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  • Mercury and Acrodynia (1995)

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    Articles by Geir Bjørklund
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    Mercury was identified as the cause of acrodynia, a disease affecting infants and young children, more than 100 years after it was first recognized. Symptoms include pink skin, extreme irritability, pain in extremities, and loss of teeth. For over a century, the etiology was unknown until the 1950s when studies demonstrated mercury in the urine and bodies of acrodynia patients. Mercury-containing teething powders were identified as the primary source and were subsequently banned, leading to a decline in cases and deaths from the disease.

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    Article by Geir Bjørklund published in Journal of Orthomolekulare Medicine 1995; 10: 145-146.

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    Mercury was identified as the cause of acrodynia, a disease affecting infants and young children, more than 100 years after it was first recognized. Symptoms include pink skin, extreme irritability, pain in extremities, and loss of teeth. For over a century, the etiology was unknown until the 1950s when studies demonstrated mercury in the urine and bodies of acrodynia patients. Mercury-containing teething powders were identified as the primary source and were subsequently banned, leading to a decline in cases and deaths from the disease.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
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    104 views2 pages

    Mercury and Acrodynia (1995)

    Uploaded by

    Articles by Geir Bjørklund
    Mercury was identified as the cause of acrodynia, a disease affecting infants and young children, more than 100 years after it was first recognized. Symptoms include pink skin, extreme irritability, pain in extremities, and loss of teeth. For over a century, the etiology was unknown until the 1950s when studies demonstrated mercury in the urine and bodies of acrodynia patients. Mercury-containing teething powders were identified as the primary source and were subsequently banned, leading to a decline in cases and deaths from the disease.

    Copyright:

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    Download as PDF, TXT or read online from Scribd
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    of 2

    Mercury and Acrodynia

    Geir Bjørklund1

    Acrodynia is principally a syndrome of first suggested in 1846, and again in 1922.


    chronic mercury poisoning. The almost for- Warkany and Hubbard from USA suggested
    gotten disease, mostly affecting infants and in 1948 that the etiology of the syndrome
    young children, is probably the best studied might be chronic mercury poisoning, par-
    effect of human mercury poisoning. ticularly that administrated to infants in the
    Acrodynia is characterized by a) profound form of teething powders (Warkany &
    changes in temperament, b) skin alterations, Hubbard, 1953).
    c) neurologic symptoms, d) tachycardia, and In a review article from 1953 Warkany
    e) stomatitis (Gorlin et al, 1976). and Hubbard write (Warkany & Hubbard,
    Acrodynia was first recognized in France 1953): “... calomel has been the most fre-
    in 1828 (Hanson 1987), and the term was quent source of mercury in the cases of
    introduced in 1830 by Chardon (Chardon, acrodynia ... As pointed out by Fanconi and
    1830). The term is derived from Greek, de- associates acrodynia often follows worm
    notes painful extremities (Gorlin et al, 1976). treatment with calomel-containing anthel-
    The condition was recognized in Aus- mintics ... In other cases calomel was given
    tralia in 1890 (Akabane 1983). Selter re- for constipation, diarrhea, cough, or for un-
    ported in 1903 eight cases of the syndrome specific reasons. In England, in the southern
    among children between one and three years United States, and in East Africa, calomel
    of age (Selter, 1903). Selter used the term was usually ingested in the form of teething
    “trophodermatoneurose”, and exhibiting the powders.”
    characteristic picture of the syndrome. The Warkany and Hubbard demonstrated in
    neurologic aspects of acrodynia were em- 1948 mercury in 25 out of 28 cases of
    phasized by Swift in Australia in 1914 (Swift, acrodynia (Warkany & Hubbard, 1953).
    1914), and by Feer in Switzerland in 1923 Fanconi in Switzerland demonstrated in 1949
    (Feer, 1923). The condition was established mercury in urine in 19 out of 20 cases (Obura,
    as a clinical entity in the British and Ameri- 1965). In the review article from 1953 pre-
    can literature by Byfield and Bilderback in sented Warkany and Hubbard a series of 28
    1920 (Bilderback, 1920). new cases of acrodynia (Warkany &
    The syndrome is also known as Pink Dis- Hubbard, 1953). In all these cases exposure
    ease, Swift Disease, Feer Disease, Selter to mercury was demonstrated by history or
    Disease, Erythroderma, Erythroderma by urinalysis. Warkany and Hubbard con-
    polyneuritis, Dermatopolyneuritis, Tropho- cluded that mercury exposure only can be
    dermatoneurose, Erythema arthricum rulled out if the history and repeated urinary
    epidemicum, Vegetativ neurose, and determinations are negative (Warkany &
    Vegetativ encphalit. These terms describe Hubbard, 1950, 1953).
    different aspects of the syndrome. Acrodynia has been described as due to
    The etiology of acrodynia was rather unusual sensitivity or idiosyncrasy to mer-
    vague, and it was various theories at differ- cury (Warkany & Hubbard, 1953). Clinical
    ent times (Obura, 1965). The following theo- manifestations may include several of the
    ries were most popular: avitaminosis, chronic following symptoms which, in the well es-
    infections, combination of dietary deficiency tablished cases, are so distinctive that there
    and infection, suprarenal insufficiency, de- is practically no differential diagnosis (Gorlin
    rangement of sympathetic nervous system, et al, 1976; Akabane, 1983): pink hands and
    and mercury poisoning. feet, scarlet tip of nose and cheeks, extreme
    According to Hanson and Pleva (Hanson irritability and restlessness alternating with
    & Pleva, 1991) was the mercury etiology periods of apathy, insomnia, anorexia, pain
    in extremities, profuse perspiration, gener-
    alized skin rashes, photophobia, desqua-
    1. Toften 24, N-8610 Grubhei, Norway. mation, itching, salivation, loss of teeth,

