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Genes, drugs and sensitivity
GENES,
DRUGS AND SENSITIVITY
83
The general opinion about breast carcinoma was t h a t radiotherapy was damaging to the patient but at the present stage of medical opinion mastectomy was still necessary except in old people with slow-growing tumours. There was no common opinion about the possible damage of modern immunizing procedures but general agreement t h a t a good deal of the strong drug treatment used today was harmful. This brings up a fundamental difference in the outlook of the homceopathic doctor from his orthodox colleagues. I t was thought t h a t the homceopathic point of view should be elaborated and presented in modern form in a book. The funds of the Research and Educational Trusts should be used to help towards this and for a research on the constitutional trends of the present day, comparing frequency of cancer with acute inflammatory conditions, etc. Finally the insistence of K e n t and other masters that old symptoms must return or else our treatment is only palliation.
GENES, DRUGS AND SENSITIVITY By F. H. BODMAN,M.D., CH.B., F.F.HoM. DR. FRASER ROBERTS in his Presidential Address to the Section of Epidemiology of the Royal Society of Medicine discussed some aspects of genetics which have a bearing on drug therapy. He referred to a gene which in double dose accounts for a very reduced level of pseudo-cholestinerase. Such subjects, the bearers of this gene, if given suxamethonium as a muscle relaxant during anaesthesia, are liable to develop an arrest of respiration which m a y be fatal. This gene occurs fairly frequently, about one in a thousand persons having a double dose. From the point of view of provings, these subjects would be specially sensitive to aeetyl-choline. Dr. Roberts referred to another gene, frequently found in negroes, which was discovered during the course of anti-malarial therapy. The condition is often called primaquine sensitivity. I t is sex linked and about one in seven negroes are affected. The anomaly is a deficiency of the enzyme glucose-6-phosphate hydrogenase. These subjects develop a hmmolytic anaemia if prescribed primaquine, phenaeetin, sulphanilamide, naphthalene and several other drugs. This inherited sensitivity to a whole group of drugs, depending on an enzyme deficiency, is of interest when provings of a new drug are being planned. Dr. Roberts, as a final illustration, referred to the porphyrias common in South Africa. These depend on a dominant gene, which is now carried by over 8,000 persons. These subjects are very sensitive to barbiturates and m a n y fatalities have been reported. Dr. Roberts considered that it is likely that m a n y more genetically determined drug sensitivities will be discovered in the near future. I t m a y well be t h a t our most sensitive provers to particular drugs m a y have a predetermined genetic constitution. I t also m a y explain how in some families m a n y members react favourably to the same homceopathie drug in potency.
DRUGS AND SENSITIVITY
83
The general opinion about breast carcinoma was t h a t radiotherapy was damaging to the patient but at the present stage of medical opinion mastectomy was still necessary except in old people with slow-growing tumours. There was no common opinion about the possible damage of modern immunizing procedures but general agreement t h a t a good deal of the strong drug treatment used today was harmful. This brings up a fundamental difference in the outlook of the homceopathic doctor from his orthodox colleagues. I t was thought t h a t the homceopathic point of view should be elaborated and presented in modern form in a book. The funds of the Research and Educational Trusts should be used to help towards this and for a research on the constitutional trends of the present day, comparing frequency of cancer with acute inflammatory conditions, etc. Finally the insistence of K e n t and other masters that old symptoms must return or else our treatment is only palliation.
GENES, DRUGS AND SENSITIVITY By F. H. BODMAN,M.D., CH.B., F.F.HoM. DR. FRASER ROBERTS in his Presidential Address to the Section of Epidemiology of the Royal Society of Medicine discussed some aspects of genetics which have a bearing on drug therapy. He referred to a gene which in double dose accounts for a very reduced level of pseudo-cholestinerase. Such subjects, the bearers of this gene, if given suxamethonium as a muscle relaxant during anaesthesia, are liable to develop an arrest of respiration which m a y be fatal. This gene occurs fairly frequently, about one in a thousand persons having a double dose. From the point of view of provings, these subjects would be specially sensitive to aeetyl-choline. Dr. Roberts referred to another gene, frequently found in negroes, which was discovered during the course of anti-malarial therapy. The condition is often called primaquine sensitivity. I t is sex linked and about one in seven negroes are affected. The anomaly is a deficiency of the enzyme glucose-6-phosphate hydrogenase. These subjects develop a hmmolytic anaemia if prescribed primaquine, phenaeetin, sulphanilamide, naphthalene and several other drugs. This inherited sensitivity to a whole group of drugs, depending on an enzyme deficiency, is of interest when provings of a new drug are being planned. Dr. Roberts, as a final illustration, referred to the porphyrias common in South Africa. These depend on a dominant gene, which is now carried by over 8,000 persons. These subjects are very sensitive to barbiturates and m a n y fatalities have been reported. Dr. Roberts considered that it is likely that m a n y more genetically determined drug sensitivities will be discovered in the near future. I t m a y well be t h a t our most sensitive provers to particular drugs m a y have a predetermined genetic constitution. I t also m a y explain how in some families m a n y members react favourably to the same homceopathie drug in potency.