Tales of discovery, obfuscation, error, and improvement

Asked to describe medical journals to somebody unfamiliar with them, you probably wouldn't say that they are full of stories. But they are, as this issue shows.

The first story tells of attempts to improve the treatment of people with arthritis, but, as with most good stories, there is a subplot that hints at wickedness. Non-steroidal anti-inflammatory drugs (NSAIDs) have long been used to treat the inflammation of arthritis (p 1289). They do this by inhibiting an enzyme called cyclo-oxygenase that is needed for the production of prostaglandins. Unfortunately the same process operates in the stomach and causes harm. Then it was discovered …