Taking the Medicine by Druin Burch
|Taking the Medicine by Druin Burch|
|Category: Popular Science|
|Reviewer: George Care|
|Summary: A fascinating history of pharmacology and medicine and the development of evidence based research.|
|Buy? Yes||Borrow? Yes|
|Pages: 336||Date: January 2010|
In the same week that I read this outstanding book on the development of pharmacology, the newspapers were full of issues on which this book has not just a bearing but something significant to say.
In 1898, Burch points out that a new drug was developed and marketed for the treatment of tuberculosis by Bayer & Co. TB is such an ancient enemy of man that there is apparently evidence of an earlier strain to be found in Egyptian mummies. The German firm had discovered a chemical that seemed to work well, and patients and indeed their own staff, who were tested seemed to respond well - it was named Heroin - and its addictive effects were at first missed.
Just this week a group of paediatricians from a variety of hospitals, from Great Ormond Street to St James's in Leeds, have become concerned that in 2010 pharmaceutical companies are still acting unethically, by paying too little attention to funding research for babies and children. Why? It seems to be less profitable than spending an equivalent amount of money on the development of medicines for adults. The history of the development of Aspirin appears on Bayer's website but the marketing of Heroin – initially believed therapeutic, was abandoned by them in 1913 - but not all firms - is not recorded. Burch points out the need for careful testing; the humility of empiricism over anecdote or even worse arrogant authority.
An outstanding aspect of this stimulating and quite riveting read is its description of the heroic roles played by courageous men like Lind (the R.N. surgeon who treated scurvy) and Cochrane. The latter's insistence upon weighing the evidence by careful statistical analysis in comparative groups was based on bitter experience of attending his sick fellow prisoners in the woeful conditions imposed and aggravated by sadistic German guards in occupied Salonika. Despite the shortage of available treatments the whole experience taught him the benefits of making his own careful comparative assessments. He had already fought fascism in the Spanish civil war and seen his friend Julian Bell die from a wound in a shattered thorax.
After such arduous episodes Cochrane committed his later days to introducing methodological rigour to medical research in relation to statistics and in the author's telling phrase, having a more profound effect on human health than any newly discovered drug. One of the diseases on which such procedures most quickly had an effect was tuberculosis. Because of its latency period after infection TB is still remains something of a hazard for some elderly patients, as has been mentioned in the media this week. Its genes also mutate. However, the structured argument that Druin Burch pursues has contemporary relevance and is argued with engaging historic research. His brief and concise pen portraits have the elegance of Aubrey's Brief Lives to whom he makes passing reference.
In a significant recent article in the national press Hadley Freeman, characterised our own 'noughties' as an age of fakery, in both science and medicine. She refers to Mike Specter's new commentary on the MMR and autism furore. She mentions views pronounced by celebrities from Ace Ventura, Tony Blair, Jim Carey and others on an issue which is likely to mislead vulnerable members of the public away from analysis, fact and experience. In Taking the Medicine, Druin refers to the fascinating figure of Boston's nineteenth century physician, Oliver Wendell Holmes, who notes a somewhat similar propensity of patients to grasp at straws to find a cure and to pay dearly for it. He states with an engaging touch of irony, Like politicians who need to be seen to be doing - something - anything - about problems that are actually beyond their control, doctors are pushed into playing a part. The danger comes when they start to believe in their own illusory importance.
In the next year or so, genetic advances will help to identify the sequences that drive patient's cancers. Such work depends upon the earlier endeavours of figures like Paul Ehrlich who developed the effective use of chemical dyes in haematology, to discover a description of the way in which living cells produce antibodies. This led to a greater understanding of the immune system. The award of the first Nobel prize for medicine to Ehrlich was, however blocked by an anti-Semitic chemist. Ehrlich went on, as Burch so clearly describes to test Salvarsan on animals with Saachiro Hata who had arrived from Tokyo in 1909. This led to the effective treatment of syphilis which, held a position roughly equivalent to that of AIDS before the development of anti-retrovirals. Ehrlich was a kind, sensitive and inspiring clinician. Domagk became his student, and after a terrible time on the Western Front worked on the development of the first antibiotic. This was needed to tackle puerperal fever - often lethal for infected women after childbirth - and also meningitis in the inter-war period. Dogmagk was to receive the Nobel prize but under Hitler's influence, he was made to refuse. He was still taken away by the Gestapo because his refusal was too polite.
Altogether this is an intelligent, wide ranging and stimulating read. The sort of book you hope that a sixth form biologist would find time to read and should be a supplement to the reading list in the first year at medical school. The author is an NHS doctor and his book is thoroughly enjoyable and much easier to read than many medicines are to swallow!
I'd like to thank Vintage Books for sending a copy to The Bookbag.
If this book appeals then you might also enjoy Bedlam: London and Its Mad by Catharine Arnold.
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