Samuel Gershon: Lithium history

Barry Blackwell’s comment on Hector Warnes’ comments

       Once again I am impressed with the scope of Hector Warnes’s erudition, demonstrated in frequent contributions to INHN controversies; on this occasion  an attempt to understand the phenomena he calls “pharmakon” – a drug that is both a remedy and a poison.

       Hector attributes this property to a variety of influences, among them genetic heterogeneity among bipolar patients but also a population subject to polypharmacy, side effects and sloppy plasma monitoring – also a molecule with a narrow therapeutic index. 

       There is little doubt, supported by Sam Gershon’s comments and those of Cade’s  biographers, that Cade himself had  considerable ambivalence towards  the natural substance he re-discovered but abandoned without explanation after his first patient died and others, treated by colleagues, followed suit. He banned its use in his own hospital, chose to ignore the availability of safe plasma monitoring, discovered at his own university, and only resumed  enthusiasm after Schou described its far wider use in prophylaxis, befriended Cade and accorded him more credit that Schou’s own ancestors, including his father.

June 20, 2019