The History of Medical Progress (by Dr. Ray Greek, Director of the Medical Research Modernization Committee) INTRODUCTION Why do we experiment on animals? Are they just funny looking people with exactly the same organ tissues and diseases we have? When did all this start? In the first century, the Church prohibited performing autopsies on humans. So, the scientists did what they thought was the next best thing. Scientists like Galen dissected animals and applied his results to humans. Galen was wrong in many of the conclusions he derived from animal experiments. In fact, animal experiments led scientists astray for centuries. Galen thought that the "heart was a warming machine for two separate types of blood. He was convinced veins and arteries were not connected and blood flowed both backward and forward from the heart." Historians have said this about Galen: "based mainly on the study of apes and pigs, and he unhesitatingly transferred his discoveries to human anatomy, thus perpetuating many errors." This misinformation lasted for centuries. Unfortunately, we have not progressed as far as some people think. We are still experimenting on animals, despite the fact that better techniques are available. The first big step for medical discoveries was during the Renaissance when the Italian scientists and artists began to perform autopsies on humans. This corrected many of Galen's errors. Vesalius was condemned to death by the Church and had to hide because his discoveries disproved Galen's theories. The Church had adopted Galen's positions and was reluctant to change. Much as the scientific community of today is reluctant to accept progress. During the 19th century, many discoveries were made because of human experiments. Harvey described the circulation of the blood. Many have tried to credit Harvey's discovery to animal experiments (or vivisection). Lawson Tait, a famous nineteenth century surgeon, had a rather different impression of this part of medical history. He stated: "That he [Harvey] made any contribution to the facts of the case [blood circulation] by vivisection is conclusively disprovedIt is, moreover, perfectly clear that were it incumbent on anyone to prove the circulation of the blood as a new theme, it could not be done by any vivisectional process but could, at once, be satisfactorily established by a dead body and an injecting syringe." Medical discoveries were rampant during the 19th century. The stethoscope, blood pressure manometer, microscopes and a host of others were all discovered without animal experiments. This had not dissuaded people who earn their livelihood from making the claim that animal experiments were vital to these discoveries. If you made your livelihood off experimenting on animals, you would have a vested interest in saying the same thing. Animal experiments really took off in the 19th century, largely due to the efforts of Claude Bernard. He had this to say about laboratory experiments on animals: "Experiments on animals, with deleterious substances or in harmful circumstances, are very useful and entirely conclusive for the toxicity and hygiene of man. Investigations of medicinal or of toxic substances also are wholly applicable to man from the therapeutic point of view; for as I have shown, the effects of these substances are the same on man as on animals, save for difference in degree." "I consider hospitals only as the entrance to scientific medicine; they are the first field of observation which a physician enters; but the true sanctuary of medical science is a laboratory; only there will he seek explanations of life in the normal and pathological states by means of experimental analysis. "In leaving the hospital, a physicianmust go on into his laboratory; and there, by experiments on animals, he will account for what he has observed in his patients, whether about the actions of drugs or about the origin of morbid lesions in organs and tissues. There, in a word, he will achieve true medical science." That is an amazing statement. Animals are more like humans than humans. Unfortunately for patients today, scientists still believe the preposterous words of this man. ______________________________________________________________________ Surgical Advances Would you want a surgeon to operate on you if he or she had never performed the procedure on humans? How about if the operation had only been done on dogs? Do you think surgery residents should watch their teachers perform operations and then very gradually be allowed to help with the operation until finally they are able to do the entire procedure under supervision or should they practice on animals and then on you? How were all the surgical advances discovered and how do physicians learn to be surgeons? Is modern surgery the result of animal experimentation or human clinical observation? Have technological discoveries or animal experiments led to the great advances in surgery? What have animal experiments done for the field of surgery? Surgery would not be possible without anesthesia. Indeed, anesthesia is one of the contributions to the history of medicine from the United States. Physicians discovered the properties of anesthetics while having so-called ether parties in the 1800's. Participants noticed that while inhaling the substances, they became insensitive to pain. Thus, the field of anesthesiology was born. Anesthesiology and infectious control allowed surgery to advance out of the dark ages. Many famous surgeons of the 19th and 20th centuries opposed animal experimentation for surgery. Lawson Tait stated that animal experimentation should be stopped "so the energy and skill of scientific investigators could be directed into better and safer channels." Tait stated that he had been led astray time and time again by animal experiments. He believed vivisection wrong because of misleading results and because focus was diverted from more reliable data. Dr. Charles Mayo, of the famous Mayo Clinic, stated: "I abhor vivisection. It should at least be curbed. Better, it should be abolished...I know of no discovery that could not have been obtained without it...." Sir Frederick Treves stated about performing surgery on dogs, "my experiments had done little but unfit me to operate with the human intestine." The differences between human anatomy and physiology were again cited by president of the Royal College of Surgeons, Dr. Moynihan who stated, "Has not the contribution of the laboratory to surgery of the stomach, for example, been almost negligible when it has not been potentially dangerous because divergent from human experience and therefore inapplicable." Perhaps the most important surgical advances have resulted from new technology. CT scans, MRI's, ultrasound and other technologies allow quicker and more accurate diagnosis of disease. Technological contribution does not stop with the diagnosis however. New sutures have been developed which allow very small incisions in the eye, heart and other tissue. Microscopes which allow surgeons to reattach severed fingers, hands and arms, have revolutionized surgery and saved many people from devastating injuries. The microscope is also used for the common procedure of placing tubes in a child's ears in order to decrease ear infections and hearing loss. Microscopic discectomy, the removal of a herniated disc in the back is accomplished with the microscope. The microscope is also used in neurosurgery to allow very small precise cuts of tumors off nerves. The development of the stapler has done away with sutures in some operations. Making for a better closure and quicker operating time. Lasers now allow ophthalmologists to correct potentially blinding conditions without anesthesia and as on an outpatient basis. Lasers are also used in removing birth marks from the face and aid in stanching blood flow during liver transplant surgery. One advance in technology which has saved many patients from surgery and from death is the endoscope. These instruments are commonly used in order to visualize the inner colon, looking for early cancers. They are also used in the upper GI tract to look for cancer and ulcers. Prior to this patients were forced to swallow or have placed via an enema, a chalk like substance which did not always provide adequate visualization. Many procedures which would have required a major surgery can now be performed non-surgically via endoscope. Along the same lines of viewing without cutting, many operations are now performed as laparoscopic procedures. Appendectomy, cholecystectomy, hysterectomy, hernia repair and others were once only possible with a large incision and a prolonged recovery. Laparoscopes allow surgeons to make several very small incisions thus decreasing the likelihood of infection and other complications and decreasing recovery time. As more and more technology became available, more specialized training was needed in order to use it. General surgery divided in to neurosurgery, urological surgery, ophthalmology, otorhinolaryngology, plastics, orthopedics, vascular, thoracic, cardiac, transplant surgery and other sub specialties. This led to even more knowledge and further technological refinements. The invention of the ophthalmoscope in 1851 allowed physicians to see inside the eye for the first time. The otoscope, in 1860, allowed visualization inside the ear and the laryngoscope in 1874, allowed better visualization of the larynx. The ability to look at tissue under a microscope utilizing certain stains and dyes allowed surgeons to decide whether or not to remove tissue or treat more conservatively. Tissue implants including artificial eyes, heart valves, penile prosthesis, skin expanders used in order to harvest more skin for skin grafts, artificial blood vessels, pacemakers and other advances came to us via technology not animal research. The field of neurosurgery owes much to advances in radiology. The ability to actually see inside the nervous system