Wonder Drug
RITISH drug triumph,' Express headlines IDObellowed last week : 'Hospital danger will be removed'; and the writer, the ineffable Chap- man Pincher, went on to describe how Super- penicillin, the new wonder drug, kills germs that have become resistant towards its predecessor. Not surprisingly, the day that his story appeared the shares of Beecham's, the manufacturers of the new drug, shot up. And as the public remains staunchly gullible in such matters, Superpenicillin will presumably be hailed as yet another proof that the medicine of today is all right, particu- larly when it's British.
But is it? The significant fact about Super- penicillin is that it should be required. Year after year the public is feasted on accounts of what the latest wonder drugs can do. Yet here we are in 1960—after a period when, it is generally boasted, medical science has advanced more rapidly than ever before—with our hospitals full of patients, and with the chance of those patients contracting new diseases in hospital greater than at any time within living memory.
This is not to dispute that the advances have saved lives; some illness can actually be attributed to the fact that more people are kept alive, to fall ill later, Yet the net results of the Drug Era have been disappointing. Some of the cures which have been introduced with a flurry of ecstatic publicity have had dangerous side-effects —as penicillin itself often has—or have been shown up as pretenders. The classic ease is cortisone, hailed as the great break-through, a drug which, would conquer rheumatoid arthritis. For a year or more, heart-warming, circulation- building and profit-making stories were circu- lated about bedridden arthritics hurling off their eiderdowns and running out into the street, or cripples resuming their former athletic activities after cortisone treatment. Then came a lull: and finally, a report from the British Medical Research Council announced that the introduc- tion of cortisone had not materially affected the prospects of rheumatoid arthritis patients, for whom 'there appears to be little difference be- tween the therapeutic effects of aspirin and corti- sone'-- on balance, in fact, treatment with aspirin was rather more effective than with cortisone.
One reason why drugs boom and slump is that they tend to be prescribed indiscriminately, often for no good reasons and sometimes for thoroughly bad ones, the moment they come on the market. This happens, the profession com- plains, because the drugs are boosted all too suc- cessfully by reporters looking for good copy, and by drug manufacturers looking for pub- licity, with the result that the patients are in the GP's surgery demanding to be cured by the latest wonder drug almost before the GP himself has heard of it.
As a result, the benefits of a drug may be dissipated. Germs acquire resistance to drugs much as rabbits acquire resistance to myxoma- tosis; so, penicillin loses its effectiveness, and has to be replaced by Superpenicillin—and in time, no doubt, Superpenicillin by hyperpenicillin. And although the profession realises this, and from time to time issues warnings and 'exhortations about the dangers of indiscriminate prescribing, it has been unable to do anything effective to stop it.
But the 'acquired resistance' explanation does not tell the whole story. Within the profession there is a growing feeling that the whole principle of filling patients up with ever more potent drugs to destroy ever more powerful disease germs is wrong. There is currently a tendency to go back to the ideas of men like Claude Bernard, who taught that the function of medicine should be to stimulate the patient's own resistance to disease —not to take over the contest, as heavy dosage of drugs is designed to do, and fight the patient's fight for him. But such is the public's credulity about drugs, and such is the weight of commer- cial pressure behind their promotion, that the profession cannot control the appetite for them. To find ways to persuade the public that the day of the wonder drug is past will take some hard thinking.
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