Happy Accidents: Serendipity in Major Medical Breakthroughs in the Twentieth Century by Morton A. Meyers Page B
Authors: Morton A. Meyers
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emergence of antibiotic-resistant pathogens, which in turn fuels an ever-increasing need for new drugs.
In 1993 the World Health Organization (WHO) declared tuberculosis, which claimed about 2 million lives each year, a global emergency. WHO estimates that by 2020, one billion people will be newly infected.
8
“This Ulcer ‘Bugs’ Me!”
Nothing is so firmly believed as that which we least know.
—M ICHEL DE M ONTAIGNE
“Oysters,” my grandfather, a Russian immigrant to America, called them. “Calm down, relax, or you'll get oysters in the stomach,” or “Don't eat so much spicy food—it'll give you oysters!” In the small inland town in which I grew up, oysters were an unknown delicacy, but to an immigrant's ear, the nuances of the English language often were lost. Pronunciation issues aside, my grandfather nevertheless displayed enough familiarity with the prevailing medical opinion of the time regarding the relationship between stress or spicy foods and stomach ulcers to admonish the members of his family.
“N O A CID , N O U LCER ”
An ulcer is an open sore on the mucous membrane lining the stomach or the duodenum, the portion of the intestine extending immediately beyond the stomach. Since ulcers affect an estimated 5 million Americans, with about 400,000 new cases reported each year, the condition—with the complications of pain, bleeding, and perforation—is no small matter.
For many decades, Schwartz's dictum of 1910—“No acid,noulcer”—governed treatment of peptic ulcer disease. 1 The inside of the stomach is bathed every day in about half a gallon of gastric juice, which is composed of digestive enzymes and concentrated hydrochloric acid. Doctors typically treated ulcers by initially ordering changes in a patient's diet, in an attempt to protect the stomach walls from its acid. The Sippy diet, introduced by Chicago physician Bertram W. Sippy in 1915, was practiced well into the 1970s. Sippy called for three ounces of a milk-and-cream mixture every hour from 7:00 A.M . until 7:00 P.M ., and one soft egg and three ounces of cereal three times a day. Cream soups of various kinds and other soft foods could be substituted now and then, as desired. Accompanied by large doses of magnesia powder and sodium bicarbonate powder, such “feedings,” as meals were known, would continue for years—if not for life. 2
Unfortunately, the intake of food brings about not only increased saliva but also the production of stomach acid in preparation for digestion. The Sippy method was thus rarely successful because, though doctors didn't realize it, the diet actually increased levels of stomach acid and therefore aggravated the symptoms of ulcers. In contemplating this well-intended but entirely inappropriate approach, one is reminded of the all-purpose huckster advertising slogan: “Successful except in intractable cases.” Physicians treating their ulcer patients with the Sippy diet must have been amazed at how many of their cases proved intractable. The fact that this falsely based approach nonetheless persisted for six decades illustrates the unfortunate fact that conventional wisdom once adopted remains stuck in place even when it flies in the face of reality.
Ulcers often progressed to the point of chronic distress with the potential of life-threatening bleeding. In such cases, the answer was surgery to remove the acid-secreting portion of the stomach.
Besides blaming stress, diet, and tobacco as factors in the development of ulcers, many physicians believed there was also a psychosomatic aspect. Building on Freud's insights and Adler's idea of “organ inferiority,” the concept of psychosomatic medicine was furthered by the experience of World War I, in which as many as 80,000 “shell-shocked” soldiers suffered from various severe somatic symptoms that seemed to have emotional origins. In his 1950 book Psychosomatic Medicine, Franz Alexander defined the cause of ulcers as internal conflict
In 1993 the World Health Organization (WHO) declared tuberculosis, which claimed about 2 million lives each year, a global emergency. WHO estimates that by 2020, one billion people will be newly infected.
8
“This Ulcer ‘Bugs’ Me!”
Nothing is so firmly believed as that which we least know.
—M ICHEL DE M ONTAIGNE
“Oysters,” my grandfather, a Russian immigrant to America, called them. “Calm down, relax, or you'll get oysters in the stomach,” or “Don't eat so much spicy food—it'll give you oysters!” In the small inland town in which I grew up, oysters were an unknown delicacy, but to an immigrant's ear, the nuances of the English language often were lost. Pronunciation issues aside, my grandfather nevertheless displayed enough familiarity with the prevailing medical opinion of the time regarding the relationship between stress or spicy foods and stomach ulcers to admonish the members of his family.
“N O A CID , N O U LCER ”
An ulcer is an open sore on the mucous membrane lining the stomach or the duodenum, the portion of the intestine extending immediately beyond the stomach. Since ulcers affect an estimated 5 million Americans, with about 400,000 new cases reported each year, the condition—with the complications of pain, bleeding, and perforation—is no small matter.
For many decades, Schwartz's dictum of 1910—“No acid,noulcer”—governed treatment of peptic ulcer disease. 1 The inside of the stomach is bathed every day in about half a gallon of gastric juice, which is composed of digestive enzymes and concentrated hydrochloric acid. Doctors typically treated ulcers by initially ordering changes in a patient's diet, in an attempt to protect the stomach walls from its acid. The Sippy diet, introduced by Chicago physician Bertram W. Sippy in 1915, was practiced well into the 1970s. Sippy called for three ounces of a milk-and-cream mixture every hour from 7:00 A.M . until 7:00 P.M ., and one soft egg and three ounces of cereal three times a day. Cream soups of various kinds and other soft foods could be substituted now and then, as desired. Accompanied by large doses of magnesia powder and sodium bicarbonate powder, such “feedings,” as meals were known, would continue for years—if not for life. 2
Unfortunately, the intake of food brings about not only increased saliva but also the production of stomach acid in preparation for digestion. The Sippy method was thus rarely successful because, though doctors didn't realize it, the diet actually increased levels of stomach acid and therefore aggravated the symptoms of ulcers. In contemplating this well-intended but entirely inappropriate approach, one is reminded of the all-purpose huckster advertising slogan: “Successful except in intractable cases.” Physicians treating their ulcer patients with the Sippy diet must have been amazed at how many of their cases proved intractable. The fact that this falsely based approach nonetheless persisted for six decades illustrates the unfortunate fact that conventional wisdom once adopted remains stuck in place even when it flies in the face of reality.
Ulcers often progressed to the point of chronic distress with the potential of life-threatening bleeding. In such cases, the answer was surgery to remove the acid-secreting portion of the stomach.
Besides blaming stress, diet, and tobacco as factors in the development of ulcers, many physicians believed there was also a psychosomatic aspect. Building on Freud's insights and Adler's idea of “organ inferiority,” the concept of psychosomatic medicine was furthered by the experience of World War I, in which as many as 80,000 “shell-shocked” soldiers suffered from various severe somatic symptoms that seemed to have emotional origins. In his 1950 book Psychosomatic Medicine, Franz Alexander defined the cause of ulcers as internal conflict
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