and thus find exactly where the problem lay was the sticking point in neurosurgery for decades. Better diagnostic techniques such as myelography, angiography and MRI scanners, has revolutionized the field. One of the first neurosurgeons was Harvey Cushing of Boston, who developed many techniques and instruments. The concept of using electricity to coagulate bleeding vessels was Cushing's idea. The old method of sewing each individual vessel when it was bleeding was time consuming and imprecise. Today virtually no operation is performed without electrocautery. Other technical advances involving the microscope has allowed much more pin point resection of tumors and lesions. This quote from Paul Carrao, MD a former animal experimenter in head trauma exemplifies the animal model dilemma: "I just know what the literature shows, and I know what our results were, and I challenge anybody to show that any of that[animal research] has advanced the cause of the treatment of human head injury one iota. The bulk of the knowledge that now exists and upon which the treatment of head injuries is predicated is that which has been derived from head injuries in the past, whether in the civilian sector or in the military. In many ways the results which were obtained with animals have been misleading, because in the case of quadrupeds, the physiological mechanisms are different, so that the kinds of data obtained from different systems - circulatory, the blood pressure and so forth, respiratory, the cardiac - are different from those obtained from human head injuries." One example of animal experimentation misleading surgeons is the operation called Radial Keratotomy. This operation is performed in order to enable patients to see better without glasses. The procedure was initially performed on rabbits. But it blinded the first humans. The problem was that the rabbit cornea is able to regenerate on the underside. The human cornea can only do this on the surface. Surgery now performed only on the surface. Thomas Starzl of Pittsburgh has been transplanting organs from animal to humans for years. Starzl started by experimenting in the laboratory for years and in the 1990s began to experiment on humans. He stated that baboon liver transplants would be viable in humans in part because baboons were resistant to hepatitis , a common cause of liver failure and thus the need for a new liver. It was hoped that the baboon liver would be resistant to the disease which infected the patient. If the baboon liver functioned properly perhaps the patient would not re-infect himself with the hepatitis. However even Starzl admitted that, "a baboon liver could impose on a human recipient lethal interspecies metabolic differences." Others were not so optimistic. An advocate of xenotransplantation at Harvard, Dr. Hugh Auchincloss stated, "survival rates reported for allotransplantation (human to human) in those patients with hepatitis B is superior to that which we could expect from xenotransplantation." At autopsy, Starzls' transplanted baboon livers proved to be carrying hepatitis. Of interest is the fact that Dr. Auchincloss also stated that,"successful rodent experiments do not make an adequate scientific basis for human experimentation." Two baboon liver transplants were performed in 1993. One died within 4 weeks and the other 10 weeks. The quality of life during the time the patients were alive was not something anyone would desire. Life in the intensive care unit, unable to eat, walk, drink eliminate or even breathe without constant mechanical assistance is not a decent quality of life. The first baboon liver was infected with CMV, Simian Agent 8, H.Papio and other diseases. Thomas Starzl of the University of Pittsburgh has received over $8,000,000.00 in public funding in order to experiment on baboons for xenotransplants. None have so far been successful. Dr. Starzl expressed his contempt for preventative measures when stated that he had a "cure for alcoholism" referring to liver transplants. Approximately 4,000 viruses have been identified which occur in humans, animals, plants, and other organisms. Many of these can be transmitted from xenotransplants (animal to human transplants). Hepadnavirus, papillomavirus, retrovirus, aterivirus, togavirus, adenovirus, parvovirus, hantavirus, papovavirus, and others can cross over to humans, under the right circumstances. Some scientists also postulate that Hepatitis B may have come to humans from chimpanzees. Chimps harbor the virus asymptotically. The idea of species contamination is not new. Millions of doses of polio vaccine were infected with SV40. This virus causes cancer in humans. The Marburg virus, from monkeys, killed 7 people in 1967. The clinical manifestations of the virus caused physicians in Germany to describe their patients as having "blood pouring from all apertures." The patients became demented, went into coma, and eventually died secondary to heart failure. The survivors did not fare much better. Chronic liver failure, impotence and insanity were long term sequellae. HTLV-2 may have originated as STLV in monkeys. The disease causes leukemia in humans. Jacob-Cruetzfeld can cross from sheep and cows and other animals to humans. This is the virus that has been associated with "mad cow disease" in Great Britain. Rodent hantaviruses can spread from rodents to humans. Monkey pox, elephantiasis, yellow fever, tuberculosis and other diseases have been documented to spread from animals to humans. The macaque herpes B virus leads to brain infections in humans. It is benign in monkeys. Scientists are now experimenting with pigs because they do not believe pigs harbor deadly Ebola like viruses. However, pigs do harbor pseudorabies, leptospirosis, erysipelas, wabah babi, and others. The important question regarding any animal donor is "what does it harbor that we do not know about?" New viruses are being discovered in animals on a regular basis. Some of them do not harm the host animal, but can be deadly for humans. Fortunately for the human race, the viruses stay where they belong unless we disturb them. Remember in the movie Jurassic Park when the character played by Jeff Goldblum told the creator of Jurassic Park that "Nature finds a way." We do not know as much as mother nature. We like to think we do, but we don't. The public health implications of another retrovirus which could mutate and be passed along like the common cold are devastastating. Arguably the invention to most change the face of medicine in the 20th century was the cardiopulmonary bypass (CPB) machine. Dr. Gibbon's machine was in part based on animal experiments. This was in part responsible for the initial failure of the machine. Two out of 3 of Gibbon's first patients died as a result of the heart-lung machine. When the machine was revised based on studies of humans by Andresen, the success rate increased. Andresen studied human circulation and contributed the low flow theory of circulation to science. This is when the blood volume is reduced in order for the patient to be successfully connected to the heart lung machine. It was this human data which allowed the CPB machine to be successful on humans. Consider this statement from one of the inventors of modern cardiopulmonary bypass: "Biomedical research does not need animals any more, but should use computers. It is pointless and even dangerous to continue following the traditional paths, for the differences between man and animals is so great that it mostly leads us into error. Artificial heart valves, for example, and also the pacemaker for the heart, were first tested on humans and only later was it established that they also function if they are implanted in animals." The correction of the congenital heart anomaly called Tetrology of Fallot (TOF) is frequently cited to justify spending money on more animal research. TOF is one of the causes of "blue babies." A Blue baby is one who does not have enough oxygen in the blood to provide the healthy pink color to the skin. The blood is bypassing the lungs, thus not receiving the oxygen. A malformation of the heart usually, does not allow blood to circulate normally. The whole story can be found in Dr. Taussig's memoirs and textbooks of medical history. Cardiologist Helen Taussig suggested a surgical correction of the problem to Alfred Blalock, a surgeon. She based her suggestion on autopsy findings on the affected infants. Dr. Blalock attempted the procedure on dogs with poor results. Instead of using animals with heart defects they cut lung tissue out of dogs in an attempt to mimic the naturally occurring disease. Tetrology of Fallot does occur in dogs, especially Keeshonds, but it is rare. So the animal model was fundamentally flawed from the start. Dr. Blalock's experience led him to state to Dr. Taussig, "The experiments are suggestive but not very conclusive. But if you are convinced the operation will work, I am convinced I know how to do it." Dr. Blalock had in fact not been successful performing the procedure in dogs. He thought it could be done in humans based on Dr. Taussig's experience and based on his surgical experience. Contrast his statement with this statement from those promoting animal research, "The (animal) experiments were so successful and confirmed Dr. Taussig's theory so completely that Blalock felt he could venture to operate on one of the poor children."