John Cade
Encyclopedia
- This article is about the Australian psychiatrist. For the leader of the Kent Rebellion, see Jack CadeJack CadeJack Cade was the leader of a popular revolt in the 1450 Kent rebellion during the reign of King Henry VI in England. He died on the 12th July 1450 near Lewes. In response to grievances, Cade led an army of as many as 5,000 against London, causing the King to flee to Warwickshire. After taking and...
.
For the former Maryland State Senator, see John A. Cade
John A. Cade
John A. Cade was a Republican State Senator from District 33 in the U.S. state of Maryland.-Background:John A. Cade was first elected to office in 1975 to represent District 33, which covers a portion of Anne Arundel County, Maryland...
For the Louisiana
Louisiana
Louisiana is a state located in the southern region of the United States of America. Its capital is Baton Rouge and largest city is New Orleans. Louisiana is the only state in the U.S. with political subdivisions termed parishes, which are local governments equivalent to counties...
Republican
Republican Party (United States)
The Republican Party is one of the two major contemporary political parties in the United States, along with the Democratic Party. Founded by anti-slavery expansion activists in 1854, it is often called the GOP . The party's platform generally reflects American conservatism in the U.S...
state chairman, see John H. Cade, Jr.
John H. Cade, Jr.
John Hamilton Cade, Jr. , was an Alexandria businessman and a pioneer in the development of the modern American Republican Party in Louisiana. Though he never held elected office himself, Cade was the GOP national committeeman and thereafter the Louisiana party chairman from 1976–1978...
Dr John Frederick Joseph Cade AO
Order of Australia
The Order of Australia is an order of chivalry established on 14 February 1975 by Elizabeth II, Queen of Australia, "for the purpose of according recognition to Australian citizens and other persons for achievement or for meritorious service"...
(18 January 1912 – 16 November 1980) was an Australian psychiatrist
Psychiatry
Psychiatry is the medical specialty devoted to the study and treatment of mental disorders. These mental disorders include various affective, behavioural, cognitive and perceptual abnormalities...
credited with discovering (in 1948) the effects of lithium carbonate
Lithium carbonate
Lithium carbonate is a chemical compound of lithium, carbon, and oxygen with the formula Li2CO3. This colorless salt is widely used in the processing of metal oxides and has received attention for its use in psychiatry. It is found in nature as the rare mineral zabuyelite.-Properties:Like almost...
as a mood stabilizer in the treatment of bipolar disorder
Bipolar disorder
Bipolar disorder or bipolar affective disorder, historically known as manic–depressive disorder, is a psychiatric diagnosis that describes a category of mood disorders defined by the presence of one or more episodes of abnormally elevated energy levels, cognition, and mood with or without one or...
(then known as manic depression). In an age where the standard treatments for psychosis were electroconvulsive therapy
Electroconvulsive therapy
Electroconvulsive therapy , formerly known as electroshock, is a psychiatric treatment in which seizures are electrically induced in anesthetized patients for therapeutic effect. Its mode of action is unknown...
and lobotomy
Lobotomy
Lobotomy "; τομή – tomē: "cut/slice") is a neurosurgical procedure, a form of psychosurgery, also known as a leukotomy or leucotomy . It consists of cutting the connections to and from the prefrontal cortex, the anterior part of the frontal lobes of the brain...
, lithium had the distinction of being the first effective medication available to treat a mental illness.
Early life
John Cade was born in MurtoaMurtoa, Victoria
Murtoa is a wheat district town in Victoria, Australia, situated around Lake Marma on the Wimmera Highway, north-west of the state capital, Melbourne. The town is in the Shire of Yarriambiack local government area. At the 2006 census, Murtoa had a population of 912.The name Murtoa is believed to...
