An ounce of prevention, says grandma, is worth a pound of cure. Few people take her seriously. Unless we are singed by the fire before being snatched to safety, we are not likely to know that anything has been prevented; and mass prevention seems anonymous or impertinent and elicits no gratitude. We still like to have the doctor give us something in response to a complaint; and few doctors can restrain the compulsion to leave the patient with a prescription, although the best ones admit doubts, even dangers. Here in the age of science the patient's gratitude still overflows when relief or recovery follows the doctor's ministrations; yet most of us know the fallacy of post hoc. In medicine the age of bacteriology, when we began to understand disease and treat it rationally, gave way to the age of pharmacology although it isn't called by that name and we see something like a reversion to the prescientific custom in which there was a remedy for every symptom. Medical reports attempt to bypass clinical errors with tests of new drugs called "double blind" and even "reversed double blind" in which code marked drug and placebo are given without being identified by either giver or taker; and where possible the groups are then reversed to eliminate all prejudice. But we still tend to recover from disease without drugs and to die with them, possibly as often as the opposite. There are times, we have pretty good reason to believe, when it is the smile and the kind word, the simple act of concern of one human being for another the expression of love that is more therapeutic than anything the chemist can fabricate.

Nevertheless there are drugs that cure, and none do so more dramatically than the modern remedies for venereal disease. Possibly something associated with the very fragility of the microbes that dictates their venereal way of life, that makes them easy prey to harmful influences generally, also makes them the more susceptible to therapeutic drugs. But if that is true, you would hardly have believed it before Paul Ehrlich gave us "606" in 1910, or perhaps even before the modern age of sulfonamides and penicillin, which started only in 1935. Even today, after the first flush of therapeutic victory has begun to fade, we are beginning to think, again, that grandma was right. (see CURE AND CURABILITY PART II)