Seems chealation was safe then but not now

[Guest guest]

Don Cheek, father of 2 daughters, was born in South Australia. By the timehe was 25 he had received 10,000 letters from grateful mothers around the world.The reason was the medical breakthrough he made with Pink Disease.The disease was affecting young children and the cause was traced to themercury compounds then being used in teething powders and ointments prescribedfor children. The clue to the breakthrough was young patients complaining ofconstant thirst. He was to go on to spend another 10 years proving his thesis thatthe adrenal gland was vitally involved in Pink Disease.He was Professor of Pediatrics at s Hopkins Uni Hospital, Baltimoreand had won the Borden Award of the American Academy of Pediatrics.GO to NEXT PAGEpcheek41http://www.users.bigpond.com/difarnsworth/pcheek41.htm (2 of 3) [05/28/2000 1:44:08 AM](In fact, only 1

in 500 children exposed to the teething powders developedthe disease). In 1950 authoritative British medical opinion was still cautiousabout the mercury hypothesis-an understandable caution, yet responsible, asit turned out, for the prolongation of the epidemic, with uncountable cost inhuman and financial terms, for several years later.But slowly the evidence was stacking up against mercury. Dimercaprol(British anti-ite; BAL) is a chelating agent developed for military useagainst possible gas attacks and in the 1950s was the standard treatment forindustrial mercury poisoning. Several physicians gave their pink diseasepatients dimercaprol with gratifying cures. (The drug was never tested in aproper controlled clinical trial as the disease disappeared before such a trialcould be organized.)Warkany and Hubbard’s reports of an association between mercuryexposure and the

disease was confirmed by several other workers, thoughthese later reports also noted that urinary mercury levels were often high inhealthy children too. In the rare cases of industrial mercury poisoning thatoccurred, astute clinicians noted that in the recovery phase after the acuteillness, a condition indistinguishable from pink disease could be seen for a fewweeks. Clearly, if mercury was responsible for the disease, it could not besimple poisoning, or all exposed children would suffer in a dose relatedmanner; the children who became ill must be excessively sensitive to thepoison (idiosyncrasy).And there the matter rested at impasse between the mercury hypothesisand the manufacturers of mercurials. In the absence of decisive evidence,Parliament declined repeated calls to ban the products (although several statesin USA and Australia did so), and the disease remained a chronic

and fearfulcurse.The impasse was finally broken in 1953 by Dr J G Dathan ofStokes-on-Trent. Upset and incensed by the miserable deaths of 2 of his youngpatients and refusing to certify the deaths as due to natural causes, he referredthe cases to the coroner. The scientific cases for and against the mercuryhypothesis were arrayed against each other in an English court of law-surelyan unusual setting for a scientific debate.The jury found that the deaths were caused by mercury poisoning fromSteedman’s teething powder-in one case by frank overdose and in the otherbecause of unusual sensitivity of the child-and fearing litigation orParliamentary action the manufacturers immediately removed the mercuryfrom their preparations and recalled all old stocks.The other manufacturers gradually followed suit. 3 years later, inSheffield, the intake of mercurials and the incidence of pink disease had bothdropped sharply and by

1966 Warkany, the originator of the mercuryhypothesis was able to write a final ‘post mortem’ article on pink disease inthe “American Journal of Diseases of Children”-a rare, but deserved accoladefor a dedicated (and lucky) medical scientist.The story illustrates the difficulty of achieving change when doctors are confronted by powerful commercial interests, and finds an echo in the 1980sin the continuing sagas of tobacco and lead. This is specially so when thecompanies can muster 1 or 2 experts who will say that “the evidence is not yetdecisive”.In truth it is still not proven beyond doubt that mercury caused pinkdisease and it is still possible that an epidemic virus, now fortunately passed,caused it. Of course, that explanation is very implausible and now that thedisease is departed no one is sufficiently interested to do more experiments. Itis also true that had the world had

waited for 100% proof of cause and effect,our children would probably still be ravaged by this dreadful, but preventabledisease.It would be dishonest to close the pink disease story without one lastremark, though as scientists we are embarrassed to have to make it. Warkanyand Hubbard’s original 1948 study on urinary mercury were drawn fromWarkany’s own practice in Cincinnati where the disease was rare and whereteething powders were rarely used. Had the control urines been taken fromthe geographical areas where patients came from, mercury would have beenfound in several apparently normal, healthy children, thus making theassociation far less striking. If Warkany and Hubbard had done ascientifically impeccable trial, the cause might never have been noticed.