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Have you heard about the great new treatment for choked-up coronary
arteries which has made those inelegant, time-consuming bypass operations
passe and redundant? All they need to do nowadays is make a tissue culture
extract containing capillary blood vessel buds and growth-stimulating substances.
This is then injected through the chest wall and into the heart muscle.
Lots of new little arteries start sprouting and burrowing their way through
the badlands surrounding the blocked pipe, full health is restored, and
the clever cardiothoracic surgeons sulkily concede the match and slink off
to see whether they can’t do a bit better on the golf course.

And did you know that ‘fully effective’ cigarette filters have been
available for something like 15 years, and that only the stubborn conservatism
of an addle-pated smoking public has so far obstructed the passage of legislation
making it compulsory for all cancer sticks to be fitted with these miraculous
life-savers?

If you, dear reader – a well-read and up-to-the-minute member of the
cognoscenti – haven’t heard of these remarkable advances in medical technology,
don’t feel too badly about your ignorance because (yes – you’ve guessed
it) they haven’t actually happened. Not yet, anyhow. They are just a couple
of the predictions contained in a treatise entitled Medicines in the 1990’s
published by the Office of Health Economics in 1969. (Note the misuse of
that damned apostrophe – when will they learn?)

The OHE is an admirable institution set up by the British pharmaceuticals
industry in 1962 as a public relations exercise. Since then the office has
produced a steady flow of objective, well-documented, literate and attractively
presented publications encapsulating the known facts about subjects ranging
from suicide and rabies and heart disease to what the public expects from
the NHS, and these tracts are only occasionally and partially biased toward
promoting the use of the industry’s costly products.

Medicines in the 1990’s was its 50th publication, and to mark the occasion
the office invited 40 gurus (including lots of professors and NHS consultants
and the celebrated ‘lateral thinker’, Edward De Bono), all having expert
knowledge of their corner of the medical scene, to prognosticate the happenings
of the next 20 years. Only those guesses of individuals which passed muster
with the panel, and various other referees, were incorporated in the final
document. So Medicines in the 1990’s can be accepted as a fair reflection
of the informed opinion of the time.

It’s easy enough to mock with the benefit of hindsight, but mockery
is not my purpose. Let us, rather, be instructed. Inter a good deal of alia
the experts predicted that by 1990:

* There will be vaccines against the sexually transmitted diseases.
(They didn’t foresee AIDS. How could they?)

* Antiviral agents safe enough for the treatment of minor diseases will
be available.

* Some 70 per cent of cancers will be controllable.

* Organs for transplantation will be grown from tissue cultures made
from the patient’s own cells.

* New drugs will result in 90 per cent of neurological disorders being
controlled.

* Perfected artificial hearts and pigs’ hearts ‘immunised’ against rejection
will have eliminated the need for human donors.

* Chemical anaesthesia will have been largely replaced by electrical
anaesthesia.

* Medicines will be capable of giving a relatively youthful appearance
to the aged.

* And, in their words, ‘the most dramatic change’ will be that ‘by 1990
the social use of medicines will have become accepted as legitimate’. In
other words, something like Huxley’s soma pills, available over the counter,
will have replaced more destructive drugs like alcohol and tobacco and pot
as the people’s comforter.

So how wrong can you get?

The prognosticators were absolutely right in suggesting that ‘unphysiological
operations such as gastrectomy for ulcers will give way to physiological
manipulations of the autonomic nervous system . . . ‘ because drugs like
cimetidine have virtually destroyed the trade in surgery for gastric and
duodenal ulcers. Nowadays a few pills do the trick instead. But in most
other areas they got things awry (and, don’t forget, they were very clever
people).

However, I was most interested in their statement that ‘most doctors
have received little or no training in the use of the many potent medicines
developed in the past 20 years. It will, however, take another 20 years
before this problem is entirely overcome, because it is only by then that
doctors who have received comprehensive pharmacological training in the
medical schools will predominate.’