(Hugo Glaser, The Miracle of Heart Surgery, London, Lutterworth Press, 1961, p59). This is where the statement, "Which would you rather save one blue baby or one brown dog?" comes from. It is not based on historical fact but rather someone's wishful thinking. Sloppy thinking such as exemplified by the above lead one surgeon to state,"The abolition of vivisection would in no way halt medical progress, just the opposite is the case. All the sound medical knowledge of today stems from observations carried out on human beings. No surgeon can gain least knowledge from experiments on animals, and all the great surgeons of the past and of the present day are in agreement on that." The development of the artificial heart valve, which has helped tens of thousands of people was delayed secondary to research in dogs. Dogs proved to be very good at making blood clots around the new valve. The blood clots could lead to stoke or pulmonary embolism or other complications in humans. Therefore, researchers would not release it to humans. Many people died as a result of the new valves not being available. The entire reason the valves were not released was based on a myth. Dogs and humans do not clot in the same way. Humans did not have the same problem with the valves and many people have the artificial valves implanted each year. Some valves do require anti-coagulants to avoid the complications, but this was not the pointed out by the dog experiments. What would happen if we did indeed abolish surgical training and experimentation on animals? Researchers at Tulane University have at least partially addressed this question. They examined complication rates for the then relatively new procedure of laparoscopic cholecystectomy. They compared the complication rate of those who practiced on animals with those who did not. They found no difference between the groups. Another area where animals are routinely used is in training physicians to handle major trauma. Advanced Trauma Life Support (ATLS) courses are costly in part because of the cost of the animals. One hospital in Georgia decreased cost by 50% by eliminating dogs from the course. Human cadavers were used instead. The participants evaluated the course as equal or better than courses using dogs. More recent studies have revealed the physicians taking ATLS prefer human cadavers to animals. This is not surprising. If you operate on humans it only makes sense to learn on cadavers. Dr. Salvatore Rocca Rossetti, surgeon and Professor of Urology at the University of Turin, Italy, states that, "Nobody has become a surgeon because of having operated on animals. He has only learnt wrongly through animals. I have been able to see this over my many decades as a surgeon, also as a Director of hospitals. I have carried out tens of thousands of operations on people without ever performing them first on an animal." Dr. Werner Hartinger of Germany agrees: "The claim, frequently heard, that animal experimentation is vital for the training of surgeons and that practice on living animals is necessary to gain manual and operating skills cannot be left unchallenged. A surgeon acquires his basic knowledge by observing and then assisting his teacher. In time, according to his experience, ability and manual dexterity he participates in supervised operating duties, until the surgeon responsible for his training, decides as to when he can start operating on his own. Specialized knowledge of microsurgery is gained in the same way, just as working at the surgical microscope does not call for operating on animals." In England, surgeons have not been allowed to practice surgery on animals since 1876. _______________________________________________________________________ Medication Testing in Animals Where would we be without the ability to test new medication on animals. Would we all become guinea pigs? Aren't animals used to see if medications are safe? Aren't animals used to figure out the correct dose to give humans? What about the bad side effects? Doesn't animal testing find out which medications are dangerous? Between 1976 and 1985, 209 new drugs were approved for use in the United States (US) after extensive animal testing. Of these 209, 198 were followed for side effects and effectiveness by the Food and Drug Administration (FDA). (Sometimes a drug will be approved but never make it to market secondary to the fact that the drug company ceases to believe it can make money off the product. Sometimes these drugs are referred to as "orphan drugs.") 102 of the 198 new medications or 52% were either withdrawn or relabeled secondary to severe unpredicted side effects. These side effects included complications like lethal dysrhythmias (when the heart beats without a regular rhythm, thus severely limiting the amount of blood it can pump), heart attacks, kidney failure, seizures, respiratory arrest (when one stops breathing and subsequently the heart stops beating as well), liver failure, stroke and many more. All these medications had been tested on animals. What happened? In 1933, a physician stated, "...the results of drug experiments upon animals are, as far as their application to man is concerned, absolutely useless and even misleading." And in 1967, Dr. Arnold D. Welch, Department of Pharmacology, Yale University School of Medicine, stated, "In part because of possible major differences in responses to drugs in animals and man, the knowledge gained from studies in animals is often not pertinent to human beings, will almost certainly be inadequate, and may even be misleading." Other scientists are now going on record stating that there is only a 5-25% correlation between animals results and human results. This is less accurate than tossing a coin. At least with tossing a coin you have a 50% chance of success. What about predicting the correct dose of a drug for humans? The dose of a medication is determined in part on how the drug is metabolized. A study of 23 chemicals revealed only 4 were metabolized the same way in humans and rats. These differences prompted one scientist to state, "It seems incredible that the rat is the model so heavily relied upon when predicting human responses to toxic/carcinogenic agents. Whether the concern is absorption, tissue distribution, biliary excretion, intestinal flora, enterohepatic circulation, and others, there are profound differences between the values of the rat and those of humans." So animals can not accurately predict dose, side effects or toxicity to humans. What about all those drugs that did not pass animal tests? Aren't we much safer because the really bad drugs were caught early? Dr. Kurt Fickentscher of the Pharmacological Institute of the University of Bonn, Germany, in Diagnosen, stated in March 1980, "Normally, animal experiments not only fail to contribute to the safety of medications, but they even have the opposite effect." Digitalis, like many medications, was discovered without animal use. It is derived from plants and has been used by herbalists for centuries. However, clinical trials of the drug were delayed secondary to the high blood pressure it caused in animals. Digoxin, an analogue of digitalis has saved countless lives. How many more could it have saved had digitalis been released sooner? FK 506 - a chemotherapeutic agent was almost shelved before proceeding to clinical trials. Researchers stated, "Animal toxicity was too severe to proceed to clinical trial". They suggested that the combination of FK 506 with cyclosporin may prove more useful. In fact, just the opposite was to be true in humans. Perhaps the most useful medication that was almost lost secondary to animal experimentation was penicillin. Flemming saw penicillin kill bacteria in petri dish and tested it on rabbits. It did not work. Rabbits excrete penicillin in their urine. The drug does not get a chance to work prior to being eliminated from the body. Flemming then discarded the drug thinking it to be useless as a systemic medication. He later had a very sick patient and since he had nothing else to try, gave the penicillin. The rest, as they say is history. It is good thing his initial tests were not on guinea pigs or hamsters, it kills them. He might have thrown the drug away entirely instead of setting it aside for possible topical use. His experience prompted him to state, "How fortunate we didn't have these animal tests in the 1940's, for penicillin would probably never been granted a license, and possibly the whole field of antibiotics might never have been realized". Dr. Howard Florey, the Nobel Prize winner who is credited with co-discovering penicillin, has stated: "Mice were used in the initial toxicity tests because of their small size, but what a lucky chance it was, for in this respect man is like the mouse and not the guinea-pig. If we had used guinea-pigs exclusively we should have said that penicillin was toxic, and we probably should not have proceeded to try and overcome the difficulties of producing the substance for trial in man." An oft repeated horror story of how animal testing could have saved patients is the story of the thalidomide disaster which occurred in the late 1950s and early 1960s. In fact just the opposite is true. Thalidomide was originally intended to decrease severe morning sickness associated with pregnancy. Unfortunately, it also caused a condition known as phocomelia; a congenital absence of the limbs. Thalidomide was tested on animals both before and after the side effects were known. The severe birth defects were not only not predicted by animal tests before the disaster, but even when the scientists knew what they were looking for, only one particular breed of rabbit and a few primates were found to reproduce the deformities. This is usually the story with animal experiments. Eventually you can find an animal which predicts the side effect, but only after you know what the side effect is and have looked for it in many different species of animals. That is essentially the point of those who oppose animal research. Look long enough and hard enough and you will find some animal somewhere which does react to medication the way humans do. Only problem is, in order to know if the side effect in question is accurately predicted by the mouse or dog, or cat or woodchuck or whatever, you must have already tested the medication in humans. With some medications the White New Zealand rabbit will predict problems accurately. With others the mouse may be predictive. But if we only know in retrospect, why perform