|Beautiful Black Poison|
|Written by Jennifer Schmid|
|Thursday, 02 April 2009 17:18|
The History of Calomel as Medicine in America
New drugs present greater hazards as well as greater potential benefits than ever beforeâfor they are widely used, they are often very potent, and they are promoted by aggressive sales campaigns that may tend to overstate their merits and fail to indicate the risks involved in their use. . . There is no way of measuring the needless suffering, the money innocently squandered, and the protraction of illnesses resulting from the use of such ineffective drugs.--John F. Kennedy, in his Consumersâ Protection Message of March 15, 19621
The more things change, the more they stay the same.--French Proverb
The doctor comes with free good will, but neâer forgets his calomel.2--American folk saying, mid 1800s
We have all heard about the deleterious effects of mercury and how it is one of the most poisonous substances on earth. In fact, the World Health Organization has deemed mercury unsafe at any level of exposure. Nevertheless, people have always been fascinated with this seemingly magical substance. Mercury, also known as quicksilver, it is the only metal that is liquid at room temperature, and if it spills, the little globules are impossibly elusive to recover. (Note that in the earth, mercury is not generally found in pure form but rather as part of cinnabar, or mercury sulfide.)
Like all heavy metals, mercury (Hg) in any form is extremely toxic to life. The Romans mandated mercury mining in AlmadĂ©n, Spain as a form of capital punishment. Typically prisoners died after six months to three years of labor.3 The ancient Greeks relied on mercury to manufacture mirrors; to be a member of the mirror guild was considered a high honor, even though most mirror masters died in their 30s, poisoned by their craft. The Mad Hatter in Alice in Wonderland probably used mercury in the felting process for his hats, hence his skewed perception of life. Mercury is also used to extract gold and silver from ore.
Here in the Silicon Valley, a former mercury mine (also named Almaden, probably for its Spanish counterpart) has become a county park, and despite assurances from various governmental agencies, many local residents believe the mine has permanently polluted the land and water for miles around. If people have known for millennia about the toxic nature of mercury, why would he use it as a âmedicineâ?
It was in the 16th century that European physicians began experimenting with metals such as mercury and antimony on the sick; one can only imagine their sheer joy (or terror) at seeing the strong effects these metals had on the body! By the founding of the American union, most physicians had decided that the merits of these powerful substances far outweighed the detrimental effects, particularly when used on people who were already ill. However, this observation is far from correct.
The history of medicine in the United States of America is full of drama fit for a soap operaâpurgings and bleedings and outrage, oh my! If you would like to research this history, however, do not turn to your local MDs, as they will probably not be able to provide you with any texts on the subject. Many of the books that you may find in the local library will contain patriotic descriptions of the great allopathic physicians in our country who, for over one hundred years, poisoned their patients with huge doses of a mercurial substance called âcalomel,â believing that these âheroicâ doses of a poisonous and powerful metal would cure their patients of whatever ailed them. Calomel, meaning âbeautiful and blackâ in Greek, was a derivative of mercury, and it slowly debilitated and killed hundreds of thousands of Americans. Only in the late 1960s did calomel quietly disappear from the U.S. Dispensatory.
The Chemistry of Calomel
What is calomel, and why did the doctors believe it to be harmless, despite the sometimes fatal reactions to its administration? Chemically speaking, calomel is mercurous, or mercury, chloride (Hg2Cl2) and is formed when elemental mercury (Hg) and mercuric chloride (HgCl2) come together.
Hg + HgCl2 â Hg2Cl2 (Calomel)
Mercurous chloride is photosensitive, meaning that when it is exposed to UV light it decomposes back to elemental mercury and mercuric chloride, causing it to turn from white to black. The concept of photosensitivity was not discovered until the 20th century, and one can only surmise how UV exposure might have affected the quality of the medicine.
Hg2Cl2 (Calomel) â Hg + HgCl2 (highly toxic)
Both elemental mercury and mercuric chloride are water soluble and known to be extremely poisonous. Calomel, on the other hand, is an insoluble salt, and if you ask many physicians and chemists today, they will tell you that only infinitesimal amounts of the mercury in calomel are absorbed. Theoretically, it should simply pass through the intestines and be eliminated in feces. It is much less toxic than other soluble, organic compounds of mercury, such as methyl mercury, responsible for Minamata Disease in Japan in the 1950s and 60s and considered to be one of the most toxic mercury compounds.4 Methyl mercury is the type of mercury that pollutes bodies of water and is found in the fish that we consume. It is different from another organic mercury compound, ethylmercury thiosalicylate, also known as thimerosal, which has been used since the 1930s as a preservative in vaccines. (See below.) Straight mercury is most poisonous as a vapor which forms when liquid mercury is exposed to air; this is why one must be so careful when a mercury thermometer or compact fluorescent light bulb breaks, and why dental amalgams are dangerous.
Another factor involved in the absorption of calomel into the tissues is ammonia, which is a byproduct in the kidneys. Ammonia (NH3) also causes calomel to disproportionate, or break down into two different forms of mercury, forming the following reaction:
Hg2Cl2 + 2 NH3 â Hg + Hg(NH2)Cl (Mercuriammonium chloride) + NH4Cl (ammonium chloride)
Thus, if any calomel reaches the kidneys for excretion, the mercury could be rendered even more poisonous after coming into contact with ammonia.
By the 1950s scientists understood that calomel could decompose in the intestines when it came in contact with substances such as sucrose and lactose as well as alkaloids like cocaine; this would create the âmore toxic, mercuric derivativeâ mercuric chloride.5 The 1967 edition of the United States Dispensatory and Physiciansâ Pharmacology, still listing calomel as a medicine rather than a poison, challenges claims that large amounts can be absorbed in the gut: âMost of a dose of calomel is probably eliminated from the bowel; only the dissolved portion, some of which is in the mercuric state, is absorbed. Because of the danger of absorption of toxic amounts of mercury if laxation does not occur after taking calomel, a saline laxative should be taken the following day.â6 Whether or not the calomel is eliminated is a matter of dispute. Of note is the fact that both internal and external use of calomel was known to cause skin reactions and fever, common symptoms after the administration of vaccines containing thimerosal.
