The DMSO Medicine Man

Thirty-five years ago, on a chilly winter day, a young surgeon at Portland's University Hospital got his first look at the strange chemical that would change his life forever. Dr. Stanley Jacob, the head of the university's organ transplant program, had been looking for a way to freeze kidneys without damaging them. He had heard about an obscure industrial solvent called dimethyl sulfoxide, a pulp and paper byproduct. It just so happened that one of its major manufacturers was Crown Zellerbach, based in nearby Camas, Washington. Jacob made a phone call, and that afternoon the company sent over a chemist with a bottle of the clear, colorless liquid.A few days later, Jacob rubbed a spot of the chemical on the back of his hand. To his astonishment, the mixture quickly vanished into his skin, leaving it warm. Stranger still, he felt a sudden taste of oysters in his mouth, even though he had not put the liquid to his lips.Thus, Jacob became the first person to explore the unusual therapeutic properties of dimethyl sulfoxide, better known as DMSO.Since that afternoon in 1961, the fortunes of Stanley Jacob have been inextricably bound up with DMSO, the enigmatic and controversial drug that became a household name. In its heyday, DMSO was touted as a treatment for cancer, stroke, arthritis, chronic pain, bursitis, burns, strains, sprains, swelling, blindness, baldness, mental retardation, and gout. Millions of people around the world used it for their ailments. Celebrities from former Alabama Gov. George Wallace to Olympic runner Mary Decker sought out its healing potential. Known as "the father of DMSO," Jacob won awards for his pioneering work. He was invited to speak at international conferences and was quoted in The New York Times. His discovery seemed poised to revolutionize the practice of medicine.Thirty-five years later, however, DMSO is still on the bottom shelf of the pharmaceutical arsenal, at least in the United States. Commonly prescribed by doctors in Germany and Russia, DMSO in this country is more likely to be found in health-food stores than pharmacies (though it is available by prescription). Although the drug still enjoys considerable underground popularity, especially among athletes and arthritis sufferers, American physicians have largely turned their backs on it. Only a few outspoken researchers dare embrace its once proud claims, and Jacob now finds his work increasingly neglected.In an age where so-called miracle drugs show up with increasing regularity -- this year's fad is melatonin -- it's worth taking a closer look at the trials and tribulations of Stanley Jacob. The story of Dr. Jacob and DMSO offers a window into the world of experimental medicine, a world where personal testimony counts for little unless it is backed by voluminous data. It is the story of how Jacob's instincts as a healer got the better of his training as a scientist, and of how he became a pariah in his own field because he refused to temper his enthusiasm with footnotes. Finally, it is the story of a medical establishment that reacted to the remarkable claims about DMSO first with disbelief, then with resentment, and finally with the iciest response of all: indifference.In the past three and a half decades, millions of people around the world have benefited from Stanley Jacob's discovery of the therapeutic properties of DMSO. More than 12,000 articles on its pharmacological properties have appeared in scientific journals. Its proponents say it is undoubtedly Oregon's greatest contribution to medicine. But there are no monuments to Jacob, no buildings devoted to DMSO research. If geography is status, Jacob has sunk into semi-obscurity. His office sits at the end of a long, dilapidated corridor in the basement of McKenzie Hall, deep in the labyrinth of Oregon Health Sciences University, next to the cafeteria kitchen. There are no slick brochures or billboards trumpeting his clinic. The only sign of its existence is a battered shingle in the hallway that reads, Stanley Jacob, MD.It is an undignified location for a distinguished surgeon -- one who built a dizzying medical career long before he ever encountered DMSO. Born in 1924 in Philadelphia to a Jewish auctioneer, Jacob and his family moved to Youngstown, Ohio, where he was high school ping-pong champ and won statewide awards in oratory and debate. He graduated Phi Beta Kappa from Ohio State University and earned his medical degree at the age of 24. He served in Japan during the Korean War, then studied surgery at Harvard, specifically the new and exciting science of organ transplants.Jacob was widely regarded as a brilliant surgeon. By age 35, he had published more than 40 papers on topics ranging from surgical shock to pancreatitis. In 1959, he moved to Oregon to head the transplant program at OHSU, then known as the University Hospital.In Boston, Jacob had had the luxury of using MIT's cryogenic laboratory to explore new techniques of preserving organs indefinitely. (His