text:
Neuroleptic malignant syndrome

Neuroleptic malignant syndrome (NMS) is a rare but life-threatening reaction that can occur in response to antipsychotic (neuroleptic) medications. Symptoms include high fever, confusion, rigid muscles, variable blood pressure, sweating, and fast heart rate. Complications may include rhabdomyolysis, high blood potassium, kidney failure, or seizures.

Any medications within the family of antipsychotics can cause the condition, though typical antipsychotics appear to have a higher risk than atypicals, specifically first generation antipsychotics like haloperidol. Onset is often within a few weeks of starting the medication but can occur at any time. Risk factors include dehydration, agitation, and catatonia.

Rapidly decreasing the use of levodopa or other dopamine agonists, such as pramipexole, may also trigger the condition. The underlying mechanism involves blockage of dopamine receptors. Diagnosis is based on symptoms.

Management includes stopping the triggering medication, rapid cooling, and starting other medications. Medications used include dantrolene, bromocriptine, and diazepam. The risk of death among those affected is about 10%. Rapid diagnosis and treatment is required to improve outcomes. Many people can eventually be restarted on a lower dose of antipsychotic.

As of 2011, among those in psychiatric hospitals on antipsychotics about 15 per 100,000 are affected per year (0.015%). In the second half of the 20th century rates were over 100 times higher at about 2% (2,000 per 100,000). Males appear to be more often affected than females. The condition was first described in 1956.

Signs and symptoms
NMS symptoms include:
 * Increased body temperature >38 °C (>100.4 °F), or
 * Confused or altered consciousness
 * Excessive sweating
 * Rigid muscles
 * Autonomic imbalance

The first symptoms of neuroleptic malignant syndrome are usually muscle cramps and tremors, fever, symptoms of autonomic nervous system instability such as unstable blood pressure, and sudden changes in mental status (agitation, delirium, or coma). Once symptoms appear, they may progress rapidly and reach peak intensity in as little as three days. These symptoms can last anywhere from eight hours to forty days.

Symptoms are sometimes misinterpreted by doctors as symptoms of mental illness which can result in delayed treatment. NMS is less likely if a person has previously been stable for a period of time on antipsychotics, especially in situations where the dose has not been changed and there are no issues of noncompliance or consumption of psychoactive substances known to worsen psychosis.

Causes
NMS is usually caused by antipsychotic drug use, and a wide range of drugs can result in NMS. Individuals using butyrophenones (such as haloperidol and droperidol) or phenothiazines (such as promethazine and chlorpromazine) are reported to be at greatest risk. However, various atypical antipsychotics such as clozapine, olanzapine, risperidone, quetiapine, and ziprasidone have also been implicated in cases.

NMS may also occur in people taking dopaminergic drugs (such as levodopa) for Parkinson's disease, most often when the drug dosage is abruptly reduced. In addition, other drugs with anti-dopaminergic activity, such as the antiemetic metoclopramide, can induce NMS. Tetracyclics with anti-dopaminergic activity have been linked to NMS in case reports, such as the amoxapines. Additionally, desipramine, dothiepin, phenelzine, tetrabenazine, and reserpine have been known to trigger NMS. Whether lithium can cause NMS is unclear. However, concomitant use of lithium is associated with a higher risk of NMS when the patient starts on a antipsychotic drug.

At the molecular level, NMS is caused by a sudden, marked reduction in dopamine activity, either from withdrawal of dopaminergic agents or from blockade of dopamine receptors.

Risk factors
One of the clearest risk factors in the development of NMS is the course of drug therapy chosen to treat a condition. Use of high-potency antipsychotics, a rapid increase in the dosage of antipsychotics, and use of long-acting forms of antipsychotics (such as haloperidol) are all known to increase the risk of developing NMS. There appears to be no relationship between duration of therapy and the development of NMS.

Use of the following agents is most commonly associated with the development of NMS:
 * Typical antipsychotics: e.g. haloperidol, chlorpromazine.
 * Atypical antipsychotics: e.g. olanzapine, clozapine, risperidone
 * Anti-dopaminergic antiemetics: e.g. droperidol
 * Withdrawal of dopaminergic agents: e.g. levodopa, amantadine

It has been purported that there is a genetic risk factor for NMS. In one study, identical twins presented with NMS, and a mother and two of her daughters have presented with NMS in another case.

Demographically, it appears that males, especially those under forty, are at greatest risk for developing NMS, although it is unclear if the increased incidence is a result of greater antipsychotic use in men under forty. It has also been suggested that postpartum women may be at a greater risk for NMS.

An important risk factor for this condition is Lewy body dementia. These patients are extremely sensitive to antipsychotics. As a result, antipsychotics should be used cautiously in all cases of dementia.

Pathophysiology
The mechanism is commonly thought to depend on decreased levels of dopamine activity due to:
 * Dopamine receptor blockade
 * Genetically reduced function of dopamine receptor D2
 * Sympathoadrenal hyperactivity and autonomic dysfunction

It has been proposed that blockade of D2-like (D2, D3 and D4) receptors induce massive glutamate release, generating catatonia, neurotoxicity and myotoxicity. Additionally, the blockade of diverse serotonin receptors by atypical antipsychotics and activation of 5-HT1 receptors by certain of them reduces GABA release and indirectly induces glutamate release, worsening this syndrome.

The muscular symptoms are most likely caused by blockade of the dopamine receptor D2, leading to abnormal function of the basal ganglia similar to that seen in Parkinson's disease.

In the past, research and clinical studies seemed to corroborate the D2 receptor blockade theory in which antipsychotic drugs were thought to significantly reduce dopamine activity by blocking the D2 receptors associated with this neurotransmitter. The introduction of atypical antipsychotic drugs, with lower affinity to the D2 dopamine receptors, was thought to have reduced the incidence of NMS. However, recent studies suggest that the decrease in mortality may be the result of increased physician awareness and earlier initiation of treatment rather than the action of the drugs themselves. NMS induced by atypical drugs also resembles "classical" NMS (induced by "typical" antipsychotic drugs), further casting doubt on the overall superiority of these drugs.

However, the failure of D2 dopamine receptor antagonism, or dopamine receptor dysfunction, do not fully explain the presenting symptoms and signs of NMS, as well as the occurrence of NMS with atypical antipsychotic drugs with lower D2 dopamine activity. This has led to the hypothesis of sympathoadrenal hyperactivity (results from removing tonic inhibition from the sympathetic nervous system) as a mechanism for NMS. Release of calcium is increased from the sarcoplasmic reticulum with antipsychotic usage. This can result in increased muscle contractility, which can play a role in the breakdown of muscle, muscle rigidity, and hyperthermia. Some antipsychotic drugs, such as typical antipsychotics, are known to block dopamine receptors; other studies have shown that when drugs supplying dopamine are withdrawn, symptoms similar to NMS present themselves.

In support of the sympathoadrenal hyperactivity model, it has been hypothesized that a defect in calcium regulatory proteins within the sympathetic neurons may bring about the onset of NMS. This model of NMS strengthens its suspected association with malignant hyperthermia in which NMS may be regarded as a neurogenic form of this condition which itself is linked to defective calcium-related proteins.

There is also thought to be considerable overlap between malignant catatonia and NMS in their pathophysiology, the former being idiopathic and the latter being the drug-induced form of the same syndrome.

The raised white blood cell count and creatine phosphokinase (CPK) plasma concentration seen in those with NMS is due to increased muscular activity and rhabdomyolysis (destruction of muscle tissue). The patient may experience hypertensive crisis and metabolic acidosis. A non-generalized slowing on an EEG is reported in around 50% of cases.

The fever seen with NMS is believed to be caused by hypothalamic dopamine receptor blockade. The peripheral problems (the high white blood cell and CPK count) are caused by the antipsychotic drugs. They cause an increased calcium release from the sarcoplasmic reticulum of muscle cells which can result in rigidity and eventual cell breakdown. No major studies have reported an explanation for the abnormal EEG, but it is likely also attributable to dopamine blockage leading to changes in neuronal pathways.

Differential diagnosis
Due to the comparative rarity of NMS, it is often overlooked. Immediate treatment for the syndrome should not be delayed as it has a high mortality of between 10-20%. Differentiating NMS from other neurological disorders can be very difficult. It requires expert judgement to separate symptoms of NMS from other diseases.

The diagnosis is suggested on patients with an accurate history of drug exposure to the most common inducing agents such as strong antidopaminergic medication. The differential diagnosis includes serotonin syndrome, encephalitis, toxic encephalopathy, status epilepticus, heat stroke, catatonia and malignant hyperthermia. Drugs such as cocaine and amphetamine may also produce similar symptoms. Features which distinguish NMS from serotonin syndrome include bradykinesia, muscle rigidity, and a high white blood cell count.

Treatment
NMS is a medical emergency and can lead to death if untreated. The first step is to stop the antipsychotic medication and treat the hyperthermia aggressively, such as with cooling blankets or ice packs to the axillae and groin. Supportive care in an intensive care unit capable of circulatory and ventilatory support is crucial. The best pharmacological treatment is still unclear. Dantrolene has been used when needed to reduce muscle rigidity, and more recently dopamine pathway medications such as bromocriptine have shown benefit. Amantadine is another treatment option due to its dopaminergic and anticholinergic effects. Apomorphine may be used however its use is supported by little evidence. Benzodiazepines may be used to control agitation. Highly elevated blood myoglobin levels can result in kidney damage, therefore aggressive intravenous hydration with diuresis may be required. When recognized early NMS can be successfully managed; however, up to 10% of cases can be fatal.

Should the affected person subsequently require an antipsychotic, trialing a low dose of a low-potency atypical antipsychotic is recommended.

