Autism: Its Causes, Contributors, and Maximizing the Chance for Recovery

Ed R Meelhuysen, Co-Founder, Sharper Mind Centers, Inc. 
Copyright © 2008 Sharper Mind Centers, Inc.  All rights reserved. Updated 11-10-09

It is my studied opinion that autism and its various forms (Autistic Spectrum Disorders) are caused by neurotoxins in the brain, complicated or contributed to by a genetic susceptibility towards a digestive metabolic disorder.

It is also my opinion that often the neurotoxins can be readily removed and the recovery process begun.  The brain may be rehabilitated to a lesser or greater degree, in some cases virtually eliminating any sign or evidence that the autism at one time was present.  The degree of the recovery depends on a variety of factors.  These include, but are not limited to:

This opinion stems over the years from reading a number of articles and studies online and in my physician wife's medical journals, talking with a number of parents of children that have autism, as well as working with children with autism and seeing some that no longer have any identifiable symptoms of autism (essentially a full recovery).

Generally there have to be several contributing factors to precipitate an autistic condition. Typically there is a genetic predisposition to being unable to metabolize grain proteins (a gluten intolerance), dairy protein (a casein intolerance) as well as being unable to metabolize and eliminate toxins. Often in conjunction with this genetic deficiency is a cognitive processing disorder. We see this combination in about approximately 30% of the children and adults we work with at our Sharper Mind Centers. Recapping the combination:

  1. Difficulty metabolizing gluten (permanent)

  2. Difficulty metabolizing casein (permanent)

  3. Difficulty metabolizing toxins (toxins are removable)

  4. Presence of a processing disorder (usually resolvable)

This genetic deficiency appears to be most commonly found in those of Northwest European descent: English, Welsh, Irish, Scottish and in the fair-haired Scandinavian population (Norwegian, Swedish, Danish, Finnish). However, most ethnic groups have this to varying degrees, and autism may occur with or without the other components and other contributive factors.

Neurotoxins can come from a number of sources. They could stem from ingestion of foods that are high in mercury content by the pregnant or breast-feeding mother, or exposure to toxins through environmental contact.  The latter might occur through the toddler eating lead paint chips or drinking first-run water from a faucet where the static water has absorbed lead or tin from the fixture.

Foods that are high in mercury content include tuna (esp. white Albacore or light), American lobster and swordfish (click here for a ranked list). The larger the fish, the higher up the food chain, the greater the bio-accumulation of mercury or other toxins.  Studies have been done comparing toddlers whose mothers while pregnant ate foods high in mercury with those who did not.  Study results clearly demonstrate that there is a diminishment in cognitive function of the toddlers whose pregnant mothers ate foods high in mercury. However, it is not reported that any of these toddlers whose mothers ate food high in mercury were autistic, just cognitively behind.  Personally, I don't recommend the eating of fish by pregnant women, but rather the usage of flaxseed oil to obtain the necessary Omega-3 essential fatty acids (EFA).  Consumption during pregnancy of high Omega-3 containing foods that DO NOT come from high-mercury fish have been showed to aid cognitive development of the baby.

However, I believe the greatest culprit in the introduction of toxins to the brain has historically been through the vaccination process and schedule.

I should make the disclosure that my firstborn child died two weeks after the baby received his eight week vaccines. Subsequently my wife, a medical doctor, elected to delay vaccination of our subsequent children until they were older. It should be noted that we are not against vaccines per se, just

There is a growing body of evidence that suggests that preservatives in vaccines played a substantial contributive role in the outbreak of autism. The reason for preservatives’ usage in vaccines is that in multi-dose vials of vaccine, the usage of a preservative is required in order to prevent the spreading of a pathogen (virus, fungus, bacteria) within the vaccine bottle (FDA website on history of preservatives). Early in the history of vaccines, it was quickly discovered that if a preservative was not used in a multi-dose vial, that if there was an accidental introduction of a pathogen into the bottle of vaccine, the pathogen would multiply and then be injected along with the vaccine into the child. A high percentage of those children died. Thus preservatives were developed, with the most common preservative being Thimerosal. 

