Remembering Yellapragada SubbaRow

Abstract

The treatment of psoriasis vulgaris in the first half of the 20th century revolved on the intake of arsenical preparations and undecylenic acid and the topical use of mainly keratolytics, chrysarobin, tar regimens, and dithranol formulations. In 1951 a major event leading to a dramatic change occurred when a 36-year-old man known only by the initials L.R. had a remission at New York’s Kings County Hospital with aminopterin conceived and developed by Yellapragada SubbaRow as an anti-cancer drug. Because of ambivalent reports about aminopterin’s toxicity, this might have found a footnote in medical history but for the switch from aminopterin to its relatively less toxic analog methotrexate made by Edmundson and Guy of Pittsburgh. Most dermatologists are, however, unaware of this significant role by India-born SubbaRow (Su as in supine and Row as in tao) in the introduction of methotrexate, also developed in his laboratory, for the treatment of psoriasis. SubbaRow was born in Andhra Pradesh, India, on January 12, 1895. He sought in religion an escape from family poverty but was directed by the Ramakrishna Mission, a religious order, to modern medicine. His close brush with death from sprue while studying at Madras Medical College exposed the inadequacies of early 20th century Western medicine. His miraculous recovery with the help of herbal juices, the main ingredient being Eclipta alba (which much later was found to be a rich source of folic acid), and his consequent fascination with the ayurvedic theory of pathogenesis made him contemplate the synthesis of Western medicine with ayurveda, the traditional Indian system of medicine. Opting for a close study of Western research techniques, he sailed for the USA in 1923. After receiving his diploma from the Harvard School of Tropical Medicine, SubbaRow entered the Biochemistry Department of Harvard Medical School. Here he worked with Fiske, his