I first became interested in alpha-lipoic acid (thioctic acid, ALA.) in 1977, while I was an internal medicine resident in a Cleveland, Ohio, hospital. One October weekend, Mr. D, a patient suffering from acute hepatic necrosis, as a result of eating hepalotoxic mushrooms, was transferred to my care. The department Chief said that I was to observe the patient as a routine learning experience and I was advised that Mr. D. would probably die very soon. The Chief added that there was nothing that I could do but. support him in the intensive care unit and watch.

Mr. D. was the sickest person I had ever seen. His laboratory values were several times normal and he had projectile vomiting and propulsive cholera-type diarrhea. Due to severe nausea, he could not find a comfortable position. He was miserable.