Prognosis
The prognosis is best when identified early and treated aggressively. In these cases NMS is not usually fatal. In earlier studies the mortality rates from NMS ranged from 20%–38%, but by 2009 mortality rates were reported to have fallen below 10% over the previous two decades due to early recognition and improved management. Re-introduction to the drug that originally caused NMS to develop may also trigger a recurrence, although in most cases it does not.

Memory impairment is a consistent feature of recovery from NMS, and is usually temporary though in some cases may become persistent.

Epidemiology
Pooled data suggest the incidence of NMS is between 0.2%–3.23%. However, greater physician awareness coupled with increased use of atypical anti-psychotics have likely reduced the prevalence of NMS. Additionally, young males are particularly susceptible and the male:female ratio has been reported to be as high as 2:1.

History
NMS was known about as early as 1956, shortly after the introduction of the first phenothiazines. NMS was first described in 1960 by French clinicians who had been working on a study involving haloperidol. They characterized the condition that was associated with the side effects of haloperidol "syndrome malin des neuroleptiques", which was translated to neuroleptic malignant syndrome.

title: Neuroleptic malignant syndrome


text:
Talk:Neuroleptic malignant syndrome

From the public domain resource at http://www.ninds.nih.gov/health_and_medical/disorders/neuroleptic_syndrome.htm

NMS and Sinemet withdrawal?
I think NMS can also be caused by withdrawal from Sinemet, but I don't know enough about it to make the edit. Can a physician or other expert comment? Sarah Waggoner 21:21, 26 September 2007 (UTC)

http://www.rxlist.com/cgi/generic/sinemet_wcp.htm It seems so - this source IS reliable, but I'm sure there are high quality ones.

It is also worth noting that the condition can occur on *withdrawing* from Neuroleptics (antipsychotics) too. Although some might say that it is 'Malignant Catatonia' in this case. And there may well be a crossover between NMS and Malignant Catatonia too! I might find sources later and add this to the article if not already there. Buckethed (talk) 01:04, 14 December 2007 (UTC)

Dubious
I question the validity of the statement "NMS should be ruled out in the case of acute behaviour change of any person on antipsychotic medication". Isn't the intended effect of antipsychotic medication to produce behavioural change, so a change in the behaviour of people starting treatment (the people most likely to be afflicted with NMS) shouldn't rule out anything — it should be expected. Neitherday (talk) 04:03, 17 December 2007 (UTC)

 * I just read it again and what I meant was:

''Acute and significant behaviour change/deterioration (eg: over a day or less) in someone who has otherwise been stable for a period of time on antipsychotics. (i.e. the dose hasn't been changed and the person hasn't deteriorated because of drug-taking or noncompliance)''

I'll get a ref and figure out the best way to word it exactly. Is that clearer? cheers, Casliber (talk · contribs) 04:38, 17 December 2007 (UTC)

 * I get it now, thank you. :) Neitherday (talk) 06:34, 17 December 2007 (UTC)

Fever vs Hyperthermia
The rise in core temperature is really hyperthermia due mostly to excessive muscle activity and not fever, although these two are frequently mixed up (even the mesh definition for Neuroleptic malignant syndrome says 'fever'). Maybe this should be changed, although the useful mnemonic would also need to be altered. —Preceding unsigned comment added by T vanhove (talk • contribs) 09:39, 30 December 2007 (UTC)

"Supportive?"
The article states, "Treatment is generally supportive." I have no idea what this means. Perhaps it is medical jargon. Perhaps it is a mistake. Either way, I think it could use some clarification. David (talk) 14:10, 24 March 2009 (UTC)

 * It means that treatment targets whatever  symptoms the patient is having, instead of targeting the cause. Giving IV fluids, pain management, etc. Peetiemd (talk) 03:05, 13 May 2009 (UTC)

I'm glad someone corrected that mistake. Thanks! David spector (talk) 00:42, 30 November 2009 (UTC)

 * there you go, now there's a wikilink pointing at the section of "therapy" article (redirect from "supportive care") explaining what supportive care means.

176.63.176.112 (talk) 20:16, 28 February 2017 (UTC).

Make sure to use proper sentence structure. For example, the phrase “Occurs in 0.1-0.2% of patients receiving conventional anti-psychotics (e.g., butyrophenones [especially haloperidol], phenothiazines, thioxanthenes)” under the “Epidemiology” section is not a complete sentence. Also, consider expanding this section. Including other factors, such as age and gender distributions, would help your article (being young and male may be risk factors for the development of NMS—you can find this information at the url: http://cat.inist.fr/?aModele=afficheN&cpsidt=2894011). Also, how do dantrolene sodium, bromocriptine, and apomorphine function to treat NMS? It is good that you have linked them to other Wikipedia articles, but a short description specifying their use is perhaps needed. Bergaa7 (talk) 02:14, 24 November 2009 (UTC)

 * Thanks for the advice. The page links to an article discussing how dantrolene sodium, bromocriptine, and apomorphine were studied, but the mechanism of how exactly they work still seems to be somewhat unknown.  jaykloo (talk) 5:12, 8 December 2009 (UTC)

I found different data on the occurrence of NMS from what you provide in the "Epidemiology" section. Instead of .1-.2% of patients receiving neuroleptics, I found data suggesting .2-3.23% of these patients experience NMS. The paper that had this data has other epidemiological data that could be helpful in expanding your "Epidemiology" section, along with the suggestions by Bergaa7. The paper can be found at: [].  --Philades (talk) 23:16, 28 November 2009 (UTC)

 * Thanks for the ideas and the good paper. The paper is a bit older than some of our other sources, but I've included the bit you point out about the epidemiology. Most of what that paper discusses about Epidemiology is discussed elsewhere in our article as well, so to avoid redundancy, we won't make many major changes to that section. jaykloo (talk) 5:12, 8 December 2009 (UTC)

you mention many signs and symptoms but you don't really go into how NMS actually causes those symptoms. further elaboration on that can help readers understand more about the pathology and what the disease is connected with physically. perhaps you can throw that into the "pathophysiology" section. the mnemonic device was pretty nifty though. it seems that those are the most COMMON symptoms though, so you should mention that they aren't just limited to those. Also, you say they are "features" which kind of puts a positive connotation. perhaps another synonym would be more appropriate? Under "causes", it is unclear whether this adverse reaction is random, genetic, or allergenic. is there any research that sheds light on this subject? "differential diagnosis" also seems to be out of place under the "causes" section. it would probably be better in the "signs and symptoms" section. "prognosis" and "epidemiology" seem so short that they can be integrated into other sections of the article. Perhaps elaborating on them or finding another place to put them could help. Good work so far!
 * Justindchien (talk) 01:45, 29 November 2009 (UTC)

 * Thank you for the advice, we have incorporated much of it! jaykloo (talk) 5:12, 8 December 2009 (UTC)

Under the signs and symptoms section, you may want to cite more of your information. For example, what did you use to determine that symptoms can last from eight hours to forty days? This would make your article more verifiable. Also, I found an article called "Symptoms of neuroleptic malignant syndrome in 82 consecutive inpatients" by G Addonizio, VL Susman and SD Roth which mentions that there are milder variants of NMS. You might want to look through the article and include information about the milder forms of the disease. The paper can be found at []. Overall, this is a great article. Farnhach (talk) 03:48, 29 November 2009 (UTC)

You have compiled great information on Neuroleptic malignant syndrome. In revising the article, you may want to expand on the Research section. You discuss past research and obstacles, but it would be beneficial to discuss current reasearch, clinical trials and/or future research. Additionally, it is helpful to understand the condition better if you include graphics. marissa.hone 29 November 2009 12:29, 29 November 2009 (UTC)

The second paragraph in the “Signs and Symptoms” section is confusing to me. It seems slightly to jump from one point to another. If at all possible, maybe explain why these events occur. For example, why does increased muscular activity and rhabdomyolysis lead to an increase in WBC count and creatine phosphokinases? Even a sentence or two could help to explain the cause and effect relationship between the two and clarify your point. Also, why is there a slowing on the EEG? Even if research is still unclear, what are some possible explanations for it? And then the way you end this paragraph “White blood cells go up in the blood” does not really make sense or smoothly end the paragraph.

Still in the “Signs and Symptoms” section, a simple bold title (like the one for Mnemonic) above the list of symptoms could be a nice way just to organize it a little bit better.

The first sentence in Pathophysiology is very long and confusing to read. Maybe breaking it up into a few sentences could help you get your point across better. For example, right after this long first sentence you talk about the release of calcium in a short sentence and then explain the significance in the next sentence (again, which is not long, but straightforward and to the point). This format was very easy to read and understand. Even though I did a little research on your topic and understand what you are trying to say in the first few sentences, I still found it confusing to read, so someone who does not have any knowledge of the subject could be easily confused.

