| Book Review | The American Historical Review, 112.5

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| Book Review | The American Historical Review, 112.5 | The History Cooperative

Book Review

Comparative/World

John E. Lesch. The First Miracle Drugs: How the Sulfa Drugs Transformed Medicine. New York: Oxford University Press. 2007. Pp. x, 364. $59.50.
For millennia, infectious endemic and epidemic diseases periodically devastated human populations. As late as 1900 infectious diseases remained the leading causes of mortality, and infants and children were at the highest risk of dying. The tools that medicine had at its disposal—vaccination, antitoxin, quarantine—were helpful but scarcely decisive.	1
The introduction of antibiotics in the decade before 1945 marked a distinct turning point in the history of medicine (although the decline in infant and child mortality between 1900 and 1940 was unrelated to antibiotic therapy). The development of penicillin has generally occupied the most prominent position in traditional accounts. John E. Lesch argues that the sulfa drugs rather than penicillin played the most crucial role. The development of Prontosil in 1935 gave a powerful impetus to the rise of the modern pharmaceutical industry and the research and development enterprise within it. Moreover, in seeking an explanation for the therapeutic efficacy of sulfa drugs, researchers began to understand how molecular modifications could lead to the development of new drugs and classes of drugs effective not only against bacterial infections but also for many noninfectious diseases, including diabetes, hypertension, gout, and cardiovascular disease. Lesch's goal is to recapture the historical importance of the sulfa drugs, which are often subordinated to the introduction of penicillin in many historical narratives. Any adequate account of the trajectory of medicine and science, he argues, must take into account the critical role of the sulfa drugs.	. . .

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