"Thimerosal is the preservative of choice for vaccine manufacturers. First introduced by Eli Lilly and Company in the late 1920s and early 1930s, the company began selling it as a preservative in vaccines in the 1940s. Thimerosal contains 49.6 percent mercury by weight and is metabolized or degraded into ethylmercury and thiosalicylate." http://www.naturalnews.com/011764.html 

Thimerosal consists of approximately 50% mercury (organomercury). When its use first began, it was used in adult vaccines (esp. during the war effort) and with the larger size of adults (as compared to children) and its infrequent utilization, no notable side effects were noted.  Subsequently Thimerosal was used in childhood vaccines, again with no major side effects noted (incidence of autism 1 in 10,000). However as the number of required childhood vaccines increased, the typical modern child was receiving a greater load of mercury than a child born years earlier. In 1991, the number of vaccines jumped from 10 to 24. At this point, we began seeing a jump in the incidence of autism (which some people are calling vaccination injury).  More recently the number of recommended vaccinations has gone as high as 36.  While arguments are offered that this is done to prevent the child from getting a broad spectrum of diseases, there is a risk/benefit ratio to everything, and I believe that our society’s vaccination schedule is at this time promoting more risk than benefits.

Another preservative commonly used in vaccines is Neomycin.  Wikipedia states the following under the entry Neomycin:  

Neomycin is an aminoglycoside antibiotic that is found in many topical medications such as creams, ointments and eyedrops. Neomycin is overwhelmingly used as a topical preparation, such as Neosporin. It can also be given orally, where it is usually combined with other antibiotics. Neomycin is not absorbed from the gastrointestinal tract .... It has also been used to treat small intestinal bacterial overgrowth. It is not given intravenously, as neomycin is extremely nephrotoxic (causes kidney damage), especially compared to other aminoglycosides. The exception is when neomycin is included, in very small quantities, as a preservative in some vaccines - typically 0.025 mg per dose. ... It is relatively toxic to humans, and many people have allergic reactions to it. http://en.wikipedia.org/wiki/Neomycin

Other entries echo the same sentiment:

Neomycin: An antibiotic may be used in some underarm deodorants. Can cause allergic reactions, photoallergy, kidney toxicity, may promote staph infections. http://www.mbm.net.au/health/cosmetics/n.html

What is neomycin used for?  It is used topically in the treatment of skin and mucous membrane infections, wounds, and burns. Although it is also used systemically, it is highly toxic. http://qanda.encyclopedia.com/question/neomycin-used-236627.html 

Are these the only preservatives used in vaccines?  "Dr Mercola reveals other ingredients to be included in the Flu vaccines are a variety of chemicals that include squalene, ethylene glycol (antifreeze), formaldehyde, phenol (carbolic acid) and even antibiotics like Neomycin and streptomycin. Not forgetting of course the true magic mushroom of any good vaccine made today 'Thimerosal'." http://www.americanchronicle.com/articles/view/113203

Recognizing that there was a link between vaccinations and autism, the government and various pharmaceutical entities began a cover-up to disassociate the evidence from the result. Some of the ways they did this were to:

Studies start with the end in mind

"Lies, damned lies, and statistics" is part of a phrase attributed to Benjamin Disraeli and popularized in the United States by Mark Twain: "There are three kinds of lies: lies, damned lies, and statistics." The statement refers to the persuasive power of numbers, the use of statistics to bolster weak arguments, and the tendency of people to disparage statistics that do not support their positions.” (Source)

I recall talking to a leading psychiatrist in the Portland, Oregon area whose fairly large research firm works for pharmaceutical companies doing medication research and the FDA required studies (I had done an in-service for the mental health professionals on their staff). He made the comment that if you are going to spend considerable money to prove the efficacy of a medication or treatment (i.e.  you start with the end goal in mind), you first do a preliminary study in order to determine the criteria that will yield the best results.  Criteria such as: Do you have to carefully screen your test subjects, (if so, what are the best characteristics: age, weight, gender, general health, family support, attitude, compliance, etc. ), control the time of day the medication or protocol is administered, frequency of administration, etc. Then one crafts a larger study based upon this preliminary study. Typically, in their research company, they would accept less than 5% of the responding applicants for a given study, screening out those who wouldn't produce the desired results. The results of the larger study are then essentially a foregone conclusion.

Of course then the positive study results are published and if adequate, the medication or treatment is approved by the FDA for usage across the board (both on label and off label prescribing).  Patients and their doctors are surprised when a medication or treatment protocol doesn’t work as promoted. Often side effects, which are not commonly seen in the carefully crafted study, are more often seen in the general population when using the medication.

