- DRUGS by Rod Flower (Yale University Press £20, 336pp)
Skara Brae, a Neolithic village in Orkney, is one of the oldest settlements in Britain.
During archaeological excavations, traces of medicinal plants have been found there.
As Professor Flower’s wide-ranging book demonstrates, humans have been using drugs to combat illness for a long time.
Egyptians swore by hippopotamus dung
Cuneiform tablets unearthed in Mesopotamia, and dating back to the 7th century BCE, include 5,000 medical prescriptions. The so-called Ebers papyrus from Egypt is even older and ‘may lay claim to be the first self-contained book on the treatment of disease with medicinal plants’. Ancient Greece and Rome had their own medical treatises.
Some of the remedies were ludicrous. It seems unlikely that burning a weasel and rubbing yourself with the ashes, as recommended in one Roman text, would do much for gout.
Egyptians swore by hippopotamus dung to treat gastrointestinal issues.
Animal faeces were long thought to be beneficial. In 1618, a pharmacopoeia published in London listed 11 types of therapeutic excrement.
The first signs of a recognisably scientific approach to medicines came in the 18th century.
A Birmingham doctor named William Withering identified the active ingredient in foxgloves which could be used to treat congestive heart failure.
James Lind, recognising that, in Flower’s words, ‘testing drugs is a straightforward but crucial idea’, conducted what can be described as an early clinical trial. Using different treatments on a ship’s crew, he showed that consumption of lemon juice prevented scurvy.
Today, pharmacology, the study of how medicines work and how they affect our bodies, is both an academic discipline and a vast global industry. More than a billion prescriptions are issued each year in the UK; in the US, it’s six times that number.
Drugs is available now from the Mail Bookshop
Big Pharma doesn’t always get good press. Flower redresses the balance by revealing just how much time, effort and money goes into the development of potentially life-saving drugs. The success rate of trials is astonishingly low. Ninety-five per cent of drugs fail, mostly before they are even tested on humans.
He also chronicles how clinical trials have changed for the better. The white male body used to be seen as, in the words of one critic, ‘the default human body’.
Drugs companies now recognise that proper account of women and ethnicity must be taken in trials.
Certain ethnic groups are more susceptible to particular diseases. Ashkenazi Jews have increased incidence of certain genetic disorders. Black people of African descent are at greater risk of complications from treatment with anti-diabetic drugs. Drugs need to be tailored to their recipient.
Flower’s book is a (mostly) accessible guide to the history and science of our attempts to do that.