the test? That's like having the answer to the test questions before the teacher gives the exam. Real life doesn't work that way. You are not getting new data, but merely "validating" data already known to be true from humans. Why does science feel they must "validate" data on animals to prove that the effects already observed in humans really occurred? Mice and rats were tested and not effected by thalidomide. The White New Zealand rabbit was effected only at a dose of 25 times that given to humans. Monkeys were effected at 10 times the normal dose. Two scientists summarized the thalidomide testing as follows: "An unexpected finding was that the mouse and rat were resistant, the rabbit and hamster variably responsive, and certain strains of primates were sensitive to thalidomide developmental toxicity. Different strains of the same species of animals were also found to have highly variable sensitivity to thalidomide. Factors such as differences in absorption, distribution, biotransformation, and placental transfer have been ruled out as causes of the variability in species and strain sensitivity." There is law in medicine which states that any substance can cause birth defects if given to the right species in the right dose at the right time in development. That is certainly true with thalidomide. One scientist stated, "In approximately 10 strains of rats, 15 strains of mice, 11 breeds of rabbits, 2 breeds of dogs, 3 strains of hamsters, 8 species of primates and in other such varied species as cats, armadillos, guinea pigs, swine and ferrets in which thalidomide has been tested, teratogenic effects have been induced only occasionally." He goes on to state: "It is the actual results of teratogenicity testing in primates which have been most disappointing in consideration of these animals' possible use as a predictive model. While some nine subhuman primates (all but the bush baby) have demonstrated the characteristic limb defects observed in humans when administered thalidomide, the results with 83 other agents with which primates have been tested are less than perfect. Of the 15 listed putative human teratogens tested in non-human primates, only eight were also teratogenic in one or more of the various speciesThe data with respect to "suspect" or "likely" teratogens in humans under certain circumstances were equally divergent. Three of the eight suspect teratogens were also not suspect in monkeys or did not induce some developmental toxicity. Over 10,000 children were crippled as a result of thalidomide. This tragedy is made worse by the fact that a physician observed the link between thalidomide and birth defects and sounded an alarm. He was ignored because of the animal experiments which had proven that the medication was safe. Since the laboratory was and is considered the true sanctuary of medicine, many individuals were effected by thalidomide who did not need to be. Another scientist states, "There is at present no hard evidence to show the value of more extensive and more prolonged laboratory testing as a method of reducing eventual risk in human patients. In other words the predictive value of studies carried out in animals is uncertain. The statutory bodies such as the Committee on Safety of medicines which require these tests does so largely as an act of faith rather than on hard scientific grounds. With thalidomide, for example, it is only possible to produce specific deformities in a very small number of species of animals. In this particular case therefore, it is unlikely that specific tests in pregnant animals would have given the necessary warning: the right species would probably never have been used. Even more striking, the practolol adverse reactions have not been reproducible in any species except man." Despite what those who earn their livelihood from experimenting on animals say, animal tests would not have prevented the thalidomide disaster and in fact delayed the acknowledgment of it's severe side effects. ______________________________________________________________________ Curing and Preventing Cancer Experts state that between 60% and 90% of all cancer can be prevented! Why are we spending so much money on animal research and so little on prevention. Didn't Benjamin Franklin say, "an ounce of prevention is worth a pound of cure"? What is the track record on animal research and cancer? We have spent billions and billions of dollars on animal research for cancer. What have we received for our money? "Everyone should know that most cancer research is largely a fraud, and that the major cancer research organizations are derelict in their duties to the people who support them." Linus Pauling, Ph.D., two time Nobel Prize winner, in Outrage, Oct/Nov 1986 Cancer research on animals has been unproductive because of the differences between humans and animals. The cancers which grow in animals are different from the cancers which afflict humans. And, the physiology of humans is different from the physiology of animals. Animals are not just funny looking people. One premise of testing new anti-cancer medications, and testing chemicals to see if they cause cancer on animals is the fallacious assumption that the animal is similar to humans in terms of physiology and pharmacological responses. Consider the following: Of 20 compounds known not to cause cancer in humans, 19 did cause cancer in animals. On the other hand of 19 compounds known to cause cancer in humans only 7 caused cancer in mice and rats. Indeed one cancer researcher has stated that "...the lifetime feeding study in mice and rats appears to have less than a 50% probability of finding known human carcinogens... we would have been better off to toss a coin." Artificially induced tumors differ from naturally occurring human tumors. One scientist has stated in a leading cancer journal, "It is in fact hard to find a single, common solid neoplasm [cancer] where management and expectation of cure has been markedly affected by animal research. Most human cancers differ from the artificially produced animal model...." Dr. Sabin, developer of the polio vaccine, stated: "The cancer research bodies cause pain and suffering to hundreds of thousands of animal every year by inducing in the animals, by chemical or by irradiation, large cancerous growths in their bodies and in their limbs. Giving cancer to laboratory animals has not and will not help us to understand the disease or to treat those persons suffering from it." According to Dr. J.C. Bailar III, the chief administrator of the War on Cancer during the Nixon administration, "Age-adjusted mortality rates (from cancer) have shown a slow and steady increase over several decades and there is no evidence of a recent downward trend." One illustration of the futility of animal research for curing cancer is that between 1970 and 1985 over half a million compounds were tested for anti-cancer properties on animals. Only twenty-four proved to have any anti-cancer activity. Of the twenty-four, twelve went on to have a substantial role in chemotherapy. All twelve of these were analogues or chemical variations of known chemotherapeutic agents. In other words, the fact that these chemicals could be used to fight cancer had already been predicted by their chemical structure. Nothing new was learned from the 15 years of study and billions of dollars. Dr. Irwin Bross in testimony in 1981 before the US Congress stated, "the discovery of chemotherapeutic agents for the treatment of human cancer is widely heralded as a triumph due to the use of animal models. There is little, if any, factual evidence that would support these claims. Indeed, while conflicting animal results have often delayed and hampered advances in the war on cancer, they have never produced a single substantial advance in either the prevention or treatment of human cancer." The American Cancer Society's' former president, Marvin Pollard has stated "We have relied too heavily on animal testing, and we believe it too strongly. Now, I think we are commencing to realize that what goes on in an animal may not necessarily be applicable to humans." The Linus Pauling Institute has been using them since at least 1985. John Leavitt of the Institute stated, "The Pauling Institute decided to explore the mechanism of carcinogenesis with an emphasis on human cells rather than on the cells of animals. Only recently have we begun to realize the significance of this intuitive premise that human cancer, while fundamentally the same as rodent cancer, may have critical mechanistic differences which may in turn require different, uniquely human approaches to cancer eradication." The real progress in cancer research has come through studying populations of people and linking lifestyle to disease. This branch of science is called epidemiology. Through population studies the link between smoking and lung cancer was confirmed. Animal experiments were notorious for failing to demonstrate this link. The tobacco industry used this to their advantage for years claiming that smoking did not cause lung cancer. One researcher stated in a leading medical journal in 1957 that, "The failure of many investigators to induce experimental cancers, except in a handful of cases, during fifty years of trying, casts serious doubt on the validity of the cigarette-lung cancer theory." This statement was made despite the fact that 27 studies on humans had been done establishing the link between smoking and cancer. Smoking related cancer is still difficult to reproduce in lab animals. In 1988 writing in the book Perspectives in Basic and Applied Toxicology Dr. Utidjian stated, "Surely not even the most zealous toxicologist would deny that epidemiology, and epidemiology alone, has indicted and incriminated the cigarette as a potent carcinogenic agent, or would claim that experimental animal toxicology could ever have done the job with the same definition." Epidemiology has linked a high fat diet (the typical American diet) with many cancers. In vitro research and epidemiology have led to the knowledge to prevent and the few cures available for cancer. Educating the public about the risk factors including fat, smoking and alcohol would do far more to decrease cancer deaths than animal research, which so far has done nothing but consume our resources. _______________________________________________________________________ Do Animals Feel Pain? The philosopher, Descartes thought that animals did not feel pain and that attitude has prevailed throughout the ensuing decades. Today we know that all vertebrates, animals with a backbone, have the same nerves that humans have. In other words, they feel pain. While this may seem like a silly statement to anyone who has ever stepped on a cat's tail or accidentally tripped over their dog, many people actually believe animals are like clocks, without feeling. When you stump your toe on the bedpost, certain nerves in your toe are stimulated. These nerves are called nocioceptors. That is a big word meaning nerves that feel pain. These nerves go to the spinal cord and on up to the brain where you experience the sensation of pain. It is of course, much more complicated than that. Many chemicals are released both at the site of injury and in the nerves. But the general anatomy and physiology of all vertebrated is essentially the same with regards to how vertebrates feel pain. There are differences too. Notice how some people experience pain with some things that others do not. The amount and type of chemicals in the body influence this. No two people are exactly the same and no two animals are exactly the same either. Just because you do not experience pain exactly like your best friend does not mean that one of you does not feel pain. You both do, only differently. The same is true of animals. Animal experimentation is very painful. Consider the following. An animal is placed in a highly artificial environment. Rats are crammed into cages, dogs are not allowed to socialize or exercise, and cats are frequently not allowed to groom. In addition to being separated from their mothers and family they do not live, what is for them a normal life. The laboratory is very stressful. Animals can sense death and their compatriots are dying all around them. The actual experiments are really torture. Did you know that scientists are not required to anesthetize the animals prior to operating on them? If they think the results of the experiment will be effected by the anesthesia, then they simply do not have to give anesthesia to the animal. Animals are paralyzed with drugs while being fully conscious. That is like being wide awake but unable to move, blink your eyes or breathe. Can you imagine the horror? Animal are cut open, have wires placed in their brains, are shocked and have acid poured on them, all without anesthesia. Do you think that is right?Animals experience pain and have interests just like us. What gives us the right to torture them? ________________________________________________________________________ AIDS Research with Animals According to some researchers, "The course of AIDS in primates is virtually identical to that of humans."(Bertha Madras of the New England Regional Primate Center in testimony before The House of Representatives Appropriations Subcommittee on Labor, Health and Human Services, Education and Related Agencies. Washington DC, US Government Printing Office, 1990, p1481-1489) But is this true? AIDS is one of the most frightening and deadly illnesses of modern time. Millions have died and millions more will die. What have the animal models of AIDS contributed to our knowledge and treatment of this devastating disease? Epidemiological research and in vitro research led to the discovery of the virus and the mode of transmission. Mary Guinan of the CDC first stated that the new disease must be transmitted via blood or other bodily fluids. Drs. Montagnier and Gallo both conducted in vitro research to isolate the virus. AZT, one of the first medications used to treat AIDS was originally an anti-cancer drug. The efficacy of AZT was first demonstrated in 1985 using test tube research. It went directly to clinical trials without going through the usual animal tests. One reason for this was that it was so well known from it's use in cancer. AZT, 3TC, protease inhibitors, ddI, ddC, d4T, Indinavir, Ritonavir, Saquinavir, Nevirapine and hydroxyurea were all developed from in vitro or test tube methods. In some instances, the scientists were studying white blood cells and had an idea for another type of attack against AIDS. Scientists without a vested interest in animal experimentation have stated, "that there is no predictive animal model for HIV infection in humans. Cell cultures offered the first treatment and the recent advances such as combination drug therapy were derived clinically. Test tube research and human epidemiological studies have been responsible for the great breakthroughs in AIDS so far. In 1988, scientists stated, "To date, adequate animal models have not been developed for HIV-related research. An appropriate model is one in which the animal can be infected with HIV and can develop diseases similar to that produced by HIV infection in humans. Difficulties with animal models persist. Chimpanzees for example, can be infected with HIV, but, to date, have not developed AIDS.The lack of appropriate animal models for HIV research makes the application of animal research to humans uncertain." (Presidential Commission: Report of the Presidential Commission on the human immunodeficiency virus epidemic. Washington DC, Government Printing Office, 1988, pp39-47) Many other scientists have acknowledged the fact that animals do not suffer from AIDS -like illnesses the same way humans do. Despite this knowledge primates and other animals have been experimented on at great cost to the taxpayer. The results have been disappointing at best. The strain of HIV used to try and infect chimps is different from the naturally occurring virus. This has resulted in researchers thinking advances had been made on numerous occasions, when in fact the results were not applicable to humans. For example, researchers thought HIV was slowly progressive with long latency periods. In humans however, it progressed rapidly with short latency periods. The journal Science stated,"a molecular clone of the prototype SAIDS virushas no notable similarity in either genetic organization or sequence to the human AIDS retrovirus." And this, also from the journal Science,"[Drs.] Tsai and Sarver are quick to point out, however, that there is a big leap from monkeys to humans: For starters, HIV-1, the main AIDS virus that infects humans, differs significantly from SIV, the simian relative that was used in the tests." Researchers can study SAIDS, but it is not like AIDS. They can study monkeys infected with HIV but the monkeys do not respond the way humans respond. Another difference is the way the disease is transmitted from mother to infant. In humans, the disease is transmitted in-utero. SIV (simian immunodeficiency virus) in rhesus monkeys can be passed in breast milk but not in-utero. Another reason that animal experiments don't offer hope for HIV infected patients is that HIV differs from SIV at the very important hypervariable region. This is an area of the actual molecule of the virus. It is difficult to use the monkey as a vaccine model since monkeys do not produce antibodies against the V-3 loop portion of a glycoprotein on the outer covering, humans do. Granted, perhaps animals can be vaccinated against immunodeficiency viruses, but that does not mean the vaccine will be anything like what is needed for HIV. We know we can vaccinate against viruses. As of this writing, probably the biggest news item related to the treatment of AIDS is the failed baboon bone marrow transplant on patient Jeff Getty. Why was this operation performed? Are there any risks to the patient or community with this type of procedure? Why was this procedure performed? The FDA conducted hearings on whether or not to approve the procedure. The committee however was composed of voting members, some of whom also had a vested interest either in the procedure or in xenotransplants. The thought of transplanting a baboons bone marrow into a human filled many infectious disease experts with fear. Dr. John Coffin stated that, "infection is a virtually inevitable consequence" of xenotransplantation. He added that, "this is a very serious worry because the animals that have been chosen for doing this, the baboon and pig, are both known to carry endogenous viruses, replication competent, but very poorly studied, that are capable of infecting human cells." Dr. Louisa Chapman of the CDC was at the hearing and explained at length that there was great danger involved in the procedure. She described previous examples of non-human viral diseases being transmitted from primates to humans. She stated, "baboon endogenous retroviral proviral DNA can be detected in tissues of all baboon species, as well as those of many other monkeys." These "retroviruses may have pathogenic potential under conditions associated with xenotransplantation." She compared this to the, "periodic emergence of new pandemic influenza strains," which is thought "to occur by a process of re-assortment between human and animal influenza viruses." In other words, one of the viruses in the baboon hitherto unknown to humans may mutate in a human recipient and become the next AIDS or Ebola. Outbreak the movie may be Outbreak the reality. Indeed some scientists believe that the first case of HIV occurred secondary to a contaminated polio vaccine. Vaccines were, and to a lesser extent, still are sometimes made with animal products. There are reported cases of death and sickness secondary to the vaccine being contaminated with animal infections. Whether or not HIV did in fact originate