So studies can be crafted to prove just about anything, and it is my opinion that the "large scale studies" that deny any link between vaccinations and autism were crafted so as to produce the foregone conclusion. They may have done this by isolating a single vaccine’s implementation as opposed to looking at the negative synergistic consequences of administering 24 to 36 vaccines within the first 24 months of birth. The vaccines used in the study may have been "mercury-reduced" or came from preservative-free batches (i.e.  single dose vials). They may have used an alternative preservative such as neomycin, ethylene glycol (a component of antifreeze) or aluminum. The cross section of the population may have been skewed to include a high Hispanic or Asian population which may have a lower tendency towards the gene that contributes to a child's susceptibility towards autism.

So study research isn’t always as objective and unbiased as it should be. And yet professionals often discount anecdotal evidence even if the anecdotal evidence is very substantial.  

As I mentioned earlier, I have spoken to a number of moms whose children exhibited autistic symptoms within hours of receiving a vaccine.  As one mother said, "I had concerns taking my child in for the vaccination but the pediatrician persuaded me that it would be alright.  She was almost to the bottom of her vial of Hepatitis B vaccine [where incidentally the heavier preservative tends to settle].  Within hours of receiving the vaccination, my child stopped making eye contact.  It was heart-breaking and I have had guilt for years since then."  One of my former staff members had twin grandchildren.  Within 24 hours of receiving a vaccination, one stopped talking and didn't communicate again verbally for nearly 2 years.: Here's an email I received from someone I had chatted with earlier:

"I have some good friends whose grandson just had the MMR vaccination and starting the next day had a severe reaction including seizures. He spent a week in Cook's Children's Hospital where he had a major seizure while undergoing an MRI of his brain. He is now home taking Risperdal, the same medication that my son who has schizophrenia takes. His parents have also been told that he is now autistic. He was a perfectly normal almost-three year old prior to the immunization. What is especially sad, is that his grandfather, who is a physician, warned his son about the dangers of the immunization and advised against getting it. However, the son and his wife took the child to his pediatrician and spent 45 minutes with the doctor as he explained to them how safe the MMR vaccine was. Only then did they agree to allowing their son to be immunized."

Here's what one parent shared with me:

"Both of our sons are autistic. My 9-year-old son Eric has had seizures for seven years, beginning with his first seizure at 14 months old. We began noticing that he was falling down at times. He would fall down and trip over things. We just thought he was a little clumsy. At 28 months old, he was experiencing almost 8 seizures a day. We went to the Loma Linda University Medical Center and he was hospitalized for a week at five different times for his seizures.

"He’s been treated with most of the anticonvulsants. He will at times go through periods of being seizure free, but those are passed. The longest we went without a seizure was when he was on Klonopin (clonazepam) for a year. And then that stopped working. Currently he’s on Ativan (lorazepam). Currently he is experiencing between 8-12 intense seizures per day. It will go at this intensity for a week or so and then taper off. Then it will recur.

"The second son, a six-year-old, became autistic definitely after receiving his vaccines. We went into the pediatrician’s office and the nurse noted that our son was behind the recommended vaccination schedule. She strongly stated that we get him caught up. They gave him 9 vaccines in one day. We lost him three days later. He lost eye contact and has never been the same after that. He’s mentally working at a three-year-old level."

And another parent shared the following:

"I have a high functioning autistic daughter who is currently 17 years old. We began noticing autistic symptoms when she was around three years old. Right after she had received a multiple shot series [immunizations], she got a shocked look on her face and would not snap out of it. She had fevers over 104° for some time after that. She also had seizures. She was on time with all her immunizations. Prior to that, she was developing normally, was talking and walking, and on track with what was expected."

How incredibly sad!  Well-meaning parents thought they were doing the right thing by immunizing their kids, but instead their child reacted to the vaccination and now the parents have to live with the guilt of what transpired.

Obviously, to the open-minded individual, outside of a traumatic brain injury, there is an association between the vaccine and the reaction including the seizures. The big question is what? What is that link?  

So what are the numbers?

"In February 2007, the Centers for Disease Control and Prevention issued their ADDM autism prevalence report. The report, which looked at a sample of 8 year olds in 2000 and 2002, concluded that the prevalence of autism had risen to 1 in every 100 American children, and almost 1 in 94 boys." (source)

Jenny McCarthy and Jim Carrey are actors and parents actively involved in autism-related causes.  They have an autistic child Evan, which they have been able to help to a substantial level of recovery.. McCarthy is the author of the book "Louder Than Words: A Mother's Journey in Healing Autism."  She has spoken to many moms and dads who also observed their children become autistic after receiving a vaccination.

