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Galeria de Léo Pinheiro via Wikimedia Commons // CC BY-SA 3.0

Blue People

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Galeria de Léo Pinheiro via Wikimedia Commons // CC BY-SA 3.0

There have always been tales of blue people in mythology, popular fiction, and in the news. Yes, blue people exist here and there in the real world.

Two conditions cause people to live and be (literally) blue. Methemoglobinemia is a condition in which the blood carries less-than-normal amounts of oxygen, making the blood appear blue. Argyria is caused by the ingestion of silver, usually for medicinal purposes. The effects of silver ingestion are permanent, and if the consumption of silver continues long enough, can be fatal.
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Methemoglobinemia can be acquired through use of certain drugs, or can be inherited through the presence of recessive genes. There have been reports of blue families or tribes through history that could be explained by inherited Methemoglobinemia. The best-documented of these is the Blue Fugates of Kentucky.

200bluepeople.jpgMartin Fugate emigrated from France in 1820 and married Elizabeth Smith, a Kentucky native. Apparently, both had the very rare recessive gene for Methemoglobinemia. Four of their seven children were blue! They lived in an isolated area of eastern Kentucky and their children grew up and married those who lived close to them, meaning a very few families in the area, or even their own cousins. One Fugate son married his mother's younger sister. Over several generations of intermarriage within these same few clans, the recessive genes were preserved and the Fugates came to be known as the Blue Fugates. The exact reason for their color wasn't known until medical tests were conducted in the 1960s. In the early 80s, only three blue members of the Fugate family were reported surviving.

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Before the advent of antibiotics, silver nitrate and colloidal silver were used as antiseptics. Captain Fred Walters was prescribed silver as a remedy for locomotor ataxia, a degenerative neural disease. It  turned his skin so blue that by 1891, he was exhibiting himself at side shows for profit. At the time, the poisonous effects of silver were unknown. Walters continued to take silver to maintain his profitable blue coloring until his heart gave out in 1923. He had essentially died of silver poisoning.
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Because of "products containing silver, which have flooded the market in past years", the state of Florida posted a warning that silver is unsafe to consume. Accompanying the warning are these photos of a victim of argyria, shown beside a healthy man to highlight the difference in color. Online information on the safety and efficacy of colloidal silver supplements varies from "no side effects at all" to "unsafe and ineffective", depending on where the funding comes from. The FDA says such products are not judged to be safe.
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Rosemary Jacobs began using nose drops containing colloidal silver when she was 11 years old. Within a few years, her skin had turned blue. Despite discontinuing the use of colloidal silver, Jacobs face remained blue for decades, as particles of silver were embedded in her skin and organs. In the 70s (after this picture was taken), Jacobs underwent dermabrasion treatments, which removed the top layers of her skin. She now has blotchy pink skin. Jacobs is campaigning against colloidal silver dietary supplements because of what happened to her.
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Paul Karason began using colloidal silver 15 years ago. He believes his blue skin was caused by rubbing the concoction on his skin to treat dermatitis, and not by drinking it. Karason, who is sometimes referred to as "Papa Smurf" continues to drink colloidal silver as a cure-all. See a video report here.
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Montana Libertarian Stan Jones was an unsuccessful candidate for the US Senate in 2002 and in 2006. He is also a victim of argyria. Jones began using colloidal silver he made himself in anticipation of antibiotic shortages predicted from the Y2K scare. He continues to take colloidal silver and believes in its health benefits.

There are other conditions that can cause the skin to turn blue, usually due to lack of oxygen, but serious cyanosis must be treated immediately and is not a condition people can just "live with". And then there are people who go the extra mile to appear blue.
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History
The Doctor Who Modernized Royal Births—in the 1970s
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Gary Stone/Getty Images

When Prince William eventually ascends to the English throne, he’ll be the first British monarch ever born in a hospital. And he has a man named George Pinker to thank for that.