with a contaminated polio vaccine is irrelevant at this point in time. What is relevant is the fact that scientists acknowledge that it is possible that HIV could have entered the human species that way. Even scientists at the University of Pittsburgh had reservations about the procedure. Dr. Marion Michaels stated before the FDA committee, "the donor organ, the tissue or the accompanying hematopoietic cells can also be a source of infection. Most often these infections are latent organisms and are often clinically silent in the donor." The most outspoken critic may be Dr. Jonathan Allen from the institution which supplies the baboons. As an expert on primate viruses he stated that, " any agent or pathogen that a baboon may harbor is also going to be more likely to be transmitted to humans." He is concerned that the same type of mutations that Dr. Chapman warned the committee about. He went on to state that it is, "well established that most new emerging human infectious diseases have their origins in other species." He also explained to the committee that a new virus may not be detectable by current means. The safety issue involved in xenotransplantation does not end with the patient. According to these scientists, and others, the entire population may be at risk. Is the benefit worth the risk? Dr. Allen concluded that,"to proceed with this kind of procedure in the face of knowing how AIDS is transmitted, is to repeat the past because none of the types of screening processes, none of the registries, none of the archiving of samples, none of the surveillance, none of that would pick-up on an AIDS like virus. If you proceed with this, you need to understand there is going to be a risk that you are not going to eliminate the risk of transmitting another virus that could be as deadly as the AIDS virus." These experiments "constitute a threat to the general public health and not merely a complication of the risk/benefit calculation for the individual xenogenic tissue recipientDo not use non-human primates as organ donors if you don't want to infect the human population." So why did the FDA approve the procedure? In addition to having voting members who had vested interests in the field, one member of the committee admitted that,"We were heavily influenced by emotional pleas on the part of the family of the recipient."The risk to other humans from xenotransplantation is real. Many scientists and physicians have stated that xenotransplants are not in the best interest of the public and have encouraged caution in dealing with this potentially catastrophic situation. Perhaps the most ironic aspect of the xenotransplantation and AIDS is the fact that some scientists believe that AIDS originally crossed the species barrier and mutated as a result of using monkey tissue in the development of the polio vaccine. ______________________________________________________________________ Heart Disease The leading cause of death in the USA is heart disease. Roughly, one third of patients do not survive their first heart attack. We are all aware of the risk hypercholesterolemia (high cholesterol) has for coronary artery disease (CAD). Other risk factors include hypertension, cigarette smoking, diabetes, a family history of the disease, lack of exercise, obesity and stress. The risk between CAD and cholesterol levels was determined by clinical studies, not animal research. In fact, coronary artery disease has been quite difficult to induce in laboratory animals. All of the risk factors listed were determined from human research not animal experiments. Indeed, epidemiology and in vitro research have been the only way to study heart disease since scientists have not been able to reproduce CAD in animals. Rabbits have been studied for CAD but there are major differences between the way the humans and rabbits manifest the disease. First and most importantly, rabbits don't suffer from CAD naturally. In order to study CAD in rabbits, researchers must artificially induce the disease in the rabbit. They can make the arteries to the heart clog, but again not like humans. The clogs, or plaques, in humans tend to break off. Hence heart attacks. Heart attacks can also be caused by frank obstruction of blood flow. The plaques that researchers induce in rabbits do not ulcerate and break off like they do in humans. Rabbits also differ in their response to diet. Rabbits with induced diabetes that are fed a high cholesterol diet, develop less CAD. As everyone knows, a human patient with diabetes who eats a high cholesterol diet is increasing his risk of CAD. No animal model reproduces the CAD in humans. Baboons, a favorite of researchers, have CAD induced over a course of hours, not years as in humans. The vessels which the researchers are trying to induce disease in, are normal. In humans, CAD is not just an isolated clog. The entire vessel is diseased. Some scientists are now suggesting it is actually the vessel which causes CAD, in addition to the fat content of the blood. The human clog is composed of blood, fat, and other substances. The baboon clog is only blood. There are profound differences between what blood does to the artery and what an actual plaque does. Rats are not suitable models secondary to the fact that rats metabolize fats differently from humans. A high fat content in the diet leads to higher cholesterol levels in humans and thus a higher risk of CAD. This difference has led researchers to state, "the rat is not an appropriate human model for studies involving lipids." (Nutrition and Cancer, 1983;4(4):285-291) Other scientists have stated, "It is not possible to extrapolate directly from rat to human studies because of differences in plasma lipoprotein [cholesterol and triglycerides] metabolism between the species." The great apes have also been unsuccessfully used to study CAD. In 1963, scientists stated, "The indications of current research findings that this [atherosclerosis] may be essentially a nutritional disease raise questions that cannot be satisfactorily answered in the laboratory. In fact, atherosclerosis is one of several areas in which research has reached the practical limits of laboratory investigation with the present state of our knowledge and techniques. The road to further progress now seems to lie in large-scale and long-range epidemiological studies utilizing large population groups as the basic unit of study." (Shannon JA. Testimony before the Department of Labor and Health, Education , and Welfare Appropriations, Subcommittee of the Committee on Appropriations, United States Senate, Eighty-sixth Congress, First Session. Washington. United States Government Printing Office, 1959, p609) And indeed that is what happened. The Framingham and other epidemiological studies have provided us with more information about CAD than any other modality. The ability to diagnose heart disease has been improved by the use of radionulide imaging of the heart and stress testing of the heart. Patients frequently undergo a "stress test" in order to evaluate how the blood flow to heart is compromised in the face of CAD. By exercising and demanding that more blood go to the heart, the lesions can be better visualized and more information can be gained regarding prognosis. Various techniques have been developed in order to look into the arteries of the heart. These tests can be used prior to sending a patient to surgery in order to ascertain if the patient is at high risk for a heart attack during surgery. They are frequently used in order to diagnose heart disease or quantify how bad the disease is, in order to properly medicate the patient. Other uses include measuring the degree of damage after a heart attack, assessing the quality of the left ventricle, or monitoring for damage that certain chemotherapeutic medications may cause to the heart. If a patient is unable to walk on the treadmill, other options are available. He or she may ride a stationary bicycle, or utilize a hand squeezing devise. If unable to do this, certain medications may be given which will cause the heart to beat faster and need more oxygen thus increasing blood flow. Adenosine, dipyridamole, and other medications are often used for this purpose. The use of radionuclides, such as thallium can be used with or without the stress portion of the test. The radionuclides provide the "film" for taking a picture of the process. The thallium will look different depending on the disease state. Certain "high tech" machines are used to "photograph" the thallium and hence interpret the "picture". PET scans, CAT scans and other devices are also used to evaluate the heart in a similar fashion. A common method of evaluating ventricular function is with a multiple gated acquisition analysis (MUGA). This technique allows excellent evaluation of how well the heart is pumping blood, and does not involve catheterizatio or other invasive procedures. These techniques rely on technology, not animal research. Another great step in the diagnosis and treatment of heart conditions is Transesophageal Echocardiography (TEE). Echocardiography has been used for years and again was a discovery based on other than animal research. But the technique was marred by the fact that the cardiologist could not visualize the certain pats of the heart well. Also the entire image was sub-optimal secondary to the transducer being separated from the heart by skin, tissue and bone. With the advent of catheters used for colonoscopy and esophagealgastroduodenoscopies (EGD) and the advent of computer chip technology, cardiologists are now able to place the TEE into a patients esophagus and visualize the heart better than ever before. There is less distance for the sound wave to travel and therefore much less interference. TEE is used for many patients both in and out of the operating room. _______________________________________________________________________ Cardiovascular Disease High blood pressure or hypertension (HTN) affects approximately 50 million Americans. Approximately 30% of black people and 20% of white individuals over the age of 18 years, living in the US, suffer from HTN. As the population ages, HTN becomes more prevalent. Untreated HTN can lead to stroke, CAD, kidney failure, eye damage and death. Over the past twenty years more and better means of detecting HTN have resulted in a decrease in CAD and other complications of the disease. Clinical studies first led researchers to conclude that treating HTN would decrease the incidence of stroke and MI. HTN can be controlled, prevented or at least influenced by diet, cessation of smoking, cessation of drinking alcoholic beverages, and exercise. The influence of salt on blood pressure was learned from epidemiological research in Great Britain. Restricting salt in the diet has let many Americans do away with medications or at least take less. As Sassard states: "The fact that there are so many models for hypertension and atherosclerosis indicates that none of them is completely satisfactoryIdentical observations can be made for the other severe cardiovascular pathologies: coronary ischemia, cerebral ischemia, cardiac insufficiency and rhythm disorders." The treatment for high blood pressure today consists of, among other things, lifestyle changes and medications. Beta blockers are a type of medication taken by many people to treat HTN, dysrhythmias, headaches and other illnesses. Side effects of beta blockers include heart failure, bronchospasm, fatigue and others. Note what Drs. said about the side effects in 1984, "Unwanted effects such as bradycardia, hypertension, heart failure, bronchial spasm, cold extremities and easy fatiguability are attributable to known actions of beta antagonists. With the exception of bradycardia, none of these was predicted from the initial animal studies." Interestingly, one of the first treatments for hypertension was a salt restricted diet and rest. Dr. Kempner, in 1944 advised a high fiber, low salt diet for his patients suffering from HTN. It worked. Imagine that! Modify your diet and lifestyle and maybe you will be healthier. In describing how the anti-hypertensive class of medications was developed, Ray Gifford MD, a major contributor to knowledge in the field states, "We had no protocols, no informed signed consents, no statistical consultation. We just gave the drugs in any combination we thought would reduce blood pressure and minimize side effects." Dr. Gifford goes on to state,"I can't help but wonder how long it would take to get hydralazine or chlorothiazide on the market today?" Although people who earn their living by experimenting on animals will try to convince you that all medical knowledge has been obtained via calculated experiments on animals in a controlled laboratory environment, this example is more in keeping with how actual discoveries take place. There are many more such examples of where medical knowledge actually came from. More than the respected medical researchers of today would like you to know. The development of the anti-hypertensive medications was not only not dependent upon animals, it would have been impossible to use animals. Note what Dr. Gross states in the textbook The Scientific Basis of Official Regulation of Drug Research and Development, "The anti-hypertensive effect of diuretics does not occur in normotensive animals and is difficult to obtain in hypertensive rats or dogs. Similar problems have to be faced with respect to the antihypertensive action of beta-adrenoreceptor blocking drugs. The beneficial effect of phentolamine, of prazosin, or of hydralazine in the treatment of heart failure is hardly demonstrable in experimental animal models. The predictive value of the results of numerous preclinical [animal] tests or experimental models for the therapeutic uselessness of a drug is at best uncertain, and the predictability will not be improved by simply increasing the number of tests. One of the most widely studied examples of a disease model is experimental hypertension, but for the development of new drugs for the treatment of high blood pressure the various types of experimental hypertension are dispensable tools" Stroke is the third leading cause of death in the USA. Most victims of stroke live with the residual of the devastating attack. Paralysis, loss of the understanding of speech, the inability to speak, inability to walk or feel sensations, loss of memory and other terrible effects are frequently the sequellae of stroke. Many animal experiments have been conducted in order to elucidate knowledge which would lead to stoke prevention or diminish the sequellae of stroke. HTN is a known cause of stroke. As with other causes of stroke such as high cholesterol and smoking, HTN was discovered to be a risk factor by epidemiological studies. With early detection and proper medication, stroke can be prevented in this population. Another factor leading to stroke is atherosclerotic plaque deposited in the carotid arteries. This plaque can break loose and go into the circulation of the brain, occluding blood flow and causing a stroke. The ability to visualize the plaques is aided by injecting dye into the arteries. This is called angiography. It was invented based on clinical research. No lab animal has cerebral blood supply comparable to man's. Most animals have greater cerebral circulatory reserve. These differences profoundly affect the implications of any research findings. Dr. Whisnant stated in 1958 that, "For the most part, these studies have tended to lag behind clinical and pathologic-anatomic investigation and too frequently have served as confirmatory work after clinical impressions have been virtually accepted". It is obvious at the outset, that investigations with laboratory animals can not be directly related to human disease. No experimental animal has an entirely comparable cerebrovascular supply to that of man" Dr. Neff of New England Medical Center stated in 1989 in Stroke, "The repeated failures of laboratory proven stroke therapies in humans can be due only to the inapplicability of animal models to human cerebral vascular disease." Between 1978 and 1988, 25 drugs were shown to be effective in treating stroke in animals. None of these worked in humans. Along the same line, 22 drugs have been tested on animals and shown to be therapeutic in spinal cord injury. Again, none worked in humans. Dr. Wiebers, of the Mayo clinic, has summarized the contribution of animal research to knowledge of stroke as follows: "A large proportion of patients with ischemic stroke have underlying multi-focal atherosclerosis which has developed over may years or decades. Such individuals may have numerous associated risk factors which predispose to this disease processSome attempts have been made to model atherosclerosis in some animal species and to account for hypertension and increasing age, but it is clear that these circumstances do not reproduce the human situation. In fact, most models of ischemic stroke are derived from young animals with no underlying chronic disease or any genetic predisposition to such diseases. Many variations, both within and between species, have been recognized not only in the vascular anatomy, but also in histopathologic response to identical ischemic insults and treatment responses to cerebral schema. While the use of these experimental [animal] models has provided much information about the methods of producing and potentially treating cerebral schema and infarction in specific animal species and experimental circumstances, the relevance of most of these data to human conditions remains dubiousalthough animal models of cerebral schema have been used extensively to test new therapies in human stroke, their record for identifying clinically effective drugs has been disappointing "Among those [25] compounds subjected to clinical trials, none has proven efficacious, nor have any of these agents come into general clinical use. "Ultimately, however, the answers to many of our questions regarding the underlying pathophysiology and treatment of stroke do not lie with continued attempts to model the human situation more perfectly in animals, but rather with the development of techniques to enable the study of more basic metabolism, pathophysiology, and anatomical imaging detail in living humans." _______________________________________________________________________ Childhood Diseases Nothing tugs at our heart strings like a sick child. When pressed to produce facts regarding how animal research has enhanced our lives, researchers will frequently speak of a sick child whose life was saved as a result of animal research. The focus of the explanation will be the emotional appeal of a sick child instead of actually relating facts about the research. Tearful parents will be asked to share their opinion of animal research. The almighty doctor who has just saved their child has told them that the knowledge gained from research on animals was used to save the child. In this emotional setting, we the viewer are confronted by individuals much like ourselves, who assure us that animal research is productive and necessary. What would any of us say in the same situation? The same thing, of course. So what we are actually witnessing is the parents being callously manipulated by the medical establishment. The distraught parents are only repeating what their doctors have assured them is true. What we do not witness or know, is what interest the doctor has in animal research. Does she or he work for a university heavily funded by the NIH funding research on animals? Has she or he ever taken a critical look at animal research to see if what he was taught was true? Or has she or he just repeated the age old line that all the great medical advances have come from research on animals, and in fact knows no better? Physicians are trained to be just that, physicians. They are not trained to be