Pharmacosis: The day the music died

June, 25, 2012 | 11 Comments


  1. Could we be seeing a combination of genetic predisposition combined with viral infection or environmental toxins? I did some research a few years ago on spinocerebellar atrophy mainly in the Nebraska kindred. This family is identified in the literature and can trace its roots to one Dutch ancestor. The family still exists in the Netherlands but although the American branch has developed an autosomal dominant disease, with the aberrant gene now identified, not one member of the family still in Holland has ever been affected. If we also consider the ALS-Parkinson-Dementia of Guam, it was decided that the disease could be traced to a food that was toxic if not thoroughly washed. In one year, in Toronto, I had four patients, all presenting clinically differently, who came to autopsy as part of a large research study and were found to have ALS-PD-Dementia. The transport of syphilis from the Americas to Europe might be of the same nature e;g; a food stored for the return journey, an environmental toxin to which the indigenous peoples had developed an immunity etc. HIV appeared just as suddenly for reasons that remain obscure for all the billions that have been spent on investigation. Perhaps some previously unencountered fauna of the “New World” played a part. in the development of syphilis. We know that many of our common environmental toxins cause damage to the DNA but perhaps were not so common in the days of Beethoven, Mozart et al. Treating a disease with such obvious poisons as mercury and then arsenic can hardly fail to strike one as supremely harmful but, as we know, all medications are tiny doses of poison – consume enough and they’ll all kill you.

  2. Thanks so much for writing about this. Regarding the higher number of males than females with GPI, I have read that mercury tends to affect males worse than females.
    “Mercury studies in mice and humans consistently report greater effects on males than females, except for kidney damage (57). At high doses, both sexes are affected equally; at low doses only males are affected (38,40,127).”
    p. 467 at

    “Testosterone and estrogen-like compounds give vastly different results. Using female hormones we found them not toxic to the neurons alone and to be consistently protective against thimerosal toxicity. In fact, at high levels they could afford total protection for 24 hours against neuronal death in this test system (data not plotted). However, testosterone which appeared protective at very low levels (0.01 to 0.1 micromolar), dramatically increased neuron death at higher levels (0.5 to 1.0 micro- molar). In fact, 1.0 micromolar levels of testosterone that by itself did not significantly increase neuron death (red flattened oval), within 3 hours when added with 50 nanomolar thimerosal (solid circles) caused 100% neuron death. Fifty nanomolar thimerosal at this time point did not significantly cause any cell death.”

    Mark Blaxill and Dan Olmsted recently wrote an excellent book about the history of mercury in medicine: “The Age of Autism: Mercury, Medicine, and a Man-Made Epidemic”.

  3. Is there anything in official medical histories about the use of mercury to TREAT depression and other mental ailments? It looks like this may have happened in the case of Abraham Lincoln – with ghastly results. This blog post inspired me to do some checking up on our 16th president, probably the most famous allegedly-bipolar Great American. It’s well-known that he suffered from spells of depression, which could be profound at times, all his adult life. This article by medical historian Norbert Hirschhorn et al. claims that Lincoln took a mercury preparation called “Blue Mass” to treat his condition:

    Apparently doctors of the time labeled his condition “hypochondriasis” – a combination of depression, anxiety and loosely defined digestive complaints. Following the ancient Greeks, it was often attributed to black bile, and Benjamin Rush among others recommended mercury as a treatment. Lincoln himself referred to his bouts of melancholy as hypochondriasis or “the hypo.” There is fairly good evidence that at some point in the 1850’s he started taking “Blue Mass” pills. Among the effects were tremors, memory lapses, outbursts of uncontrollable rage and what some observers swore was worsening melancholy. Shortly after his inauguration in 1861 he told a friend he’d stopped taking the pills because they “made him cross.” For the rest of his life, through the storm and stress of the Civil War, he was known for his almost superhuman steadiness of character, and no more episodes of rage were reported.

    If it’s true, then ours is not the first era in which depression sufferers were given treatments with side effects that seemed to mimic the worst features of the illness – and were probably mistaken for a worsening of the illness itself. And apparently it took a brilliant man, with access to the best doctors in America, years to figure out what was happening.

