Pink Disease--Ten Years After (The Epilogue)

Abstract

Since pink disease was described by Swift in 1914 there has been no unanimous view concerning the causation of this disease.Warkany and Hubbard (1948) first suggested that the cause might be chronic metallic poisoning, incriminating mercury, particularly that administered to infants in the form of teething powders.This view received support from Bivings (1949), who found mercury in 28 out of 31 consecutive cases of pink disease, and was reinforced by Gaisford (1949) in Manchester.Three years later, however, in a reply to a question in the House of Commons, Miss Hornsby-Smith (1952), for the Minister of Health, stated: " Inquiries are already in progress at various children's hospitals, and, although the indiscriminate use of teething powders is clearly undesirable, there is not yet definite evidence to justify general publicity."The deaths of two infants in 1953 were reported to H.M. Coroner in Stoke-on-Trent, and the verdict at each inquest showed that death was from bronchopneumonia due to pink disease resulting from chronic mercurial poisoning from teething powders.On 10 December 1953 the attention of the Home Secretary was drawn to the first of these inquests, and he was asked whether, in view of the evidence, action should not be taken to prohibit the use of these substances.During the course of his reply the Home Secretary stated that "inquiries were not yet complete."Thus his reply differed little from that made on behalf of the Minister of Health some 20 months earlier.However, as a direct result of these two inquests, which received wide publicity, the manufacturers of the teething powders concerned ceased their production, and subsequently advertised " new and improved " powders, made to a formula which did not include mercury.The British Medical 7ournal (1954), commenting upon the paper incriminating mercury that appeared in the same issue (Dathan, 1954), stated that " there will be a good opportunity for investigating the residual cases which occur after the present supplies of powders containing calomel have disappeared from the chemists' shops."This opportunity is now taken after 10 years, and results show how correct earlier authors had been in their belief that chronic mercury poisoning was the main, if not the only, cause of pink disease.