team pioneered the technique of freezing a dog's heart from the inside out, to avoid damage caused by the encircling shell of ice.) But there was no such resource in Portland, and Jacob began casting around for a chemical preservative to facilitate the deep-freezing.So it was that Jacob found himself in his lab on that winter evening, wondering what he had stumbled into. Preliminary tests had shown that DMSO might well be useful in preserving organs, but that was the furthest thing from his mind. He was busy thinking about its penetrating properties. "I was excited and intrigued," he says. "The skin is not supposed to be a route for absorption."If DMSO could penetrate the skin, he realized, it could it pull other medicines in along with it. Later, Jacob would demonstrate this principle in his presentations with a toy train set. The engine was labeled DMSO. And behind it, the cars were labeled Cortisone and Iodine.The implications were tremendous. DMSO represented a new way of administering medications, something as revolutionary as the invention of the hypodermic needle.But this was just the beginning. During the next few months, Jacob tried DMSO on patients and colleagues alike. Every application seemed to reveal a new and unsuspected potential. When an acquaintance got chemical burns in the face and hands, a quick application of DMSO make the pain go away. Later, a co-worker sprained an ankle: DMSO made the swelling vanish. Jacob and his colleagues began testing DMSO on everything they could think of. It relieved headaches. It worked on cold sores. It eased the pain of arthritis.In short order, Jacob realized that the drug was capable of far more than just penetrating the skin. It also relieved pain, reduced swelling, improved circulation and enhanced the effectiveness of other drugs.It seemed to do everything.Jacob became convinced that DMSO was more than a new drug. "It was a whole new therapeutic principle," he says. "The song says there's nothing like a dame, and there's nothing like DMSO."To many of his colleagues, Jacob might as well have been seeing fairies. Word quickly spread around campus that the star surgeon had gone off the rails, and several faculty members asked the dean to fire him. Jacob had no better luck in scientific journals. In the summer of 1963, Science, Nature and Surgery all rejected an article Jacob had written on the various wonders of DMSO. To many researchers, Jacob's enthusiasm was taken as a sign that DMSO was suspect. "Jacob was very naive about the sociology of science," says Terry Bristol, a former professor at Linfield College who as a senior at Cleveland High School worked in Jacob's lab and has known the impish doctor for years. "He was enthusiastic, exuberant even. He came out and made claims that turned out to be true, but nothing was published on it. The truth is, [the drug companies] had done the studies, and he knew about them . But the scientific community is very, very fickle. Stan spoke too early, and they just trashed him for it."Jacob's colleagues may have had their doubts, but many of his patients did not. Liberated from years of pain and expensive therapy, they told their family, friends and co-workers. Word got around. In the fall of 1963, Jacob and his counterpart at Crown Zellerbach, Robert Herschler, decided to seek a joint patent on the therapeutic uses of the compound. Because DMSO had been first synthesized almost 100 years previously by a Russian chemist, it was impossible to take out a patent on the compound itself. But applicants were free to seek a more limited kind of patent, enumerating specific techniques for treating specific conditions. This patent, if it stood up in court, could serve as the basis for subsequent rights to the drug: OHSU and Crown Zellerbach could then grant production rights to various drug companies who would pay for the costly research required to get the blessing of the Food and Drug Administration and sail into the marketplace. Without an underlying patent, no drug company could be sure their investment would be worthwhile.The joint patent application finally set off bells in newsrooms. On Dec. 18, 1963, The New York Times ran a front-page story hailing DMSO as a new medical miracle.In a single hour, Crown Zellerbach stock jumped $5.50 a share on the news, increasing the company's worth by roughly $250 million. The New York Stock Exchange halted trading on the stock, and company officials had to issue a statement saying the compound would be a long time in coming to market.Following the patent application, drug companies leaped on the bandwagon, obtaining preliminary licenses from Jacob and CZ, and began underwriting research projects across the country. Jacob, it seemed, was on his way to becoming the Jonas Salk of his day. In 1965, then-Gov. Mark Hatfield presented him with the Governor's Award for Outstanding Northwest Scientist. He was invited to speak at international conferences. Meanwhile, DMSO was gaining disciples on the underground circuit. Although