Other than that, there were a few grammatical mistakes and some inconsistencies (eg versus e.g.) so just keep an eye out for that when doing your final revisions. I really liked the external links since they offer a good jumping off point for others who want to do more research. I also thought your first introduction paragraph was a good overall description of the subject matter (since this is the most important part that most people look to when using Wikipedia). I tried to find some more resources for you guys to possibly use, but you already have all the resources I was finding so good job on the research of your subject. Overall, really good job.
 * MichelleMaglio (talk) 18:35, 29 November 2009 (UTC)

I think your article would greatly benefit from a little background information on how neuroleptic and antipsychotic drugs function and if so, how they lead to dopamine receptor blockade or decreased D2 function. I realize this may be found on their own respective wikipages, but it would certainly make your pathophysiology section much more clearer. Also, you may want to talk about some case studies that have played a pivotal role in understanding NMS under your history section. This would probably give the reader a better understanding of the syndrome as a whole. An article called "Neuroleptic Malignant Syndrome" by James L. Levenson discusses some of these case studies. Gandhi7 (talk) 19:00, 29 November 2009 (UTC)

I agree with what was stated before that some of the sentances were hard to understand and sometimes breaking them up into short strong statements is best. I was wondering if some citations are missing becuause i felt some facts were listed, especially in symptoms sections without any citation. I also would like to see some expansion on what exactly the drugs do to cause NMS and maybe look at some studies to support that. I was somewhat confused on the example about the twins and mother having NMS I think you are trying to say it can be linked to genetics but maybe rework that section to make it more clear. Finally I was wondering if the order of your subsections is the most effective. I felt there was some repition and maybe should start out with basics of what is happening and then expand with experiments and other data. I just felt that I went and read later sections to fully understand what was stated prior. EPalmquist (talk) 00:33, 30 November 2009 (UTC)

Do you have any more information that you can include as to why there are elevated white blood cell counts observed during NMS? Also, what is the time-frame of attack for NMS, does it last a few hours or days, is it acute or chronic, etc? Furthermore, you mention that NMS must be caught in its early onset if fatality is to be avoided; how fast is the onset of the disease, and what is the inital treatment while a diagnosis is being made? Other than that, you might want to try to combine parts of your research section with the pathophysiology section, as you mention in the research section that the pathophysiology remains unclear. This could be said before giving an explanation of the suspected mechanism, and perhaps the pathophysiology section could be reworded so that it is nto so dense, as it seems just a little confusing. Other than that, great job, this is a well written article. Rueltnj (talk) 01:33, 30 November 2009 (UTC)

This topic seems very interesting and the information that you have so far is very good. I think the best thing that you can do to improve your article is to include some studies that would support what you are saying. For example, in the introduction of the causes section I think it would be beneficial to maybe include some studies that have supported some of these facts that you are stating or perhaps at least some statistics which support your information. Additionally, I think you should include some information about how the lowering of D2 actually causes the symptoms that you talk about. What are the biological links? I think it would also be good to look into how NMS is related to other diseases. I found a few articles about how NMS relates to Wilson’s disease and also how NMS affects people with AIDS. Perhaps you will find some useful information in these articles to include in your article.

Article 1: “Neuroleptic malignant syndrome in the acquired immunodeficiency syndrome” http://www.ncbi.nlm.nih.gov:80/pmc/articles/PMC2431511/pdf/postmedj00156-0013.pdf Article 2: Kontaxakis V., C. Stefanis, M. Markidis, et al. “Neuroleptic malignant syndrome in a patient with Wilson’s disease” Journal of Neurology, Neurosurgery & Psychiatry

I know this was already said in above comments so I will just say that I agree that the changing the formatting of the article will help reader comprehension. I would suggest moving the Pathophysiology section so that it is earlier in the article. I think it would make more sense for the reader to know what mechanism is causing NMS before they know how it is diagnosed. Lastly, I found one more article that I think would be helpful in expanding on the information that you already have in your article. From what I can tell this information has a lot of information on the topics that you touched upon in your article.

Article: http://psychservices.psychiatryonline.org/cgi/content/full/49/9/1163

Overall, I think the information that you have is good but I think it would serve you and the reader best to just reformat the article and perhaps correct sentence structure so that it is clearer to understand. Msprockel (talk) 21:34, 30 November 2009 (UTC)

I think your article is very well written, cohesive and informative. I really like how you included a mnemonic to remember the symptoms of NMS because I think it is important to remember that the purpose of the article is to be informative and a mnemonic strengthens the reader's ability to retain the information given in the article, making it an article with real purpose. I also liked how you summarized the symptoms in bullets, but I would preface it with a sentence or two instead of jumping right into the bullets. I think you need to look most closely at your causes and pathophysiology sections. In the causes section you list several drugs that can cause NMS, but you do not include what those drugs are used for. I think it would benefit your article to include more detail about the diseases those drugs are used to treat. I think the pathophysiology section seems rushed when it should probably be your most in depth section of the article. Much of it was unclear and difficult to follow. Also, it seemed as if you used parentheses to restate or clarify the preceding statement. I suggest you take the parentheses out altogether and try to incorporate clarifications in the body of the text, which would make it easier to understand. I think you should go more in depth in the mechanisms involved in NMS in this section as well. You mentioned the sympathoadrenal hyperactivity hypothesis, but didn't explain what it was very well, how it came to be, arguments for it, or arguments against it. I think including these things would strengthen your article's validity. Be sure to read it over and catch some grammatical errors and awkward wording. There were a couple of sections where you used phrases, but I suggest you make them complete sentences (e.g. epidemiology). Overall, I think it is a good start and could be a very strong article. Brikathleen (talk) —Preceding unsigned comment added by 136.167.247.48 (talk) 02:56, 30 November 2009 (UTC)

I enjoyed reading your article but would like to recommend perhaps some addition to the pathophysiology section. I found an article on NMS and catatonia that compared the two syndromes. I found that NMS may be caused by "dysregulation in cortical- subcortical circuits between motor/premotor cortex and basal ganglia i.e. the so-called “motor loop”." There are other sections that include specifically the relation to the brain that I think would serve useful in your article. There is also mention of atypical neuroleptics acting predominantly on other receptor types, such as glutamatergic, sertoninergic, and adrenergic/noradrenergic receptors. The article I found can be located at this web address and I think it may serve useful: http://www.imhr.ca/research/northofflab/documents/catatonia_neuroleptic_malignant_syndrome.pdf. Other than that I think you may want to revise the grammar and sentence structure you used. Some of the wording is not as clear as it can be. It may also be better if you reorganized the format of the article and moved the history section prior to the signs and symptoms. Good job so far. Nalvarez (talk) —Preceding unsigned comment added by 136.167.159.63 (talk) 05:12, 30 November 2009 (UTC)

Oh bloody hell - where to start....
Damn - alright. First step is to find some nice review articles - hopefully there is something recent which will include stats from the epidemic of olanzapine and quetiapine prescribing.....Casliber (talk · contribs) 00:36, 25 February 2012 (UTC)

 * Need to read this review but there should be something more recent.....Casliber (talk · contribs) 01:52, 25 February 2012 (UTC)

 * Using the following Pubmed search: http://www.ncbi.nlm.nih.gov/pubmed?term=%22Neuroleptic%20Malignant%20Syndrome%22[Majr]
 * Restricted to reviews:
 * (Mov Disord 2010)
 * (J Child Adolesc Psychopharmacol 2009) - children and teenagers
 * (Am J Nursing 2008)
 * (Am J Psychiatry 2007, free and fairly comprehensive)
 * (Med Clin North Am 2005) - context with other drug-induced hyperthermia syndromes
 * Something to chew on. JFW | T@lk  11:50, 26 February 2012 (UTC)

Stopping neuro to hinder nms?
even with neuro pills, you cant stop nms that easily by stopping them, since your coming off neuro will take a significant amount of time even if you're on pills (much longer with injection, unless you're near the expiration of a lowest dose; besides, doctors are hard to make say ok to stopping neuro), and then it takes a long time for neuro to come out of the blood too.--78.156.109.166 (talk) 20:40, 17 December 2013 (UTC)

 * Sorry, are you proposing a change in the article or simply making an observation? Decisions on continuing medication should be made individually, but should take into account the risk of recurrent NMS. JFW | T@lk  21:01, 17 December 2013 (UTC)

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Possible problem
As per this article in Science, a major 2003 paper on neuroleptic malignant syndrome was by a researcher who was involved in massive amounts of fraud to the extent that he seems to have committed suicide upon being exposed. I'm concerned that this may affect the reliability of some of the papers cited in our article, but lack the skillset to make such an assessment. Anyone? DS (talk) 01:51, 22 August 2018 (UTC)
 * Interesting - I presume you mean the Mihara paper (Sato is not mentioned as one of the authors...?)? I'll have a read a bit later today. Cas Liber (talk · contribs) 04:11, 22 August 2018 (UTC)
 * Well, I don't know, is the thing. What if we cite scholarly article A, which cites scholarly article B, whose legitimacy is in question? DS (talk) 17:52, 22 August 2018 (UTC)
 * Sigh. started looking...but really need to do a refresher on the whole topic....Cas Liber (talk · contribs) 00:43, 23 August 2018 (UTC)

Unrelated concepts
Add "Diagnosis is urgent, to control significant mortality and morbidity", with "diagnosis is based on symtoms" does not make sense as these are two seperate ideas / concepts. Doc James (talk · contribs · email) 10:21, 26 May 2019 (UTC)

 * I’m struggling slightly to understand the point being raised? Yes, how fast you need a diagnosis and how you’re going to achieve it - urgency and basis - are different things.  But they’re both things about the diagnosis.  They’re naturally linked, too.  That is, if you need a diagnosis fast, the very *next* question is how you’re going to get it.  (That is, use the pager rather than a strategy of keeping an eye open in the canteen over the next couple of weeks for anyone knowledgeable from Path.)

 * Diagnosis can itself be a complex concept, of course. But you’re not saying that there are two separate concepts *of diagnosis* involved here, are you?

 * On a rather different point - I owe you an apology for reverting another edit of yours without explanation / summary. It’ll be good to talk about that edit when convenient - but what happened there this morning was a three-cornered misunderstanding between me, my smartphone and the rather different screen layout involved in reverts!