  4. Winston Churchill fought all his life from his “black dog”.
    “I don’t like standing near the edge of a platform when an express train is passing through”, he wrote.” I like to stand right back and if possible get a pillar between me and the train. I don’t like to stand by the side of a ship and look down into the water. A second’s action would end everything. A few drops of desperation.”
    In 1911 a friend of Churchill’s claimed to have been cured of depression by a doctor but no details survive or none that I have been able to find.
    Churchill’s doctor, Lord Moran, wrote a memoir about his patient, emphasizing the black dog with plenty of symptoms but no treatment which was probably very fortunate for the eventual fate of Great Britain and the outcome of WWII.
    Interestingly, with respect to a previous post on GPI, his father, Lord Randolph Churchill died at age 45 supposedly of syphilis although there remains controversy about the accuracy of the diagnosis.

  5. Apparently Abe Lincoln’s “treatment” with mercury pills for melancholy was not an exception. Calomel and other mercury concoctions were an accepted treatment for mental illness, according to this 1865 medical text, “A Manual Of Practical Therapeutics”, by Edward John Waring:

    1392. In Insanity, the administration of mercurials is occasionally productive of benefit, but much discrimination is required in their use. Dr. Copland’s* observations on this point are well worthy of attention. Mercurials, he remarks, are employed for mental disorders, with three intentions, – 1st, to evacuate biliary and fAecal accumulations; 2nd, to improve the secretions, particularly that of the liver; and 3rd, to produce a copious flow of saliva. To fulfil the first of these intentions, Calomel is particularly useful, especially in melancholia and in mania; but should be conjoined with or followed by other purgatives. To produce the second effect, any of the mercurial preparations may be employed, either alone, or with Tartar Emetic, Digitalis, Camphor, &c. To accomplish the third end, Calomel, or Corrosive Sublimate, or Blue Pill, may be given, either combined as above, or alone.

    The employment of mercurials to an extent likely to produce salivation is of very doubtful propriety, although recommended by some writers. Dr. Prichard remarks, that it is by no means a general remedy for maniacal diseases; but in cases of torpor, with suppression, or a very scanty state of any of the secretions, it is frequently advantageous ” Several instances of cure effected by salivation,” continues Dr. Copland, “have been recorded by authors; still I believe,” he adds, ” that Mercury exhibited to the extent necessary to produce the effect, and especially when it fails of causing it, is quite as likely to be as injurious as beneficial – to cause partial insanity, melancholia, and mania, particularly in weak, susceptible, and irritable constitutions. Unfortunately, we know nothing of the symptoms of insanity which indicate probable advantage from mercurial salivation. The most likely conditions are mania or melancholia consequent upon apoplexy, or complicated with hepatic disease. Mercurials, and particularly salivation, are most likely to prove injurious in every form of insanity which has been occasioned by depressing moral, or by exhausting physical causes, and especially by prolonged anxiety or by masturbation. Corrosive Sublimate, however, in minute doses, as an alterative in conjunction with tonics, is sometimes of service in several forms of mental disorder, and particularly in scrofulous constitutions.”

    This book, by a British Army doctor, at least recognizes the risk that high doses of mercury could themselves cause “partial insanity, melancholy and mania.” In that sense at least, he’s ahead of most contemporary psychiatrists, who tend to double the dose when their pills cause symptoms. If Lincoln were alive today he might be told he had rapid-cycling bipolar disorder and the Blue Pills had merely “unmasked” it!

  6. It’s amazing the number of “studies” diagnosing artists from other centuries.
    Van Gogh has already received all the diagnostics.
    I once watched a documentary about a kind of epilepsy that makes some lights…
    I don’t remember but… Van Gogh was on the list and, of course, if affected his
    Someone gave me a book of a French therapist who not only explained his disease but also found in his paintings the “prove”: a certain pattern on the wall clearly is a sign of his loneliness.
    I didn’t read the entire book.
    Few people can see his work detached from his mental illness. His biography is known by everybody.
    This is sad.

  7. I have some comment to make about Paresis differential diagnosis.
    I’m a french jurist (i hope you will forgive my terrible english !) and developpe obstinate interest for study of syphilis and other STS, and more specifically neurologic manifestations of the disease. I wish to tell you a few words about the encephalitis called dementia paralytica or general paralysis.

