For Arthritis

Rheumatoid arthritis claims some 7,000,000 victims in the U.S. Looking for a cure, doctors have tried just about everything, including high-calorie diets, low-calorie diets, vitamins A, B, C and D, typhoid vaccine, streptococcus vaccine, artificial fever, blood transfusions, injections of milk and horse serum, aspirin and whisky (for pain), massage, dry heat, mineral baths, metals such as gold, change of climate, psychotherapy, exercise and rest in bed. Some of the treatments proved to be harmless, some harmful. Some even seemed to work, but only for a while.

Last week a new experiment in treatment, the result of 20 years' work, was announced by four Mayo Clinic researchers: Dr. Philip S. Hench, an authority on arthritis, Dr. Edward C. Kendall, who isolated the thyroid hormone (TIME, Nov. 8, 1937), and Drs. Charles H. Slocumb and Howard F. Polley.

Substance X. In 1929 Dr. Hench noticed that men & women with arthritis suffered less pain when they had jaundice. Women suffered less when they were pregnant. He noticed too that patients who had surgical operations got better for a while (during an operation, the adrenal cortex, or outer layer of the adrenal gland, is stimulated).

As early as 1941, Drs. Hench and Kendall speculated that an unknown "anti-rheumatic substance X" might be a hormone from the adrenal glands. In 1946, with the help of Merck & Co. chemists, they developed a compound from the adrenal glands of cattle. It was called Compound E (full name: 17-hydroxy-11-de-hydrocorticosterone). Compound E belongs to the steroid group of body chemicals. So do the sex hormones (a link with relief during pregnancy) and some bile products of the liver (a link with jaundice). Compound E was obtained later from an element of bile. Seven months ago Mayo's began treating human patients.

E and ACTH. The results were dramatic but, like the results of earlier work, they were fleeting. Fifteen patients, some unable to walk, showed great improvement soon after injections of large doses of Compound E (as much as 100 milligrams a day). The first patient was a woman who was barely able to get out of bed. By the third day she was walking with only a slight limp; a week later, pain and muscular stiffness had almost disappeared. But improvement ended when the drug was stopped. After varying periods without the drug, the patients were back where they started. Two other patients are being treated, with similar results, with another hormone called ACTH (adrenocorticotropic hormone), a pituitary gland secretion that stimulates the adrenals Oee below).

The Mayo doctors cautiously said that it was too early to use even the word treatment "except in an investigative sense." Some doctors thought that Compound E, even though it did not cure, might be used, like insulin for diabetes, to control the disease. Others feared that it could not be used for long without upsetting the body's whole glandular system. The argument would not be settled for a long time. Meanwhile, Mayo doctors warned that Compound E is very scarce, hard to produce, and may not be available generally until 1951.

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