The Development of Calomel as a Medicinal Substance
Paracelsus, born in Switzerland with the name Theophrastus Bombastus von Hohenheim (1493-1541), was one of the first physicians to incorporate chemistry and pharmacy into his therapies. A somewhat controversial figure in the history of medicine, Paracelsus believed in the spiritual nature of humanity and in the unity between material and spiritual. Unlike most modern physicians, he felt that all remedies, no matter how chemical in nature, also had a spiritual component. He adhered to the âDoctrine of Similarsâ (the idea that like cures like) but in a different way from Hippocrates or homeopathic physicians, as he felt that one must use âpoisonousâ remedies in order to expel disease, which come out of imbalance and poison within. âIt is possible to make good out of evil,â he wrote.7 Mercury or calomel, therefore, would be given as a purgativeâ driving out disease and that which is impure.
When Paracelsus began experimenting with chemistry and heavy metals, no one knew much about them; there was no Table of Elements, oxygen had not yet been discovered, and no one knew how the body produced blood. Paracelsus not only made many chemical remedies more popular, but he is also credited with having invented several, including calomel. He believed that matter was solely composed of mercury, sulphur and salt. âBasically there are only three kinds of medicine and three kinds of illnessesâŠ each [doctor] will remember to give mercury to the mercurial diseases, salt to the saline diseases, sulphur to suphuric diseases, to each illness that which is appropriate and fitting.â8
If disease is thus manifested from an imbalance of mercury within, for example, one must administer mercury in order to cure the disease. Compounds were formulated based on the state and origin of the disease.
Paracelsus was one of the first physicianchemists to suggest the use of mercury applied externally to the lesions of syphilis. Yet he was aware of the potential to harm patients with too much mercury, and in his many publications he rebuked his fellow physicians for their free use of calomel and other mercurial compounds. He âurged physicians to reduce their doses, as they were killing patients with mercury more quickly than even the syphilis could do it.â9
By contrast, many European physicians and chemists were loath to prescribe metallic preparations such as calomel because of the toxic side effects.10 In France, for instance, prescribing external or internal mercury or antimony-based chemicals was grounds for dismissal from the Academy of Medicine. Fear of reprisal was not enough to stop the use of calomel, however. Medical historians credit the Swiss-born Sir Theodore Turquet de Mayerne with introducing calomel into the general repertory of pharmaceuticals in England at the beginning of the 17th century.
Turquet de Mayerne had been a member of the Paracelsan (Iatrochemical) school of medicine and thus experimented with many different formulations. As official physician to Henry IV of France, he wrote a treatise in 1600 espousing âthe use of mineral medicines, particularly the antimonials and mercurials.â11 This was enough to stir the ire of the Paris Faculty of Medicine, which essentially decreed via edict that he was never to practice medicine in France again. But rather than give up the use of these chemicals, Turquet de Mayerne left France for England, becoming the official physician to King James I of England. Turquet de Mayerne was also instrumental in the 1618 publication of the first London Pharmacopoeia, which was sponsored by the London College of Physicians. Upon publication, âKing James I immediately issued a proclamation requiring all apothecaries in the realm to obey this pharmacopoeia,â of which calomel was an important item.12
Thus it is only natural that the use of calomel made its way from London to Edinburgh, Scotland, where, until the establishment of the first medical school in the United States in the mid 1700s, most American colonial physicians were trained. Perhaps the two most inï uential figures in Edinburgh were the Dutch physician and teacher Hermann Boerhaave (1668-1738) and the Scot William Cullen (1710-1790).
Despite their philosophical differences regarding the origin of disease, both men equally championed the use of calomel for a whole range of illness, from fever to gout to dysentery. Boerhaave, âtreated all âobstructionsâ with mercury.â13 Cullen popularized the use of calomel in his Practice of the Physic, published in 1784. Likewise, in his Treatise of the Materia Medica, he offers many different observations about calomel, without actually having any concrete idea about how it works once inside the body. Like his colleagues, he believed that cathartics like calomel, which cause the body to purge from the bowels, did not penetrate the blood, and if they did, they would be quickly expelled from the body via âsecretory or excretory organs.â Cullen was obviously aware that calomel could affect the saliva, the âwhole of the alimentary canal [and] perspirationâ and felt that it could be used universally for many diseases because it would be âdistributedâ throughout the body. Although he was not sure how mercury worked, he believed it to be âentirely in the mouth.â14
Externally, mercury was considered a saving grace for the increasing number of cases of syphilis developing throughout Europe and the Colonies. Cullen and other physicians at the time saw how an external application of mercury could make the genital sores of venereal diseases disappear. On the other hand, Samuel Hahnemann, the founder of modern-day homeopathy, showed that such applications simply caused the disease to go âinward,â sometimes for years, until the symptoms of secondary and tertiary stages of syphilis appeared; most physicians simply confused the symptoms of advanced-staged syphilis with mercury poisoning, since they bore some commonalities.
According to another prominent homeopath, James Tyler Kent, these applications contributed to the spread of syphilis and gonorrhea because men would think they were no longer contagious once the canker was gone but would then infect their wives.15 Physicians continued to use external applications of mercury to treat syphilis well into the 20th century, until the advent of antibiotics. Additionally, in the Colonies in the 18th century, purging with calomel was often used as âpreparationâ for small pox inoculation.16
Benjamin Rush and the "Heroic" Dose
The first half of the 19th century saw the rise of heroic, or orthodox, medicine among American physicians, and by 1844 âthe most common method of treatment. . . was âbleeding, calomel, and mineral medicines.ââ17 One doctor was quoted as saying, âBile to cause, and calomel to cure, everything.â18
Until the middle of the 19th century, little was known about pathology and physiology, and most symptoms were believed to come from an imbalance in the âhumorsâ or fluidsâbile, phlegm and blood. Consequently, the aim of the physician centered around âpurgingâ the body of the humors through strong drugs such as calomel, which could have a violent laxative effect.19 This philosophy, as well as the methods used, had not really changed since the time of Paracelsus. What did change, however, was the strength of the therapies, thanks to men like William Cullen and his American pupil, Benjamin Rush (1746-1813), whose âheroic,â or excessive doses of calomel and other toxic therapies would reverberate for a century.
