TO father one life-changing drug is admirable, but to develop two is truly remarkable. Such an achievement can be credited to Scottish-born doctor and pharmacologist James Black, who was awarded the Nobel Prize for Medicine in 1988. This was in recognition of his work leading to the development of two of the world’s biggest selling prescription drugs, propranolol and cimetidine.
Propranolol has been hailed as the greatest breakthrough in heart disease treatments since the 18th century discovery of digitalis, while stomach ulcer drug cimetidine was the first of a new class of drugs – the H2-receptor antagonists.
When Black began his research in the 1950s the idea that drugs could be designed to change biochemical processes on cell receptors was new. Propranolol, a beta blocker, interrupts the action of the stress hormone adrenalin and relieves angina, while cimetidine, launched under the brand name Tagamet, prevents excess acid secretion in the stomach.
Black was born in Uddingston, Lanarkshire, but grew up in Fife where his father worked as a coal mining engineer. After school at Beath High, he won a scholarship to read medicine at St Andrews and Dundee. His elder brother was a doctor but that career seemed dull to James’ restless, enquiring mind. Instead he turned to physiology to address such questions as the effect on blood pressure from substances absorbed through the gut. He only stayed a year in the department of RC Garry, choosing to work in Singapore at the University of Malaya to repay his student debt.
Returning to the UK in 1950 he soon secured work from William Weipers, director of the Veterinary School of Glasgow University. During the next eight years Black established a well-equipped physiology department where he carried out ground-breaking work on adrenalin. In 1948, Raymond Ahlquist in America had postulated that different alpha and beta receptors in smooth muscle were the sites where hormones such as adrenalin relaxed or contracted smooth muscle. Black saw that drugs could be developed to modulate the action of receptors. This was beyond the scope of a university department and prompted his move to ICI with whom he would make propranolol and prove that it blocked beta receptors. That done, he was eager to explore further the action of H2 receptors and search for an effective blocker of these histamine receptors in the gut wall. ICI were not interested but Smith, Kline & French gave him that opportunity and by 1972 cimetidine was created and, under the brand name Tagamet, was approved in the UK in 1976.
In 1973, Black was appointed professor of pharmacology at University College, London where he established a new undergraduate course in medicinal chemistry. However, he found that what he had gained in academic freedom he lost in applied science, so he gladly accepted an invitation to work at the Wellcome Laboratories as director of therapeutic research in 1978. His work in analytical pharmacology continued with a new generation of scientists. In 1984 he was made professor of a small academic research unit at King’s College London, again with funds from Wellcome, but independent of industrial control. Funding from Johnson & Johnson in 1988 of a James Black Foundation gave him the resources for laboratory research with a large staff of scientists.
Pharmacology has become an essential part of our brave new world. Propranolol remains popular today and has uses beyond the treatment of angina, particularly in the treatment of high blood pressure, as Black appreciated. Cimetidine has also been a worldwide commercial triumph. Both owe their existence to the clear thinking of James Black and both drugs significantly changed patients’ lives.
Black’s achievements were honoured by FRS in 1976, a knighthood in 1981, Order of Merit in 2000, but above all by Nobel Laureate in 1988 with Gertrude B Elion and George H Hitchings for “discoveries of important principles for drug treatment”. A very private man who did not seek out publicity, Black was said to be horrified to discover he had won the Nobel Prize.
His final career move was back to Scotland to be chancellor of the University of Dundee in 1992. The university awarded him two honorary degrees, the second of which was Doctor of Science in 2005. His happy connection with the University of Dundee was marked the following year with the launch of the £20 million Sir James Black Centre for the promotion of interdisciplinary research in the life sciences.
Black claimed that his most important influence as a schoolboy was a book by Victorian polymath D’Arcy Wentworth Thompson, On Growth and Form, about the chemistry of crystals. His time at St Andrews also broadened his outlook and enthusiasm for academic study that proved so satisfying, if not financially rewarding. Black met his first wife Hilary Vaughan at a university ball in 1944. They married in 1946 and had a daughter, Stephanie, five years later. Following Hilary’s death in 1986, Black remarried in 1994 to Professor Rona MacKie. He died aged 85 after a long illness and was hailed as “one of the great Scottish scientists of the 20th century”.
Julia Merrick is a freelance writer and editor in Edinburgh