 * -SquisherDa (talk) 12:02, 26 May 2019 (UTC)
 * My position is they should be in two different sentences rather than in one. Thus why I split them. Doc James (talk · contribs · email) 03:26, 27 May 2019 (UTC)

Fixed
I think there is a numerical error in the 4th paragraph of the opening section. "As of 2011, among those in psychiatric hospitals on neuroleptics about 15 per 100,000 are affected per year.[1] In the second half of the 20th century rates were higher at about 2% (2,000 per 100,000).[1]" Should the figure 15 be 1.5? - ''unsigned contribution top-posted by at 10:34, 29 January 2020.
 * Believe it or not, no! I've had another go at clarifying what the article is trying to convey here. - ''SquisherDa (talk) 13:15, 29 January 2020 (UTC)

license: Creative Commons - Attribution Share-Alike - https://creativecommons.org/licenses/by-sa/4.0/

title: Talk:Neuroleptic malignant syndrome


text:
Talk:East Petersburg, Pennsylvania

Politics and Government
East Petersburg is governed by a seven-person Borough Council and Mayor. As of July 2012 the Council President was Cappy Panus and the Mayor was Jeff Geoghan

East Petersburg Borough Council is comprised of seven members elected to four-year staggered terms. Borough Council elects from members a president of council and a vice-president. Borough Council serves as the legislative body elected by citizens of the borough. Council is responsible for establishing policies, enacting by ordinance or resolution laws and regulations to implement approved policies, providing for annual budgets and appropriations of funds for lawful expenditures, appointing members to boards, and commissions established by Borough Council. Mayor is responsible for law enforcement and holds a non-voting membership in the council, but with tie-breaking and veto powers per the Pennsylvania Borough Code

Borough Council meets twice per month to conduct business - a formal meeting the first Tuesday and a business meeting the third Tuesday.

The East Petersburg Borough Website is http://www.eastpetersburgborough.org/ — Preceding unsigned comment added by 75.151.165.233 (talk) 14:29, 6 July 2012 (UTC)

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title: Talk:East Petersburg, Pennsylvania


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Drumore Township, Pennsylvania

Drumore Township is a township in southwestern Lancaster County, Pennsylvania, United States. At the 2020 census, the population was 2,568.

It is named after Dromore (Irish: Droim Mór), County Down, now in Northern Ireland, with which it has been twinned since 1996.

Geography
According to the U.S. Census Bureau, the township has a total area of 28.9 sqmi, of which 23.9 sqmi is land and 5.0 sqmi (17.36%) is water. It includes the communities of Liberty Square, Chestnut Level, Fernglen, Drumore, Furniss, and Fairfield, and parts of the communities of Buck and Henzel.

Demographics
As of the census of 2000, there were 2,243 people, 739 households, and 597 families residing in the township. The population density was 93.8 PD/sqmi. There were 819 housing units at an average density of 34.3 /mi2. The racial makeup of the township was 98.75% White, 0.27% Black or African American, 0.09% Native American, 0.09% Asian, 0.27% from other races, and 0.53% from two or more races. 0.71% of the population were Hispanic or Latino of any race.

There were 739 households, out of which 38.8% had children under the age of 18 living with them, 71.7% were married couples living together, 5.4% had a female householder with no husband present, and 19.2% were non-families. 16.4% of all households were made up of individuals, and 6.2% had someone living alone who was 65 years of age or older. The average household size was 3.04 and the average family size was 3.44.

In the township the population was spread out, with 32.0% under the age of 18, 8.6% from 18 to 24, 27.9% from 25 to 44, 22.5% from 45 to 64, and 9.1% who were 65 years of age or older. The median age was 34 years. For every 100 females, there were 104.3 males. For every 100 females age 18 and over, there were 106.5 males.

The median income for a household in the township was $47,250, and the median income for a family was $51,645. Males had a median income of $36,366 versus $22,560 for females. The per capita income for the township was $17,470. About 4.0% of families and 5.1% of the population were below the poverty line, including 7.2% of those under age 18 and 6.5% of those age 65 or over.

Drumore Township Park
The Drumore Township Park is located at 1675 Furniss Road, Drumore, Pennsylvania and is located on 10 acre of land immediately in back of the Township Municipal Building. The land was purchased from the John O’Donnel farm with grant money from the county.

The Park is open to the public each day of the week from sun up to sun down.

Fishing Creek
Fishing Creek Nature Preserve is a 167 acre preserve of mature forest along fishing creek, a creek that runs into the Susquehanna River. The creek is one of the few places in Lancaster County where a natural trout population remains. A dirt road runs along the stream, and there are several trails through the woods.

Schools
Drumore Township is served by the Solanco School District. Schools in the district are:

Solanco High School 585 Solanco Road, Quarryville, PA 17566 (717)786-2151

George A. Smith Middle School 645 Kirkwood Pike, Quarryville, PA 17566 (717)786-2244

Swift Middle School 1866 Robert Fulton Highway, Quarryville, PA 17566 (717)548-2187

Providence Elementary School 137 Truce Road, New Providence, PA 17560 (717)786-3582

Quarryille Elementary School 211 South Hess Street, Quarryville, PA 17566 (717)786-2546

Clermont Elementary School 1868 Robert Fulton Highway, Quarryville, PA 17566 (717)548-2742

Bart Colerain Elementary School 1336 Noble Road, Christiana, PA 17509 (717)529-2181

Notable people

 * William Whipper, abolitionist
 * John Steele, Brigadier General

title: Drumore Township, Pennsylvania


text:
East Cocalico Township, Pennsylvania

East Cocalico Township is a township in northeastern Lancaster County, Pennsylvania, United States. At the 2020 census, the population was 10,808.

History
Cocalico Township was divided into East Cocalico, West Cocalico, and Ephrata Townships in 1838. The Bucher Thal Historic District was listed on the National Register of Historic Places in 1987.

Geography
According to the U.S. Census Bureau, the township has a total area of 20.6 sqmi, all land. It contains the communities of Swartzville and Reamstown, and part of Stevens and Frysville.

Demographics
As of the census of 2000, there were 9,954 people, 3,461 households, and 2,709 families living in the township. The population density was 482.9 PD/sqmi. There were 3,557 housing units at an average density of 172.6 /mi2. The racial makeup of the township was 95.76% White, 0.47% Black or African American, 0.11% Native American, 2.22% Asian, 0.03% Pacific Islander, 0.53% from other races, and 0.87% from two or more races. 1.38% of the population were Hispanic or Latino of any race.

There were 3,461 households, out of which 37.0% had children under the age of 18 living with them, 69.5% were married couples living together, 5.8% had a female householder with no husband present, and 21.7% were non-families. 17.3% of all households were made up of individuals, and 6.3% had someone living alone who was 65 years of age or older. The average household size was 2.82 and the average family size was 3.21.

In the township the population was spread out, with 28.3% under the age of 18, 6.8% from 18 to 24, 30.6% from 25 to 44, 21.9% from 45 to 64, and 12.4% who were 65 years of age or older. The median age was 36 years. For every 100 females, there were 100.3 males. For every 100 females age 18 and over, there were 98.2 males.

The median income for a household in the township was $50,580, and the median income for a family was $55,401. Males had a median income of $38,833 versus $24,189 for females. The per capita income for the township was $21,387. About 2.3% of families and 3.4% of the population were below the poverty line, including 5.2% of those under age 18 and 3.4% of those age 65 or over.

Recreation
A small portion of the Pennsylvania State Game Lands Number 274 is located along the eastern border of the township. East Cocalico Recreational Park is located on East Church Street off U.S. Route 222.

title: East Cocalico Township, Pennsylvania


text:
East Donegal Township, Pennsylvania

East Donegal Township is a township in northwestern Lancaster County, Pennsylvania, United States. At the 2020 census, the population was 8,690.

History
It is named after County Donegal, Ireland. The original township of Donegal was organized by the court of Chester County in 1722, and was one of the two townships which composed Lancaster County at the time of its erection in 1729. On June 24, 1838, a division was effected, whereby the old township was constituted into two townships, to be separately and distinctly recognized as East Donegal and West Donegal.

The settlers of East Donegal were of Scots-Irish descent and were primarily farmers who were drawn to the area by the rich soils and plentiful streams. Thus the abundant produce provided by the land was able to be made into flour by the many mills which sprang up in the area.

Early settlers, Arthur Patterson and others, organized a Presbyterian Church at Donegal in 1726, and erected the old church edifice at that time. The first three pastors of it were from Scotland. Bartram Galbraith, grandson of James Galbraith, was Lieutenant for Lancaster County, the first three years of the Revolution, and many members of that family served in various official positions, as also did Alexander Lowrey and several of that family.

The Chickies Historic District, Donegal Presbyterian Church Complex, Grove Mansion, Donegal Mills Plantation, Byers-Muma House, and Cameron Estate are listed on the National Register of Historic Places.

Geography
According to the U.S. Census Bureau, the township has a total area of 24.1 sqmi, of which 21.8 sqmi are land and 2.3 sqmi, or 9.46%, are water.

The boundaries of the township are north by Mount Joy, northeast by Rapho, east by West Hempfield, south by the Susquehanna River, and west by Conoy and West Donegal. Little Chiques Creek flows along the eastern boundary. The borough of Marietta, a separate municipality, is on the southern border of the township and occupies land formerly belonging to it. Unincorporated communities within the township include Donegal Heights, Donegal Springs, Maytown, Rowenna, and part of Chickies.

Demographics
As of the census of 2000, there were 5,405 people, 1,941 households, and 1,554 families residing in the township. The population density was 247.7 PD/sqmi. There were 2,010 housing units at an average density of 92.1 /mi2. The racial makeup of the township was 97.19% White, 0.76% Black or African American, 0.06% Native American, 0.57% Asian, 0.04% Pacific Islander, 0.65% from other races, and 0.74% from two or more races. 1.78% of the population were Hispanic or Latino of any race.

There were 1,941 households, out of which 38.9% had children under the age of 18 living with them, 70.1% were married couples living together, 6.6% had a female householder with no husband present, and 19.9% were non-families. 16.1% of all households were made up of individuals, and 4.8% had someone living alone who was 65 years of age or older. The average household size was 2.78 and the average family size was 3.13.

In the township the population was spread out, with 27.9% under the age of 18, 7.9% from 18 to 24, 32.6% from 25 to 44, 22.5% from 45 to 64, and 9.1% who were 65 years of age or older. The median age was 34 years. For every 100 females, there were 100.7 males. For every 100 females age 18 and over, there were 98.3 males.

