Modern Medicine and Expectations

"Why can't they just give me a pill?"

"Why don't pharmaceutical companies develop cures instead of treatments?"

Well, perhaps a little history lesson is in order. Hippocrates the "Father of Modern Medicine is so acclaimed because he wrote more than 70 books 2400 years ago. He must have known something because he lived to be 104! However, I think what truly counts as modern western medicine had its birthplace in Europe when Antonie Philips van Leeuwenhoek (1632 - 1723) first observed microorganisms with a microscope giving birth to microbiology. Over about the next 200 years the germ theory of disease came to be with the help of Louis Pasteur, the familiar inventor of the pasteurization process to kill microbes in liquids. He also developed the first laboratory developed vaccine for Anthrax in sheep. Many advances were made in surgery by other familiar historical figures, such as Florence Nightingale in a similar time frame (mid to late 1800's), but I will stay focused on drug history.

So, onto modern times! The very first pill I ever recall receiving I swear I can still taste...that chalky orange flavor proved quite memorable, along with the tag line "Thank Goodness for St. Joseph!"

Thanks go to Bayer AG, which created a synthetic version of salicin, a natural product from meadowsweet, called Aspirin in 1897. So it wasn't until ~1900 that we had Aspirin, which with its ability to reduce fever, saved countless lives. In 1928 Penicillin was discovered giving us the first antibiotic providing me with the second drug I ever recall taking, and a nasty tasting cherry liquid it was! 1946 brought the first effective chemotherapy drug,nitrogen mustard, based on the white blood cell killing properties of mustard gas. 1960 brought "The Pill" to the formulary, perhaps the most widely used medicine on earth, closely followed in 1962 by the first beta blocker, Propranolol (a drug I became familiar with as a chemist in the early 1990's). Another popular drug, Valium, arrived in 1963 along with the measles and rubella vaccines shortly before my birth at the end of 1966.

So, where am I going with this? Keeping in mind this is a blog, I will insert my opinion that the current expectation of "a pill for everything" reflects scientific capabilities not established until ~1960-1970! After then, what I will call "small molecule" pharmaceutical industry took off bringing us the pharmaceutical industry as we have come to know it. In truth, this iteration of our industry wasn't in the cure business, with the exception of vaccines and some others. The industry's ability to truly target developing cures instead of treatments didn't arrive until The Human Genome Project was completed (at least in draft) in 2000. And that was only the tip of the iceberg as our understanding of the 20,300 genes in the human genome and all the myriad proteins. peptides, oligonucleotides involved in what makes us all go and all sick is still literally in its infancy. Now we even have an effective gene editing tool, CRISPR, (Clustered Regularly Interspaced Short Palindromic Repeats) proven to make effective gene edits in Human tripronuclear zygotes in 2015 in China.

Wow...from Aspirin to wide availability of small molecule treatments in ~50-60 years...then to an understanding of the human genome and to opening the door to understanding and treatment of disease on a genetic level in another 50-60? You just can't please people! What is next? Will people be able to change their eye color at will to match their outfit? Or perhaps we will at least see cures for common cancers and the elimination of a lot of orphan maladies that are currently death sentences. I am just amazed at the progress. Stay tuned. We are truly living in the golden age of modern medicine right now.