The Hormone Front

Specialists in rheumatic diseases from 35 countries met in Geneva last week; as might be expected, much of the talk centered on progress made in the treatment of rheumatoid arthritis.

The rheumatologists listened with respect to the U.S.'s Dr. Philip S. Hench, who shared a Nobel Prize for his part in the discovery and application of the wonder hormone cortisone. Granting that cortisone is not the "fountain of life" that many sufferers hoped that it would be, Hench inveighed against too much timidity in the use of the drug, which he said had raised "as many false fears as false hopes." In four years' use at the Mayo Clinic, he said, cortisone has proved effective in more than 50% of the thousands of patients receiving it. Moreover, experience has shown physicians how to deal with some of the undesirable side effects, e.g., hypertension, psychosis, by careful dosage and the combined use of hormones with other drugs. Even So, Dr. Hench sounded the usual note of medical caution: many more years of experience will be necessary before cortisone will be fully understood.

The experts also heard more about phenylbutazone, a nonhormonal substance synthesized from coal tar (TIME, June 16, 1952). They got an encouraging report on the use of phenylbutazone in the treatment of gout and gouty arthritis by Dr. William C. Kuzell of the Stanford University School of Medicine: major improvement or complete relief in 168 cases out of 200. Bad side effects, which have proved so serious that many U.S. doctors frown on phenylbutazone, were noted in 52 cases, but of these, 38 were cases in which it was possible to continue the treatment successfully, because the degree of toxicity was so small. The consensus of the Geneva experts: everybody should have a better idea of the drug's value by the time the next international rheumatism congress rolls around in 1957.

Meanwhile, before last week's sessions broke up, the experts got news of yet another potential medical tool. Nobel Prizewinner Tadeus Reichstein of Basel University announced that he had isolated a powerful adrenal hormone which he provisionally called "electrocortin." Since the newly isolated hormone undoubtedly plays a part in the body's balances. Dr. Hench called electrocortin "the biggest thing" of the congress, but neither he nor Dr. Reichstein would prophesy as to its therapeutic possibilities. Whatever its potentialities in the treatment of arthritis and other diseases, electrocortin will probably not be available in large quantities for some time: Dr. Reichstein used 1,100 lbs. of beef adrenals to get 22 milligrams of it.

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