Josef Warkany

Calvin Willhite1

Department of Toxic Substances Control, State of California, 700 Heinz Street, Suite 200, Berkeley, California 94710

Dr. Josef Warkany, pediatrician, scientist, and artist, was the first person to demonstrate that exposures to environmental chemicals, including dietary deficiencies and excesses, are responsible for production of congenital malformations. Until that time, it was widely believed that birth defects were due to chance or "God's will." For his work in this area, Dr. Warkany is known as the father of teratology.

Warkany was born and educated in Vienna, Austria, and by 1930 had published 23 scientific papers. Warkany then accepted a one-year fellowship at Cincinnati's Children's Hospital Research Foundation and arrived by train January 5, 1932. He stayed 60 years. Dr. Warkany remarked that he never left Cincinnati because

As a resident in Vienna, I had the good fortune to land in a small babies' hospital that had a sunny laboratory with many shiny bottles. The Chief, who was strongly in favor of research, had to approve additional supplies and chemicals. It was a time when vitamin D concentrates became available and spectacular cures of rickets could be achieved. How did these compounds cure rickets? I was able to acquire a rabbit and study the increase in blood phosphorous levels after a single dose of sodium phosphate and could repeat the experiment after the rabbit had been saturated with irradiated ergosterol. There was a marked increase in the rise of these phosphatemic curves, and I was jubilant, thinking I had solved the riddle of vitamin D action. I was ready to publish this work when one of my mentors suggested I repeat the experiment with another rabbit. So I approached the Chief and said, `Herr Professor, I need a rabbit.' Whereupon his amicable attitude changed to indignation and he said, `But you already have one.'

In America, he was given 12 rabbits instead of the one rabbit he had in Austria.

About his early days in Cincinnati, Warkany said,

"We were not paid much, we had no retirement system, and no tenure, but it was a happy time, a paradise ...the most important research equipment was the investigator's mind; this was a revolutionary group, but we had no slogans, no banners, and no flags ...but what the founders of our institution did was to create a place to work ...in the main, research consists of thinking."

During his long career, he published the results of more than 200 investigations, fully 100 of those after he retired. He also published his magnificent 1981 textbook Congenital Malformations. Notes and Comments, a major 20th-century milestone in the field of congenital malformations.

Before his work gained worldwide attention, conventional medicine often neglected the first 9 months of life. Warkany's research in teratology began in Austria, where children from remote Alpine regions presented with cretinism, a consequence of endemic prenatal iodine deficiency. His 1940 findings on dietary deficiency and excesses in laboratory animals broke the traditional medical view that these conditions were genetic in origin. He espoused the medical philosophy that prenatal disease should be viewed no differently from postnatal ailments. In 1961, he introduced the concept of intrauterine growth retardation as distinct from prematurity.

Dr. Warkany was an astute physician, activist, and politician. In 1948, he suspected and later proved that pediatric acrodynia (erythredema polyneuropathy, "pink disease"—painful, pink-colored rashes of the hands and feet, scarlet cheeks and nose, profuse perspiration, hair and tooth loss, hypertension, failure to thrive), commonly thought caused by dietary factors or infections, was pathognomonic of chronic mercury intoxication from calomel-containing teething powders, ointments, and worm and diarrhea medications (Warkany and Hubbard, 1948Go). Over 10 years, these products killed at least 585 children. Dr. Warkany's data were instrumental in the federal regulatory actions that banned these products and eradicated the disease.

In 1956, Dr. Warkany founded the Hamilton County (Ohio) Diagnostic Clinic for the Mentally Retarded, a facility that tends to the medical, psychological, and social needs of mentally impaired children. In 1957, Warkany met with the president of the National March of Dimes Foundation and persuaded him to shift the organization's funding from polio (eliminated by the Sabin and Salk vaccines) to prevention of birth defects. In 1986, Dr. Warkany was the first recipient of the March of Dimes Basil O'Connor Award. Dr. Warkany received 18 career awards, including the Academy of Pediatrics Mead Johnson Award (1943), the Academy of Pediatrics Borden Award (1950), the Modern Medicine Award for Distinguished Achievement (1964), Academy of Pediatrics Howland Award (1970), the Charles H. Hood Foundation Award (1972), the American Association on Mental Deficiency Research Award (1976), and the Procter Medal Award for Distinguished Research (1979). Dr. Warkany was a founding member of the Teratology Society and was its first president.

Dr. Warkany was also an accomplished and well-recognized etcher listed in Who's Who in American Art.

NOTES

1 For correspondence by fax: (510) 540-3819. E-mail: calvinwillhite{at}hotmail.com. Back

REFERENCES

Warkany, J. (1988). Story of a teratologist. In Issues and Reviews in Teratology, (H. Kalter, Ed.), Vol. 4, pp. 1–79. Plenum Publishing Corp., New York.

Warkany, J., and Hubbard, D. M. (1948). Mercury in the urine of children with acrodynia. Lancet 1, 829.

Wertelecki, W. (1989). Of dreaming on solid grounds and silent triumphs of one man: a story about Josef Warkany. Am. J. Med. Genet. 33, 522–536.[ISI][Medline]





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