Benjamin Rush was a longtime friend of Benjamin Franklin, whose letters of introduction opened many doors for Rush. Rush began his medical studies in 1761 at the age of 15 through an apprenticeship in Philadelphia with Dr. John Redman, who according to Rush had one of the most âextensive business[es]â in Philadelphia and who also was a firm believer in bloodletting and âpurging,â that is, causing forceful evacuation of the bowels.20 Rush studied with Redman for five years. At the time there were not yet any âwell-establishedâ medical schools in the Colonies, and so in September 1766, Rush headed to Scotland, to finish his medical training at the University of Edinburgh, just as Redman had done. (Redman had studied with Cullen and was a protĂ©gĂ© of Boerhaave.) One of the most influential figures for Rush in Edinburgh was William Cullen. Rush biographer, Carl Binger states, âFrom him Rush got his notion that all life is an expression of nervous force and that disease is due to a failure of its regulatory powers, leading either to exaggeration of nervous functions or to weakness of them. . . Treatment. . . must aim to build up nervous energy by restorative drugs and diet or to reduce it by bleeding, purging and semi-starvation.â21
Another important influence on Rush, perhaps the most important, was Thomas Sydenham, âa 17th-century London practitioner, without academic position or pretensions. . . the first modern clinician.â22 According to Binger, âSydenham was concerned with the description of symptoms and their changes rather than with speculations in natural philosophy. . . He recognized symptoms as the expression of the struggle between the nature of the sick person and the noxious influences that produced illness. In other words, he saw them as part of natureâs healing activity, and from this he concluded that the doctorâs goal must be to assist nature in its struggle and to guide and intensify the healing power of nature. Furthermore, he realized that illness was never a local process but a reaction involving the whole organism.â23
In contemporary terms, Sydenhamâs philosophy would be considered âholisticâ in his approach to symptomology, although his primary methods of treatment, particularly during the Bubonic Plague, were calomel and bloodletting. Despite Rushâs admiration for Thomas Sydenham, Rush did not always agree with the Londonerâs methods. Sydenham cautioned against giving too much calomel even if the patient was not salivating, for âdysentery and deathâ might follow. Rush, on the other hand, claimed that it was not problematic if a patient did not salivate and that one could continue to administer the calomel until salivation occurred.24
Pharmacology during Rushâs studies was mostly empirical, meaning based on experience rather than todayâs double-blind placebo testing. Although many considered the methods of bleeding and purging to be quite barbaric, Rush and his teachers believed these methods to be the best and most helpful measures to cure sickness. Physicians such as Cullen and Rush could not understand how calomel acted in the body, although its effects were plain enough. Medical historian Harris Coulter intimates that they supported the use of calomel not for its therapeutic benefits, but because âthey were reluctant to admit to ignorance in any realm of medicine.â25
Ultimately Rush would choose the same treatments he was taught (such as bloodletting, purging via calomel and other cathartics, blistering and water) for every illness in the Colonies and later, the United States. He considered calomel to be the sine qua non for any and all ailments, preferring mineral medicines that were not âinert.â26 This philosophy would have a profound effect on the subsequent practice of medicine in America. Rush graduated in 1768 and returned to America in 1769 after studying briefly in London and Paris. He began his career working with the poor of Philadelphia. He was a major proponent of smallpox inoculation and in the beginning, âhis treatment relied more upon diet and drinks than on the use of medicines.â27
Early in his career he was appointed Professor of Chemistry at the College of Philadelphia. Rushâs lectures were open to the public and he espoused chemistry only in its relation to medicine. He was an excellent orator and was highly esteemed as a chemist, despite his ignorance of modern theories of his time (including the existence of oxygen, discovered in 1771). He was also well published, thanks to supporters such as Benjamin Franklin, who âencouragedâ contributions from physicians. In 1774 Rush was chosen as a delegate to the first Continental Congress and became acquainted with many important historical figures, including George Washington and the Adamses, and was a signer of the Declaration of Independence. In 1777, after working as a doctor during the Revolutionary War, Rush left his position in Congress and was appointed Surgeon General (later titled âPhysician Generalâ) of the Middle Department of the Continental Army. He resigned this post in 1778 and returned to Philadelphia, at which point he became one of the most influential figures, for better or worse, in American medical history. Much of his influence came as a teacher; between 1779 and 1812 he taught over 2800 students and apprenticed many more. He also served as chairman of the Theory and Practice of Physic at what would become the University of Pennsylvania, and at one time he was called âthe greatest physician in the United States.â28
His was a time of various âbilious feversâ and acute diseases, such as typhus, typhoid fever, malaria, cholera, dysentery, yellow fever and dengue. Practitioners had little knowledge of hygiene (although Rush was one of the leaders in this area), and most fevers were lumped together into one illness, with similar treatmentâ bleeding and purgingâprescribed for all. Rush believed in abstaining from alcohol, but nevertheless often prescribed it in copious amounts as a medicine, for example, with a daily dose of cinchona bark (from which quinine is derived). According to Binger, âhis fondness for emetics and purges was much in evidence; ipecacuanha, tartar emetic, calomel and jalapâ were prescribed âfreely;âin fact he believed so strongly in the effects of these medicines that he helped to organize a free pharmacy for the poor in Philadelphia in 1786.29
Rush developed the âheroic doseâ of calomel during the yellow fever epidemic in Philadelphia in the autumn of 1793. In September 1793, he came across a book written in 1741, which Benjamin Franklin had given to him many years earlier. As treatment for âbilious fever,â in particular yellow fever, the book recommended âvigorous purges to rid the viscera of their âfeculent corruptible contents.ââ30
Armed with this information, he developed a powder consisting of calomel and jalap, another strong purgative, and recommended that it be given three times daily. Rush later wrote that the medication âperfectly cured four out of the first five patients to whom I gave it, notwithstanding some of them were advanced several days in the disorder.â31
Rush lost hundreds of patients during the epidemic and prepared so many doses of his âbilious pillsâ (made from calomel and jalap) that his hands were rumored to have turned black from the mercury. Even though a great many patients died âdespiteâ the heavy doses of calomel and bleeding and despite the attacks on Rush by his fellow doctors, who did not agree with the harshness of his âheroicâ methods, Dr. Rushâs impact on American medicine regarding high doses of calomel would continue for another 70 years, until the end of the Civil War.32
Heroic Medicine as Standard Orthodox Therapy
Throughout the 19th century medical knowledge grew tremendously, but during Rushâs day, physicians knew little about pathology, diagnostics or physiology. There were as many schools of thought on these matters as there were remedies and therapies.