The median income for a household in the township was $55,414, and the median income for a family was $58,117. Males had a median income of $35,901 versus $26,071 for females. The per capita income for the township was $20,488. About 0.4% of families and 1.5% of the population were below the poverty line, including 0.6% of those under age 18 and 2.7% of those age 65 or over.

Notable person

 * John Andrew Hiestand (1824-1890), former U.S. Representative

title: East Donegal Township, Pennsylvania


text:
East Drumore Township, Pennsylvania

East Drumore Township is a township in south central Lancaster County, Pennsylvania, United States. At the 2020 census, the population was 3,903. It is part of the Solanco School District.

Geography
According to the U.S. Census Bureau, the township has a total area of 23.2 sqmi, all land. It includes the communities of Mechanic Grove, Puseyville, Unicorn, and Drumore Center, and part of Buck and Henzel.

It is named after Dromore (Irish: Druim Moir), County Down, now in Northern Ireland.

Demographics
As of the census of 2000, there were 3,535 people, 1,055 households, and 876 families living in the township. The population density was 152.2 PD/sqmi. There were 1,079 housing units at an average density of 46.5 /mi2. The racial makeup of the township was 98.36% White, 0.45% Black or African American, 0.03% Native American, 0.14% Asian, 0.06% Pacific Islander, 0.62% from other races, and 0.34% from two or more races. 0.82% of the population were Hispanic or Latino of any race.

There were 1,055 households, out of which 38.9% had children under the age of 18 living with them, 73.5% were married couples living together, 6.6% had a female householder with no husband present, and 16.9% were non-families. 14.1% of all households were made up of individuals, and 5.6% had someone living alone who was 65 years of age or older. The average household size was 3.00 and the average family size was 3.31.

In the township the population was spread out, with 27.8% under the age of 18, 7.0% from 18 to 24, 23.6% from 25 to 44, 21.6% from 45 to 64, and 19.9% who were 65 years of age or older. The median age was 39 years. For every 100 females, there were 90.0 males. For every 100 females age 18 and over, there were 83.9 males.

The median income for a household in the township was $47,237, and the median income for a family was $49,726. Males had a median income of $36,768 versus $22,398 for females. The per capita income for the township was $17,229. About 8.6% of families and 12.9% of the population were below the poverty line, including 21.8% of those under age 18 and 2.9% of those age 65 or over.

title: East Drumore Township, Pennsylvania


text:
East Earl Township, Pennsylvania

East Earl Township is a township in northeastern Lancaster County, Pennsylvania, United States. At the 2020 census, the population was 6,721.

History
The Spring Grove Forge Mansion and Henry Weaver Farmstead are listed on the National Register of Historic Places.

Geography
According to the U.S. Census Bureau, the township has a total area of 24.7 sqmi, of which 24.6 sqmi is land and 0.1 sqmi (0.24%) is water. It contains the communities of Union Grove, Weaverland, Goodville, Blue Ball, East Earl, Fetterville, and Cedar Lane. The township surrounds the borough of Terre Hill, a separate municipality. Welsh Mountain, elevation 1107 ft, is on the southern border of the township.

Demographics
At the 2000 census there were 5,723 people, 1,738 households, and 1,485 families living in the township. The population density was 232.6 PD/sqmi. There were 1,795 housing units at an average density of 73.0 /mi2. The racial makeup of the township was 98.17% White, 0.58% Black or African American, 0.05% Native American, 0.37% Asian, 0.03% Pacific Islander, 0.12% from other races, and 0.68% from two or more races. 0.66% of the population were Hispanic or Latino of any race. There were 1,738 households, 42.2% had children under the age of 18 living with them, 75.8% were married couples living together, 6.3% had a female householder with no husband present, and 14.5% were non-families. 11.9% of households were made up of individuals, and 5.1% were one person aged 65 or older. The average household size was 3.28 and the average family size was 3.59.

The age distribution was 33.4% under the age of 18, 9.5% from 18 to 24, 25.1% from 25 to 44, 21.0% from 45 to 64, and 11.0% 65 or older. The median age was 32 years. For every 100 females, there were 99.8 males. For every 100 females age 18 and over, there were 97.8 males.

The median household income was $48,118 and the median family income was $51,450. Males had a median income of $36,438 versus $20,923 for females. The per capita income for the township was $17,127. About 3.2% of families and 5.2% of the population were below the poverty line, including 9.1% of those under age 18 and 2.0% of those age 65 or over.

title: East Earl Township, Pennsylvania


text:
East Hempfield Township, Pennsylvania

East Hempfield Township is a township in west-central Lancaster County, Pennsylvania, United States. At the 2020 census the population was 26,350.

East Hempfield is one of the six immediate suburbs of the city of Lancaster, all sharing the same official designation as Lancaster, Pennsylvania by the United States Postal Service.

History
The Landis Mill Covered Bridge, Shenk's Mill Covered Bridge, Christian Habeck Farm, and Samuel N. Mumma Tobacco Warehouse are listed on the National Register of Historic Places.

Geography
According to the U.S. Census Bureau, the township has a total area of 21.1 sqmi, all land. It includes the unincorporated communities of Mechanicsville, Landisville, Bamford, Centerville, Chestnut Ridge, Rohrerstown, Donerville, Chestnut View, and Wheatland, as well as part of Salunga.

Demographics
As of the census of 2000, there were 21,399 people, 8,552 households, and 6,054 families residing in the township. The population density was 1,011.6 PD/sqmi. There were 8,761 housing units at an average density of 414.2 /mi2. The racial makeup of the township was 93.45% White, 1.51% Black or African American, 0.11% Native American, 2.56% Asian, 1.51% from other races, and 0.86% from two or more races. 2.78% of the population were Hispanic or Latino of any race.

There were 8,552 households, out of which 30.9% had children under the age of 18 living with them, 62.0% were married couples living together, 6.3% had a female householder with no husband present, and 29.2% were non-families. 24.1% of all households were made up of individuals, and 9.5% had someone living alone who was 65 years of age or older. The average household size was 2.47 and the average family size was 2.96.

In the township the population was spread out, with 23.9% under the age of 18, 6.7% from 18 to 24, 27.4% from 25 to 44, 26.7% from 45 to 64, and 15.4% who were 65 years of age or older. The median age was 41 years. For every 100 females, there were 96.2 males. For every 100 females age 18 and over, there were 93.6 males.

The median income for a household in the township was $54,431, and the median income for a family was $68,965. Males had a median income of $43,958 versus $29,496 for females. The per capita income for the township was $28,192. About 1.8% of families and 3.9% of the population were below the poverty line, including 4.1% of those under age 18 and 5.1% of those age 65 or over.

Points of interest

 * Amos Herr House & Park, donated by Amos Herr upon his death, contains an old farmhouse built in 1852, adjoining barns and the East Hempfield Township municipal building.
 * Dutch Apple Dinner Theatre, a professional dinner theater.

Notable person

 * Melissa Minnich Coleman, architect

Local businesses

 * Kellogg's
 * Y&S Candies

title: East Hempfield Township, Pennsylvania


text:
East Lampeter Township, Pennsylvania

East Lampeter Township is a township in central Lancaster County, Pennsylvania, United States. At the 2020 census, the population was 17,834.

East Lampeter Township is one of the six suburbs that border the city of Lancaster, all sharing the same ZIP code with Lancaster. Though the township is predominantly rural and agricultural, the busy highway U.S. 30, also known as the Lincoln Highway, crosses the township from the northwest to the southeast, traveling about eight and one-half miles. The two and one-half mile stretch bordering the city of Lancaster is very congested and serves many businesses including East Town Mall, the Lancaster Mennonite School, Dutch Wonderland amusement park, Tanger Outlets, The Shops at Rockvale, and several hotels and fast food businesses.

History
The Herr's Mill Covered Bridge, Michael Dohner Farmhouse, Bird-in-Hand Hotel, Christian Stauffer House, and Witmer's Tavern are listed on the National Register of Historic Places.

The Dutch Wonderland amusement park opened in the township in 1963. The former Wax Museum of Lancaster County History was also located in the township, directly adjacent to Dutch Wonderland, from 1969 until 2006.

Geography
According to the U.S. Census Bureau, the township has a total area of 20.0 sqmi, of which 20.0 sqmi is land and 0.1 sqmi (0.30%) is water. Unincorporated communities and neighborhoods in the township include Zooks Corner, Hornig, Holland Heights, Witmer, Bridgeport, Eastland Hills, Smoketown, Bird-in-Hand, Fertility, Greenland, Ronks, and Soudersburg.

Demographics
As of the census of 2000, there were 13,556 people, 5,342 households, and 3,739 families residing in the township. The population density was 679.5 /mi2. There were 5,611 housing units at an average density of 281.2 /mi2. The racial makeup of the township was 92.13% White, 2.11% Black or African American, 0.07% Native American, 2.72% Asian, 0.03% Pacific Islander, 1.85% from other races, and 1.09% from two or more races. 3.87% of the population were Hispanic or Latino of any race. The township has a large Amish and Mennonite population.

There were 5,342 households, out of which 30.3% had children under the age of 18 living with them, 59.0% were married couples living together, 7.7% had a female householder with no husband present, and 30.0% were non-families. 24.5% of all households were made up of individuals, and 7.9% had someone living alone who was 65 years of age or older. The average household size was 2.53 and the average family size was 3.05.

In the township the population was spread out, with 25.5% under the age of 18, 7.3% from 18 to 24, 29.6% from 25 to 44, 22.9% from 45 to 64, and 14.6% who were 65 years of age or older. The median age was 37 years. For every 100 females, there were 97.7 males. For every 100 females age 18 and over, there were 94.0 males.

The median income for a household in the township was $46,179, and the median income for a family was $54,494. Males had a median income of $36,718 versus $25,578 for females. The per capita income for the township was $22,744. About 4.9% of families and 6.5% of the population were below the poverty line, including 10.8% of those under age 18 and 6.0% of those age 65 or over.