,Some authors state Cade was born in Horsham, one of the larger towns in the Wimmera area. However other authors, notably Cade's son Jack Cade, state John Cade was born in Murtoa, a town 32 kilometres (20 mi) NE of Horsham. in the Wimmera
Wimmera
The Wimmera is a region in the west of the Australian state of Victoria.It covers the dryland farming area south of the range of Mallee scrub, east of the South Australia border and north of the Great Dividing Range...
region of Victoria, Australia. John's father David was Murtoa's general practitioner. Ellen, John's mother, and younger brothers David and Frank completed the family. When John was a small boy, his father left for World War I and served in Gallipoli
Gallipoli
The Gallipoli peninsula is located in Turkish Thrace , the European part of Turkey, with the Aegean Sea to the west and the Dardanelles straits to the east. Gallipoli derives its name from the Greek "Καλλίπολις" , meaning "Beautiful City"...
and France
Western Front (World War I)
Following the outbreak of World War I in 1914, the German Army opened the Western Front by first invading Luxembourg and Belgium, then gaining military control of important industrial regions in France. The tide of the advance was dramatically turned with the Battle of the Marne...
. On return from the war, his father suffered from 'war weariness' and had difficulty in continuing in general practice. Therefore, his father sold the practice and accepted a position with the Mental Hygiene Department. Over the next 25 years, Dr Cade Sr became medical superintendent at several Victorian mental hospitals, namely Sunbury
Sunbury Asylum
Sunbury Lunatic Asylum first opened in October 1879. Its proclamation as an Asylum was published in the Government Gazette on 31 October 1879....
, Beechworth
Beechworth Asylum
Beechworth Lunatic Asylum, originally known as Mayday Hills Lunatic Asylum is a decommissioned psychiatric hospital located in Beechworth, a town of Victoria, Australia. Mayday Hills Lunatic Asylum was the four such Hospital to be built in Victoria, being one of the three largest...
and Mont Park. John and his brothers spent many of their younger years living within the grounds of these institutions, which had a great bearing on John's later deep understanding of the needs of the mentally ill. John was educated at Scotch College, Melbourne
Scotch College, Melbourne
Scotch College, Melbourne is an independent, Presbyterian, day and boarding school for boys, located in Hawthorn, an inner-eastern suburb of Melbourne, Victoria, Australia....
, matriculating in 1928. He then studied medicine at the University of Melbourne
University of Melbourne
The University of Melbourne is a public university located in Melbourne, Victoria. Founded in 1853, it is the second oldest university in Australia and the oldest in Victoria...
, graduating at the age of 21 years with honours in all subjects. He became a House Officer at St Vincent's Hospital
St Vincent's Hospital, Melbourne
St Vincent's Hospital, Melbourne is the major hospital in Fitzroy, Melbourne, Australia.It is operated by the St Vincent's Health service, previously known as the Sisters of Charity Health Service, Melbourne...
and then Royal Children's Hospital
Royal Children's Hospital, Melbourne
The Royal Children's Hospital is a major children's hospital in Melbourne, Australia.As the major paediatric hospital in Victoria, the Royal Children's Hospital and offers a full range of clinical services, tertiary care and health promotion and prevention programs for children and adolescents...
before becoming severely ill with bilateral pneumococcal pneumonia. While he was convalescing, John fell in love with one of his nurses, Jean. They married in 1937.
World War II
Like his father before him, Cade left his young family to fight for Australia in the Armed Forces in World War II. Cade was appointed captain, Australian Army Medical Corps, A.I.F.Second Australian Imperial Force
The Second Australian Imperial Force was the name given to the volunteer personnel of the Australian Army in World War II. Under the Defence Act , neither the part-time Militia nor the full-time Permanent Military Force could serve outside Australia or its territories unless they volunteered to...
, on 1 July 1940 and posted to the 2nd/9th Field Ambulance. Although trained as a psychiatrist, Dr. Cade served as a surgeon
Surgery
Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...
and departed for Singapore in 1941 on RMS Queen Mary
RMS Queen Mary
RMS Queen Mary is a retired ocean liner that sailed primarily in the North Atlantic Ocean from 1936 to 1967 for the Cunard Line...
