Historians often regard the latter part of the 19th century as a time of great "flowering" in the evolution of medicine. New insights in to how germs affect the human body, as well as advancements in microscopy, led scientists to discover the root causes for a multitude of infectious diseases. 

    Now medicine is on the threshold of a second renaissance, and the discoveries of this period may lead to a revolution in the treatment of everything from heart disease to cancer. The field is known as pharmaco-genetics and the mission is to design drugs that are targeted to a patient's genetic profile. Though still in its infancy, the field has made critical steps in the battle against some cancers, and show great potential for improving the overall effectiveness of all drugs. 

    歷史學(xué)家常把十九世紀(jì)后半段視為醫(yī)學(xué)演進(jìn)“百花齊放”的時代。有關(guān)細(xì)菌如何影響人體的新見解，以及顯微技術(shù)的進(jìn)展，都引領(lǐng)科學(xué)家找到多種感染性疾病的根源。 

    現(xiàn)在醫(yī)學(xué)又來到第二個復(fù)興的門檻，這一階段的種種發(fā)現(xiàn)可能帶動從心臟病到癌癥各種疾病治療方法的革新。這一個領(lǐng)域叫做藥物遺傳學(xué)，宗旨是依照病人的基因特質(zhì)設(shè)計藥物，雖然還在草創(chuàng)階段，但已經(jīng)在對抗一些癌癥方面有重要的進(jìn)展，并且在改進(jìn)所有藥物的整體療效上展現(xiàn)了很大的潛力。 

    Breaking the Mold  打破窠臼 

    Drug companies have an especially keen interest in personalized medicine. The current model of prescribing one big-name drug to millions upon millions of patients has proven ineffective, and sometimes deadly. 

    Drug-maker Merck and Co. knows the dangers of the blockbuster drug model all too well. One of their products-the painkiller Vioxx-was shown to increase the risk of blood clots in a very small number of patients. As a result, a jury recently returned a $253 million verdict against the company for the death of a patient who had been taking Vioxx. And this was only the first of many lawsuits.

    Right now, scientists know very little about how human genes are linked to drug side effects. Pharmacogenetics seeks to change all that. Someday all patients may undergogenetic screening. They can then be divided into different categories based on those test. Doctors will be able to take a genttic profile and immediately know which drugs are safe to prescribe, and which ones are not. Drugs won't be hand-crafted fro every patient, but rather prescribed to different populations determined by their genetic subsets.

    藥廠對個人化藥品的興趣特別濃厚。目前為數(shù)以百萬計的病人開出同一種名牌藥品處方的模式，已證實效果不彰，有時還會致病人于死地。

    默沙東藥廠對一體通用給與知名藥品模式的個中危險知之甚詳。該廠的一種產(chǎn)品──止痛劑偉克適──經(jīng)證明會增加極少數(shù)病人的凝血風(fēng)險。因此陪審團最近對一位病患服用偉克適死亡的案件，做出由該廠賠償兩億五千三百萬美元的判決，這只不過是許多訴訟案的第一件而已。

    目前科學(xué)家對于人類基因與藥物副作用之間的關(guān)系所知非常有限。但藥物遺傳學(xué)要改變這種情況。有朝一日，所有病人都可能要接受基因篩檢，然后根據(jù)化驗結(jié)果將他們分門別類。醫(yī)生一拿到基因資料，立刻就知道開出哪些藥很安全，哪些藥卻不然。藥物并非為個別病人量身訂做，而是針對依照基因群組來分類的各種人分別開藥。