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With the limited lab facilities of a city hospital, the doctors at Sea View were trying to evaluate the medical progress of their patients when Squibb & Sons gave their Nydrazid to doctors at New York Hospital. There, though patients with advanced TB were scarce, the lab facilities were enormous. Dr. Walsh McDermott began elaborate biochemical tests on Nydrazid and soon made an important discovery: although it is swallowed as a pill (smaller than an aspirin tablet), the substance soon appears in the spinal fluid in "beautiful concentration." This meant that it might be extremely useful for tuberculous meningitis. Other tests recommended Nydrazid for miliary tuberculosis (throughout the body).
The Patient Navajo. Another shipment of Nydrazid was sent to Tuba City, where Dr. Charles Clark found, among the unhappy Navajos, all too many cases of both meningeal and miliary tuberculosis. A 17-year-old girl (a miliary case), admitted with a fever of 103° and so weak that she could not walk alone, was fever free within a week and soon coughed no more sputum. Now she is up & around.
On New Year's Eve Dr. Elmer Sev-ringhaus of Hoffmann-La Roche dropped in to see Dr. McDermott of New York Hospital and tell him about Rimifon. It was soon clear that Rimifon was chemically the same as Nydrazid, and a week later Squibb and Hoffmann-La Roche got together to plan further testing of the drug and arrange a request to the Food & Drug Administration to have it released for general use by physicians. That release cannot be given until May or June; by then, both companies will be ready to market the drug in wholesale lots (it is easily made from coal tar). Probable price: about 75^ for a day's dosage.
Lesson of History. Before the FDA acts, it will want to know whether the new drugs, given over long periods, will prove too poisonous for the patient to tolerate. Doctors want to know much more. Will the germs learn to resist the new drugs and live with them, as they often do with streptomycin? If a patient's sputum is free of germs a month after treatment is started, will it still be clear a year later, or will he suffer a shattering relapse?
Even harder to answer is whether the new drugs halt the disease long enough for the body to repair long-standing damage, especially in the lungs. So far, even with X rays, the answer is only hesitant: the drugs seem to restore the patient so that he should be better able to stand drastic surgery. And in many cases, surgery will still be necessary. So will bed rest and sanatoria. It is far too soon to talk about tearing down the hospitals.
It will take six months for doctors to render a confident verdict on Rimifon, Marsilid and Nydrazid. Meanwhile, there is a sobering lesson in the history of anti-TB drugs: dozens have come and all but one "wonder drug" (streptomycin) have gone, but TB remains.