Schools
In 2017 the public school system is the Conestoga Valley School District. There is also a campus of the Lancaster Mennonite School in the township, as well as other private schools. The Lancaster campus of Harrisburg Area Community College is located in East Lampeter Township.

title: East Lampeter Township, Pennsylvania


text:
Eden Township, Pennsylvania

Eden Township is a township in southeastern Lancaster County, Pennsylvania, United States. At the 2020 census, the population was 2,248. It is part of the Solanco School District.

History
Eden Township was named for the furnace at Mount Eden.

What is now Eden Township was part of Sadsbury, Chester County before the formation of Lancaster County.

In 1744, Sadsbury Township was split into two; the western part was organized as Bart Township and the eastern part remained Sadsbury Township. In 1854, Bart Township was split into two, with the western part organized as Eden Township, and the eastern part remaining Bart Township.

Geography
According to the U.S. Census Bureau, the township has a total area of 12.4 sqmi, all land. Unincorporated communities in the township include Camargo, Hawksville, and Conners Mill. The borough of Quarryville borders the southwestern corner of the township.

Demographics
At the 2000 census there were 1,856 people, 578 households, and 476 families living in the township. The population density was 149.4 PD/sqmi. There were 606 housing units at an average density of 48.8 /mi2. The racial makeup of the township was 98.81% White, 0.48% Black or African American, 0.11% Asian, 0.05% Pacific Islander, 0.11% from other races, and 0.43% from two or more races. 0.97% of the population were Hispanic or Latino of any race. There were 578 households, 43.4% had children under the age of 18 living with them, 72.8% were married couples living together, 5.7% had a female householder with no husband present, and 17.5% were non-families. 14.0% of households were made up of individuals, and 6.6% were one person aged 65 or older. The average household size was 3.21 and the average family size was 3.57.

The age distribution was 34.1% under the age of 18, 10.1% from 18 to 24, 25.9% from 25 to 44, 21.8% from 45 to 64, and 8.2% 65 or older. The median age was 30 years. For every 100 females, there were 99.8 males. For every 100 females age 18 and over, there were 95.2 males.

The median household income was $44,620 and the median family income was $47,857. Males had a median income of $34,917 versus $21,638 for females. The per capita income for the township was $16,764. About 7.5% of families and 8.9% of the population were below the poverty line, including 11.2% of those under age 18 and 6.0% of those age 65 or over.

title: Eden Township, Pennsylvania


text:
Elizabeth Township, Pennsylvania

Elizabeth Township is the name of at least two townships in the U.S. state of Pennsylvania:
 * Elizabeth Township, Allegheny County, Pennsylvania
 * Elizabeth Township, Lancaster County, Pennsylvania

title: Elizabeth Township, Pennsylvania


text:
Talk:Elizabethtown, Pennsylvania

Vandalism
I just fixed a bunch of vandalism to the page. I'm only an occasional contributor to Wikipedia and I don't know how pages get protected, but protecting this page seems like a good idea to me. Pha telegrapher (talk) 22:45, 28 July 2012 (UTC)

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title: Talk:Elizabethtown, Pennsylvania


text:
Shape of the universe

In physical cosmology, the shape of the universe refers to both its local and global geometry. Local geometry is defined primarily by its curvature, while the global geometry is characterised by its topology (which itself is constrained by curvature). General relativity explains how spatial curvature (local geometry) is constrained by gravity. The global topology of the universe cannot be deduced from measurements of curvature inferred from observations within the family of homogeneous general relativistic models alone, due to the existence of locally indistinguishable spaces with varying global topological characteristics. For example; a multiply connected space like a 3 torus has everywhere zero curvature but is finite in extent, whereas a flat simply connected space is infinite in extent (such as Euclidean space).

Current observational evidence (WMAP, BOOMERanG, and Planck for example) imply that the observable universe is spatially flat to within a 0.4% margin of error of the curvature density parameter with an unknown global topology. It is currently unknown whether the universe is simply connected like euclidean space or multiply connected like a torus. To date, no compelling evidence has been found suggesting the topology of the universe is not simply connected, though it has not been ruled out by astronomical observations.

Shape of the observable universe
The universe's structure can be examined from two angles: The observable universe (of a given current observer) is a roughly spherical region extending 46.5 billion light-years in all directions (from that observer, the observer being the current Earth, unless specified otherwise). It appears older and more redshifted the deeper we look into space. In theory, we could look all the way back to the Big Bang, but in practice, we can only see up to the cosmic microwave background (CMB) (roughly $370,000$ years after the big bang) as anything beyond that is opaque. Studies show that the observable universe is isotropic and homogeneous on the largest scales.
 * 1) Local geometry: This relates to the curvature of the universe, primarily concerning what we can observe.
 * 2) Global geometry: This pertains to the universe's overall shape and structure.

If the observable universe encompasses the entire universe, we might determine its structure through observation. However, if the observable universe is smaller, we can only grasp a portion of it, making it impossible to deduce the global geometry through observation. Different mathematical models of the universe's global geometry can be constructed, all consistent with current observations and general relativity. Hence, it is unclear whether the observable universe matches the entire universe or is significantly smaller, though it is generally accepted that the universe is larger than the observable universe.

The universe may be compact in some dimensions and not in others, similar to how a cuboid is longer in one dimension than the others. Scientists test these models by looking for novel implications – phenomena not yet observed but necessary if the model is accurate. For instance, a small closed universe would produce multiple images of the same object in the sky, though not necessarily of the same age. As of 2023 current observational evidence suggests that the observable universe is spatially flat with an unknown global structure.

Curvature of the universe
The curvature is a quantity describing how the geometry of a space differs locally from flat space. The curvature of any locally isotropic space (and hence of a locally isotropic universe) falls into one of the three following cases:
 * 1) Zero curvature (flat) – a drawn triangle's angles add up to 180° and the Pythagorean theorem holds; such 3-dimensional space is locally modeled by Euclidean space $E^{3}$.
 * 2) Positive curvature – a drawn triangle's angles add up to more than 180°; such 3-dimensional space is locally modeled by a region of a 3-sphere $S^{3}$.
 * 3) Negative curvature – a drawn triangle's angles add up to less than 180°; such 3-dimensional space is locally modeled by a region of a hyperbolic space $H^{3}$.

Curved geometries are in the domain of non-Euclidean geometry. An example of a positively curved space would be the surface of a sphere such as the Earth. A triangle drawn from the equator to a pole will have at least two angles equal 90°, which makes the sum of the 3 angles greater than 180°. An example of a negatively curved surface would be the shape of a saddle or mountain pass. A triangle drawn on a saddle surface will have the sum of the angles adding up to less than 180°.

End of universe.jpg is greater than, less than, or equal to 1.

From top to bottom: a spherical universe with $Ω$, a hyperbolic universe with $Ω > 1$, and a flat universe with $Ω < 1$. These depictions of two-dimensional surfaces are merely easily visualizable analogs to the 3-dimensional structure of (local) space.]]

General relativity explains that mass and energy bend the curvature of spacetime and is used to determine what curvature the universe has by using a value called the density parameter, represented with Omega ($Ω = 1$). The density parameter is the average density of the universe divided by the critical energy density, that is, the mass energy needed for a universe to be flat. Put another way,
 * If $Ω$, the universe is flat.
 * If $Ω = 1$, there is positive curvature.
 * If $Ω > 1$, there is negative curvature.

One can experimentally calculate this $Ω < 1$ to determine the curvature two ways. One is to count up all the mass–energy in the universe and take its average density, then divide that average by the critical energy density. Data from Wilkinson Microwave Anisotropy Probe (WMAP) as well as the Planck spacecraft give values for the three constituents of all the mass–energy in the universe – normal mass (baryonic matter and dark matter), relativistic particles (predominantly photons and neutrinos), and dark energy or the cosmological constant:
 * Ωmass ≈ $0.315$
 * Ωrelativistic ≈ $9.24$
 * ΩΛ ≈ $0.682$
 * Ωtotal = Ωmass + Ωrelativistic + ΩΛ = $1$

The actual value for critical density value is measured as ρcritical = $9.47 kg.m-3$. From these values, within experimental error, the universe seems to be spatially flat.

Another way to measure Ω is to do so geometrically by measuring an angle across the observable universe. We can do this by using the CMB and measuring the power spectrum and temperature anisotropy. For instance, one can imagine finding a gas cloud that is not in thermal equilibrium due to being so large that light speed cannot propagate the thermal information. Knowing this propagation speed, we then know the size of the gas cloud as well as the distance to the gas cloud, we then have two sides of a triangle and can then determine the angles. Using a method similar to this, the BOOMERanG experiment has determined that the sum of the angles to 180° within experimental error, corresponding to Ωtotal ≈ $1$.

These and other astronomical measurements constrain the spatial curvature to be very close to zero, although they do not constrain its sign. This means that although the local geometries of spacetime are generated by the theory of relativity based on spacetime intervals, we can approximate 3-space by the familiar Euclidean geometry.

The Friedmann–Lemaître–Robertson–Walker (FLRW) model using Friedmann equations is commonly used to model the universe. The FLRW model provides a curvature of the universe based on the mathematics of fluid dynamics, that is, modeling the matter within the universe as a perfect fluid. Although stars and structures of mass can be introduced into an "almost FLRW" model, a strictly FLRW model is used to approximate the local geometry of the observable universe. Another way of saying this is that if all forms of dark energy are ignored, then the curvature of the universe can be determined by measuring the average density of matter within it, assuming that all matter is evenly distributed (rather than the distortions caused by 'dense' objects such as galaxies). This assumption is justified by the observations that, while the universe is "weakly" inhomogeneous and anisotropic (see the large-scale structure of the cosmos), it is on average homogeneous and isotropic when analyzed at a sufficiently large spatial scale.

