Medicine: Righting the Boat

More than most men, doctors respect the human body. James Howard Means, Harvard professor of clinical medicine, has so keen a regard for the body’s complex hormone-producing system that he urges his fellow doctors to be wary of tampering with it. He is particularly worried by “the present all-prevailing ACTH-cortisone furor.”

If the body’s hormone system is out of kilter, says Dr. Means, the sound thing to do is simply to make up the deficiency—e.g., give thyroid hormone to a patient whose thyroid gland is not producing enough. But that is not what a doctor does, says Means, when he gives ACTHand cortisone in large doses.

This type of treatment, says Means, may cause a permanent change in the patient’s hormone balance. Then, instead of the treatment making the patient normal, he will be forced to adjust himself to the treatment. Says Dr. Means: “The situation may be likened to that in which one tries to bring to even keel a boat with a list to starboard by putting a load to port. Perhaps the boat is righted, but … if the load imposed is too heavy, the boat may sink! I believe that is what will happen with . . . ACTH and cortisone.”*

*For news of cortisone last week see SCIENCE.