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 advancements¹ in microscopy, led scientists to discover the root causes for a multitude of infectious diseases.

Now medicine is on the threshold of a second renaissance², 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 genetic³ profile. Though still in its infancy⁴, the field has made critical steps in the battle against some cancers, and show great potential for improving the overall effectiveness of all drugs.

历史学家常把十九世纪后半段视为医学演进“百花齐放”的时代。有关细菌如何影响人体的新见解，以及显微技术的进展，都引领科学家找到多种感染性疾病的根源。

现在医学又来到第二个复兴的门槛，这一阶段的种种发现可能带动从心脏病到癌症各种疾病治疗方法的革新。这一个领域叫做药物遗传学，宗旨是依照病人的基因特质设计药物，虽然还在草创阶段，但已经在对抗一些癌症方面有重要的进展，并且在改进所有药物的整体疗效上展现了很大的潜力。

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 painkiller⁵ Vioxx-was shown to increase the risk of blood clots⁶ 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 lawsuits⁷.

Right now, scientists know very little about how human genes⁸ 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 determined⁹ by their genetic subsets.

药厂对个人化药品的兴趣特别浓厚。目前为数以百万计的病人开出同一种名牌药品处方的模式，已证实效果不彰，有时还会致病人于死地。

默沙东药厂对一体通用给与知名药品模式的个中危险知之甚详。该厂的一种产品──止痛剂伟克适──经证明会增加极少数病人的凝血风险。因此陪审团最近对一位病患服用伟克适死亡的案件，做出由该厂赔偿两亿五千三百万美元的判决，这只不过是许多诉讼案的第一件而已。

目前科学家对于人类基因与药物副作用之间的关系所知非常有限。但药物遗传学要改变这种情况。有朝一日，所有病人都可能要接受基因筛检，然后根据化验结果将他们分门别类。医生一拿到基因资料，立刻就知道开出哪些药很安全，哪些药却不然。药物并非为个别病人量身订做，而是针对依照基因群组来分类的各种人分别开药。