. He was promoted to major
Major
Major is a rank of commissioned officer, with corresponding ranks existing in almost every military in the world.When used unhyphenated, in conjunction with no other indicator of rank, the term refers to the rank just senior to that of an Army captain and just below the rank of lieutenant colonel. ...
in September 1941. After the Fall of Singapore
Battle of Singapore
The Battle of Singapore was fought in the South-East Asian theatre of the Second World War when the Empire of Japan invaded the Allied stronghold of Singapore. Singapore was the major British military base in Southeast Asia and nicknamed the "Gibraltar of the East"...
to Japan, he became a prisoner of war
Prisoner of war
A prisoner of war or enemy prisoner of war is a person, whether civilian or combatant, who is held in custody by an enemy power during or immediately after an armed conflict...
at Changi Prison
Changi Prison
Changi Prison is a prison located in Changi in the eastern part of Singapore.-First prison and POW camp:...
from February 1942 to September 1945. During his imprisonment, he reportedly would observe some fellow inmates having strange, vacillating behaviour. He thought perhaps a toxin was affecting their brains and when it was eliminated through their urine, they lost their symptoms.
Discovery of the effect of lithium on mania
After the war, Cade recuperated very briefly in Heidelberg Hospital, then took up a position at Bundoora Repatriation Mental Hospital in Melbourne. It was at an unused kitchen in Bundoora where he conducted crude experiments which led to the discovery of lithium as a treatment of bipolar disorder. These experiments mostly consisted of injecting urine from mentally ill patients into the abdomen of guinea pigGuinea pig
The guinea pig , also called the cavy, is a species of rodent belonging to the family Caviidae and the genus Cavia. Despite their common name, these animals are not in the pig family, nor are they from Guinea...
s. These would appear to die faster than when healthy persons' urine was used, leading him to think that perhaps more uric acid was present in the samples provided by his mentally ill patients. Then, in an effort to increase the water solubility of uric acid, lithium urate was added to the solution. Cade found that in the guinea pigs injected with the lithium urate solution, toxicity was greatly reduced. However, his use of careful controls in his experiments revealed that the lithium ion had a calming effect by itself. After ingesting lithium himself to ensure its safety in humans, Cade began a small-scale trial of lithium citrate and/or lithium carbonate on some of his patients diagnosed with mania
Mania
Mania, the presence of which is a criterion for certain psychiatric diagnoses, is a state of abnormally elevated or irritable mood, arousal, and/ or energy levels. In a sense, it is the opposite of depression...
, dementia præcox
Schizophrenia
Schizophrenia is a mental disorder characterized by a disintegration of thought processes and of emotional responsiveness. It most commonly manifests itself as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, and it is accompanied by significant social...
or melancholia
Melancholia
Melancholia , also lugubriousness, from the Latin lugere, to mourn; moroseness, from the Latin morosus, self-willed, fastidious habit; wistfulness, from old English wist: intent, or saturnine, , in contemporary usage, is a mood disorder of non-specific depression,...
, with outstanding results. The calming effect was so robust that Cade speculated that mania was caused by a deficiency in lithium.
While Cade's results appeared highly promising, side-effects of lithium in some cases lead to non-compliance. Toxicity of lithium led to several deaths of patients undergoing lithium treatment. The problem of toxicity was greatly reduced when suitable tests were developed to measure the lithium level in the blood. Moreover, as a naturally-occurring chemical, lithium salt could not be patent
Patent
A patent is a form of intellectual property. It consists of a set of exclusive rights granted by a sovereign state to an inventor or their assignee for a limited period of time in exchange for the public disclosure of an invention....
ed, meaning that its manufacturing and sales were not considered commercially viable. These factors prevented its widespread adoption in psychiatry for some years, particularly in the United States, where its use was banned until 1970.
John Cade, Royal Park and RANZCP
Royal Park Hospital
Royal Park Psychiatric Hospital, commonly known as Royal Park is a former Receiving House and Psychiatric Hospital located in Parkville. Operating for over 90 years, Royal Park Hospital was the first psychiatric hospital established in Victoria after the Lunacy Act of 1903, and was intended for...
