The invention: A drug with unique hypertension-decreasing effects
that provides clinical medicine with a versatile and effective
tool.
The people behind the invention:
Robert Wallace Wilkins (1906- ), an American physician and
clinical researcher
Walter E. Judson (1916- ) , an American clinical researcher
Treating Hypertension
Excessively elevated blood pressure, clinically known as “hypertension,”
has long been recognized as a pervasive and serious human
malady. In a few cases, hypertension is recognized as an effect
brought about by particular pathologies (diseases or disorders). Often,
however, hypertension occurs as the result of unknown causes.
Despite the uncertainty about its origins, unattended hypertension
leads to potentially dramatic health problems, including increased
risk of kidney disease, heart disease, and stroke.
Recognizing the need to treat hypertension in a relatively straightforward
and effective way, Robert Wallace Wilkins, a clinical researcher
at Boston University’s School of Medicine and the head of
Massachusetts Memorial Hospital’s Hypertension Clinic, began to
experiment with reserpine in the early 1950’s. Initially, the samples
that were made available to Wilkins were crude and unpurified.
Eventually, however, a purified version was used.
Reserpine has a long and fascinating history of use—both clinically
and in folk medicine—in India. The source of reserpine is the
root of the shrub Rauwolfia serpentina, first mentioned in Western
medical literature in the 1500’s but virtually unknown, or at least
unaccepted, outside India until the mid-twentieth century. Crude
preparations of the shrub had been used for a variety of ailments in
India for centuries prior to its use in the West.
Wilkins’s work with the drug did not begin on an encouraging
note, because reserpine does not act rapidly—a fact that had been
noted in Indian medical literature. The standard observation in
Western pharmacotherapy, however, was that most drugs work
rapidly; if a week has elapsed without positive effects being shown
by a drug, the conventional Western wisdom is that it is unlikely
to work at all. Additionally, physicians and patients alike tend to
look for rapid improvement or at least positive indications. Reserpine
is deceptive in this temporal context, andWilkins and his
coworkers were nearly deceived. In working with crude preparations
of Rauwolfia serpentina, they were becoming very pessimistic,
when a patient who had been treated for many consecutive
days began to show symptomatic relief. Nevertheless, only after
months of treatment did Wilkins become a believer in the drug’s
beneficial effects.