Hippocrates knew best

Some 2,500 years ago, the Greek physician Hippocrates, who is regarded as the father of western medicine, wrote: “Drugs may be administered to pregnant women from the fourth to the seventh month of gestation.”

If only this Hippocratic advice had been followed half a century ago, the devastating birth defects due to thalidomide would not have occurred, since the drug has its teratogenic effects between the 34th and 50th days of gestation, well before the four-month period that Hippocrates deemed safe.

It was 50 years ago this month that thalidomide was withdrawn from the UK market, only three-and-a-half years after its launch. Licensed from a German drug company by Distillers Co Ltd, it was marketed as Distaval and promoted as a sedative and analgesic. Since it was an effective antiemetic as well, it was also advocated for morning sickness.

Although reports had already linked thalidomide to peripheral neuropathy, one advertisement in 1960 described Distaval as “outstandingly safe” and claimed: “Distaval can be given with complete safety to pregnant women and nursing mothers without adverse effect on mother or child.”

Impressed by these claims, GPs brushed Hippocrates aside and prescribed the drug in the early days of pregnancy, with tragic consequences. In the UK some 2,000 babies were born with birth defects. Fewer than 500 survived.  

But that was not the end of the road for thalidomide. Research has continued and other roles have been found for it. In July this year, the National Institute for Health and Clinical Excellence endorsed its use on the NHS for the first-line treatment of multiple myeloma in patients for whom high-dose chemotherapy with stem cell transplantation is inappropriate.

So it seems the drug still has its uses — so long as the medical world remembers to pay heed to the wise words of Hippocrates.