Cortisone Discovery and the Nobel Prize
In the 1930s, Edward Kendall, Ph.D. had isolated six hormones from the tiny adrenal glands. He named them in the order in which they were isolated: compounds A through F. Dr. Phillip Hench, M.D., who was Mayo Clinic's first rheumatologist, saw many patients with rheumatoid arthritis. There was no cure, and very few ways to provide even temporary relief from pain.
Dr. Hench saw patients with arthritis whose symptoms had mysteriously improved when they experienced jaundice, during pregnancy, and immediately after unrelated surgery. He hypothesized that in these patients, something had prompted the secretion of a natural anti-rheumatic. He termed it "Substance X."
Dr. Hench knew of Dr. Kendall's work on the adrenal cortex. He asked if Dr. Kendall thought any of the isolated hormones might help in treating rheumatoid arthritis. Over the course of many conferences, the two physicians decided that Substance X was most likely an essential hormone, possibly a steroid. In January 1941, Dr. Hench jotted in his red notebook: "Try Compound E in rheumatoid arthritis."
It took years to synthesize the compounds so that enough could be manufactured to allow clinical tests. On Sept. 21, 1948, a patient at Saint Marys Hospital received the first injection of Compound E. Three days later there was an astonishing change -- less muscular stiffness and soreness. Over the next seven months, trials were completed on 14 patients with severe or moderately severe rheumatoid arthritis. All showed marked improvement.
Publication of the Mayo collaborators' findings brought them international recognition. In 1950, Drs. Kendall and Hench learned they were co-winners of the Nobel Prize in Physiology and Medicine -- sharing the prize with Dr. Tadeus Reichstein of Switzerland, who had simultaneously isolated the hormones of the adrenal cortex. They accepted the award at the Nobel presentations in Stockholm, Sweden. Dr. Hench commented: "In our opinion, the awards we received belong truly to all the men and women of the Mayo Clinic because it was the spirit of cooperative endeavor, the fundamental credo of the institution, which made possible the work which resulted in our trip to Stockholm."