The truth about Pa Ping

The truth about Pa Ping

Knee injury leads medical student to investigate mysterious disease

By April Frawley Birdwell

Lauren Bowen, a College of Medicine student, studied Pa Ping disease and had a paper published in Neurology./Photo by Maria Belen Farias

At the start of her third year of medical school in 2009, Lauren Bowen found herself with something she had grown rather unaccustomed to as a medical student — free time. Ready to try something new and take advantage of the time, she enrolled in a jujitsu class.

Things didn’t exactly go well.

“During the second class I jumped over someone and tore both of my ACLs and my meniscus,” said Bowen, who will graduate from the UF College of Medicine May 14. “My doctors wrote an abstract about it for a conference because no one does this.”

The injury left her sidelined at home for six weeks while she recovered from the surgery to repair her knees. So she enrolled in a history of medicine elective, a decision that would lead to her first published paper — in the prestigious journal Neurology, no less — and help her choose a specialty.

For a class project, Bowen began to investigate the history of Pa Ping disease in China during the 1930s. One of her professors, S.H. Subramony, M.D., had talked about the mysterious condition before.

“I decided to look into it because no one knew about it,” said Bowen, who worked with faculty members Subramony and Michael Okun, M.D., on the paper, which traced the origins of the disease.

Bowen began digging up information on Pa Ping in old journal articles. Canadian medical missionary Alexander Stewart Allen, M.D., documented the disease in 1930. He noticed a pattern; patients would come in with sickness that would progress to paralysis. Often, they died. Allen would eventually contract the disease himself, though he recovered.

In later years, other physicians in the region reported similar outbreaks. Mystery surrounded the disease until the 1940s, when the true culprit emerged. According to the paper, the discovery occurred after a group of middle school children became sick with Pa Ping. The children had all eaten the same soup, which was found to contain toxic levels of barium from salt. Later animal studies would show that when given barium, the animals would develop the same sickness associated with Pa Ping.

After reviewing the literature, with assistance from colleagues working in China, Bowen contacted relatives and associates of the people involved to confirm what they had found, including Allen’s daughter.

“It took awhile for her to even recall that (Dr. Allen) had talked to (her family) about it,” Bowen said.

The article was published last May and earned Bowen a trip to the American Academy of Neurology’s annual conference. The experience solidified her desire to pursue neurology as her specialty.

“Lauren is someone with a very energetic motor under her feet, and she kept several paces of ahead of me throughout the project,” said Subramony, a UF professor of neurology. “She is someone we will hear more about in the future, I am sure.”

Since working on the paper, Bowen has worked on other historical articles with Okun, examining, for example, whether Gen. Douglas MacArthur had Parkinson’s disease.

“I think it gives you a really good appreciation for the medicine we practice now,” said Bowen, who will complete her neurology residency at UF. “As humans we have a really short worldview; it only spans a couple decades. If you start to look back, you get a really good sense of how history applies to what we do now.”