NA TURE 



i6i 



THURSDAY, APRIL 7, 1921. 



Editorial and Publishing Offices: 



MACMILLAN &- CO.. LTD.. 



ST. MARTIN'S STREET, LONDON, W.C.2. 



Advertisements and business letters should be 

 addressed to the Publishers. 



Editorial communications to the Editor. 



Telegraphic Address: PHUSIS, LONDON. 

 Telephone Number: GERRARD 8830. 



Standardisation of Vaccines, Toxins, and 

 Antitoxins. 



WE referred last week to the special 

 measures proposed by Sir Mackenzie 

 Chalmers's Committee for the control of the 

 quality and authenticity of vaccines, toxins, anti- 

 toxins, salvarsan, and certain other drugs. What 

 is there in the special circumstances of our time 

 to justify a closer superintendence of the many new 

 therapeutic substances now in common medical 

 use? It might well have been supposed that in 

 the vast technical developments of the last half 

 century "big business" had, through the sheer 

 excellence of its scientific methods, reached a plane 

 where further public control was superfluous. 

 Over a large area of the drug field this is true. 

 If we look back for half a century we can trace, 

 since the medical Acts, a steady growth in the 

 technical standardisation of all the drugs used in 

 medicine. The British Pharmacopoeia itself came 

 into existence because experimental pharmacology 

 showed the need for precision of dosage and the 

 consequent standardisation of drugs. The demand 

 made by scientific medicine evoked the best powers 

 of scientific chemistry. To-day there are few fields 

 of applied science that can show greater precision 

 of practice than the drugs now used as therapeutic 

 substances. Standardisation, therefore, and con- 

 trol in one degree or another are accepted methods 

 of securing the consumer not merely against fraud, 

 NO. 2684, VOL. 107] 



but also against inertness and inefficiency in 

 chemical medicines. 



But within the half century there have arisen 

 other products not capable of easy standardisation. 

 It is only some thirty years since Koch pro- 

 duced his first "tuberculin." To those who re- 

 member the wild rush to Berlin to secure the magic 

 poison and to inject it without afterthought, the 

 memory is full of horror. The damage done by 

 the indiscriminate use of tuberculin alone would 

 justify severe restrictions on the use of all such 

 toxins, and the antitoxins had also to pass their 

 trial. It is only twenty-five years since von 

 Behring's diphtheria antitoxin was given to the 

 world. Immediately, in this and other countries, 

 von Behring's processes of production were imi- 

 tated, sometimes without his exactness of tech- 

 nique, and the result was here and there a serious 

 disaster. For even the large firms had not evolved 

 the superb machinery they now command, and 

 every person that used the new antitoxin did so 

 with uncertainty and misgiving. Steadily, as 

 methods improved, standards of potency and 

 purity improved with them. Fortunately, 

 diphtheria antitoxin from the beginning was 

 capable of very exact standardisation by control- 

 lable units. It was the model for all later anti- 

 toxic serums. Of such serums many have since 

 been produced, and some have succeeded as cures. 

 But still more recently the treatment by vaccines 

 has grown by leaps and bounds. 



When Koch's tuberculin, which is really a dead- 

 germ vaccine, appeared, many of the " elder states- 

 men " of medicine prophesied a period of special- 

 ised vaccines of endless variety. The period is now 

 upon us. The refinements of technique are almost 

 incredible. Smallpox vaccine was for a century the 

 pioneer. To-day every common cold has its vac- 

 cine. This is because bacteriology has been active, 

 methods have grown in scientific precision, and 

 clinical medicine has come to understand the 

 therapeutic value of biological products. But these 

 products vary in potency, in purity, and in danger. 

 In careless hands they may do immense harm ; in 

 skilled hands, immense good. But if widespread 

 use and possible occasional danger are relevant 

 grounds for control, the case for the control of 

 these biological products is as strong as the case 

 for the control of other potent and dangerous 

 drugs. 



The Committee's remit covered, however, other 

 substances perhaps as dangerous. Salvarsan is a 

 type of product that cannot be adequately tested 

 by direct chemical means. Its toxicity is a primary 



G 