It is my opinion that strong and consistent anecdotal evidence is a clue, and that if an unbiased well-designed study was truly to look at the factors involved, it would turn up the self-evident results. However most current studies are not funded in an unbiased environment, but rather are funded with the end in mind, usually by the pharmaceutical companies who stand to gain or lose if their products are approved or denied, or by government researchers who don't want to shut off the vaccination pipeline for "national security" (such as creating the H1N1 Swine Flu vaccine) or other purposes (why an EIi Lily Protection act?). The close relationship between the FDA and pharmaceutical companies (it can be a revolving door between the two at the higher executive levels) is unfortunate and the lack of the FDA oversight, properly guarding the American public, has contributed in the widespread distrust of this organization and the government.

Another study that needs to be redone on a larger scale was the small study of 12 children done by the University of Texas. This study demonstrated that 100% of children given methylphenidate (the active ingredient in Ritalin, Concerta, Metadate) for ADHD developed chromosomal abnormalities consistent with long term cancer risk.  100% is called a clue. (Search)  But who would fund a larger, longer term study that would truly be unbiased?  Would the pharmaceutical companies that would be at risk of diminished revenues or increased liability (or would they rather craft a study to prove that it doesn't)?  Would the government fund such a study and risk taking many kids off of meds?  Can you see why clues are ignored?  As my astute wife has said, "If something doesn't make sense, follow the money or the power."

Seizures and autism

Many autistic children experience seizures or tics. In talking with a few parents, for their "autistic" child, some traumatic event, such as a fall from a play set, damaged the brain and seizures resulted. However, if the seizures are not traumatic brain injury (TBI) or tumor induced, then generally these types of events are caused by neurotoxins lodged within the sensory-motor cortex. Because the mind-muscle feedback loop is not functioning properly, the sensory cortex of the brain that receives the input from the sensors that feedback a muscle’s position to the brain improperly interact with the nerve cells that fire those muscles, and a seizure or tic results.  Eliminate the neurotoxins and often the seizures can be eliminated.

Example: a mother brought her six-year-old boy to us who was experiencing 5 to 8 seizures a day including convulsive, grand mal seizures. He often wore a helmet to protect his head when he blacked out and took a fall. The boy did not have any speech or language function and virtually no emotions. We began by putting him on our rapid intensive detox protocol. The mother reported that within three weeks, the boy was seizure free. He remained seizure free for almost 6 months until the toxins (due to his inability to metabolize toxins) begin accruing again resulting in some very minor seizures. The mother then placed him on a low maintenance detoxification protocol to keep him seizure free.  After the detox protocol, he began to make speech efforts, revealed a teasing personality and was interested in fun things, was able to discontinue the ketogenic diet that he had been placed on, and was more responsive to additional therapies.

Recovery protocol

So, if your child has autism or you suspect so, what can you do?  Since 1967 the Autism Research Institute has been collecting parent ratings of the usefulness of the many interventions tried on their autistic children.  The data have been collected from the more than 23,700 parents who have completed their questionnaires designed to collect such information. See Parent ratings.  I have analyzed the data for effectiveness and produced a table showing the most effective interventions.  Click here for that table. It should be pointed out that non-medical interventions, with the exception of anti-seizure and anti-fungal medications, are generally notably more effective with fewer negative side effects.

Here are my recommendations:

  1. Detox quickly and safely of the majority of the neurotoxins (~5-6 weeks for our protocol), and then maintain the individual on a low detoxification protocol for the rest of their lives. (76% noted improvement with a detox.)

  2. Eliminate the use of gluten products and dairy (Casein containing) products.(65% noted improvement with a Gluten Free Casein Free (GFCF) diet.)

  3. Consider the use of antifungal agents such as Nystantin or Diflucan which can be helpful in reducing a systemic yeast (candida albicans) infection due to the prior use of antibiotics.  Many of those with an autistic spectrum disorder (ASD) have a systemic fungal infection. (an avg. of 53% noted improvements)

  4. Use highly absorbable vitamins and minerals to help offset the malabsorption disorder and provide adequate nutrition for the child.  Especially supplementation linked to mental development such as Omega-3, -6, Lecithin, Gingko Biloba, the Vitamins B-6 and B-12, Concord grape juice and others.

