sexual feelings. Others argued for a role of “sperm
overload.” In 1983 and 1984, a newly discovered vi-
rus, eventually named human immunodeficiency vi-
rus (HIV), was shown by two independent laborato-
ries to be the etiological agent of AIDS. Tens of
thousands of persons in the United States, and larger
numbers worldwide, were infected by the end of the
decade, and one-third of these persons died. Victims
included prominent members of the entertainment
community such as Liberace and Rock Hudson.
Nevertheless, the administration of President Ron-
ald Reagan largely ignored the outbreak until it had
arguably spread out of control. By 1989, the first ef-
fective drug for treatment of AIDS, azidothymidine
(AZT), had been licensed by the Food and Drug Ad-
ministration (FDA). The closing of many of the
bathhouses linked to spread of the disease in larger
cities, as well as education of the homosexual com-
munities, served to slow the spread in this popula-
tion. However, the increase in numbers of intrave-
nous drug abusers more than offset any reduction in
numbers from the gay population.
From Prions to Lifestyle Diseases In 1982, Stanley
B. Prusiner, a neurologist at the University of Cali-
fornia, San Francisco, proposed that a “protein-
aceous infectious substance,” known as a prion, was
the etiological agent behind a neurodegenerative
disease in cattle and sheep called scrapie. The same
agent was also shown to be the cause of a number of
human diseases, most notably Creutzfeldt-Jakob dis-
ease (CJD). Ingestion of the scrapie agent in con-
taminated beef by large numbers of the British pop-
ulation during the latter half of the decade resulted
several years later in the diagnosis of more than one
hundred cases of CJD that developed in this popula-
tion. The illness became known as “mad cow dis-
ease,” reflecting its source. An unusual aspect of
prions was the lack of genetic material in their struc-
ture, one composed entirely of protein. Since all
forms of replicating biological agents were thought
at the time to contain either deoxyribonucleic acid
(DNA) or ribonucleic acid (RNA), Prusiner’s pro-
posal of a “replicating protein” was highly controver-
sial. He was proven correct and was awarded the No-
bel Prize in Physiology or Medicine in 1997.
Gastric ulcers were historically linked to effects
of lifestyle, particularly diet and stress. Treatments
generally consisted of stress therapy or the use of
acid inhibitors such as Zantac or antacids to neutral-
ize gastric acid. In 1983, Australian physician Barry
Marshall discovered that a bacterium,Helicobacter py-
lori, was associated with both ulcer formation and
(subsequently) certain forms of stomach cancer.
Marshall began prescribing antibiotics for treatment
of ulcers, noting a significant reduction in recidi-
vism of ulcers. Marshall would be awarded the Nobel
Prize in Physiology or Medicine in 2005.
The association between smoking and lung can-
cer, well known since the publication ofSmoking and
Healthby the office of the U.S. surgeon general in
1964, continued in the news. In 1982, Surgeon Gen-
eral C. Everett Koop referred to smoking as “the
chief preventable cause of death.” Lung cancer asso-
ciated with smoking killed more than 100,000 Amer-
icans that year, six times the level reported thirty
years earlier; deaths from lung cancer in women,
most of which were associated with smoking, passed
those resulting from breast cancer.Pharmaceuticals Antacids historically were based
upon neutralization of acids produced in the stom-
ach and generally consisted of forms of bicarbonate
salts. The exception was Tagamet, an antiulcer drug,
introduced by SmithKline in the 1970’s, that
blocked acid production. However, it often pro-
duced unwanted side effects. In 1981, Glaxo Phar-
maceuticals began the sale of Zantac, a drug similar
in action to Tagamet but with fewer side effects.
Within five years, the popularity of Zantac would
place it at the top of prescription drug sales. Zantac
was shown to be both safe and effective, and it would
eventually be sold over the counter.
Over-the-counter pain medication at the begin-
ning of the decade consisted primarily of aspirin and
acetaminophen (such as Tylenol). In 1983, ibupro-
fen, formerly available only through prescription,
became available over the counter. Ironically, Nobel
laureate Ulf von Euler, whose work contributed to
the development of acetaminophen, died in March
of that year at age seventy-eight. Extended use of as-
pirin and acetaminophen in high doses would later
be linked to liver damage, and long-term use of
ibuprofen in high doses was later shown to induce
ulcers.
Several anti-AIDS drugs were introduced during
the decade: isoprinosine and ammonium-tungsto-
antimoniate (HPA-23) in 1985 and AZT in 1987.
Only AZT would be shown to exhibit long-term effi-
cacy against AIDS. Other antibiotics directed against630 Medicine The Eighties in America