Men like Rush practiced âheroic medicine,â believing greatly in the benefits of copious bleeding and excessive purging; surgeons were becoming skilled in operating even though they had no anesthesia; there were homeopaths, who believed in minute doses based on the laws of Samuel Hahnemann; the Thomsonians, eclectics and botanists, followed the teachings of Samuel Thomson; the Indian doctors used Native American remedies including sweating; and many who used combinations of these approaches.
There was no health insurance, no licensing, very few medical schools and very little âstandardized care,â meaning that everyone had a choice of which kind of doctor to engage. Then as now, those therapies with a chemical basis (such as calomel) were more costly than herbal or homeopathic remedies, so those doctors practicing âheroic medicineâ were mainly concentrated in the cities and towns where people with money and wealth tended to live.
Rush continued to be vocal in his support for heroic doses of calomel for âvirtually every disease,â and calomel became the remedy of choice for practitioners of what became known as âheroic medicine.â33 John Eberle, whose 1822-23 Treatise of the Materia Medica and Therapeutics influenced many students and practitioners of heroic medicine, said, âof all the articles of the materia medica, calomel is undoubtedly the most important, whether we consider it in relation to its purgative operation, or to its more extensive and specific influence upon the animal economy.â34
Despite criticism from many of his colleagues, Benjamin Rushâs treatment using âenormousâ doses of calomel and jalap during the Yellow Fever Epidemic in 1793 became the standard prescription as a âpanaceaâ for whatever ailed: âWhen a practitioner was puzzled about the administration of any medicine in a disease, it was deemed perfectly proper for him to prescribe a dose of calomel. . . Many physicians believed that the omission of calomel in desperate cases was tantamount to abandoning the patient without a final saving effort. . . Most regularly trained physicians used these standardized therapies almost exclusively, even though textbooks on therapeutics contained hundreds of alternatives. . . Heroic medicine became normative, and those physicians who did not conform were chastised by their colleagues.â35
Rothstein goes on to say, âThe average graduate (of medical school in the first half of the 19th century) was often completely ignorant of medical practiceâ and as a result they relied upon their âpanaceas.â36 Physicians rationalized the use of calomel with two different approaches. First, it cured disease because of its powers as a purgative and therefore took away the âmateries morbidâ from the intestines. Second, it had the power to change a personâs disease into a âmercurial disease,â which was believed to be âself-healing.â According to Coulter, âThe mercurial disease itself sometimes got out of hand, however, and remedies were then sought for it, such as general and local bloodletting, saline cathartics, sulphur, [and] iodine.â37
The doses of calomel at the time were at least 6-10 grains, the equivalent to 389-650 mg of mercury, thousands of times higher than what the EPA currently recognizes as the âsafeâ limit of mercury ingestion. During the 19th century, calomel was given in even higher doses than those prescribed by Rush. One doctor in New Orleans was known to have given 60 grains of calomel per dose (as opposed to Rushâs 10 grains) to children during the epidemics of yellow fever, cholera and diphtheria. Other physicians were known to have prescribed 80 grain or even 120 grain doses or about 3-4 ounces of calomel.
Moreover, calomel was often found in teething powders and given regularly to children. Mercury-containing powders compounded with chalk were given to children with indigestion or vomiting. For respiratory illnesses such as cough, diphtheria and ulcerations in the mouth and throat caused by syphilis, physicians exposed patients to vapors of mercury, known now to be the most toxic form of exposure. Calomel was even used to fight intestinal worms, as it was believed the strong purges would force the worms out of the intestines.
Even Abraham Lincoln suffered from the effects of mercury. In 1858 he began to show signs of mental instabilityâhe would become enraged, he was melancholic, and he was getting into fights. His âoutbursts of rage and bizarre behavior,â however, were most likely a result of the âblue mass pills,â given freely as an antidepressant in the 1800s. According to Wayne Bethard, these little blue pills âcontained mercury, honey, rose water, licorice root and rose petals; recent research using a typical 19th century recipe for the blue pills showed that each pill contains over 3000 times the amount of maximum daily mercury exposure recommended by the EPA.â 38
Fortunately, Mr. Lincoln stopped taking the pills within days of beginning them, once he realized that they were causing the outbursts.
Life on the Frontier
Why did so many physicians enthusiastically jump onto Rushâs calomel bandwagon? Rush was famous because of his political ties, including his close friendships with Benjamin Franklin and Thomas Jefferson. These powerful friendships contributed to Rushâs reputation as probably the most influential physician in early America and far beyond his death in 1813.39
Despite the relationship between Rush and Jefferson, however, Jefferson remained a critic of heroic medicine, claiming that inexperienced doctors killed more people âthan all the Robinhoods, Cartouches and MacHeaths do in a century.â40 Nonetheless, Jefferson chose Rush to give the pioneer explorer Meriwether Lewis a two-week crash course in medicine before his famous expedition with William Clark, although Lewis had already received some limited medical training in the military. On their renowned journey, the crew of 52 men set off with a large supply of several medicines, including a few different forms of calomel, thanks to Rushâs recommendations. Historian Volney Steele recalls, âFollowing Rushâs advice, the expedition carried fifty dozen of the doctorâs bilious pills, a strong purgative containing calomel and jalap, which, according to Rush, would âgently open the bowelsââthe understatement of the century. This combination of drugs produced an explosive intestinal passage and became known by all who used them as âthunderclappers.ââ41
Lewis and Clark used the mercurial preparations extensively, including for the many cases of syphilis contracted by both the men in the crew and the Native Americans with whom they socialized. Despite the âheroicâ treatment, the mercury simply suppressed the syphilis rather than curing it, and many men began to show the symptoms of the secondary and tertiary stages of syphilis within months or sometimes years of both the oral mercury (calomel) and its external applications.