Not mentioned in the foregoing table are brain development interventions.  These should include:

  1. Use brain growth stimulating therapies to improve brain function, especially auditory integration therapy (including bone conduction audio therapy), sensory motor integration therapy, balance therapy and visual therapy. The Sharper Minds program which addresses each of these areas (and much more) is probably one of the most effective for stimulating the brain to grow properly. With our guided home training system, this is available to anyone in the U.S. and Canada. However, unlike those with conventional ADD or dyslexia, due to the greater severity and number of factors in dealing with autism or an ASD, we cannot guarantee full resolution of these conditions.

  2. Utilize a blend of therapies such as speech therapy, occupational therapy, physical therapy, psychological services, and additional special education services, which can be helpful for the child.

  3. It is also very important for the parents to tend to their own needs.  Parenting classes and support groups can also help the parents emotionally, and marriage seminars and relationship books/courses can strengthen the marriage bond to keep the family together. If one exhausts all one's time with the autistic child and spends little time building the marriage bond, divorce will likely happen.

Detoxification and chelation therapy

Chelation therapy, both oral and intravenous (IV), has been around for many years and has many proponents. However, I feel there are much more effective methods with lower side effects and substantially lower costs. Two clients of mine spent $10,000 each on IV chelation therapy.  In my opinion, the best detoxification therapy includes the usage of binding agents that are negative ionically charged ingestible minerals such as Calcium Montmorillonite and Zeolite Clinoptilolite.  Use of a negative ionically charged footbath can also be helpful, but does not replace use of the ingestible minerals.  Highly effective for larger children and adults is also combining use of the binding agents with a green-juice-fast for a week, or spending extended time in a low heat sauna (not recommended for young or thin children).  Sharper Minds can provide most of these items including rental of an ionic footbath if that is of interest, along with training and instructional materials. The FDA has ruled that the ingestible materials are under the GAS (Generally Accepted as Safe) classification, and even at high doses (10 times the recommended doses), no harm has been observed.

Uncommonly seen side affects (lasting only a few days to a week) during the detox period may include some emotional volatility, drooling, slight hair loss, intestinal discomfort and flu-like symptoms (Herxheimer affect) as the toxins are pulled out and replaced by beneficial minerals.  If these are seen, decreasing the amount of ingestible binding agents and extending the duration of the detox may be helpful. Again, these symptoms only last a short time and are not commonly seen in kids.

The initial detox process generally takes 4-6 weeks, but as mentioned earlier, due to the individual's difficulty in metabolizing toxins, over time toxins of some nature will begin to accrue again, so a low dose, maintenance detox needs to done on a regular basis (e.g. once a week, twice a month, etc.).

Eliminate use of gluten and dairy products and other considerations

As was discussed earlier, it is common for someone who has an autistic spectrum disorder to also have the same gene that causes Celiac Sprue disease. This condition is also known as malabsorption disorder. There is a lot of information on the Internet on Celiac Sprue and how to go on a gluten-free diet, recipes, restaurants, etc., so I won’t cover that here.   What’s really challenging to go gluten free and be a vegetarian at the same time. Many restaurants such as the Old Spaghetti Factory and the Olive Garden now offer gluten-free pastas to their customers (but you must ask for their gluten-free menu).

I suggest doing an in-depth food screening to determine which foods your child may have a sensitivity or delayed intolerance to.  US BioTek Laboratories is a good resource (http://www.usbiotek.com). Click on the IgA, IgE & IgG Antibody Assessment link.

If your child is struggling with the foregoing, other things to watch out for include autoimmune disorders such as Hashimoto's thyroiditis.

Nutritional supplementation 

Studies have shown that often the systemic nutritional levels of those with Autism is less than what one would suspect.   I believe this is due to the malabsorption disorder that most of these have. Therefore it is essential to incorporate highly absorbable nutritional supplements into their daily regimen. This includes both vitamins and minerals. Liquid vitamins are best, though capsules or tablets can be used. To test if a tablet or capsule breaks down readily, drop it in a glass of warm water and see how long it takes for the tablet to break apart.   It should take no longer than 5 minutes, preferably less than 3.  I don't recommend the use of "Performance" or high potency supplements as the trace elements or unique components in these may have undesirable side affects that the autistic child may not be able to tell you about. Stick with a good basic supplement.  While they are more expensive, I do prefer and recommend concentrated food supplements as opposed to chemically derived ones.  There are also a growing number of supplements designed with the autistic child in mind.  Supplementing with a stem-cell releasing product (such as StemTech's StemEnhance or KlamathBlueGreen's products AFTER doing a detox and 30-60 minutes prior to engaging in therapy sessions may enhance the effectiveness of the therapy and accelerate recovery.

