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Hexamethonium, Hypertension and Pharmaceutical Innovation: The Transformation of an Experimental Drug in Post-war Britain

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Devices and Designs

Part of the book series: Science, Technology and Medicine in Modern History ((STMMH))

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Abstract

Hypertension is one of the most common medical problems in the developed world.1 It is also one of those modern conditions that we do not find discussed in old medical textbooks, and hypertension has not always been self-evidently viewed as a disease.2 High blood pressure has variously been interpreted, for example, as a physiological response to ageing, a metaphor for life under the strains of modernity, or the symptom of a so far unrecognized underlying genetic disease. Only in the last five decades it has become acceptable to treat high blood pressure, the symptom, without knowing the causes. Thanks to a new measuring technology (the familiar combination of an inflatable cuff, a sphygmomanometer and a stethoscope), blood pressure could be measured easily outside the laboratory since the early-twentieth century, but high blood pressure was not perceived as a public health problem and the method was initially not taken up widely by physicians.3 In Britain such reluctance prevailed until after World War II, as part of a general scepticism towards using laboratory methods in the clinic.4 In the US, in contrast, medical directors in the life insurance industry were quick to realize the potential of using this portable technology extensively, leading to the drawing up of tables that associated blood pressure with insurance risks.

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Notes

  • T.E. Kottke, R.J. Stroebel, R.S. Hofman, ‘JNC 7 – It’s More than High Blood Pressure,’ Journal of the American Medical Association, 289 (2003), 2573–5.

    Article  Google Scholar 

  • C. Timmermann, ‘To Treat or Not to Treat: Drug research and the changing nature of essential hypertension,’ in T. Schlich and U. Tröhler (eds), The Risks of Medical Innovation: Risk perception and assessment in historical context (London: Routledge, 2006)

    Google Scholar 

  • I.H. Page, Hypertension Research: A memoir 1920–1960 (New York: Pergamon Press, 1988)

    Google Scholar 

  • G.W. Pickering, High Blood Pressure (London: Churchill, 1955).

    Google Scholar 

  • N. Postel-Vinay, A Century of Arterial Hypertension 1896–1996 (Chichester: Wiley, 1996)

    Google Scholar 

  • K. Ilsley, An Historical Study of Arterial Blood Pressure and its Management, from the Seventeenth Century to Modern Times (MA dissertation: University of Wales Swansea, 2005).

    Google Scholar 

  • C. Lawrence, ‘Still Incommunicable: Clinical holists and medical knowledge in interwar Britain,’ in C. Lawrence and G. Weisz (eds), Greater than the Parts. Holism in biomedicine 1920–1950 (New York & Oxford: Oxford University Press, 1998), 94–111.

    Google Scholar 

  • D. Riesman, ‘High Blood Pressure and Longevity,’ Journal of the American Medical Association, 96 (1931), 1105–11.

    Article  Google Scholar 

  • W.G. Rothstein, Public Health and the Risk Factor: A history of an uneven medical revolution (Rochester: University of Rochester Press, 2003)

    Google Scholar 

  • A.B. Davis, ‘Life Insurance and the Physical Examination: A chapter in the rise of American medical technology,’ Bulletin of the History of Medicine, 55 (1981), 392–406.

    Google Scholar 

  • J. Austoker and L. Bryder (eds), Historical Perspectives on the Role of the MRC (Oxford: Oxford University Press, 1989)

    Google Scholar 

  • C.C. Booth, ‘From Art to Science: The story of clinical research,’ in A Physician Reflects: Herman Boerhaave and other Essays (London: Wellcome Trust Centre for the History of Medicine at UCL, 2003), 79–101

    Google Scholar 

  • C.C. Booth, ‘Clinical Research,’ in: W.F. Bynum and R. Porter (eds), Companion Encyclopedia of the History of Medicine (London & New York: Routledge, 1993), 205–29.

    Google Scholar 

  • A.M. Brandt and M. Gardner, ‘The Golden Age of Medicine?’ in R. Cooter and J. Pickstone (eds), Companion to Medicine in the Twentieth Century (London: Routledge, 2003), 21–37.

    Google Scholar 

  • J.P. Gaudillière and I. Löwy (eds), The Invisible Industrialist: Manufactures and the production of scientific knowledge (Houndmills: Macmillan, 1998).

    Google Scholar 

  • N. Rasmussen, ‘The Drug Industry and Clinical Research in Interwar America: Three types of physician collaborator,’ Bulletin of the History of Medicine, 79 (2005), 50–80

    Article  Google Scholar 

  • V. Quirke, ‘From Evidence to Market: Alfred Spinks’s 1953 survey of fields for pharmacological research, and the origins of ICI’s cardiovascular programme,’ in V. Berridge and K. Loughlin (eds), Producing Health: medicine, the market and the mass media in the twentieth century (London: Routledge, 2005), 144–69.

    Google Scholar 

  • G.H. Acheson, ‘Tetraethylammonium, Ganglionic Blocking Agents, and the Development of Antihypertensive Therapy,’ Perspectives in Biology and Medicine, 19 (1975), 136–48.

    Article  Google Scholar 

  • W.D.M. Paton, ‘Hexamethonium,’ British Journal of Clinical Pharmacology, 13 (1982), 7–14.