Throughout the middle 19th century, calomel remained a popular medicine in the West. Many travelers on the frontier were besieged with cholera, which came in from Europe and could kill a person within twelve hours. Despite the sufferersâ copious diarrhea and dehydration, frontier doctors would administer calomel in order to rid the system of its disease, and thousands died as a result. Ignorant of the connection between vitamin C deficiency and scurvy, many physicians on the frontier treated scurvy with calomel, but never with success.
Moreover, with the large numbers of single men on the frontier, saloons and brothels flourished, and consequently syphilis and gonorrhea ran rampant. While the mercury injections and oral calomel applications caused the external lesion to disappear, transmission was still possible, especially from womenâmostly prostitutesâ who had no outer symptoms.
Towards the end of the 19th century and into the 20th century, thousands of people were institutionalized with the mental illness that accompanies the tertiary stage of syphilis, despite (or because of) treatment with the heavy metal. Up until the mid 1800s, frontier physicians used calomel to treat the diarrhea from thphoid, a disease that was sometimes fatal. The violent purging of the bowels often worsened the patientâs state of dehydration and hastened death.
One group that refused treatment with calomel was the Mormons, who crossed the frontier from Iowa to Salt Lake in the 1840s. The founder of the Mormon religion, Joseph Smith, had watched his brother die after taking calomel. Therefore the religious leader chose Thomsonianism as the therapy for his followers.42
The Effects of Calomel on the Physical Body
Joseph Smith was hardly the first or the last person to watch a member of his family succumb to poisoning and death from calomel. Indeed, the physical symptoms that manifest as a result of mercury exposure via calomel are horrific, yet many physicians still believed in the benefits of calomel and âhad few qualms about using it.â43
Calomel was used specifically because of its power as a potent laxative, causing complete âexplosiveâ evacuation of the bowels but sometimes vomiting as well.
What were the other problems created by all of this âinsolubleâ mercury? One journal noted: â. . . the first noticeable effect following the administration of mercury in small medicinal doses is seen in an increased activity of the secretions, especially those of the intestines. . . If the action of the medicine is pushed farther, it becomes apparent that we are dealing with a destructive agent. . . The blood itself is altered in character. . . and coagulates with difficulty. Processes of repair are interrupted, so that recently healed wounds open afresh; the body becomes emaciated, the face pallid. These effects appear in the most striking manner in the well-known phenomenon of mercurial salivation. . . In the effort of the system to rid itself of so deadly a poison. . . the normal avenues of excretion not proving sufficient to carry off this unusual accumulation of dead matter, the salivary glands as a last resource are called to do an unusual duty. . . [in mercury poisoning] more frequently the patient lingers for ten to twenty-four hours, often enduring all that time atrocious sufferings.â44
It was not until after the Civil War that excess salivation was recognized universally as a sign of mercurial poisoning. Some patients were able to recover from their illnesses and from the poisoning, although they tended to be somewhat disabled for the remainder of their lives, especially those who had lost teeth, jaw muscle, or jaw bone in the process.
Reports from alternative journals, such as those of the homeopaths, botanicals, and eclectics, are quite gruesome in describing some of the suffering and deaths resulting from mercurial poisoning from calomel. Partly because of how it accumulates in the tissues, partly because of the sheer amount of exposure in relation to body weight, children and adolescents were particularly affected by the high doses of calomel as well as from the poisoning they probably encountered in utero, and many children, if they even survived, endured a lifetime with no teeth, sore gums and a jaw that could open less than an inch. Specialists in surgery began to devise ways of saving patients who were deformed by the poisoning, creating devices that would slowly re-open the jaws that were closed in a fixed position as a side effect of too much calomel.45
John M. Scudder, one of the most prominent practitioners of eclectic medicine, described some of the effects that he saw in patients who continued to receive âheroicâ doses of calomel even after the onset of swollen gums and salivation: âThe mouth feels unusually hot, and is sometimes sensible of a coppery or metallic taste; the gums are swollen, red, and tender; ulcers make their appearance and spread in all directions; the saliva is thick and stringy, and has that peculiar, offensive odor characteristic of mercurial disease; the tongue is swollen and stiff, and there is some fever, with derangement of the secretions. The disease progressing, it destroys every part that it touches, until the lips, the cheeks, and even the bones have been eaten away before death comes to the suffererâs relief.â46
Rothstein goes on to elaborate that when a person has taken a toxic dose of calomel, not only do the teeth then become loose, rot, and fall out, but the jaw bones begin to disintegrate in flakes and layers. Parts of the mouth, tongue and palate could also rot away, and in this state one existed for the rest of oneâs lifeâprovided one actually survived both the disease and the therapy.47 Even after small doses for a longer period of timeâsay, six monthsâthe gums would be swollen, eating painful, and teeth loose, if they had not already fallen out.
Criticism Against Calomel
It was exactly because of these horrific side effects of heroic medicineâs beloved calomel that Americans began turning to safer, alternative forms of therapy such as botanic medicine, eclectic medicine and homeopathy.
