1949

Philip Hench and colleagues at Mayo Clinic announce dramatic effects of “Compound E” (cortisone, a steroid found in minute amounts in the adrenal cortex) on arthritis sufferers. Results of first 16 patients published as “Preliminary Report” on 13 April 1949 issue of “Proceedings of the Staff Meetings of the Mayo Clinic” (Hetenyi & Karsh). The drug could only be produced in minute quantities, so the manufacturer, Merck, requested that the National Academy of Sciences establish a committee (which was headed by A. N. Richards) to allocate it among researchers. The NAS had directed the clinical evaluation of penicillin during WWII. “. . . the failure of Merck’s efforts to have the NAS direct the evaluation and allocation of cortisone reinforced existing pressures for proprietary control over clinical drug research” (Marks III, 421). The rise of NIH’s research empire “may equally be regarded as the response to a deadlocked system of private agencies and interests. In this interpretation, the cortisone episode represents in microcosm a recurring dilemma of postwar science: the search for authoritative, disinterested scientific advice in circumstances where no single authority appeared disinterested to all parties. Merck began the quest for authoritative science by delegating its authority to the NAS. The NAS and the Richards committee seemed disinterested to Merck but not to the disease specialists or the disease foundations . . . . Similarly, to the medical scientists on the NAS committee, the disease specialists seemed excessively self-interested. Officials of the Bureau of the Budget and officers of the Rockefeller Foundation were similarly skeptical of the disease foundations. . . . Meanwhile, the disease foundations, having undermined the NAS committee, found themselves on the NIH’s doorstep” (438-439).