Part one of this series examined the role Australian scientist John Cade (1912 – 1980) played in helping establish the drug lithium as the gold standard in the treatment of mentally ill patients from the 1950’s onward.

This second installment will unearth exactly what the substance known as lithium is and what it’s myriad of uses in today’s world are.

Lithium has been around since the very beginnings of the Universe. At the moment of the Big Bang, according to scientists, only three elements were at play – hydrogen, helium and lithium. In every single star and planet there is lithium.

In the modern context, lithium was ‘discovered’ in 1817. It’s distinction on the Periodic Table is it is the lightest of all the 91 metals listed. It is so light, in fact, it can float on water. It is also soft; soft enough that it can be cut with a kitchen knife.

Lithium is found in the world’s oceans at very low concentrations and is a naturally occurring trace element in the human body. A person weighing 70 kilograms has about half a gram of lithium residing in their body.

0.0007 percent of the Earth’s crust is composed of lithium. Lithium is only found in nature locked up in minerals and salts. In other words, when we speak of ‘lithium’ per se, we are most often actually referring to what in the science world is known as a compound ie. a mixture of two or more different substances. Lithium salts, lithium citrate and lithium carbonate are the three most often sold and prescribed forms of ‘lithium‘ serving as mood stabilizers in the pharmaceutical world today.

Everyone knows about lithium batteries but probably not that lithium is a lethal component of the hydrogen bomb. Lithium is used in the most astonishing variety of places. When you gaze upwards on New Years Eve and marvel at the incandescent pyrotechnics and the night sky turning blood-crimson, you are gazing at lithium burning in the heavens.

Lithium-based compounds are used in aircraft manufacture as well as the production of bicycle frames. As well, lithium is used in glass ceramics, air-conditioning units and industrial drying systems. Only 5 percent of all lithium production is devoted to medication.

As to the question, “Where do we get lithium from?” there are two main sources of lithium: mines and brine water. Over 80% of the world’s lithium comes from the brine water obtained from briny (salt) lakes.

As of 2019, the top three lithium producing countries were –

• Australia – 51 000 metric tonnes
• Chile – 16 000 metric tonnes
• China – 8000 metric tonnes

Demand for lithium is expected to surge this current decade. This is being driven chiefly by the growing demand for lithium-ion (Li-ion) batteries to supply the electric car market. As but one example, Tesla plans to produce 500,000 battery-powered vehicles per year by 2020, with batteries supplied by the company’s 13.6 million square foot “gigafactory” which, once completed, will be the world’s second largest building by volume.

Apple (believe it or not) will be competing directly with Tesla with its own electric car which is expected to be available in 2021, while the start-up Faraday Future is planning a new $1-billion factory in Las Vegas, and is hoping to produce its first car next year. All these battery factories will demand an estimated 100 000 tonnes of new lithium carbonate by 2021.

Economists have been forecasting a lithium economy for decades, and it may well be that someday every car, computer and wearable electronic device — not to mention our energy storehouses — will depend on lithium.

The next great frontier for lithium production is investigating ways in which the almost unlimited supply available in seawater (though as already stated, in very low concentrations) within the world’s oceans can be harnessed and mined. Currently there is considerable research and development taking place in this area.

** Attribution – The facts and research used to compile this article / conduct this inquiry assemble this… this…fact-riddled ‘thing’ were taken from a total of fourteen separate resources, all accessible via knowledge-seekers the world over’s best friend – the internet.

In our next installment we investigate the use of lithium’s application within the psychiatric domain. We delve into lithium’s past reputation as a general panacea for a variety of ills. And we attempt to answer the question “Was Australian scientist John Cade really the first to pioneer lithium’s use as a mood stabilizer?”

Anyone’s who’s followed this blog for more than a few minutes will know life around here, to quote the renown philosopher Forest Gump, is most definitely a box of chocolates – hard and soft centers. You never know what you’re gonna git.

This brings us to the fascinating (to me) story of the drug lithium and the Australian scientist who pioneered it’s use in the early 1950’s as a treatment for depression and bi-polar disorder.

As much as it hurts me to say this, if knowing more about this topic sounds not the least appealing, you may want to take a brief sojourn from Scenic Writer’s Shack – for let’s say the next month or so. I intend to employ no less than a fleet of industrial excavators equipped with alloy steel bucket teeth – they’re the ‘diggiest’ – to fully unearth this game-changing chapter of medical/scientific history.

