Hope Deferred

Some 25,000 times a day in the nation's stockyards a hog offal operator plunges her hand into the bloody base of a hog's severed head as it travels down the conveyer chain. With deft fingers she gets hold of the pituitary gland. Then, with a pair of tweezers, she removes the front half of the gland and drops it into a container of Dry Ice. That is the first step in the production of ACTH, the new wonder drug which may ultimately save millions from the ravages of arthritis, gout, rheumatic fever and kindred ills (TIME, May 2).

But that happy event is years distant, at best. Last week, Chicago's Armour Laboratories, the world's main source of ACTH (adrenocorticotropic hormone), gave the reasons.

The usable front half of each hog's pituitary is about the size of a pea. It takes 1,360 of them to make a pound, from which about 1 1/2 grams (a third of a teaspoonful) of ACTH can be extracted in a solution and separated as a fluffy, white powder. The process is remarkably simple. But even with the cooperation of non-Armour stockyards, the Armour Laboratories can get so far only about 125,000 hog pituitaries a week--enough to make five ounces of ACTH. All the hogs slaughtered in the U.S. would not yield much more than a pound a week.

Spread Thin. Having spread the facts on the record, Armour Laboratories began spreading the short supply of ACTH thinner than ever. Contracts were signed with 45 leading hospitals and clinics across the U.S. To qualify for a tiny share of the priceless powder (it is not for sale), each institution must show that it has the staff and equipment to carry out carefully controlled experiments.

Much must be learned before the drug can be generally used. ACTH is one of at least six important hormones secreted by the pituitary, each of which acts as a master control regulating the flow of a series of other vital substances in the body. ACTH got its full name from the group it controls: the hormones of the cortex (outer casing) of the adrenals (the glands which bestride the kidneys). No less than 28 such slave hormones, including cortisone (see below), have been found in the adrenals. When their flow is stimulated, there may be harmful side effects.

Touted Wide. Medical researchers and big, blond Dr. John R. Mote, head of Armour Laboratories, would be happier if publicity on ACTH could have been delayed until their work was farther advanced. But the results of the first experimental treatments were too good to be withheld. The laboratories and clinics known to be using ACTH experimentally were bombarded with unanswerable requests from arthritis sufferers for a supply of the drug.

Alongside the medical research to learn just what ACTH can do and how it works,

Armour is conducting its own research in the hope of increasing the supply, said Mote. If the complex structure of the ACTH molecule can be determined, he hopes to be able to stop making it in minute quantities from hogs' heads, and start to synthesize it by the hogshead. Until then, the millions of sarthritics and the countless sufferers from gout and a dozen other diseases must live in hope.

One of the slave hormones whose flow can be speeded by ACTH is cortisone, formerly known as Compound E (TIME, June 13). Like its master, cortisone almost always relieves the symptoms of crippling rheumatoid arthritis in a few injections, but, again like its master, it must be used continuously or the condition recurs.

Cortisone is even scarcer than ACTH. Merck & Co., who make it, in 37 tedious steps, from the bile of butchered cattle, expect to produce little more than 1 1/2 ounces a week for the rest of the year. Last week it was announced that henceforth cortisone will be doled out to suitable hospitals and research institutions through a committee of the National Academy of Sciences. And Merck has stopped giving it away: the price now is $60 for a 300-milligram vial ($5,670 an ounce).

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