technically legal for testing only, black marketeers around the country began hawking the drug in locations ranging from gas stations to health-food co-ops.Then in September 1965, the roof caved in. A woman in Ireland died of an allergic reaction after taking DMSO. And later that year came reports that DMSO caused subtle changes to the eyes of lab animals. Suddenly, DMSO was taboo. The freewheeling "wonder-drug" attitude that had prevailed among its adherents in the first heady days was replaced by paranoia. Researchers were ordered to return their stocks. And scientists who had earlier urged caution with this newfangled cure felt they had been vindicated.The early reports of DMSO's dangers turned out to be overblown. Subsequent research did not demonstrate any effect on the human eye, and although there are rare cases of allergy to DMSO, there have not been any more reported deaths since 1965.Meanwhile, DMSO continued to attract legions of followers -- sufferers of all kinds of debilitating illness who finally found relief in Jacob's elixir.In December 1970, Jacob and Herschler were awarded a sweeping patent for the therapeutic uses of DMSO. The next step was getting the go-ahead from the FDA-not a simple task. The mammoth agency was renowned for red tape and foot-dragging: Its cumbersome ap proval process could take 10 years from start to finish. FDA bureaucrats staunchly defended their agency's plodding approach. Just a few years before, it had protected Americans from an anti-nausea drug known as thalidomide.Despite hundreds of studies and millions of patients who had taken DMSO, the FDA refused to let the drug come on the market. Although FDA bureaucrats never disputed individual testimonies, they continued to insist on the gold standard of modern drug evaluation -- the "double blind" study. In this kind of study, the pool of patients is split in half. One-half get the drug, the other half get a placebo -- something that looks and tastes just like the drug but is actually neutral. Neither the patients nor the doctors know which is which. This technique helps researchers avoid the placebo effect, where patients get better just because they think they're being treated with a "wonder drug." The trouble with using this technique with DMSO was the drug's characteristic taste, and the smell it produced in the body. No one could devise a placebo that could mimic it. As a result, double-blind studies with DMSO were extraordinarily difficult to carry out.It's hard to get a handle on what the studies actually show. Proponents cite dozens of articles showing that DMSO is highly effective against a multitude of conditions, including scleroderma, arthritis, lupus and chronic pain. But the FDA continues to insist that these studies are flawed.Even if it won FDA approval, DMSO faced another difficulty: the complex intricacies of patent law. If Jacob and Herschler's underlying patent did not stand up in court, the drug companies they had granted licenses to might not be able to recoup their investment. This uncertainty made the pharmaceutical giants less eager to pursue a long and costly battle with the FDA.These drawbacks kept DMSO in the realm of investigational therapy until 1978, when the FDA finally approved DMSO as a treatment for interstitial cystitis, a rare disease of the bladder. Technically, this ruling could have brought DMSO to everyone: Once the FDA has certified that a drug is safe for a particular use, physicians may prescribe it for other purposes. By this time, however, conventional medical wisdom held that DMSO was too good to be true. Most mainstream doctors wouldn't touch it. "You couldn't get people to work on it," Bristol says. "No one wanted DMSO on their resume.""Unfortunately, it got the reputation of being snake-oil," says Bill Weaver, another of Jacob's former aides who is now a professor at Linfield College.In March 1980, Mike Wallace of 60 Minutes did a compelling segment on DMSO, interviewing several patients who sang its praises. Jacob's office was flooded with calls-100,000 in the first week. The university added 12 operators to handle the load. CBS was also deluged. To this day, Wallace says the DMSO segment brought in more calls to 60 Minutes than anything else. The show helped focus public pressure on the FDA to approve DMSO for other conditions.But congressional hearings into the FDA's handling of DMSO eventually went nowhere, and the drug remained in a sort of pharmaceutical no-man's land. Even as patients such as George Wallace flew to Portland for DMSO therapy, Jacob's reputation among the medical establishment never recovered. "He's a brilliant, brilliant man," one observer says. "He just lost sight of his objectivity." Even its critics admit that DMSO has an extraordinary range of chemical and pharmacological properties. Its compact structure, a molecular arrowhead with an ionic tip and an organic fledge, gives it the unique ability to penetrate the skin, drawing other molecules with it. DMSO is also a