As early as the 1750s some traditional physicians in the Colonies were speaking out against such strong practices and encouraging natural remedies. Two hundred years earlier, Paracelsus had chastised his fellow physicians to give smaller doses, as he recognized that mercury, even in the form of calomel, was a poisonous substance. By 1826, perhaps thanks to Samuel Hahnemann and his concepts of homeopathy, many Europeans were beginning to speak out against the use of calomel. Pierre Bretonneau (1778-1862) was a French physician who saw that local, external applications of mercury compounds triggered ulcerations similar to syphilis on the skin, and in 1837 the Scot, John Hunter, stated that âmercurial medicines caused typical rheumatism symptoms, with administration of more medicine only worsening the patientâs condition.â48 American and British physicians came under fire from their continental European counterparts even as late as 1870 for their âmercurial fetishism.â49
In America, many were skeptical of doctors, particularly those using âheroic medicine.â Public opposition to heroic medicine, including the use of calomel, grew exponentially throughout the 19th century as other therapies became more popular. Rothstein writes that many of the well-to-do turned to practitioners of homeopathy because they did not want to endure the suffering produced by physicians using bloodletting and drugs such as calomel. Likewise, he states, âIn the 1830s and 1840s, a few courageous regular physicians began to criticize heroic therapy. Unfortunately, their circumspect language and the restricted interpretations placed on their statements by other physicians reduced or nullified their effectiveness.â50
One of the most vocal and famous critics of heroic medicine was James Bigelow, who in 1835 denounced the use of heroic medicine, which in his opinion was not helpful for âself-limited diseasesâ such as childhood illnesses. Later, in the 1850s, Bigelow disputed the validity of all heroic therapies in general, including the use of calomel, although he and other physicians were criticized loudly by orthodox physicians practicing heroic medicine.
There was also much self-criticism which the physicians leveled against themselves, although they still continued to use (and abuse) cathartics like calomel. According to Rothstein, one doctor, John Beck, wrote in 1847 that calomel was ââdangerous, sometimes lethal, abused beyond relief by reckless and foolhardy physicians,â andâalthough this was never explicitly statedâof little demonstrable benefit in treating disease. . . He concluded by blaming homeopaths and patent medicines for its excessive use.â51
Throughout the mid 1800s the public continued to rise up against the âheroicâ nostrums of medical orthodoxy, turning instead to alternative practitioners for treatment. In 1845 citizens of Westmorland County in Pennsylvania went so far as to petition their legislature to ban the use of mercury and calomel outright, but the committee reviewing the matter denied the petition, because, âif physicians were to be deprived of all agents capable of doing harm they would have no medicine left.â52
Meanwhile, the orthodox physicians claimed that the public was simply too ignorant to understand orthodox medicine, but that they (the physicians) knew best. Nevertheless, heroic physicians could see that they were losing patients to the alternative practitioners and wanted to get that business back. This is one of the reasons why the AMA was founded back in 1847âwith the pretense to improve medical education, but with the real reason to come together against the so-called âquacksâ who took away and often cured their patients of diseases and illnesses upon which the heroic measures had no beneficial effect. Many seemingly orthodox physicians used homeopathy with their patients instead of the standard drugs and treatments, but they hid this fact from their colleagues lest they be shunned from the medical societies. On the other hand, for fear of losing more patients, many physicians disguised their penchants for using high doses of calomel and instead proclaimed publicly that they only used small doses.
One reason the physicians were so reluctant to come to terms with the dangers of calomel was because they would then have to acknowledge some truth to the Law of Similars, upon which homeopathy is based. As early as 1844, American physicians started to come forward with research showing that the symptoms of mercury poisoning were very similar to the advanced stages of some kinds of syphilis, a fact which Samuel Hahnemann had already documented in Europe in his Organon of the Medical Art, his main treatise on homeopathy.53
During a symposium in 1874 the Detroit Review of Medicine and Pharmacy looked at the use of mercurial medicines. They found that many physicians not only were reluctant to take responsibility for harming their patients through the use of calomel but also claimed that they were responsible for no deaths due to calomel administration. At this same time, a folk saying was created, âThe doctor comes with free good will, But neâer forgets his calomel.â54 Likewise, many physicians blamed the âpremature decayingâ of teeth solely on foods and sugars, rather than on the combined consumption of calomel with refined sugars and flours.
The Civil War and the Beginning of the End for Calomel
Although the idea of bloodletting had faded out of fashion by 1860, âmany physicians continued to use huge doses of powerful medications, especially âŠ calomel.â55 Volney Steele, the son of a frontier physician and a doctor himself, who learned to hide his childhood stomachaches in order to avoid a dose of calomel and castor oil states, âDuring the Civil War, the use of calomel as a purge was still nearly sacrosanct.â56
Another reason physicians continued to prescribe large doses of calomel during the Civil War had to do with the development of a new in- fluential industry, the pharmaceutical companies. They made sure that the Union troops were well supplied with their drugs, including calomel.57 These manufacturers, who were already growing wealthy through the increased uses of their compounds and patent medicines, were among those outraged in 1863 by the actions of Surgeon General William Hammond, who had commanded the respect of the civilian and military medical community, despite his reputation for being difficult to get along with. This support evaporated âovernight,â however, when on May 4, 1863 Hammond ordered the removal of calomel and tartar emetic from the official formulary of the US Army, called the army supply table. Hammond became convinced that these drugs killed more patients than they helped. But when Hammond removed these medications from the army formulary, much of the civilian medical community arose in revolt. For a generation, medical doctors had competed with a series of other healers, with botanists and homeopaths, whose only unifying creed was that regular medicine used too much calomel.58
When Hammond lost the support of the medical community, Secretary of War Edwin M. Stanton saw the perfect opportunity to remove Hammond from office, as their relationship had always been contentious. Hammond refused to resign his post but lost the court-martial trial, which many believed was rigged.59 Nevertheless, his directive to eliminate calomel from the military pharmacopoeia had far-reaching effects on the use of calomel in America.
It took several more generations to see the complete elimination of calomel from the American materia medica. Although use of calomel had already begun to decline in the middle of the 19th century, many physicians, particularly those in the South, prescribed it through World War II.
Even through the latter part of the 19th century, the East was the only area with a âmarkedâ reduction in the use of calomel. As late as 1905, many old-time doctors were still prescribing heavy doses of the mercurial. According to one source, in 1891-92, over a 12-month period, Americans consumed approximately â13,900 pounds of calomel and other mercurial medicinal preparations.â60 In 1909, calomel was still listed as a drug manufactured by the pharmaceutical giant Parke, Davis and Co., and medical textbooks included calomel as a possible remedy.61 Calomel was removed from the British Pharmacopoeia in 1958, partially as a result of âpink disease,â a type of mercury poisoning that babies got from teething powder. It is unclear when calomel was removed from the United States Dispensatory.
