Experiment at Blackmill

HUMAN GUINEA PIGS

FACED WITH virulent cases of smallpox, the medical authorities resorted to desperate measures. In the Glanrhyd files is a copy of a letter from the Wellcome Laboratories of Tropical Medicine, dated 9 April 1962. It is addressed to Dr Lewis at the Welsh Regional Hospital Board in Cardiff and accompanied a consignment of 245 grams of a drug known as 33T57.

‘It should be reserved for new cases caught as early in the illness as possible, preferably during the pyrexial period and without waiting for confirmation. This is not as much as you asked for, but more is being prepared, and will be sent as soon as it is ready … I would feel that if there is no visible effect after 3-4 days it is not worth going on.’ Signed D. J. Bauer.

An accompanying piece of paper from the Wellcome Foundation in London is entitled ’33T57 N-Methylisatin β-thiosemicarbazone’. It says:

‘This drug has been shown to have virustatic action in smallpox infection in animals. Its action in human smallpox infection is not yet known. Treatment with 33T57 must therefore be on an experimental basis.’

It seems highly unlikely that the elderly patients at Blackmill Hospital would have been able to give their informed consent to such an experiment. In his report on the cases he treated, Dr Pillutla confirmed that all but one were given ‘a recently introduced thiosemicarbasone (M & B 7714) brand’.

Ambulance at Blackmill Hospital
Photo: ITV Wales

‘Not unethical’

Dr Pillutla said: ‘Controlled trial of the drug was not made for various reasons but it was agreed that it would not be unethical to do it as the value of the drug was not yet proved anyway. It is impossible to make any statistically valid statement on the utility of the drug because the sample treated was small, and consisted of the higher age groups with low resistance and above all, because a controlled trial was not made. But the clinical impression gained for reasons given elsewhere was that it was encouraging and that it would be reasonable to take the Blackmill experience with the drug as a basis for a controlled trial where clinical material becomes available.’

Extracts from the documents in the Glanrhyd files are available here.

Half the patients with smallpox in Blackmill survived, so the drug may have been effective.

Wellcome’s D. J. Bauer was one of the authors of a paper in the Lancet on 7 September 1963, which reported on tests of the drug carried out in India during that year. This confirms that it had been previously tested on mice, but makes no reference to its use in Wales. Three mild cases of smallpox occurred among 1,101 contacts who were treated with the drug, whereas among a control group of 1,126 untreated contacts there were 78 cases of smallpox with 12 deaths.

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