    Google Scholar 

  • H.P. Rang and P. Walton, ‘Sir William Drummond MacDonald Paton, CBE, 5 May 1917–17 October 1993,’ Biographical Memoirs of Fellows of the Royal Society, 42 (1996), 290–314.

    Article  Google Scholar 

  • V. Quirke, ‘Putting Theory into Practice: James Black, receptor theory and the development of the beta-blockers at ICI, 1958–1978,’ Medical History, 50 (2006), 69–92.

    Article  Google Scholar 

  • R.B. Barlow and H.R. Ing, ‘Curare-like Action of Polymethylene bis- Quaternary Ammonium Salts,’ Nature, 161 (1948), 718

    Article  Google Scholar 

  • W.D.M. Paton and E. J. Zaimis, ‘Curare-like Action of Polymethylene bis-Quaternary Ammonium Salts,’ Nature 161 (1948), 718–9.

    Article  Google Scholar 

  • G. Organe, W.D.M. Paton and E.J. Zaimis, ‘Preliminary Trials of Bismethylammonium Decane and Pentane Diiodide (C10 and C5) in Man,’ Lancet, 253 (1949), 21.

    Article  Google Scholar 

  • P. Arnold and M.L. Rosenheim, ‘Effect of Pentamethonium Iodide on Normal and Hypertensive Persons,’ Lancet, 254 (1949), 321–3.

    Article  Google Scholar 

  • A.R. Hunter, ‘Hexamethonium Bromide,’ Lancet, 255 (1950), 251–2, p. 252.

    Article  Google Scholar 

  • R. Turner, ‘“Medical Sympathectomy” in Hypertension: A clinical study of methonium compounds,’ Lancet, 256 (1950), 353–8.

    Article  Google Scholar 

  • M.L. Rosenheim, ‘Lability of Blood Pressure,’ Lectures on the Scientific Basis of Medicine, 1951–52, 1 (1953), 96–115.

    Google Scholar 

  • D.R. Cameron, D.M. Dunlop, R. Platt, M.L. Rosenheim and E.P. Sharpey-Schaffer, ‘The Rice Diet in the Treatment of Hypertension: A report to the Medical Research Council,’ Lancet, 256 (1950), 509–13.

    Article  Google Scholar 

  • See R. Platt and S.W. Stanbury, ‘Sympathectomy in Hypertension,’ Lancet, 255 (1950), 659–9

    Article  Google Scholar 

  • S. Saville, ‘Pentamethonium in Hypertension,’ Lancet, 256 (1950), 358–60.

    Article  Google Scholar 

  • A. Campbell and E. Robertson, ‘Treatment of Severe Hypertension with Hexamethonium Bromide,’ British Medical Journal, 256 (1950), 804–6.

    Article  Google Scholar 

  • A.E. Doyle, ‘Sir Horace Smirk: Pioneer in drug treatment of hypertension,’ Hypertension, 17 (1991), 247–50, p. 249. Doyle joined Smirk’s department in 1952.

    Article  Google Scholar 

  • F.H. Smirk, High Arterial Pressure (Oxford: Blackwell, 1957).

    Google Scholar 

  • F.N. Fastier, ‘Biography: Sir Horace Smirk: Professor Emeritus,’ New Zealand Medical Journal, 67 (1968), 258–65, p. 258.

    Google Scholar 

  • F.H. Smirk and W.H. Hall, ‘Inherited Hypertension in Rats,’ Nature, 182 (1958), 727–8.

    Article  Google Scholar 

  • P. Arnold and M.L. Rosenheim, ‘Effect of Pentamethonium Iodide on Normal and Hypertensive Persons,’ Lancet, 254 (1949), 321–3.

    Article  Google Scholar 

  • E.A. Murphy, ‘Treatment of Hypertension with Hexamethonium Bromide,’ Lancet, 258 (1951), 899–901.

    Article  Google Scholar 

  • J. Greene, ‘Therapeutic Infidelities: “Noncompliance” enters the medical literature, 1955–1975,’ Social History of Medicine, 17 (2004), 327–43.

    Article  Google Scholar 

  • E.D. Freis, ‘Methonium Compounds in Hypertension [letter],’ Lancet, 257 (1951), 909.

    Google Scholar 

  • F.H. Smirk, ‘Hypotensive Actions of Hexamethonium Bromide and some of its Homologues: Their use in high blood-pressure,’ Lancet, 260 (1952), 1002–5.

    Article  Google Scholar 

  • K.H. Beyer, ‘Chlorothiazide,’ British Journal of Clinical Pharmacology, 13 (1982), 15–24.

    Google Scholar 

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© 2006 Carsten Timmermann

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Timmermann, C. (2006). Hexamethonium, Hypertension and Pharmaceutical Innovation: The Transformation of an Experimental Drug in Post-war Britain. In: Timmermann, C., Anderson, J. (eds) Devices and Designs. Science, Technology and Medicine in Modern History. Palgrave Macmillan, London. https://doi.org/10.1057/9780230286405_9

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  • DOI: https://doi.org/10.1057/9780230286405_9

  • Publisher Name: Palgrave Macmillan, London

  • Print ISBN: 978-1-349-54091-4

  • Online ISBN: 978-0-230-28640-5

  • eBook Packages: Palgrave History CollectionHistory (R0)

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