Drugs: A Limited Wonder

No new and virtually untested drug has ever been greeted with such optimistic fanfare as dimethyl sulfoxide, or DMSO, a colorless liquid extracted from paper-pulp wastes and commonly used as an industrial solvent. It has been widely hailed, both in the press and by some doctors, as a painkiller, a germ killer, diuretic, tranquilizer, a reliever of burns and sprains — besides being a wondrous solvent that enables other drugs to penetrate the skin and alleviate conditions as varied as crippling arthritis and athlete’s foot. The surgeon who discovered DMSO’s medicinal properties in 1963, Dr. Stanley W. Jacob, 41, of the University of Oregon, says extravagantly that it has other possible uses too fantastic to disclose. The highly purified, medicinal form of DMSO is not yet on the prescription market, but pain-racked arthritis victims have been paying $3.50 an ounce for bootlegged crude commercial DMSO, which may be dangerous.

Hitching Rides. Up to now, the claims for DMSO had not been proved by careful investigation. But in this week’s A.M.A. Journal, Dr. Albert M. Kligman, a University of Pennsylvania professor of dermatology, supplies many of the overdue answers.

After the most thorough study yet made of the drug, with state prison inmates who volunteered for tedious and sometimes painful tests, Dr. Kligman offers some negative findings. DMSO, he says, provides practically no relief for itching or superficial pain. As a germ killer, it is weak “and far inferior to alcohol.” It does nothing to promote the healing of clean, simple burns, and it worsened one of ten ultraviolet burns. DMSO also failed to tranquilize any of 20 men in a six-month test. Nevertheless, it has some remarkably beneficial properties.

Almost all the good effects result from the drug’s unrivaled ability to pass through human skin like a hot knife through butter. And since so many other drugs dissolve readily in DMSO, they can hitch a ride with it and quickly penetrate the horny (outer) layers of the skin, thus reaching hitherto inaccessible areas.*

Spare the Needle. Other physicians have been cautiously trying DMSO on selected patients, and draw these tentative conclusions:

> As a treatment for advanced rheumatoid arthritis, which affects the entire body, DMSO alone is no better than present drugs, but some rheumatologists believe it helps markedly in acute flare-ups in the earlier stages of the disease.

> In less severe rheumatic conditions involving only one or two joints, such as bursitis and “tennis elbow,” DMSO may spare the patient a painful injection into the middle of the joint. Doctors disagree as to how much of a cortisone-type drug dissolved in DMSO soaks into the joint, but patients report that they feel better and they are grateful for being spared the needle.

> For fungal infections such as ringworm and athlete’s foot, DMSO transports the basic antifungal drug and helps to speed clearing of the infection. Dr. Kligman finds that DMSO itself has moderate antifungal powers.

> DMSO is also helpful in scleroderma or “hidebound disease,” in which the skin’s fibrous middle layer becomes thickened and so hard that the victim cannot clench his hands. Cleveland Clinic’s Dr. Arthur L. Scherbel reports that daily paintings with DMSO have restored the use of the hands, and healed fingertip ulcers. He is not yet certain whether DMSO has long-term effects on the overall disease.

The Food and Drug Administration’s chief of drug investigations, Dr. Frances O. Kelsey, is strictly controlling DMSO’s use by limiting supplies to approved researchers. With so much still to be learned, DMSO cannot go on general prescription sale for at least one year and more likely three.

*How far and fast it travels is shown by the fact that a minute or two after it is swabbed on the skin it creates a garlic odor on the patient’s breath.