Symptomatic Toxicology

Abstract

What the detective novel is to fiction, symptomatic toxicology is to clinical therapeutics. Its stories are about bad deeds, committed not by a criminal, but by a drug. All the elements of an Agatha Christie thriller are there: A person is harmed and a number of drugs are immediately suspected as perpetrators; but there are few clues on which to convict the culprit. The toxicological detective must laboriously put together his circumstantial evidence, and quite often he must wait until the villain strikes again and again. Then too, many of the suspects have excellent advocates and friends in high places; they are important members of the therapeutic armamentarium, benefactors of society and may have saved the life of many of our fellow citizens. Truly, to watch these great cases of symptomatic toxicology unfold from the first suspicion voiced in a letter to the editor of Lancet to the public tribunal to which experts of all vocations contribute is much more interesting than to watch masked men holding up a bank. Many books are written and motion pictures are made about cops and robbers, but the intricate stories of highly promising drugs with their fatal attributes, their bad deeds, their prosecution, and their ultimate conviction are rarely told.