Processing disorders

It is also very common (based upon the numbers we see at our Centers) that a child with a gluten/dairy intolerance will also have a cognitive processing disorder.  It appears the same gene or a related gene that contributed to the autistic condition also contributes to improper development of the left hemisphere, especially the auditory, visual or sensory-motor cortices, or the speech and language cortices.  These impairments can include problems with auditory processing (central auditory processing disorder), visual processing (remembering what they see, proper orientation of the visual), or issues with gross or fine motor skills (esp.  handwriting and drawing). Therapies that promote the development of each of these areas should be done in order to promote cognitive development in a challenged child or adult, even more so in a child seeking recovery from vaccine injury. 

The Sharper Minds program is likely the most intensive, broad-spectrum program available to most families and we address each of these areas and more. We service families from a wide number of states and internationally.  We invite you to review this website (www.sharperminds.net) for more information on overcoming cognitive disorders (including from some traumatic brain injury), how we work with long distance families and our guided Home Training System.  Please note these programs are designed for children or adults who are already verbally competent and are capable of learning their alphabet and more.  Those with autism or an ASD will require a version of the program customized to their abilities and needs.

I also invite you to call me at toll free 1-866-HELP-A.D.D. [1-866-435-7233] to discuss your situation.

Ed Meelhuysen

DISCLAIMER: None of the statements above have been evaluated by the FDA. All content presented herein has been compiled to provide information to you and is for educational purposes only. Always consult a physician or board certified health practitioner before taking any product. Use the information at your own risk.

References

Comments:

Here are a couple of links to Jenny McCarthy's interview with Larry King Live on the subject of Autism.

Studies? What Studies?

In the referenced article Thimerosal in Vaccines on the FDA website, in reviewing the Bibliography on the Studies on Safety and Effectiveness of Thimerosal (text copied below with key points highlighted in red), note that NONE of these studies had anything to do with intravenous injection of Thimerosal compounds into an infant or young child.  Some of the study applications included use of Thimerosal in nasal sprays, ophthalmic related uses (i.e.  for cleaning contact lens, ophthalmic drugs), hardly the same thing.  We don't put contact lens on babies and we don't usually give them a nasal spray. So how do these studies correlate to the real world of infant vaccinations and why are these studies even listed?

"Bibliography

"Studies on Safety and Effectiveness of Thimerosal:

  1. Batts AH, Narriott C, Martin GP, et al.  The effect of some preservatives used in nasal preparations on mucociliary clearance.  Journal of Pharmacy and Pharmacology 1989; 41:156-159.
  2. Batty I, Harris E, Gasson A.  Preservatives and biological reagentsDevelopments in Biological Standardization 1974;24:131-142. 
  3. Beyer-Boon ME, Arntz PW, Kirk RS.  A comparison of thimerosal and 50% alcohol as preservatives in urinary cytologyJournal of Clinical Pathology 1979;32:168-170.
  4. Gasset AR, Itoi M, Ishii Y, Ramer RM.  Teratogenicities of ophthalmic drugs.  II.  Teratogenicites and tissue accumulation of thimerosal.  Archives of Ophthalmology 1975;93:52-55.
  5. Goldman KN, Centifanta Y, Kaufman HF, et al.  Prevention of surface bacterial contamination of donor corneasArchives of Ophthalmology 1978;96:2277-2280.
  6. Keeven J, Wrobel S, Portoles M, et al.  Evaluating the preservative effectiveness of RGP lens care solutionsContact Lens Association of Ophthalmologists Journal 1995;21:238-241.
  7. Naito R, Itoh T, Hasegawa E, et al.  Bronopol as a substitute for thimerosal.  Developments in Biological Standardization 1974;24:39-48.
  8. Wozniak-Parnowska W, Krowczynski L.  New approach to preserving eye dropsPharmacy International 1981;2(4):91-94."