The Age of Cures

The Age of Cures, Barry Werth. Simon & Schuster (ISBN: 9781668067833) 2026.

Summary: The birth of the U.S. pharmaceutical industry through a critical government decision resulting in a raft of miracle drugs.

The subtitle of this book caught my attention: How American Scientists Saved your Life. I realized as I read this that it was true. I never had polio and saw the fear of it recede into the distant past. On several occasions, I’ve had bouts with cellulitis of varying severity. Each time, antibiotics cleared the infection. And as I’ve read up on it, without those antibiotics, I could have died. Nearly all of these were developed within my lifetime. This book chronicles the birth of American pharmaceutical research labs and manufacturing that made those drugs possible.

The story centers around Harvard-trained research chemist Max Tishler. He led teams synthesizing key vitamins: B2, C, and B12. He also developed fermentation processes for making penicillin, streptomycin, and actinomycin in large quantities. Tishler also was part of the effort to synthesize cortisone, a breakthrough anti-inflammatory, overseeing the team led by A.N. Richards. He served as president of Merck labs, part of Merck, one of the early leading pharmaceutical companies profiled. George Merck, its head was quoted as saying “Medicine is for people, not for profits.”

Behind the explosion of pharmaceutical research was Vannevar Bush. While discovered in 1928, penicillin was difficult to manufacture on a large scale. With the approach of World War 2 came the realization that widely available penicillin could save many American soldiers from dying of infected wounds. Bush recognized that rather than building government labs to do this, funds could be used to support research efforts of universities and commercial enterprises. The success of that decision created today’s pharmaceutical industry–and provided ample quantities of penicillin in time for the D-Day invasion.

But penicillin couldn’t cure everything. Gram negative bacteria did not respond to it. One of the worst of these was tuberculosis, killing 300 of every 100,000 people. Another Merck scientist, Selman Waksman pioneered the methods of screening soil samples to identify possible drug compounds. Werth describes the process he used to isolate streptomycin, the first drug effective against tuberculosis and also the bubonic plague!

The demand for these medications exploded during the 1950s. Part of the book traces the growing competition among drug companies and the tension between cost and profit they faced. This was highlighted in the Kefauver hearings in 1959, where cortisone was found to have a 7,000 percent markup. This led to efforts to begin to regulate costs, safety, and efficacy of these drugs.

Polio, which I mentioned earlier, was the scourge that afflicted Franklin Roosevelt, who promoted the March of Dimes and research funding along the lines of Bush’s model. In this case, an obscure University of Pittsburgh researcher, Jonas Salk developed the vaccine. But there were real issues in safely manufacturing the vaccine. One batch, which included live rather than dead polio virus, infected a number with polio, as well as those close to them. It was traced to a manufacturer with poor safety protocols subsequently addressed. I received the Salk vaccine with no ill effects, just a few years after it became available.

Side effects did come along with the miracles. Werth tells the story of the psychological effects of cortisone on one patient, who required institutionalization for a time. Some of the problem was determining dosing. Fortunately, doctors found a substitute drug to treat his medical condition without the side effects.

Werth offers a well-researched and highly readable account of this period, from the 1930’s to the 1960’s when there were so many great advances. He also traces the roots of the growth of Big Pharma, with its associated shortcomings. Most of all, he chronicles the scientific research enterprise to which we owe our lives. I can’t help but wonder if part of the reason for the present attacks on that enterprise has to do with the relatively charmed existence we have lived in this “age of cures.” We don’t realize how we are just one illness out of the past, or even cut, away from death. Furthermore, in defunding that research, we risk robbing ourselves and our children of more life-saving treatments.

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Disclosure of Material Connection: I received a complimentary copy of this book from the publisher for review through LibraryThing’s Early Reviewers Program.