    Differenciation between disorders like Dementia praecox and circular insanity with Paresis is a difficult task but some clues can help :

    1. Paresis is a insidious disease, it begin quite rarely in a abrupt manner, patient show signs of incipiens dementia some time before maniac or depressive onset appears.
    2. Paresis is excessively rare before 25 years and rare before 30.
    3. Paretic rarely show premorbid personality of circular or schizophrenic or their familiar story.
    4. Time between first mental manifestations and diagnosis rarely excede 3 years.
    5. Time between first manifestations and death is, on average, 27 months, survival over 5 or 6 years is quite unusual.
    6. Survival 3 years after dementia become incapaciting (or after admission in asylum) is unusual, survival more than 5 years after is quite rare (diagnosis become doubtfull, even if autopsy proved cases duration of 20 years or more exist). Perhaps 1 per cent of paretic live more than 7 or 8 years, in a study of 346 cases maximal duration was 111 months.
    7. In upper class most males can give a story of syphilis, and the remain have usually a story of probable syphilis or penile chancre. The more intelligent patient give a story suggesting syphilis in 90/100 cases.
    8. Paresis clinical diagnosis is made no on mental manifestations alone but on neurologicals sign, slurred speech is the main symptom. Tremor, ataxia et gait disturbance come in second. Of all ocular signs only complete loss of light reflex is really ominous, miosis have some specificity.
    9. Global and rapidly progressive dementia is the main feature of paresis, depressive disorder, megalomaniac outburst are less importants. As dementia increase others psychiatric manifestation usually die out. Memory and judgment disturbances are ominous, loss of insight appears usually quite early, in advanced cases dementia is complete, the clinical presentation is somewhat similar to frontotemporal dementia but memory loss is more marked.
    10. Clinical accuracy of diagnosis is 85 to 95 per cent on average. Some experts reach nearly 100 per cent. Diagnosis of paresis is made frequently on historical figures in an abusive manner, Nietzsche is the most famoux example.
    I want to give my own amateurish diagnosis : no clear neurological pattern of paresis, like dysarthria, no history of syphilis, 11 years survival after diagnosis (!), diagnosis error extremely likely.
    De Maupassant is clearly a paretic but he presents both typical history with syphilitic anamnesis, typical clinical presentation and expected course. You can remark his litterary production end as soon as Paresis became clinically evident.

    Best regard

  8. The link between GPI and previous mercury treatment is interesting because it may serve as model for contemporary pharmacotherapeutic models which might be based on stereochemical effects. This question was debated, e.g., by Pavl Heiberg (The Journal of Hygiene, Vol. 38, No. 4 (Jul., 1938), pp. 500-506). The pivot role played by Gerard van Swieten (1711-1772) is extremely relevant and deserves a bit more serious consideration: e.g., his first name is not Jacob…

  9. Sir,

    Of the data given on therapeutic antecedents of syphilitics afflicted by general paresis i found the following study :

    Fournier considered anamnesis of 79 syphilis taken by dementia paralytica with well know medical history.

    These men were well to do observed in private pratice.

    – 4 were treated for 3 or 4 years, 12 two years approximatively, 3 for 18 month, 16 for a year.

    – 43 were under treatment less than a year : 6 of them for 6 to 12 month and 16 less than 3 month.

    -1 was never treated by mercury.

    Fournier don’t give indications about cases of general paresis without know syphilis demonstrable.
    He found syphilis in 3/4 of tabetic.
    Using the same rate of know syphilis you obtain the following results :

    100 initial cases of syphilis followed by general paralysis.

    Of them :

    22 paretic remained untreated among private patients, usually because lues infection was ignored.

    4 had chronic therapy.

    28 have relatively prolonged treatment.

    43 have short treatment

    Among these 43 cases, 16 had really minimal mercurial cure.

    Other data among therapeutic antedecents of tabetic and paretic give me rather similar results, neurosyphilitic from popular class being less treated and less frequently conscient of initial infection on average than Fournier’s wealthy patients.

    So you have perhaps among 100 paralytic of best class 1/4 of untreated cases and 15 poorly treated.

    To fix your mind :

    3 month : 1 cure
    6 month : 2 cures
    1 years : 3 to 4 cures (perhaps more frequently 3 because continuous mercurial therapy is toxic.
    2 years : 6 cures
    3 or 4 years : 8 or 10 cures approximatively

    Cf :

    Maxime GALLO-BALMA

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