374 



premature decisions based on inconclusive data of dubious merit. This un- 

 favorable atmosphere is not, I might add, a mirage of my own imagination. It 

 has been criticized by many responsible figures in the field of medicine, including 

 such well-known medical editors as Dr. Joseph Garland and Dr. Walter Modell, 

 who decry the "unnecessary expansion in the number of new products marketed 

 each year" and the inability of the medical profession to "deal with the plethora 

 of new drugs expertly, safely, effectively." ^^ 



It had been contended, he said, that all new variants of useful molec- 

 ular configurations should be allo^Yed because they might be useful with 

 some patients. This, he said, was a "dangerous reductio ad absurdum." 



First of all, it implies that all possible relatives of a useful drug should be 

 marketed, since it is patently impossible to rule out the remote chance of bene- 

 fiting one patient out of 100,000 in preliminary premarketing trials. 



Second, this line of reasoning can lead to deterioration in medical care, because 

 a large number of therapeutically similar drugs of varying merit may result 

 in suboptimal care for those patients unlucky enough to he treated first not 

 with the best drug of the group, but with the weakest.*" 



Dr. Walter ISIodell *^ agreed that a variety of drugs might be needed 

 for some particular purpose, but too many (for example, 35) would 

 "create nothing but confusion and harm.'' 



Nothing but good [he concluded] can come of the application of restraints to 

 the exuberant growth of new and poorly tested drugs and the extravagant claims 

 made for them and to the barrage of confusion laid do\\m by biased promotion 

 and meaningless and distracting nomenclature. I believe it will benefit the health 

 of the Nation, improve the practice of medicine and, strangely enough, increase 

 the profits of the drug industry.*" 



No reference to thalidomide appeared in the seven volumes of the 

 hearings before Senator Kefauver's subcommittee, which ended Feb- 

 ruary 7, 1962. Although there had been an epidemic of phocomelia *^ 

 in West Germany in the spring of 1961, and thalidomide had been 

 tentatively identified as its cause by late November of that year, na- 

 tional attention was not drawn in the TTnitecl States to the dangerous 

 nature of the drug until mid-July 1962. The New York Times, in mid- 

 April, had reported a lecture on this epidemic by Dr. Helen Taussig, 

 delivered in Philadelphia before the American College of Physicians, 

 and when this report was called to the attention of Senator Kefauver's 

 staff, a researcher had been assigned to follow up on the story. Then, 

 May 24, a graphic description (with slides) of the effects of thalido- 

 micte was presented before a House subcommittee chaired by Repre- 

 sentative Celler and considering his bill (H.R. 6245) paralleling 

 S. 1552. No notice was taken in the press of Dr. Taussig's testimony. 

 In comment on this point, the principal staff member of Senator Ke- 

 fauver's group working on S. 1552 was later quoted as remarking "I 

 tried to talk Celler's people out of using Dr. Taussig." (And then:) 

 "It's too early to s]:)ring this kind of story. All the various bills are 

 still far from reaching the floor of either House, and it's clear that the 

 thalidomide story, or something like it, is just what we need to ram 

 through some legislation. In a situation like this, timing is vital." ** 



3fllbid.. pt. 1, p. 281. 



" Ibid., pt. 1. p. 2R2. 



*^ Editor of Clinical Pharmacology and Therapeutics, editor of a biennial text, DruKS of 

 Choice, member of the revision committee of the U.S. Pharmacopoeia, chairman of the 

 formulary committee of the New York Hospital, director of clinical pharmacolog.y, and 

 associate professor of pharmaeolo^ at Cornell University Medical School. 



«=Ibid., pt. 1, pp. 310. 329-3.30 



" Phocomelia. Literally "seal extremities." In phocomelia, the lonp bones (arm, leg) may 

 be absent or deformed, and the hands or feet appear at the end of the shortened bone. There 

 may be many variants and further complications. 



** This account is talcen from Richard Harris. "The Real Voice." (New York, the Mac- 

 mlllan Co.. 1964. pp. 154-155. 160-161.) 



