantages. In the first place, in construction:--if anything happens to them, anybody can repair the damage. Secondly, water from clay pipes is much more wholesome than that which is conducted through lead pipes, because lead is found to be harmful for the reason that white lead is derived from it, and this is said to be hurtful to the human system. Hence, if what is produced from it is harmful, no doubt the thing itself is not wholesome.
> 11. This we can exemplify from plumbers, since in them the natural colour of the body is replaced by a deep pallor. For when lead is smelted in casting, the fumes from it settle upon their members, and day after day burn out and take away all the virtues of the blood from their limbs. Hence, water ought by no means to be conducted in lead pipes, if we want to have it wholesome. That the taste is better when it comes from clay pipes may be proved by everyday life, for though our tables are loaded with silver vessels, yet everybody uses earthenware for the sake of purity of taste.
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Pliny speaks of the "noxious and deadly vapour" (sulfur dioxide) of the lead furnace (XXXIV.l.167; there was, in fact, a four-fold increase in atmospheric Pb pollution during the Greco-Roman period); red lead (minium) (XXXIII.xli.124) and white lead (ceruse) (XXXIV.liv.176) as poisonous, even though both were used as a medicine and cosmetic; and the power of sapa (and onion) to induce an abortion (XXIII.xxx.62). Dioscorides cautions against taking white lead internally, as it is deadly (V.103). Soranus recommends that the mouth of the uterus be smeared with white lead to prevent conception (Gynecology, I.19.61). Galen (On Antidotes, XIV.144) and Celsus (V.27.12b) both provide an antidote for poisoning by white lead, and Vitruvius remarks on the pernicious effects of water found near lead mines and its effect on the body (VIII.3.5, 6.11).
The earliest description of acute lead poisoning (mid-second century BC) is given in the Alexipharmaca of Nicander, who speaks of "gleaming, deadly white lead whose fresh colour is like milk which foams all over" (II.74ff). The poet describes a frothing mouth, asperity of the tongue, and dry throat, together with dry retching, chills, delusions, and overwhelming fatigue. But if lead poisoning had been endemic, it presumably would have been remarked upon at the time. And yet there is no mention of the fact until early in the seventh century AD, when Paul of Aegina, a Byzantine physician, described chronic lead poisoning (although he does not associate its symptoms with the disease). "I am of the opinion that the colic affection which now prevails is occasioned by such humours; the disease having taken its rise in the country of Italy, but raging also in many other regions of the Roman empire, like a pestilential contagion, which in many cases terminates in epilepsy, but in others in paralysis of the extremities, while the sensibility of them is preserved, and sometimes both these afflictions attacking together" (Medical Compendium in Seven Books, III.64).