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GP22Jan03:  Once Again, Less Is More: Tylenol

Snake in the Grass.  Salem’s most distinguished citizen, Nathaniel Hawthorne, penned a fine story, “Rappaccini’s Daughter,” which perfectly captures the ambivalence with which the 19th century greeted emerging technology.  The story introduces us to a beautiful garden and a devastatingly beautiful daughter, both of  such allure that passersby are attracted like bees drawn to the nectar of flowers.  There’s a fly in the ointment:  both are wondrous to behold but deadly poisonous to the touch.  Rappaccini, the scientist, had brought this about through his experiments—his great achievement a prelude to catastrophe. 

Pharmacopia.  Is this story not a metaphor for our chock-full medicine cabinet?  Every drug, no matter how useful, has lots of “contra-indications.”  Each is marvelous but with a hitch.  Mother Nature did not intend for us to put chemicals, the stuff of drugs, in our bodies, when she created the human design.  This paradox is endlessly replicated in our lives—in government, in business, in the sum of human activities.  We keep discovering that our cures are much worse than the problems they’re solving. 

Just Tylenol.  We’re not just talking about complex drugs such as statins for your heart or fast-selling Celexa for your mood.  Tylenol, the everyday pill that made Johnson & Johnson huge, has had a problematic history.  Certainly J & J is a fine company, and Tylenol is a worthy product.  But we learn in literature dating back at least to 1985 that over-use or wrongful use (with alcohol, for instance) of Tylenol can lead to pernicious liver and kidney damage. Annually, more than 100 deaths and 13,000 emergency room visits stem from problems with acetaminophen, the base ingredient in Tylenol. 

Somewhat AddictiveThe New York Times Sunday Magazine (January 12, 2003, pp. 40-42) suggests that Tylenol can be  a bit addictive, especially for headache sufferers.  While it is used as a cure for headaches, it can, if over-used, actually cause them, as the body’s own pain control mechanism goes dormant.  As the Times says, “Over-the-counter analgesics taken even five times a week can transform an episodic headache into a chronic one.”  Once again, the cure suddenly becomes worse than the malady it is to remedy.  Several articles do a good job of detailing Tylenol’s problems:  one may be found at www.lef.org

Less is More.  In the 21st century, our challenge increasingly will be to use less, not only to save resources, but to save ourselves from the pain of excess.  Less drugs and hospitalization.  Fewer dollars on advertising and mass marketing (and more dollars on product).  Much less complicated weapons systems to better deal with the suicide warfare of nameless cults.  Small companies that can more smoothly create and deliver very large volumes of better goods and services.  What we need is to bring Toyota’s lean manufacturing system into more and more aspects of our lives.  In fact, using less is the economic imperative for most of the developed countries of the world. 

The Game’s Up.  That means knowing when a product is ready for the junk heap.  For prescient companies strategic insight consists of knowing when the game’s up, when yesterday’s miracle product has peaked out and when it’s time to find a new blockbuster.  GE’s jet engine unit, for instance, has designed the right engine for small regional jets, since it understands we will be pulling traffic away from mega-hubs in the future, wheeling passengers through under-utilized secondary airports in efficient small craft.  Land’s End, as we have said, has achieved significant Internet volume in semi-custom clothing.  This Christmas the Internet showed good sales growth even though overall volume at the nation’s retailers was flat.  To get renewed growth, Fidelity is moving decisively beyond its mutual fund franchise into the employee benefits business.  The Veterans Administration has peeled back the number of under-used hospital beds it offers while beefing up critical outpatient services.  The goal, simply, is to do more of the things we need, not to stuff marketing channels with a surfeit of yesterday’s products. 

Herbs and Spices.  There’s not been a deep market for spice and herbal remedies, which often can be safer than FDA approved drugs, even if they  are not without problems, too.  The fact is that it is hard to make a big enough bucks from them if you are a drug company, particularly if the product is freely available in nature, so we lack the clinical trials that would better determine their efficacy.  Saw palmetto, clearly effective for some enlarged prostrate sufferers, never quite makes it into the doctor’s tool kit.  There are a plentitude of things we know are useful, yet they don’t pass muster with doctors and the FDA. The science behind alternative remedies is still shaky, but smart pharmaceuticals will probably begin to pay more attention to them.    

There’s one scientist who has labored in the herbal vineyards all his life.  He’s a delightful fellow named James Duke who worked at the Department of Agriculture for years and who is about as expert as you can get about the medicinal use of plants.  His database lives on there, even though he’s in hyperactive retirement.  You can read a bit about him at Stitch in Time on the Global Province (www.globalprovince.com/stitchintime.htm).  

Adverse Drug Reactions.  He’s just out with two definitive books—Handbook of Medicinal Herbs and the CRC Handbook of Medicinal Spices—published by CRC Press in Boca Raton, Florida.  We will have a lot more to say about the spice book on Global Province since we are delving into spices in our Best of Class section.  In his acknowledgements, he provides a whopper of a reason to include medicinal plants in your bag of tricks:  “And to you, the reader, and your health, may the spices of life prolong and enhance the quality of your lives, saving you from what is believed to be America’s biggest killer, Adverse Drug Reactions (ADR’s), according to the Journal of the American Medical Association, May 1, 2002.”  And, oh, by the way, garlic is apparently the number one spice medicine, according to Duke.   

Best of the Week.  We finally learned that Viagra is good for something.  According to the Von Hipple brothers, seal demand has slackened as old timers around the world resort to Viagra, instead of seal appendages, to put a bounce in their steps and in their love lives.  Seals, it seems, had formerly played a big role in the galaxy of cure-alls for impotence.  You can read about this on Global Province under Wit and Wisdom, “Saving the Seals.”

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