40
is negative is "keep out of the reach of children." Can you com-
ment on why, if aspirin has such negative effects in some in-
stances, why the elderly are just passed over by being given this so-
called cure-all? Why they are not given the opportunities for varie-
ties of types of individual treatment that apparently your patients
have available to them?
Dr. SCHERBEL. Ms. Oakar, many of the things we are learning
about aspirin we are learning about now by carrying on sophisti-
cated studies. You must realize that aspirin has been around for
100 years. When I first came out of medical school we probably had
aspirin and thyroid extract and digitalis and beyond that there
were not many other drugs. Aspirin has always been recommended
in large doses for patients with arthritis and the larger the dose,
the more effect one would get from the drug. If you didn't get your
effect, you were not taking enough medication.
Now we know that all this is wrong because today there are
sophisticated studies using gastroscopy and showing that only a
few tablets of aspirin may cause gastric erosions. Normally, they
heal up and there is no problem.
But for people who don't have normal blood coagulation, who
drink some alcohol, these erosions further ulcerate and bleed; here
is where there is a problem indeed. I am a strong advocate of
aspirin. What I am trying to say, is that any analgesic drug you
mention may cause difficulty, or toxicity. Prophyxene is being criti-
cized as are all other pain relieving drugs. So where do we go?
Should we use drugs that are addictive? Do you want to do this?
No.
It is now known that elderly people don't metabolize drugs as
young people. So what do you do about this? Do you give multiple
drugs to elderly people that can result in drug interaction? These
are things we are learning today that we didn't know before.
When authorities become highly critical over DMSO, that can be
used effectively in such a simple way, there is need for clarification
of the problem that exists in the treatment of chronic pain.
Indeed, of all the drugs that I use, I would want DMSO among
the drugs that I use commonly in the treatment of pain. Frequent-
ly, one cannot give one drug to a patient and get an excellent relief
of pain in diseases which we were talking about. Arthritis is not
simple. If a patient with arthritis improves quickly while taking
some simple drug, my impression is that arthritis was not serious. I
am talking about the serious illnesses, progressive arthritis or
scleroderma with persistent ulcers, or impending amputation.
The controversy that exists over clinical effectiveness of DMSO is
not well founded-clinical effectiveness may be variable in differ-
ent patients. If toxicity is consistently minimal, the drug should
not be restricted from use in clinical practice. It is my opinion that
clinical effectiveness of DMSO can be decided with complete satis-
faction if the drug is made available to the practicing physicians.
The number of patient complaints about pain and the number of
phone calls to the doctors office will decide quickly whether or not
the drug is effective.
Ms. OAKAR. I want to thank you, Doctor, and commend you for
the wonderful work that you are doing. I am sorry it is somewhat
