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Black, Sir James (Whyte)

stomach beta control ulcers

(1924–) British pharmacologist: designer of novel drugs.

A graduate in medicine from St Andrews, Black was a university lecturer there, in Malaya and in Glasgow before working in pharmacology first with ICI, and later with Smith, Kline & French and with Wellcome. At the time of his Nobel Prize in 1988 he had been professor of analytical pharmacology at King’s College Hospital Medical School, London, from 1984.

He is best known for two major contributions to medicine. His work on beta-blockers was based on the theory that heart muscle has specific beta-receptors that respond to hormonal control; Black reasoned that if these sites could be blocked, the effect of the hormones on the heart would be inhibited and its workload reduced; and he was able to find a very satisfactory antagonist, propranolol, in 1964. Since then such beta-blockers have been much used to control heart disease and hypertension. He went on to devise a comparatively rational approach to the control of stomach ulcers; he deduced in 1972 that a particular type of histamine receptor is located on the wall of the gut and stimulates acid secretion in the stomach, and then found a compound (cimetidine) that blocked the action of these H2 receptors, so curbing stomach acidity and allowing healing. Black’s successes much encouraged a rational approach in medicinal chemistry, as well as having provided drugs of value in two major areas.

Stomach (or peptic) ulcer patients treated with cimetidine may find their ulcers recur. Happily, the young Australian physician Barry Marshall (1952– ) showed in 1983–4 that such ulcers are often due to infection by a bacterium, Helicobacter pylori . It had been assumed that bacteria could not survive the very acid conditions in the stomach: Marshall took H. pylori cultured from a sample of a patient’s stomach contents, and showed that they flourished (they burrow into the mucosa of the stomach lining). Antibiotics readily eliminate the bacteria and in most patients the cure is permanent.

Black, Hitchings and Gertrude Elion shared a Nobel Prize in 1988.

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