What have we learnt from Graham Frederick Young? Reflections on the mechanism of thallium neurotoxicity.

The recent death of the psychopathic poisoner, Graham Frederick Young, prompts the question: has our knowledge of the toxic effects of thallium been increased as a result of his activities? The answer is 'yes' but very little. However, the poisonings led to a re-examination of the topography and pathogenesis of thallium intoxication and the suggestion that there are close similarities with chronic thiamine deficiency neuropathy and arsenical neuropathy. They might be termed chronic energy deprivation neuropathies and are associated with damage to other organs with high energy requirements, namely skin and its appendages, testis and heart. While the exact metabolic 'lesion' in thallium intoxication is not yet known, circumstantial evidence continues to suggest that it may be related to the known interaction of this ion with riboflavin, with consequent effects upon energy generation mechanisms associated with tissue flavoproteins.