. Two years later, at the request of the Mental Hygiene Authority which was planning to remodel Royal Park
Royal Park Hospital
Royal Park Psychiatric Hospital, commonly known as Royal Park is a former Receiving House and Psychiatric Hospital located in Parkville. Operating for over 90 years, Royal Park Hospital was the first psychiatric hospital established in Victoria after the Lunacy Act of 1903, and was intended for...
, he visited Britain for six months to inspect psychiatric institutions. On his return, he introduced modern facilities and replaced the rather authoritarian approach to patient care with a lot more personal and informal style that included group therapy
Group therapy
Group psychotherapy or group therapy is a form of psychotherapy in which one or more therapists treat a small group of clients together as a group...
. Concerned at the number of alcohol-related cases, he supported voluntary admission to aid early detection and later proposed the use of large doses of thiamine
Thiamine
Thiamine or thiamin or vitamin B1 , named as the "thio-vitamine" is a water-soluble vitamin of the B complex. First named aneurin for the detrimental neurological effects if not present in the diet, it was eventually assigned the generic descriptor name vitamin B1. Its phosphate derivatives are...
in the treatment of alcoholism. Cade served as the Superintendent at Royal Park until his retirement in 1977.
He served as the federal president of the Royal Australian and New Zealand College of Psychiatrists
Royal Australian and New Zealand College of Psychiatrists
The Royal Australian and New Zealand College of Psychiatrists is the principal organisation representing the medical specialty of psychiatry in Australia and New Zealand and has responsibility for training, examining and awarding the qualification of Fellowship of the College to medical...
in 1969–70, and also as the president for its Victoria
Victoria (Australia)
Victoria is the second most populous state in Australia. Geographically the smallest mainland state, Victoria is bordered by New South Wales, South Australia, and Tasmania on Boundary Islet to the north, west and south respectively....
branch from 1963 until his death in 1980. In the end, Dr. Cade's discovery did receive widespread acknowledgements and praise. For his contribution to psychiatry, he was awarded a Kittay International Award in 1974 (with Mogens Schou
Mogens Schou
Mogens Schou was a Danish psychiatrist whose groundbreaking research into Lithium led to its utilization as a treatment for bipolar illness. His work ultimately benefited thousands of patients worldwide....
from Denmark), and he was invited to be a Distinguished Fellow of the American College of Psychiatrists
American College of Psychiatrists
The American College of Psychiatrists is an association of psychiatrists based in Chicago. It operates annual meetings, publishes a newsletter, presents awards, and organizes the PRITE exam for psychiatric residents and the PIPE exam for practicing psychiatrists...
. In 1976, Cade was one of the first to be made an Officer of the Order of Australia. Dr. Cade remained humble about his chance discovery, describing himself as merely a gold prospector who happened to find a nugget. Finally, in July 2004, the Medical Journal of Australia reported that Cade's 1949 article, "Lithium salts in the treatment of psychotic excitement", was the number one most cited MJA article.
Troubled Minds
In 2004, Film AustraliaFilm Australia
Film Australia was a company established by the Government of Australia to produce films about Australia. Its mission was to create an audio-visual record of Australian culture, through the commissioning, distribution and management of programs that deal with matters of national interest or...
and SBS
Special Broadcasting Service
The Special Broadcasting Service is a hybrid-funded Australian public broadcasting radio and television network. The stated purpose of SBS is "to provide multilingual and multicultural radio and television services that inform, educate and entertain all Australians and, in doing so, reflect...
screened the documentary 'Troubled Minds – The Lithium Revolution', a 60 minute documentary portraying John Cade's discovery of the use of Lithium in mental illness. The documentary received international recognition winning the main prize at the International Vega Awards for Excellence in Scientific Broadcasting.
Troubled Minds was also recognised locally with writer/director Dennis K. Smith winning the AWGIE Award for Best Documentary.
See also
- Lithium pharmacologyLithium pharmacologyLithium pharmacology refers to use of the lithium ion, Li+, as a drug. A number of chemical salts of lithium are used medically as a mood stabilizing drug, primarily in the treatment of bipolar disorder, where they have a role in the treatment of depression and particularly of mania, both acutely...