Royal births have always been fraught affairs due to the thorny issues of birthright and succession. Throughout history, English royal women were expected to give birth in rooms filled with spectators and witnesses—in part to avoid a pretender to the throne being switched with the royal baby at birth.

That made childbirth a grueling ceremony for queens, many of whom had to give birth to stillborn or dying children in the company of scores of strangers. In 1688, after 11 tragic attempts to produce an heir to James II’s throne, Mary of Modena gave birth in front of an audience of 67 people. (It was even worse for Marie Antoinette, who gave birth in 1778 in front of so many people the onlookers nearly crushed her.) And even after births became more private affairs, archbishops and officials attended them as late as 1936.

Of course, doctors have long been part of that crowd. The royal household—the group of support staff that helps royals at their various residences—has included physicians for hundreds of years, who have often been called upon to perform various gynecological duties for royal women. They have frequently been dispatched to serve other family members, too, especially those giving birth to important heirs.

Even when hospitals became popular places for childbirth at the turn of the last century, English royals continued having kids at home in their palaces, castles, and houses. Elizabeth II was delivered via Caesarean section in 1926 at her grandmother’s house in London. When she became queen, her royal surgeon gynecologists recommended she deliver her children at home, bringing in equipment to turn the space into a maternity ward.

Yet it was one of her gynecologists, John Peel, who ended up changing his tune on delivering children in hospitals, and in the 1970s he published an influential report that recommended all women do so. When he stepped down in 1973, the queen’s new royal gynecologist, George Pinker, insisted the royals get in line, too.

Pinker was different from his predecessors. For one, he skipped out on a potential career in opera to practice medicine. He had been offered a contract with an opera company, but when asked to choose between music and medicine, the choice was clear. Instead, he stayed involved with music—becoming assistant concert director at the Reading Symphony Orchestra and vice president of the London Choral Society—while maintaining his medical career.

He was also the youngest doctor ever to practice as royal surgeon gynecologist—just 48 when he was appointed. He supported controversial medical advances like in vitro fertilization. And he insisted that his patients’ welfare—not tradition—dictate royal births.

“It is very important for mothers to accept modern medical assistance and not to feel guilty if they need epidural or a Caesarean,” he told an interviewer. Pinker recommended that pregnant women lead as normal a life as possible—no easy task for royals whose every move was spied on and picked apart by the public. In fact, the doctor being anywhere near the queen or her family, even when he was not there to treat a pregnant woman, was seen as a sign that a royal was pregnant.

When Princess Diana delivered her first son, it was at a royal room in a hospital. “Most people marveled at the decision to have the royal baby in such surroundings rather than Buckingham Palace,” wrote The Guardian’s Penny Chorlton. Turns out the surroundings were pretty plush anyway: Diana delivered in her very own wing of the hospital.

Pinker served as the queen’s royal gynecologist for 17 years, delivering nine royal babies in all, including Prince William and Prince Harry. All were born at hospitals. So were William’s two children—under supervision of the royal gynecologist, of course.

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Big Questions
What Is the Difference Between Generic and Name Brand Ibuprofen?
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What is the difference between generic ibuprofen vs. name brands?

Yali Friedman:

I just published a paper that answers this question: Are Generic Drugs Less Safe than their Branded Equivalents?

Here’s the tl;dr version:

Generic drugs are versions of drugs made by companies other than the company which originally developed the drug.

To gain FDA approval, a generic drug must:

  • Contain the same active ingredients as the innovator drug (inactive ingredients may vary)
  • Be identical in strength, dosage form, and route of administration
  • Have the same use indications
  • Be bioequivalent
  • Meet the same batch requirements for identity, strength, purity, and quality
  • Be manufactured under the same strict standards of FDA's good manufacturing practice regulations required for innovator products

I hope you found this answer useful. Feel free to reach out at www.thinkbiotech.com. For more on generic drugs, you can see our resources and whitepapers at Pharmaceutical strategic guidance and whitepapers

This post originally appeared on Quora. Click here to view.

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