AN HISTORICAL REVIEW OF RHEUMATOID-ARTHRITIS TREATMENT - 1948 TO 1952

Objectives: The early responses by practicing physicians to the discov ery of the effect of cortisone (compound E) and adrenocorticotropic ho rmone (ACTH) on acute rheumatoid arthritis in 1948 and their reactions to the drugs' scarcity have been reviewed. Methods: Review of the rel evant literature in American, British, and European medical journals a nd some newspapers. Results: Whereas the effect of the compound E and ACTH was stunning, their scarcity made them unavailable to most physic ians. Nevertheless, practicing physicians took a lively interest in th e new therapy, as witnessed by the large number of letters with commen ts and questions to professional journals from all over the world. As expected, most of these were about attempts to find a substitute for c ortisone or a way to release it endogenously to a sufficient degree, A few alternative therapies were suggested too, some quite unorthodox, A lively interest was shown by the general public. Conclusions: No alt ernative therapy recommended to treat acute rheumatoid arthritis in li eu of cortisone proved to be effective. The era of scarcity was ended by the discovery of a more efficient method to manufacture cortisone. Copyright (C) 1997 by W.B. Saunders Company.