NEUROSYPHILIS, OR CHRONIC HEAVY-METAL POISONING - BLIXEN,KAREN LIFELONG DISEASE

Background: Since the 1490s, the treatment of syphilis has consisted o f heavy metals-first mercurial and later arsenic and bismuth preparati ons, Tabes dorsalis, as described by Duchenne in the 1850s, is made up of various characteristic neurologic symptoms, ''Gastric crises,'' su dden stabbing pains followed by vomiting and diarrhea, was originally included by Duchenne, but later, syphilologists disputed its relevance to syphilis, Poisoning by heavy metals, including mercury, may produc e similar pain reactions and tabes-like neurologic symptoms. Methods: According to an earlier published pathography, the Danish author Karen Blixen (1885-1962), also known under the pseudonym Isak Dinesen, suff ered from a lifelong disease described as tabes dorsalis, She got syph ilis in 1914 and took mercury pills for a year, after which she experi enced a severe mercurial intoxication, The Wassermann reaction (WR) in peripheral blood was positive only once, in 1915, before treatment wi th arsphenamine (Salvarsan), which she received during hospitalization in Copenhagen in 1915 to 1916, Her spinal fluid was examined several times from 1915 to 1956, Apart from an increased number of cells in 19 15, the fluid remained unremarkable and the WR was always negative. Re sults and Conclusions: It was postulated that her illness, ending with a cachectic state, was the result of heavy metal poisoning from the v arious treatments and not a monosymptomatic tabes dorsalis with negati ve serology.