Global universal structure
Global structure covers the geometry and the topology of the whole universe—both the observable universe and beyond. While the local geometry does not determine the global geometry completely, it does limit the possibilities, particularly a geometry of a constant curvature. The universe is often taken to be a geodesic manifold, free of topological defects; relaxing either of these complicates the analysis considerably. A global geometry is a local geometry plus a topology. It follows that a topology alone does not give a global geometry: for instance, Euclidean 3-space and hyperbolic 3-space have the same topology but different global geometries.

As stated in the introduction, investigations within the study of the global structure of the universe include:
 * whether the universe is infinite or finite in extent,
 * whether the geometry of the global universe is flat, positively curved, or negatively curved, and,
 * whether the topology is simply connected (for example, like a sphere) or else multiply connected (for example, like a torus).

Infinite or finite
One of the unanswered questions about the universe is whether it is infinite or finite in extent. For intuition, it can be understood that a finite universe has a finite volume that, for example, could be in theory filled up with a finite amount of material, while an infinite universe is unbounded and no numerical volume could possibly fill it. Mathematically, the question of whether the universe is infinite or finite is referred to as boundedness. An infinite universe (unbounded metric space) means that there are points arbitrarily far apart: for any distance $d$, there are points that are of a distance at least $d$ apart. A finite universe is a bounded metric space, where there is some distance $d$ such that all points are within distance $d$ of each other. The smallest such $d$ is called the diameter of the universe, in which case the universe has a well-defined "volume" or "scale".

With or without boundary
Assuming a finite universe, the universe can either have an edge or no edge. Many finite mathematical spaces, e.g., a disc, have an edge or boundary. Spaces that have an edge are difficult to treat, both conceptually and mathematically. Namely, it is very difficult to state what would happen at the edge of such a universe. For this reason, spaces that have an edge are typically excluded from consideration.

However, there exist many finite spaces, such as the 3-sphere and 3-torus, that have no edges. Mathematically, these spaces are referred to as being compact without boundary. The term compact means that it is finite in extent ("bounded") and complete. The term "without boundary" means that the space has no edges. Moreover, so that calculus can be applied, the universe is typically assumed to be a differentiable manifold. A mathematical object that possesses all these properties, compact without boundary and differentiable, is termed a closed manifold. The 3-sphere and 3-torus are both closed manifolds.

Observational methods
In the 1990s and early 2000s, empirical methods for determining the global topology using measurements on scales that would show multiple imaging were proposed and applied to cosmological observations.

In the 2000s and 2010s, it was shown that, since the universe is inhomogeneous as shown in the cosmic web of large-scale structure, acceleration effects measured on local scales in the patterns of the movements of galaxies should, in principle, reveal the global topology of the universe.

Curvature
The curvature of the universe places constraints on the topology. If the spatial geometry is spherical, i.e., possess positive curvature, the topology is compact. For a flat (zero curvature) or a hyperbolic (negative curvature) spatial geometry, the topology can be either compact or infinite. Many textbooks erroneously state that a flat or hyperbolic universe implies an infinite universe; however, the correct statement is that a flat universe that is also simply connected implies an infinite universe. For example, Euclidean space is flat, simply connected, and infinite, but there are tori that are flat, multiply connected, finite, and compact (see flat torus).

In general, local to global theorems in Riemannian geometry relate the local geometry to the global geometry. If the local geometry has constant curvature, the global geometry is very constrained, as described in Thurston geometries.

The latest research shows that even the most powerful future experiments (like the SKA) will not be able to distinguish between a flat, open and closed universe if the true value of cosmological curvature parameter is smaller than 10−4. If the true value of the cosmological curvature parameter is larger than 10−3 we will be able to distinguish between these three models even now.

Final results of the Planck mission, released in 2018, show the cosmological curvature parameter, 1 − Ω = ΩK = −Kc2/a2H2, to be $0.001$, consistent with a flat universe. (i.e. positive curvature: K = +1, ΩK < 0, Ω > 1, negative curvature: K = −1, ΩK > 0, Ω < 1, zero curvature: K = 0, ΩK = 0, Ω = 1).

Universe with zero curvature
In a universe with zero curvature, the local geometry is flat. The most familiar such global structure is that of Euclidean space, which is infinite in extent. Flat universes that are finite in extent include the torus and Klein bottle. Moreover, in three dimensions, there are 10 finite closed flat 3-manifolds, of which 6 are orientable and 4 are non-orientable. These are the Bieberbach manifolds. The most familiar is the aforementioned 3-torus universe.

In the absence of dark energy, a flat universe expands forever but at a continually decelerating rate, with expansion asymptotically approaching zero. With dark energy, the expansion rate of the universe initially slows down, due to the effect of gravity, but eventually increases. The ultimate fate of the universe is the same as that of an open universe in the sense that space will continue expanding forever.

A flat universe can have zero total energy.

Universe with positive curvature
A positively curved universe is described by elliptic geometry, and can be thought of as a three-dimensional hypersphere, or some other spherical 3-manifold (such as the Poincaré dodecahedral space), all of which are quotients of the 3-sphere.

Poincaré dodecahedral space is a positively curved space, colloquially described as "soccerball-shaped", as it is the quotient of the 3-sphere by the binary icosahedral group, which is very close to icosahedral symmetry, the symmetry of a soccer ball. This was proposed by Jean-Pierre Luminet and colleagues in 2003 and an optimal orientation on the sky for the model was estimated in 2008.

Universe with negative curvature
A hyperbolic universe, one of a negative spatial curvature, is described by hyperbolic geometry, and can be thought of locally as a three-dimensional analog of an infinitely extended saddle shape. There are a great variety of hyperbolic 3-manifolds, and their classification is not completely understood. Those of finite volume can be understood via the Mostow rigidity theorem. For hyperbolic local geometry, many of the possible three-dimensional spaces are informally called "horn topologies", so called because of the shape of the pseudosphere, a canonical model of hyperbolic geometry. An example is the Picard horn, a negatively curved space, colloquially described as "funnel-shaped".

Curvature: open or closed
When cosmologists speak of the universe as being "open" or "closed", they most commonly are referring to whether the curvature is negative or positive, respectively. These meanings of open and closed are different from the mathematical meaning of open and closed used for sets in topological spaces and for the mathematical meaning of open and closed manifolds, which gives rise to ambiguity and confusion. In mathematics, there are definitions for a closed manifold (i.e., compact without boundary) and open manifold (i.e., one that is not compact and without boundary). A "closed universe" is necessarily a closed manifold. An "open universe" can be either a closed or open manifold. For example, in the Friedmann–Lemaître–Robertson–Walker (FLRW) model, the universe is considered to be without boundaries, in which case "compact universe" could describe a universe that is a closed manifold.

title: Shape of the universe


text:
Talk:Lockheed SR-71 Blackbird

In Popular Culture?
How about an "in popular culture" section? X-men, etc. Theanthrope (talk) 20:28, 30 March 2023 (UTC)

 * Gif emoji vomiting 4.0.gif No! See WP:TRIVIA.  Stepho  talk 01:01, 31 March 2023 (UTC)

 * We have a special place for that sort of information: . However, it doesn't currently list the X-men, and probably won't. BilCat (talk) 02:56, 31 March 2023 (UTC)

Red warning stripes
ref "unsourced OR" revert:

it's ok to change sourced information if it's obviously incorrect. In this case the source uses incorrect terminology. Actually red stripes alone are not even an adequate warning. They will be ignored if there are no red words with the stripes, probably "NO STEP" in this case or words explaining why the stripes are there. As an example this Hawkeye has 2 separate stripes with applicable words, one to warn of whirling propeller blades and one to warn of location of disintegrating starter turbine.

To illustrate the distinction between warning and prevention see this Crusader The red stripes only warn not to get sucked in. Prevention requires a wire mesh screen to be in place. Pieter1963 (talk) 00:41, 27 April 2023 (UTC)

Accounting for my edit on the Baltic Express
Five years ago,  of the European flights section with clarify, apparently due to unsatisfactory phrasing and link rot. In repairing the dead link, I encountered information which prompted a rewrite of the second paragraph, and the inclusion of a map and a quite relevant image. The clarification prompted two new sections, one on the route and the geography of the Baltic sea, and the other on Soviet intercepts. It was also natural to either mention or include links to the Cold War relations of Sweden/USA/USSR, scrambling, the nature of intercepting foreign military aircraft and simulated shoot-downs, as well as adding a source (ref name=rbth2012) from the MiG-25 article, and also a new one I found (ref name=AGCViggen).

I included the in order to illustrate the Baltic express route. However, it has some problems. It's a modern map, which means that it doesn't show the Soviet union. It doesn't show airspace borders. It doesn't highlight the key corridors (DDR/Malmö & Gotland/Öland). And it doesn't show the Baltic express route. Despite all this, I would argue that the map still provides clarifying information to the reader about the Baltic operations mentioned in this section. (Some more locations for a custom map: "Codan", Finow-Eberswalde, Stockholm (and possibly other capitals), Ä,R,N,V,P,H,T)

Lastly, I with dual significance to the final paragraph. Not only is the photographed event mentioned in the text, but the nested operational photo that's displayed at the event is reportedly the only time an SR-71 has been photographed during an intercept. (It's a commons file. And the original copyright for both appears to have belonged to the Swedish government. So the nesting shouldn't be a problem.) BucketOfSquirrels (talk) 18:37, 17 October 2023 (UTC)

 * Interesting contribution – however, the picture in front on the Air Medal photo is clearly a painting. Might the photo be the one in the back? --Zac67 (talk) 19:07, 17 October 2023 (UTC)
 * Thanks, I didn't catch that. Just assumed that one of the reinforcing fighters had taken a photo, and that they displayed it for the occasion. Yes, the intercept photo that the sources mention might be the one displayed on the screen in the back. The caption should be changed. BucketOfSquirrels (talk) 19:17, 17 October 2023 (UTC)

Factual errors needing correction in future
1. The SR-71 was based off the YF-12 interceptor, not the A-12. The SR-71 has the same weapons bays and nose bay, while the A-12 has a large central bay. The YF-12 and SR-71 are so similar that a damaged SR-71 was repaired by cutting a YF-12 in half and joining them. This is not possible with the A-12.