    145
    Journal of Orthomolecular Medicine Vol. 10, No. 3 & 4, 1995

    hypotonia which permits the child to assume valid. The etiology of acrodynia was un-
    many different and bizarre positions. There known for more than 100 years, before the
    may be albuminuria but no blood or CSF role of mercury as the primary source of this
    changes, and no characteristic urinary find- disease was pointed.
    ings except an abnormally raised level of
    mercury (Obura, 1965). Literature
    In England, Australia, and in the southern 1. Akabane T: Mercury. In: Behrman RE,
    United States acrodynia usually occurred in Vanaughan VC (Ed.), Nelson Textbook of
    infants and young children up to two years Pediatrics, WB Saunders Company, Phila-
    delphia, 1983.
    of age. The greatest age frequently occurred 2. Bilderback, JB: Group of cases of unknown
    in the group nine months old. Acrodynia was etiology and diagnosis. Northwest Med.
    occasionally reported as locally epidemic, 19:263, 1920.
    and among members of the same family 3. Bjørklund G: Fra tannamalgamets historie.
    (Hanson 1987). The mortality rate was re- Tidsskr Nor Laegeforen 109: 3582-5, 1989.
    ported to be about five percent. 4. Chardon F: De l'acrodynie. Rev Mèd Franç 3:
    The mercury-containing teething powders 51-74, 1830.
    were withdrawn from the market in Aus- 5. Dathan JG, Harvey DD: Pink Disease - Ten
    tralia in 1953 (Hanson, 1987), followed by years after (The Epilogue). Br. Med J: 1181-
    2, 1965.
    USA. However, the role of mercury as the 6. Feer E: Eine eigenartige Neurose des
    primary source of acrodynia was not univer- vegetativen Systems bei Kleinkinde. Ergeb
    sally accepted even as late as 1956 (Dathan, Inn Med Kinderheilkd 24: 100-22, 1923.
    1965), especially in England. 7. Gorlin RJ, Pindborg JJ, Cohen MM Jr:
    The incidence and mortality rate of Syndromes of the head and neck. McGraw-
    acrodynia have fallen dramatically since Hill Book Company, New York, 1976.
    mercury-containing teething powders were 8. Hanson M: Akrodynia-eller den lärorika
    withdrawn from the market. The official historien om hur man i över 100 år kan undgå
    death-record from acrodynia in England att upptäcka kvicksilverförgiftning. TF-
    Bladet nr. 3: 4-5, 1987.
    between 1939 and 1948 is 585 (Hanson, 9. Hanson M, Pleva J: The dental amalgam issue
    1987). The death rate from acrodynia shows - Review. Experientia 47: 9-22, 1991.
    a similar decline, from 57 in 1950 to seven in 10.Obura CW: Pink Disease. Report of a Case.
    1955, and to none in 1961 and 1962 (Dathan, Br Dent. J 119: 273-4, 1965.
    1965). 11.Selter P: Über Trophodermatoneurose. Verh
    Have we something to learn from the his- Ges Kinderheilkd 20 Versammlung, p 45-50,
    tory of acrodynia? Yes, I think so. Toxico- 1903.
    logical effects of dental amalgam has never 12.Swift H: Erythrodema. In: Australian Medical
    been totally studied. Dental amalgam has Congress Transactions, 10th Session, New
    Zealand, p. 575, 1914.
    however been used in dentistry in the West- 13.Warkany J, Hubbard DM: Mercury in the
    ern World for more than 150 years Urine of Children with Acrodynia. Am J. Dis
    (Bjørklund, 1989). Is amalgam therefore Child 79: 388, 1950.
    completely safe to use? This is one of the 14.Warkany J, Hubbard DM: Acrodynia and
    most common arguments for continued use mercury. Journal of Pediatrics gastroen-
    of dental amalgam. This argument is not terology 42: 365-86, 1953.

    146

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