Calomel's Effect on Generations of Americans
One can see the detrimental long-term effects of calomel usage in both those who received calomel as well as their offspring. Thousands of Americans were directly poisoned, maimed, and killed by the toxic âheroicâ doses of mercury given via calomel, not to mention through other sources of mercury such as amalgam fillings, external mercury preparations, and teething powders.
Harris Coulter expounds eloquently on the severity of Americaâs poor health in the middle 1800s: âAn intriguing question is the responsibility of the medical profession for the generally recognized bad health of Americans in the period, 1830-1860. A recent investigator of this question writes: âit would not be too much to say that after 1830 no European traveler to the United States ever forgot to insert somewhere in his published comments on America a few disparaging remarks about the physical appearance of the people.â About 1850 âthe nation as a whole began to realize something was wrong with the general condition of its health, that these unkind criticisms on the part of foreign observers had a basis in fact.â
âHarperâs Monthly stated in 1856 that the youth of this country were âa pale, pasty-faced, narrow-chested, spinkle-shanked, dwarfed race.â In 1856 the War Department published the results of its examination of recruits during the Mexican War: American volunteers weighed less than European or English recruits, and there were nearly twice as many rejections of Americans for being âtoo slender, and not sufficiently robustâ or for âmalformed and contracted chests.â Worst off, however, were the women. Thomas Wentworth Higginson wrote in 1861: âIn this country it is scarcely an exaggeration to say that every man grows to maturity surrounded by a circle of invalid relatives, that he later finds himself the husband of an invalid wife and the parent of invalid daughters, and that he comes at last to regard invalidism. . . the normal condition of that sexâas if Almighty God did not know how to create a woman.â
âCalomel was well known to cause deterioration of the teeth, and Higginson states: âPerhaps the most universal symptom of this physical decay was the condition of Americaâs teeth; one seldom talked to a dentist, it was af- firmed, who did not despair of the republic.â It is probably true that the toothlessness of many Americans was due to the doses of calomel they received from infancy, and this medication was doubtless responsible also for many of the other ills described.ââ62
So how was it that calomel ultimately fell out of favor as a cure-all medicine? Did physicians finally âsee the lightâ regarding the painful and disfiguring effects of calomel usage, or was there another reason?
Certainly antibiotics, diagnostic techniques, advances in pathology, a better understanding of human physiology, and higher profits from synthetic drugs or extracts have all played a role in the demise of calomel as a medicine. The reality is that thousands of people are still injured or killed every year from pharmaceutical preparations, according to industry-sponsored studies published in both the Journal of the American Medical Association and the New England Journal of Medicine.63 There are simply newer, more expensive drugs that have taken the place of calomel, drugs which manifest their effects in more subtle ways than those of calomel.
Much of the dental industry still uses dental amalgams and chastises those dentists who speak out publicly against them. Some dentists opposing amalgams lost their licenses in the process, in the same way as those physicians who spoke out against calomel back in the 19th century. Parents who protest the use of thimerosal in vaccines are considered paranoid by the manufacturers of vaccines as well as by government officials, even as the same officials formally urge vaccine manufacturers to remove thimerosal from the vaccines.
Generation After Generation
With the use of calomel continuing on well into the twentieth century, in conjunction with amalgam fillings, heavy metal vaccines, and industrial practices spewing mercury into the environment, is it any wonder that we are a toxic society with epidemic rates of autism, cancer, ADD, ADHD and chronic illness? Could it be that Americans have never really had a break from all that mercury and that for most of us, the effects of mercury have literally been passed down from generation to generation, from mother to child, accumulating to the breaking point?
How have we come to the point where one in 94 boys in America has received the diagnosis of autism? Science shows that mercury crosses the placental barrier between mother and fetus, which is why pregnant women are cautioned against eating certain types of fish (although they are not counseled against getting flu vaccines or amalgam fillings).
On top of all of this, most Americans eat the Standard American Diet (SAD) and depend largely on processed, refined, empty foods that impair their ability to eliminate mercury from their tissues.64 This means that Americans are parenting children who not only come into the world with generations of mercury accumulation in their tissues, but who then, with their cereals and baby formulas and pasteurized milk from antibiotic-laden feedlot cows, have no way of ridding their bodies of the heavy metal.
Mercury in its many forms is but one debilitating and lethal toxin in our environment. One hopes that its use in industry will be restricted and even banned in the years to come so that our children and grandchildren can enjoy healthy lives without wasting precious metabolic resources trying to eliminate this and the many other poisons of our modern world. The best solutions are to teach them about the benefits of real, unprocessed foods grown on rich, healthy soils; environmentally friendly business practices; and healthy living in accordance with nature. In this way, we can begin to reverse a trend that started over 200 years ago and give our children the future they deserve.
Thimserosal: Responsible for an Epidemic?
Since the 1930s, ethylmercury thiosalicylate, also known as thimerosal, has been used as a preservative in vaccines and injection compounds worldwide due to its antifungal and antibacterial properties. Comprised of 50 percent mercury, thimerosal is an organic mercury compound that breaks down in the body into ethyl mercury and thiosalicylate and is thought by many parents and scientists to be primarily responsible for the epidemic of autism and other neurological disorders in children over the last 20 years.
