Chairman Dorfman: We thought that this subject was so broad and had so many ramifications that an attempt at complete coverage would result in nothing but a listing of the diseases in which ACTH and cortisone have been used. Therefore, it would seem instead worth while to consider general problems relating to ACTH and cortisone and then proceed to a discussion of a limited number of diseases. It is going to be difficult for us to give an expert opinion on every possible phase of this subject.
We should consider first of all: (1) What type of therapy these drugs represent and (2) how the effects observed relate to the pathogenesis of the diseases in question. When the announcement of the effect of ACTH and cortisone was made in 1949, they were heralded widely by many people as a new approach to the disease state and consequently these agents were studied in a wide variety of apparently unrelated diseases. Originally there was great enthusiasm. I can recall attending the first Armour conference; it was more like attending a meeting of a mystic cult than a scientific meeting. Everybody arose and shouted, "I, too, have seen the miracle!"
Since that time investigators have come to a more careful assessment of the usefulness of these drugs. We now are in the process of a swing toward a more pessimistic viewpoint, with some people saying, "they are not any good for anything, they are just poison and shouldn't be used at all." Most people who have thought about the problem feel that the truth lies somewhere between the extremes. ACTH and cortisone are not effective in all diseases.
- Copyright © 1953 by the American Academy of Pediatrics