powerful scavenger of "free radicals," destructive agents found in damaged tissue, greedily seeking them out and neutralizing them. DMSO also functions as a topical analgesic -- think of it as aspirin for your skin -- and a powerful anti-swelling agent.Despite these remarkable properties, many authorities say DMSO just isn't that helpful in practice. "There are no controlled studies demonstrating its safety and effectiveness in relieving swollen, inflamed arthritic joints," according to an FDA press release. "People with arthritis often get some transient relief from DMSO," says Dr. Robert Bennett, the head of rheumatology at OHSU. "But now there are more effective drugs." Bennett says DMSO is not as popular as it was 15 years ago. "When something's not available, there's a perception on the part of some people that it's being suppressed," he says. "Once it's available, it doesn't have the same mystique."For many years, former Trail Blazers physician Dr. Robert Cook used DMSO for players' ankle sprains, but now he is less than enthusiastic about the drug. "I'm not convinced that the DMSO we used was any better than the standard treatment," he says. "There are 25 anti-inflammatories out there. DMSO is probably the 25th."Many long-time users still swear by DMSO, however. Former Portland-area congressman Bob Duncan has used it for years for burns, and recently began to use it for arthritic pain. "Remember when your mother used to give you medicine, and you'd ask, 'Why am I taking this?' She'd say it's good for what ails you. That's why I take it. It's good for what ails you."Down in his cramped, basement lab, Jacob doggedly tracks the dream he has pursued for 30 years. At the age of 72, he still works more than 70 hours a week, arriving in the office by 5 am. Besides his teaching duties (he lectures on surgical anatomy), he sees about 10 or 12 patients a day, many of whom travel from out of state to be treated by him. Recently, he has been trying to arrange studies on using DMSO for head injuries and AIDS. And he's setting up a home page for DMSO on the World Wide Web.A workload like this might tire another man. But not Jacob. "I love it, you see" he says, speaking slowly and tilting his head slightly. "For me it's a raison d'etre. DMSO is the aspirin of our time.""Stan is completely dedicated to medicine and helping people, and that's not being corny," says Russ Krueger, a former patient and now a partner of Jacob's in a venture seeking FDA approval of DMSO for spinal and central nervous injuries. "He doesn't walk on water. But money means nothing to him. All he truly enjoys, if that's the right word, is trying to help people." Until 1979, when DMSO became available by prescription, Jacob never charged a dime for it.In the cheerful confusion of his office, Jacob orchestrates recoveries like a diminutive maestro, promising to fax a letter for a patient who's going to New Zealand, advising a caller on ideal dosages for her husband's arthritis. Over the rumblings of an ancient air conditioning unit, nurses ferry bottles of DMSO back and forth or fuss over paperwork. Jacob zips between patients, calling them Honey and Dear.Jacob's unyielding passion for DMSO may have cost him his career as a scientist, yet it earned him something else, something less tangible but more precious: the love and gratitude of thousands of patients, many of whom suffered for years before trying DMSO. Patients from 20 years ago still speak of Jacob with awe. His walls are covered with cards from them. His file cabinets groan with supportive letters.Though Jacob wishes DMSO were better known and more readily available, it's not as if DMSO has been completely ignored by the scientific community. Over the years, the patent royalties to the medical school added up to more than $600,000. (Jacob always gave his 30 percent share to the department.) DMSO has been approved in more than 100 countries around the world, and it is widely used by veterinarians as a horse liniment.This is a far cry from Jacob's vision of DMSO as "the aspirin of our time." But he does not resent the medical establishment for failing to embrace the drug. "I know DMSO's truth and I believe I'll live to see the day it's more widely accepted," he explains. "I feel no bitterness. If I had to choose one word, it would be sadness."Sometimes, when patients leave his office, they hug him. They share a bond, doctor and patient, a hard-won faith that transcends the cold logic of scientific research. They believe DMSO has worked for them-no matter what the FDA says.Jacob himself takes a spoonful of DMSO every morning, as he has done for the last 34 years. "I figured that if there were any long-term side effects, I wanted to test them on myself first," he says. And one of these days, he's going to get around to writing a book about his experiences with DMSO. He's even got a title in mind. He wants to call it The Good Stuff.Kimberly Lusk contributed to this report.

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