medical historians. Most are told that animal experiments made possible the treatments they administer and never give it another thought. Working 20 hours per day during internship and residency does not lend itself to critically evaluating the system. The physicians and parents and patients who give testimonials to animal research are not bad people, merely misinformed. Please don't misunderstand, there are people who are paid to mislead the public: spokespersons for the tobacco industry, spokespersons for the animal research industry, and those who pay their mortgage from the grant money for animal experiments. But most physicians do not have a vested interest and simply have never critically evaluated the situation. Why should they? The Foundation for Biomedical Research has produced a video entitled HOPE, which accounts the scenarios of numerous children saved as a result of research on animals. It also portrays the death of one child whose life could have been saved with more animal research. Concepts which rely on emotional appeal instead of fact should raise suspicion in our minds. If the facts of the case are so persuasive and overwhelming, why do they avoid facts, speak in sweeping generalities, and assure us that the only way to save babies is through research on animals? What has animal research done for sick children? Where have the advances come from? Must we choose between children and animals or must the researcher choose between what is expedient and what actually works? _______________________________________________________________________ Birth Defects Nelsons Textbook of Pediatrics states, "Much of our knowledge of fetal physiology has been obtained from animals and often is not directly applicable to man." Birth defects continue to rise despite billions of dollars in funding, both public and private. One cause of birth defects is medications. Animals have been used for years to study medications and birth defects. But do they accurately predict birth defects? Karnofsky's Law states any medication or substance can be teratogenic (cause birth defects) if given to the right species, at the right time in development, in the right dose. Therefore, any medication can cause birth defects in some creature. In 1963 the Lancet had the following statement: "In fact, the pitfall is that, having found no teratogenic effect in a `sufficient number of different species of laboratory animals', one can still not be sure of the effects on the human fetus, which is always the ultimate purpose of investigation." No where is this more evident than in the Physicians Desk Reference (PDR). The PDR is now an ubiquitous book both for the health professional and the lay public. Have you ever looked in it to see if a medication was safe to use in pregnancy? The answer is usually: "Reproduction studies have been performed in rats, rabbits and mice at doses up to six times the human dose and have revealed no evidence of impaired fertility or harm to fetus due to the drug. There are, however, no adequate and well controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, the drug should not be used during pregnancy unless clearly needed." (1993 PDR) Read through the PDR and see how many times this answer or a similar one is written concerning a medication. Animal tests do not provide answer. One example of this is the medication aspirin. Aspirin is safe for pregnant women but causes birth defects in guinea pigs, monkeys, rats, cats, dogs, and mice. Streptomycin, insulin and penicillin are also safe in pregnant women while causing birth defects in animals. In 1978, Dr. Ralph Heywood stated, "There is fundamental lack of knowledge of pathogenesis of most malformations and, therefore extrapolation to man has to be done with reservation and care. Negative results cannot be used to predict that an agent will lack teratogenic effect in manSurprisingly few compounds have been shown to be teratogenic in man although a large number, including aspirin, steroids, vitamin A and B, insulin and hydantoin, have been shown teratogenic in rats." In 1984, Dr. Lasagna stated, "False positives and false negatives abound. Once one has established that a drug is a teratogen for man, it is usually possible to find, retrospectively, a suitable model. By trying to predict human toxicity - which is after all what the screening game is all about - is quite another matter. Cortisone is a potent dysmorphogen in the rabbit and mouse, but does not produce malformations in the rat. Carbutamide produces malformations in the eyes of rats and mice, but facial and visceral malformations in rabbits." The best example of this may be studies published in 1992. The FDA and Council on Environmental Quality collected information yielding the following: Predicting teratogenicity is best accomplished in the following animal models: the mouse model was correct 85% of the time, followed by the rat, 80%, rabbit 60%, hamster 45% and monkey 30%. Sounds reasonable right? Unfortunately, when the same methods were used to predict substances which do not cause birth defects the list basically reversed itself: Mice and hamsters correctly predicted the results 35% of the time, rats 50%, rabbits 70%, and monkeys 80%. When you average the chance of predicting a teratogenic agent with the chance of predicting a non teratogenic agent, the odds are about 50/50 with every species. Flipping a coin will give a 50/50 chance. It does not cost any money to flip a coin. Scientists have recognized this for years. In 1980, Dr. Yaffe stated: "Experiments with animals have yielded considerable information concerning the teratogenic effects of drugs. Unfortunately, these experimental findings can not be extrapolated from species to species or even from strain to strain within the same species, much less from animals to humans." Birth defects affect 150,000 babies per year. The medical cost of caring for children with birth defects is over $1,000,000,000.00 annually. The CDC conducted a study between 1979 and 1989. They followed 38 birth defects. During this time period, 27 of the birth defects actually increased in the US population. 9 did not change and only 2 decreased in incidence. So what are scientists doing in order to curb this trend? The March of Dimes (MOD) has donated over $2.5 million dollars for the following: Scientists wanted to study the effects of cocaine on the learning of babies exposed to cocaine. Instead of studying human babies who are unfortunately born to mothers who consume cocaine, they decided to study pregnant rats. Scientists have unfortunately too much data on this type of thing. But the MOD decided to fund this project anyway. The scientists found that maternal cocaine exposure influenced the learning of female rats but not male rats. Interestingly another study found male rats affected and not females. So much for studying learning in rats. The effects of cocaine are well documented in human babies. It is a totally preventable birth defect. As taxpayers we are often told that our only choice is the life of a lab animal or the life of a child. In fact our choice is good science or bad science. In the words of Dr. Anderson, "It needs to be recognized that, as well as a personal tragedy for the families concerned, congenital abnormalities now present a major public health problem. Evidence of an effect in rats is not also evidence of an effect in humans." One common sense approach to prescribing medications to a pregnant patient would be to give the drug only if absolutely necessary. Although this is some what counter to our `take a pill' mentality, it would save many babies from potentially dangerous medications. In the book, Monitoring for Drug safety, Dr. Smithells states: "In the absence of useful tests for teratogenicity clinicians have to accept the responsibility for drug exposure in early pregnancy if clinicians were more aware of the shortcomings of animal teratogenicity testing they might take this responsibility more seriously." Dr. Smithells continues, "The extensive animal reproductive studies to which all new drugs are now subjected are more in the nature of public relations exercise than a serious contribution to drug safety." And Dr. Hawkins, professor of Obstetrics, states, "The great majority of perinatal toxicological studies seems to be intended to convey medico-legal protection to the pharmaceutical houses and political protection to the official regulatory bodies, rather than produce information that might be of value in human therapeutics." Dr. George Lin wrote in the journal In Vitro Toxicology, "there is no ideal animal model to extrapolate teratogenicity results to human exposure because of species sensitivity and species difference." 1.3 million mothers receive inadequate pre-natal care each year. Almost all, if not all, chemicals which cause birth defects were shown to do so secondary to human epidemiology studies. The effects of thalidomide, Fetal Alcohol Syndrome, fetal hydantoin syndrome, the effects of DES, the effects of mercury, spina bifida and folic acid deficiency, fetal rubella syndrome, and others were all identified with epidemiological studies, not animal experiments. The connection between maternal rubella and birth defects was found by epidemiological studies in Australia in 1941. Cataracts in newborns were found to increase in incidence after a rubella outbreak. The effect of radiation on the fetus was discovered by epidemiological studies between 1958 and 1962. The cancer causing effect of radiation to the fetus may have gone undetected in animal studies. The risk of too much oxygen in premature babies was discovered through epidemiological studies. The risk of retinopathy of prematurity, which causes blindness in newborns, can be diminished by giving only as little oxygen as possible for as short period of time as possible to premature babies. This does not always prevent blindness but it does lessen the chances of developing it.