Drugs: A Very Short Introduction by Les Iversen

Author:Les Iversen
Language: eng
Format: epub
ISBN: 9780191062964
Publisher: OUP Oxford
Published: 2016-04-21T04:00:00+00:00

Plagues and pestilences

Throughout human history infectious diseases have plagued us. As the human species became more and more numerous and lived in increasingly high densities in towns and cities, we became a fertile breeding ground for the many species of bacteria, fungi, viruses, and parasites that have evolved specifically to take advantage of Homo sapiens. In some cases disease has been spread from animals to man, bubonic plague spread from rat fleas to humans, with disastrous consequences. For most of human history we have had no effective medical means of combating the ravages of infectious diseases, and epidemics of such diseases have proved lethal. The spread of bubonic plague (the ‘Black Death’), throughout Europe in the Middle Ages, for example, led to the death of as many as half of the population in many countries. Even in the 20th century, the ‘Spanish flu’ epidemic killed some thirty million people within six months in 1918—twice as many as had died in World War I.

The German chemist Paul Ehrlich developed the first effective anti-bacterial drug. He experimented with the effects of various chemical substances on disease organisms and in 1910, and found that the 606th compound in a series of synthetic chemicals prepared in his laboratory was effective. The compound contained arsenic, and was called arsphenamine. It was one of the first drugs that effectively killed disease microorganisms, and it inaugurated an era which was to revolutionize the treatment and control of infectious diseases, which had hitherto been largely untreatable. Arsphenamine (sold under the trade name ‘Salvarsan’) was particularly lethal to the micro-organism responsible for syphilis. Until the introduction of penicillin, ‘Salvarsan’ (or one of its close chemical relatives that were subsequently developed) remained the standard treatment of syphilis and went a long way towards bringing this social and medical scourge under control.

German chemists learned how to make synthetic dye chemicals that bound strongly to fabrics and could not be removed by washing. They used the same principles to make synthetic medicines that targeted diseases like ‘magic bullets’, in Ehrlich’s famous phrase. In 1932 the German bacteriologist Gerhard Domagk discovered that the red dye Prontosil is active against streptococcal infections in mice and humans. Soon afterward French workers showed that its active antibacterial agent is sulphanilamide. In 1936 the English physician Leonard Colebrook and his colleagues provided overwhelming evidence of the efficacy of both Prontosil and sulphanilamide in streptococcal septicaemia (bloodstream infection), thereby ushering in the sulphonamide era. Domagk and others produced new sulphonamides with astonishing rapidity, many of which had greater potency, wider antibacterial range, or lower toxicity. Domagk was awarded the Nobel Prize in Physiology or Medicine for this work in 1939, but because of his persecution by Nazi Germany he was not able to accept the award until 1947. Some of the new sulpha drugs stood the test of time; others, like the original sulphanilamide and its immediate successor, sulphapyridine, were replaced by safer and more effective successors, many of which are still in use. The sulphonamides represented the first big advance in the war against infectious diseases.

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