2. The SR-71 was not retired for political reasons, it was retired after a CIA report found that it was causing extremely excessive attrition of ground crews, who were pulled from other squadrons in large numbers. The additional training was so excessive that enlisted personnel only had 18 months remaining on their contracts by the time training was complete, requiring several times the number of crews for a given amount of contracts. It also was an extreme burden to maintain, causing nearly all enlisted personnel to refuse to reenlist. The turbines also had a terrible TBO of only a few hundred hours.

3. The engines reached maximum temperature at Mach 2.4, requiring gradual reduction of turbine rpms to maintain temperature as intake temperature increased above mach 2.4. The article says the overheating is caused by fuel flow, but it is not. The manual clearly shows maximum fuel flow available to Mach 3.2 as long as rpms are not exceeded. 2600:1008:B062:697C:E0:241C:CEE6:ED14 (talk) 02:16, 3 July 2024 (UTC)

title: Talk:Lockheed SR-71 Blackbird


text: Talk:Great Victoria Desert

title: Talk:Great Victoria Desert


text:
Talk:Blackface

"Negerköpp" has been changed to „Wilde Frechener“
https://www.wz.de/nrw/nach-anfeindungen-koelner-karnevalsverein-negerkoepp-aendert-namen_aid-32712349

Wiki Education assignment: Black American Music
— Assignment last updated by Isha0323 (talk) 19:30, 27 November 2023 (UTC)

denial of blackface being racist.
certain users are making vandalized edits trying to protect political figures from their racist actions. anyone denying that blackface is mockery of blacks and racialized peoples is a white supremacist. just as holocaust denial  is also white supremacy.

https://www.washingtonpost.com/lifestyle/blackface-is-white-supremacy-as-fashion--and-its-always-been-in-season/2019/02/07/fdb60c06-2b1e-11e9-b2fc-721718903bfc_story.html 70.30.146.188 (talk) 18:25, 13 November 2023 (UTC)

 * Actually, based on historical, folklore, social and post-colonial research, there's an ongoing and highly controversal debate if the practice of 'blackfacing' should be regarded (and forbidden) as a decisive 'racist' practice or not, reaching from a complete denial up to statements like "anyone denying that blackface is mockery of blacks and racialized peoples is a white supremacist just as holocaust  denial  is also white supremacy"
 * As the term'blackfacing' is defined highly different and and applied on to different phenomena, geographical areas, groups of people involved, historical periods and their - very different - corresponding traditions and practices, a conclusive answer, if or if not the practice is ment and used in a potentially racist context must always depend on a deep understanding of it's historical, practicological, psychological, ideological and social context, wich - for example - is highly different between the "morisco dances" first occuring as far as we know - in the late medieval mediterranean, or the 'classical' example of pseudo-'black' Soul and Blues bands or Comedians in the USA and Great Britain during a period between the late 19th century and about the 1970s, made up of 'white' artists,'blackfaced' in a practice and style clearly indicating, showing and transmitting dusguise, mockery and even open racial prejudices against black and other people if colour.
 * So, as always, when it comes to history, heritage and phenomena of popular culture knowing and understanding (historical) context and is everything, as things looking very similar at first glance, can indeed have completely contradictionary sources and meanings. Special warnings to American readers included, when it comes to European phenomenons. As those phinomenins are not only much older, they base also on a completely sociohistorical context and history, which is much more diverse, complicated and ambiguous and therefore much more difficult to research and to understand, as it is regularly the case, with the relatively young, unambiguous and quite comprehensively documented American ones. Especially as the - often completely unreflected and unchanged - introduction of historical theories, methods and interpretation schemes, developed and based in US-American examples, has led to huge misinterpretations and misunderstanding of phenomena in other parts if the world, and especially in a Europe beyond the British isles, often completely unknown or simply underestimated, if not ignored in its complexity to and by American and even British scientists, leading even to the misconception, racism, biologism, primordialism, imperialism and/or colonialism would be a - pretty recent - and 'exclusive' European invention, practice and 'export'...
 * So untill those phenomena are much better understood and researched, the wide spread practice of defining Non-US-American phenomena as 'blackfacung' or even 'racist' isn't only highly inaccurate, unscientific and anachronistic, it also bares the very real risk to be based on highly inaccurate, imperialistic and even racist stereotypes itself - like everything imposed on a culture or region by another, very different and far away one.
 * How difficult and misjudged things can get, if not done on a proper knowledge if the case, actually can be seen in the debate about the 'moores head' in the Coburg city blason, where stidents inspired by post-colonial theory and the black lives matter movement in a shirt trip to the city where 'shocked' and started a petition against the further use of a 'racist Moorish head' in the cities coat of arms...Nor they know, who was shown, nor why, nor that the Nazis once had done the exact same as the Coburgs more should - and was indeed during the NS-regime banned from use in an extreme racist attempt to 'arify' and 'whiten' the cities history, appearance and image, in an attempt to make forget, that there was more than a millienua of history, when the main and highly venerated Saint and Identification figure of the Holy Roman Empire, and therefore the Imperial court, many noble families and even whole regions and cities was Saint Mauritius, depicted and visioned as a Roman soldier from Northern Africa and clearly with 'black' skin and African origin at least from the Hugh medieval if nit the Middle and Early Byzantines time...And yes, believe it or not, in an attempt to protect their 'black' and very African identification figure, national and regional symbol, Saint and hero, the Coburgians hide and protected hundreds of pictures of Saint Mauritius from the Nazis, only to become now the aim of an historical completely uninformed mob, who tried to make vanish these depictures and symbols of a millennia old, and very 'different' African-European (hi)story again...And yes, as the Hohenzollern do originally came from the same Franconian Region, and their family Saint also is the 'Moorish' aka 'black' Saint Mauritius quite some historians also claimed the infamous and now renamed 'Moorenstraße' in Berlin, may didn't refer to any kind of racist tradition, but, in sharp contrast, to thus very much connecting and highly antiracial tradition of the "Black" protection Saint if the whole Holy Roman and later German Empire...And no, it even could be, this tratition line in Berlin (not in Coburg, not in most other places) was blurred quite on purpose and replaced by an other more'colonial' and therefore 'racist'storyline of black colonial soldiers suspected living there, when the Hohenzollern attempted to become (and became) an colonial power themselves more than 800 years, after Mauritius became the Black Saint, Protecting and Identificatiin figure of the whole Empire, connected even to Christ itself...And yes, it even could be the now attaced '(Venetian) blackamoor' could be in fact a slightly dusguised Saint Mauritius, as Venice owns quite some reliquies of this Saint, and pictures of the Saunt often were worn as some kind of talisman all around Europe. Also there's actually emerging a very similar storym concerns pro-black-activist attacs against the few remaining "Moorenapotheke" in Germany, whose "Moore" denomination is depicted as "colonial reluct" and "racist" in many post-colonial publucations... Unfortunately, the scientists and activists making thus assumption did a very bad job in researching tbe topic, as it has become clear, the Apotheken-Moor or pharmacy moor in English (or black African) predates any European colonialism by centuries, and derives directly from an hagiographic Episode of the two Medicine and Pharmacist Saints Cosmas and Damian, who according to the pious legend pretty much saved the live of one if their white patients by the miraculously sucessfull (!) amputation and transplantantation of the keg if a 'black' person, or vice versa...Honestly said, the Greek and Latin Versions of the text are a bit confusing, and could also be read as the succesfull healing or amputation of a gangrene and therefore 'black' leg...But this isn't his the story was actually read and depicted, as from the Middle Byzantine era on, there was the story of a Moore healed by the amputation if a white leg, or a white healed vuce versa with a black one, cinected wuth the clear message that race should be of no matter, neither to medicines, nor to pharmacists nor to their patients...And so the Moore out of this Episode became the trademark sugn if Pharmacies, nit fir the exotuc goods, but for shouting out the message, that everyone of every race is welcome and will be treated the same as a mere human, as race makes abso,Ute no difference and should be completely irrelevant for a pharmacist or anyone else...
 * So things are complicated, and a black face in Europe nit always must be something racist,,even if it is crowned, or wears an golden (ear)ring or necklace (all part of the hagiography, and actual signs of the high rank and not the inferiority of the depictured!).
 * Same with the 'blackfacing' of one if the holy king's, wich weren't holy nor kings nor three, but simply were depicted as living symbols of the unity of all mankind, as only 3 continents (Europe, Asia and Afrika) and their predominantly 'white','yellow' and 'black' populations were known around the year 1000 (or earlier, it's quite unclear if it was done already earlier) to those, 'inventing' and imposing this symbolism and depiction to the Biblical story of the 'magoi' honouring baby Christ in its creddle...and no there's no rank, nor racism in the message, just unity and equality if all mankind and races, so we may should think twice, if we really understand the message of a 'black(faced) face', and should at least accept, not each black facing automatically includes or trasports a racist message...This even more so, as some of the most noble 'white' families of Europe and Asia are quite proud, still caring and showing of their real or assumed 'moorish', 'black' or 'african' genealogy and heritage, sometimes beeing much closer related to some of the bug mythuc African heroes and heroine than most black activists even know, immagine or - unfortunately - can accept...
 * Things are complicated and sometimes very surprising and different in the old world...
 * So all this is said to show how difficult the 'right' interpretation, and therefore decission, if or if not something has a discriminative' or 'racist' connotation can and must be, without knowing the exact historical context... — Preceding unsigned comment added by Alex-ried (talk • contribs) 19:23, 6 May 2024 (UTC)

title: Talk:Blackface