370 



See table.^^ The clinical syndrome had been characterized by H. R. 

 Weidemann.^" 



First medical suspicions that thalidomide was associated with phoco- 

 melia apparently occurred almost simultaneously in Australia and 

 Germany. In Australia — 



* * * W. G. McBride, a physician in New South Wales * * * saw three newborn 

 babies with severe phocomelia during April 1961. In October and November he 

 saw three more. From the histories of the mothers he found that all six had 

 taken Dlstaval in early pregnancy. McBride notified the Australian branch of 

 Distillers Ltd. and it cabled his findings to the London headquarters on Novem- 

 ber 27. This and the news from Germany caused the firm to withdraw the drug 

 on December 3. 



In German}^ the identification was made by Widukind Lenz of 

 Hamburg, on the basis of questionnaires to the parents of deformed 

 infants and their attending physicians, and subsequent followup 

 interrogations. 



On November 15 Lenz warned Grunenthal (the manufacturing company) that 

 he suspected Contergan (the German name for thalidomide) of causing the 

 catastrophic outbreak of phocomelia and he urged the firm to withdraw it from 

 sale. On November 20. at the pediatric meeting, he announced that he suspected 

 a specific but unnamed drug as the cause of the "Weidemann syndrome" and 

 said that he had warned the manufacturer * * *. 



On November 20 Grunenthal withdrew the drug and all compounds containing 

 it from the market. Two days later the West German Ministry of Health issued 

 a firm but cautious statement that Contergan was suspected as the major factor 

 in causing phocomelia. 



It is unlikely that the total impact of phocomelia attributable to 

 thalidomide will ever be determined with any degree of precision. The 

 drug was distributed almost worldwide. Moreover, some of the factors 

 that delayed original detection of the relationship between drug and 



«« Incidence of phocomelia in the various university pediatric clinics.* 



1949-59 1959 1960 



Bonn... _. 2 19 



Bremen 4 



Frankfurt 1 4 



Gottingen___ _ 3 1 



Hamburg (Lenzperson) _ 1 16 



Hamburg (Lenzletter) 1 3o 



Heidelberg. _ _ 2 5 



Kiel 2 4 



Munchen 3 2 14 



Munster__. (i) 3 27 



Birmingham 4 



Liverpool. - 8 



Stirling 



*"A Study of the German Outbreak of Phocomelia," op. cit., p. 101. 

 ' 4/ypar. 



•0 Material and quotations in this selection except as indicated are taken from the two 

 articles by Dr. Taussig, both cited earlier, in JAMA and Scientific American. The character 

 of phocomelia was described by Dr. Taussig, based on the Weidemann source, as follows : 



As in most malformations, the severity varies but the pattern is remarkably specific. The 

 essential feature of the abnormality concerns the long bones of the extremities. The prehen- 

 sile grasp is lost. The hand arises directly from the distal end of the affected bone. The 

 radius is absent or both radius and ulna are defective ; in some instances only one short 

 bone remains ; in extreme cases the radius, ulna, and humerus are lacking and the hand 

 buds arise from the shoulders. Both sides are affected but not usually with equal severity. 

 The legs may be affected in the same manner ; in most instances the deformity of legs Is 

 less severe. The tibia fails to form. The fibula also may not form and the femur may be short. 

 The hip girdle is not fully developed and there is a dislocation of the hip with external 

 rotation of the stub of the femur. The feet are externally rotated. Polydactylism and 

 syndactylia of the toes are common. In the extremely severe cases the arms and the legs 

 are missing. In some instances the external ear is missing then the internal auditory canal 

 is abnormally low. Usually hearing is not grossly impaired. Unilateral facial paralysis is 

 relatively common. The vast majority of children are of normal mentality. 



