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A Third Revolution in Modern Medicine, Part One
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13162 |
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Section : |
NATURAL SCIENCE
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| Issue
Date : |
11 / 1987 |
2,560 Words |
| Author
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Wolfgang Sadee
Wolfgang Sadee is professor of pharmacy and pharmaceutical
chemistry at the University of California, San Francisco and
editor of Pharmaceutical Research. |
In this two-part series, Part I covers the knowledge and technologies of the protein domain. Part II, in the December issue, will present the new protein drugs and the novel therapeutic approaches that they allow.
Historians of the health sciences contend that modern medicine came about in two revolutions of extraordinary magnitude and suddenness. With the first revolution came the understanding of the causes of disease. With the second revolution came the possibility of a cure.
Early in the nineteenth century French medical scientists paved the way for the first revolution with the introduction of modern diagnosis and statistics. This advance was followed by German scientists, who began to discover the causes of diseases. The isolation of the bacillus Mycobacterium tuberculosis as the cause of tuberculosis by Robert Koch in the late nineteenth century stands as a hallmark of this era. However, knowledge of the causes of disease did not immediately result in effective therapy, and a medical nihilism took root. The supreme task of a physician became the diagnosis of disease, without any real potential for cure.
The possibility of cure was realized with the second revolution of modern medicine during the first half other twentieth century. Encourage by his early clinical results in treating syphilis, Paul Ehrlich, the father of modern immunology and chemotherapy, coined the term "magic bullet" for drugs that killed disease-causing agents without damage to the host. It was not until the 1940s, however, that the antibiotic penicillin, which had been discovered by Alexander Fleming in 1928, was used clinically to treat syphilis.
The important drug discoveries that followed, such as sulfonamides and antibiotics against bacterial infections, diuretics to increase the flow of urine, hormones, and drugs effective against some mental illnesses, raised hopes that diseases could be conquered. Despite these advances, however, there is little cause for complacency. As miracle drugs, antibiotics are a two-edged sword--not only do they fight disease, they also, in effect, promote the proliferation of resistant bacterial strains that are increasingly difficult to treat. Further, major modern diseases such as cardiovascular disease, mental illness, and cancer have no highly effective therapy or cure.
Heralding The Third Revolution
The 1953
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