A DARK INHERITANCE

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Discovering early just who has glutaric aciduria is more than half the battle. Once the disease is diagnosed, Morton's main task is to put his young patients on a low-protein, high-riboflavin diet to lessen the effects of the disorder and prevent medical complications. If a stricken child can survive to age 5 with this help, he or she typically becomes resistant to the worst of the disease.

Meanwhile, Morton's clinic has become a model for rural health care, reducing hospitalization for the disorders to one-tenth their historic rates. The Amish and Mennonites who use the clinic do not buy medical insurance or subscribe to Medicare, but instead depend on family and community for help. Says Dr. C. Everett Koop, former U.S. Surgeon General: "Holmes Morton has forced his way into the hearts of the Amish people and, based on that trust, has accomplished a remarkable service."

Morton may well have performed an even more remarkable service to modern medicine by establishing a link between metabolic disorders like glutaric aciduria and cerebral palsy. Most practitioners have long believed that oxygen deprivation or trauma at or before birth causes cerebral palsy, a motor disorder that reflects injury to the cerebral cortex and basal ganglia. But Dr. Karin Nelson at the National Institutes of Health, as well as colleagues at other research centers, has concluded that these causes do not explain most cases of the disease. "Holmes Morton has given us fresh insight into the source of cerebral palsy," says Nelson. Adds Dr. Victor McKusick, professor of medical genetics at Johns Hopkins University: "The beauty of his research is that we can apply it to children all over the world."

Morton and his colleagues have tested thousands of Pennsylvania newborns for inherited metabolic disorders during the past five years and in the process discovered that more than half the children with glutaric aciduria are not of Amish descent. In fact, Morton points out, many countries, including Ireland, Germany, Sweden, Israel, Spain, Saudi Arabia, Canada and the U.S., have clusters of children with glutaric aciduria.

When he received the Albert Schweitzer Prize for Humanitarianism in 1993, Morton noted how his practice--and his life--had changed since he arrived in Lancaster County. "At first I shared information with this community that I thought would help them. Now I am indebted to them for what they have shared with me. As outsiders, we tend to view Amish traditions as archaic and feel they don't have much to teach us. But we should look at how the Amish keep families together and serve the needs of the disadvantaged, the ill and the aged. They have a much better way of dealing with these problems than we have."

Morton recalls visiting an Amish family just before he established his clinic. "We will be glad if you can learn to help these children," said the father of a boy who had just died. "But such children will always be with us. They teach a family how to love and accept the help of others." Morton has not only helped one small community on the fringes of modern society but also taught the world something new and quite important in the process.