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Bedside & Laboratories. Page began his work in 1937 at the Lilly Laboratory for Clinical Research at Indianapolis City Hospital, after three years at Munich's Kaiser Wilhelm Institute and six years at the Rockefeller Institute. With Canadian-born Dr. Arthur Curtis Corcoran, who has been teamed with him since 1936, Page made important discoveries on the workings of renin,* an enzyme secreted by the kidney when it is starved of blood. An injection of renin raises the blood pressure. It also alters the fat-protein combinations in the blood in such a way as to encourage atherosclerosis.
Since 1945, Page has been research chief of the Cleveland Clinic (a private medical center founded by the late Surgeon George Crile). In seven floors of laboratories, Dr. Page and his staff (eight physicians, four other research scientists, 26 technicians) are attacking all phases of hypertension from as many angles as possible, and in 20 research beds in the clinic's adjoining hospital the medical staff cares for patients who agree to cooperate in the study and treatment of their disease. Some of the scientific attacks are so basic that they seem remote from bedside medicine.
Brazilian Dr. Lauro Sollero studies how one billionth of a gram of serotonin (a powerful, blood pressure-raising chemical isolated by Page and colleagues) makes a strip of rat uterus contract, and the ways in which serotonin and other body chemicals cancel each other's effects. Dr. James McCubbin is probing breakdowns in nerve impulses that throw blood-pressure control out of kilter. Famed Internist Willem Kolff, who invented the artificial kidney when his native Netherlands was under Nazi occupation, has developed a $14 model in a gallon can. Dr. Page himself spends two or three days a week in the lab—last week he was testing the effects of new chemicals on blood pressure in dogs.
However far apart they seem, says Dr. Page, the pure science researcher and the bedside physician must be brought together, as they are in his own laboratory. From 20 years of personal study and correlating his views with those of other researchers, Dr. Page sums up: "Hypertension is not a single disease. It may be almost as variable as the many different forms of cancer. Neither can it have a single cause. There are at least eight mechanisms in the body operating to maintain an even blood pressure, and these are all interrelated. The balance of one cannot be upset without upsetting the balance of the others."
Treatments. For the relatively mild case of hypertension, Page and colleagues prescribe the obvious—massive doses of moderation. First, they reassure the patient by explaining what they can do about his disease. Then they advise him to do what he can to avoid fatigue and excitement. He should spend ten hours in bed and take short naps, often. Every extra pound of flesh on the patient means work for the heart, so—reduce. Moderation is also prescribed in smoking and drinking, in exercise and sexual activity.