Quick Relief, Quick Relapse

Outstanding among the substances which regulate body functions are hormones, and one of the most powerful of them is ACTH (adrenocorticotropic hormone). Secreted by the pituitary gland at the base of the brain, it directs a pair of glands above the kidneys in the production of about 30 other hormones.

Virtually all that has been learned so far about ACTH's awesome power to change the innermost workings of the body was published last week in a single volume, Clinical ACTH (Blakiston; $6.50). Normally it would have taken years for 52 such reports to seep into scattered medical journals. Dr. John R. Mote, director of the Armour Laboratories, which produce most of the world's pitifully small supply of ACTH, collected the papers, with 421 illustrations, so that researchers could have all the available data in one package.

After tests on 53 normal people and 560 patients suffering from 72 diseases and disorders, there was no doubt of ACTH's dramatic powers. It can interrupt many diseases which have baffled doctors for centuries. But the way it works is no less baffling. Says Dr. Mote: his collection of data will raise many more questions than it answers. Its chief significance lies not in promises of quick cures by ACTH itself, but in giving clues to how the body works in health and disease, so that cures may eventually be found.

It is not yet certain that ACTH will cure anything, but its temporary effects are noteworthy. Examples: P: In delirium tremens, ACTH begins to show results in three to ten hours. It is "easily the most effective treatment we have used," reported Dr. James J. Smith of Manhattan's Bellevue Hospital. P: Allergic conditions are often "materially relieved," said Drs. Theron G. Randolph and John P. Rollins of Northwestern University. In asthma, the relief is short-lived, but some hay fever (ragweed) victims were sneeze-free for the season after a few shots of ACTH. P: The "collagen diseases" (involving the connective tissues) are most responsive. Rheumatoid arthritis and rheumatic fever, which first put ACTH in the headlines (TIME, May 2), are placed in this group by many authorities. Several others follow the same pattern of quick relief, quick relapse when treatment is stopped.P: Swollen lymph glands and nodes shrink visibly; even lymphatic leukemia (blood cancer) is slowed for a while.*

Hardly less striking than the short-term benefits of ACTH are its side effects. Many patients develop a severe acne, mental symptoms, a moon-shaped, swollen face, "buffalo hump," diabetes or hirsutism, i.e., a woman may grow a mustache and beard, but, along with other ill effects, they usually disappear after treatment is stopped.

Because of ACTH's power to turn certain disease processes off & on at will, Dr. Mote believes that its discovery compares in importance with the identification of bacteria as causes of disease. After a century, the full bacteria story is not yet known. It may take as long to unravel the mysteries of such hormones as ACTH.

*Some ACTH treatments of leukemic children have been misrepresented as cures. A victim of leukemia must still be considered under sentence of death; ACTH offers a short reprieve for the few who can get it.

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