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From Dogma to Medical Sciences and Clinical Discipline

Teratology versus Reproductive Toxicology

Dr. Josef Warkany, Mobile Alabama, 1989
Josef Warkany is known as the main pioneer of Medical Teratology. Trained as a pediatrician, he became a pioneer in Pediatric Endocrinology and a student of child growth and development.

One of his main discoveries was that mercury containing teething powders were the cause of Acrodynia, a disease that his work eliminated (no cases are known after 1970s). His discovery was branded as "madness" by corporations selling such products. Warkany also showed that maternal lack of micro-nutrients caused "birth defects" (the correct expression is "congenital malformations"). Today we know that lack of folates (or vitamin B9) is a the cause of spina bifida and today, in the US, most foods derived from cereals are fortified with folic acid. Further, all women who may get pregnant should take extra folic acid supplements.

Dr. Warkany pioneered the development of a Teratology Society which was cloned in Japan and Europe, where it is currently represented by Japanese and European Teratology Societies respectively. Their collective task is to prevent causes of "birth defects", a term that led to the creation of the March of Dimes Birth Defects Foundation which previously was named the "Polio Foundation". Dr. Warkany's research provided the basis for the FDA to demand testing of new drugs for safety of the unborn. This impact prevented marketing of thalidomide in the US in contrast to Canada, UK, Germany, Japan, and other nations, where tens of thousands of children were born with serious malformations known today as "Thalidomide Embryopathy".

Even a broader impact of Warkany's contributions is reflected in the demise of a long-standing dogma that congenital malformations are "genetic" defects inherited from parents. This dogma allowed for social policies not only in the United States (forceful sterilization) but also "euthanasia" of the "defective" in Nazi Germany. The highlights of Warkany's sensitivity to social circumstances and cultures are reflected in his etchings and comments - "The price of civilization is to sustain the "imperfect" ... and  ... "Societies should strive to ensure that every child born is free from abnormalities we know how to prevent ..."

NOTE: Would you like to see Dr. Warkany explaining how he did it? You may view several very short excerpts of TV interviews.

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