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Friday, June 6, 2008

1972 Dobson 'fecal body odor' reply to which Rosebury later commented on (part 3 of 3)

this is a continuation of the Rosebury 'fecal body odor' paper mystery

So Rosebury was a skeptic. Dobson on the other hand, seems to have taken the reported case at its word, but sadly for us, probably coming up with the wrong conclusion in believing that it was a skin condition.

It seems to have been a question and answer section in JAMA, to which Dobson was the answerer. The question was sent in by Dr Eugene T Baldridge of Pasadena about one of his patients, a "55-year-old man who is in good health has been troubled intermittently for several months at a time by an intense body odor which he describes as fecal in character". The problem seemed to have started 10 years earlier (at age 45). The patient had no obvious 'malabsorption disorder', but claimed to respond well to lincomycin hydrochloride monohydrate (Lincocin) one time for a respiratory infection, the 'odor' becoming less noticeable (or so he thought).

Dobson seems sure of the answer, saying it's 'undoubtedly due to the decomposition by bacteria of keratin, sebum, apocrine gland secretion, or a combination of these.' He reckons the response to the antibiotic confirms this. His suggestions are:
1. twice daily wash with an antibacterial soap
2. use an antiperspirant-deodorant to the axillie
3 after bathing, the axillae, groin and intergenital area should be dusted liberally with triacetin (Enzactin) powder;

and if that doesn’t work after 2 or 3 weeks, he suggests 'tetracycline hydrochloride, 250 mg twice a day, for one month. A maintenance dosage of tetracycline hydrochloride, 250 mg once or twice daily may be required indefinitely.'

Richard L. Dobson, MD
State University of New York
School of Medicine

Dobson went on to found the dermatology dept at M.U.S.C in Charleston.

Knowing what we do now about bloodborne odors, we could perhaps think it unlikely to have been a skin condition, but ironically he may have been in the right area with the antibiotics (if it had an effect on a mild gut infection ?). It's worth noting in these letters that the patient was possibly the first reported case of what we know today as 'fecal body odor' and he probably would have been discouraged from testing for TMAU had he asked for advice today, being too old when it developed.

So that is the pubmed mystery solved, and as usual it muddies the waters rather than shining any light on this problem. Perhaps the main point is, 35 years later we still don't know what the problem is, and the medical community still doesn’t know it exists.

Please note: in no way is this treatment recommended or expected to work. It is posted only out of historical interest.

related posts (this is part 3 of 3)

part 1 :
part 2 :


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