Here we go…

Born in the city of Horsham, 300km northwest of Melbourne, John Cade would grow up to be nothing short of one of the true rock stars of Australian medicine. Wearing his stereotypical thick-framed glasses, he had a professional look reminiscent of ‘Brains’ from the 1960’s tv show THUNDERBIRDS.

He was the son of a psychiatrist in the days when psychiatrists lived on the grounds of what today are referred to as ‘mental health facilities’ but back then were known as asylums.

As a young boy, John Cade was taken from asylum to asylum through his father’s work and observed mentally ill patients every day. Instead of being objects of curiosity or people to fear he was able to regard them as friends with imaginary worlds from a very early age.

Back in this era however, people with serious mental illness lived in a kind of netherworld. Then, it was almost romantically referred to as melancholia; now it would be considered severe clinical depression.

Those severely affected by melancholia sometimes fantasied that their brains were rotting, their bowels unmoveable and that life was a farce in need of obliteration.

Another hallmark of institutional care back at this time was that every shade of mental affliction – from alcoholics, epileptics, the brain-injured and vagrants to manics, the depressives and those who imagined their minds were being wirelessly tampered with were all lumped together under the one all-embracing roof. Routine, rigidity and responsibility were the triad of asylum life.

John Cade would himself become a psychiatrist, but not before serving as a Major in the Australian army during World War 2. During this time he survived three and a half years incarcerated in the notoriously hellish conditions of the Japanese Prisoner of War camp in Changi, Singapore. This experience would help shape his theories on human psychology, physiology and mental health care.

After the war ended Cade found himself working at Bundoora Asylum (which closed in 2001 but has since developed a reputation for being haunted) on the outskirts of Melbourne, treating ex-diggers who were afflicted with mental illness.

It was here he began crude experiments examining the urine of patients and injecting guinea pigs with the naturally occurring substance lithium. Cade noticed that when he did this the guinea pigs became calm. After then ingesting it himself and confirming it was safe he began administering it to several test patients at the asylum.

By the start of 1949, John Cade knew he had uncovered something remarkable in lithium, and with his once-ill patients blooming with health, he was ready to break his silence and write up his work for publication.

In his research paper, he would argue that lithium – a simple element on the Periodic table, could tame a specific mental illness – mania. The notion itself was almost unbelievable to many at the time – that lithium, a metal dug from the earth’s crust and made into a solution or a tablet, could do this.

Even the idea that something inanimate, a naturally occurring chemical that had been around since the beginnings of time, could shape a person’s mind and govern his behavior was repugnant and against the natural order of things to the traditionally thinking minds of some doctors.

Many of John’s colleagues saw the source of manic depression as stemming from a disturbed family upbringing. To such psychiatrists, it was a mother’s malevolent word or a father’s brutal fist that twisted a child’s upbringing and caused madness.

John knew his research paper would provoke bitter opposition, particularly among fans of Sigmund Freud and psychoanalysis. He had read Freud (the Austrian neurologist who pioneered the clinical method for treating psychopathology through dialogue between a patient and a psychoanalyst) extensively but rejected his theories. He saw the body and brain as an interconnected chemical laboratory and much preferred the chemical causation theory to explain and treat mental illness.

John Cade’s historic paper was published without fanfare in THE MEDICAL JOURNAL OF AUSTRALIA on the 3rd of September 1949. It was his four page magnum opus. In due course it would be celebrated as that esteemed journal’s (THE MEDICAL JOURNAL OF AUSTRALIA commenced publication in 1856 and today is a peer-reviewed medical gazette published 22 times a year) most cited paper.

This single published paper would forever change the way we think about mental illness.

What exactly is the substance known as lithium? Where does it come from? Was lithium really an ingredient in the soft-drink 7-Up? Is it true John Cade really was the first to pioneer lithium’s use in psychiatric medicine or were there other’s who tried before him? And is lithium still the gold standard in treating mental illness today? These questions and more will be answered in the second part of our inquiry next week.

**Attribution

Research for this write-up used seven separate information sources – including the 2016 John Cade biography FINDING SANITY. I read this book cover to cover a few months back. The most recently written book on the subject was published in August of last year. It’s title is LITHIUM – A DOCTOR , A DRUG AND A BREAKTHROUGH.

Ps. Naturally you deserve a bonus read, right? Click HERE to read a movie review of the film THREE CHRISTS (2020) starring Richard Gere. It tells the story of real-life psychologist Milton Rokeach who conducted a groundbreaking study in the late 1960’s of three psychiatric patients who all firmly believed they were Jesus Christ.