According to Boyd Haley, a researcher at the University of Kentucky, the mercury in thimerosal acts as an enzyme inhibitor that can negatively affect the immune systemâs ability to deal with toxins introduced in the body, such as the various diseases in the vaccines themselves.1 When combined with other heavy metals present in vaccines, the toxic effect of the metals is intensified, the same way it is enhanced after exposure to multiple forms of mercury, such as methyl mercury (in fish), ethyl mercury (thimerosal), and mercury vapors (from air pollution and amalgam fillings). Mercury has a particularly synergistic relationship with aluminum. Mercury âeats awayâ at aluminum, potentially releasing more mercury into the environment or tissues. Consequently, scientists believe that the aluminum present in vaccines may exacerbate the toxicity of the thimerosal.2
Many children experience external allergic reactions such as hives and eczema because of the repeated doses of thimerosal in the childhood vaccine schedule.3 Of far greater concern is the fact that the nervous system can become âintoxicatedâ or overwhelmed from exposure to mercury. Symptoms of mercury intoxication include memory loss, uncontrollable shaking and loss of balanceâsome of the same symptoms exhibited by children after receiving a vaccine (or two or three) containing thimerosal. Many of these symptoms do not appear until some time after the vaccine has been administered, which may explain some of the learning problems and mental disorders that could potentially be associated with vaccines. The fetus is also at risk of mercury intoxication if the mother receives thimerosal-containing injections while pregnant.
Currently the Centers for Disease Control (CDC) is âworking withâ vaccine manufacturers to remove the thimerosal from vaccines on a voluntary basis.4 However, at the time of this writing, it is still present in some stocks of hepatitis B, DPT and other vaccines on the recommended pediatric vaccination schedule; all influenza vaccines; and vaccines administered in Third World countries. In 2001 it was removed from the RhoGam shot given to pregnant women with Rh blood incompatibility, although lawsuits against its manufacturer, Johnson and Johnson, are still pending.
References (This Sidebar)
Dental Amalgams: What the ADA Doesn't Want You To Know
The word âamalgamâ means a mixture of mercury with other metals. Dental amalgam fillings containing silver and mercury were introduced in the 1830s; however, the fillings would expand uncontrollably, and thus tin, copper, and zinc were added shortly thereafter. The formula for dental amalgams has remained basically the same for the last hundred years, and there is great controversy over their safety, as more and more dentists join together to speak out about the toxic effects of dental amalgams.1
Each mercury amalgam filling contains about 50 percent mercury by weightâbetween 100 to 1000 mg of mercury. On average, one amalgam filling contains the same amount of mercury as one mercury thermometerâ500 mg (1/2 gram)âwhich is enough to make a 20-acre lake unsafe for fishing.2 (Many municipalities are taking steps to eliminate the mercury wastewater that is discharged from dental offices into sewage, since this mercury combines with microflora to become methyl mercury, thus polluting the entire food chain.3 )
Presented as an economical way to restore teeth, amalgam fillings never stop emitting mercury vapors, from the time they are manufactured to the time they are removed from or fall out of a personâs mouth (or the person with the filling dies). This means that a person with mercury amalgam fillings inhales mercury vapors 24 hours a day, especially when ingesting hot liquids or foods, chewing gum, or even brushing teeth, with the mercury accumulating in all of the tissues. For a pregnant woman, this mercury crosses the placental barrier and begins to accumulate in fetal tissues, long before the baby receives its first thimerosal-containing vaccine, and women with amalgam fillings generally have more mercury in their breastmilk than those without amalgams.4 According to Stephen Koral, the average person with dental amalgams inhales about 10 micrograms (mcg) of mercury per day, far above the recommended Tolerated Daily Intake (TDI) of .014mcg Hg/m3 air/kg of body weight as set by the Agency for Toxic Substances and Disease Registry (ATSDR) of the U.S. Public Health Service.5 Animal studies show a concentration of mercury from amalgam fillings in the kidneys, gums, jaw, liver, and especially in the digestive tract, and blood levels of mercury in humans correspond to the number of dental amalgams that a person has. In addition, there is an increased release of vapors when other metals are present in the form of gold restorations or crowns, orthodontia, and of course the other metals that make up the amalgam filling itself.6
Koral establishes the following chain of toxic events: 1) amalgam releases significant amounts of mercury; 2) the mercury distributes to tissues around the body, and is the biggest source of mercury body burden; 3) the mercury from amalgam crosses the placenta and into breast milk, resulting in significant pre- and post-partum exposures for infants; and 4) adverse physiological changes occur from that exposure on the immune, renal, reproductive and central nervous systems, as well as the oral and intestinal flora.7
There is considerable evidence that amalgam fillings cause serious harm to dentists, dental assistants, as well as to the patients who receive them. Studies done in the United States show a direct correlation between the numbers of amalgams placed by dentists with the amount of mercury excreted in the dentistsâ urine. Likewise, dental hygienists who place amalgam fillings without proper controls experience reduced fertility and more miscarriages and birth defects compared to women not exposed to mercury in their workplace.8
Why do some dentists and the American Dental Association (ADA) continue to stand by the use of amalgam fillings, despite knowing about the potential and proven toxic effects? Probably because they accept annual royalty payments from the very companies that manufacture them!9 Likewise, the potential for litigation is unimaginable if the ADA were to admit that mercury amalgam fillings were toxic, in the same way that vaccine manufacturers do not want to take responsibility for vaccine injuries, and tobacco companies are being forced into trials for lying about the health effects of cigarettes.
Currently about 52 percent of American dentists are mercury-free, having changed over to less toxic forms of dental restoration.10 For many years dentists could not speak out against the dangers of amalgam fillings for fear of losing their license to practice as a result of the gag rule imposed by the ADA and state dental boards in 1989.11 (The gag rule has been struck down by several courts and overturned by Coloradoâs state legislature.) As of January 1, 2008, Norway became the first country to forbid completely the use of amalgam fillings, and Sweden followed suit on April 1, 2008. Similar bans are under consideration in other European nations. Here in the United States Congressional Representatives Diane Watson (D-California) and Dan Burton (R-Indiana) have twice introduced a bill to ban the use of amalgam fillings in the United States, and twice the bill has been blocked by the ADA and FDA.
Many local WAPF chapters maintain lists of biological and holistic dentists who not only practice amalgam-free dentistry but also know how to safely remove and dispose of amalgam fillings.
References (This Sidebar)
REFERENCES (MAIN ARTICLE)
This article appeared in Wise Traditions in Food, Farming and the Healing Arts, the quarterly journal of the Weston A. Price Foundation, Summer 2008.
About the Author
written by Tina @ curtain rods for bay windows, Feb 09 2011
|Last Updated on Tuesday, 08 December 2009 00:19|