The treatment failures mark the point at which medical explanation and medical rescue separate in Scott Carey’s illness: clinicians identify a process that is progressively undermining his body, but neither hormone treatment nor the later antitoxin can stop it. Each unsuccessful intervention narrows the hope attached to a different account of the disease, until understanding its cause offers no assurance of a cure.

Early treatment attempts

The medical team first tries ACTH, possibly to check the catabolic breakdown of tissue. It has no effect. The failure is significant because the treatment is directed at a process already visible in Scott’s changing chemistry: his body is losing the capacity to maintain growth, while creatinine, phosphorus, and calcium are being displaced into waste. The doctors’ approach is medical and experimental, but the treatment does not interrupt the decline.

They then consider pituitary extract. The proposed benefit is specific: it might help Scott retain nitrogen and form new protein. The doctors also recognize the uncertainty of administering growth hormone to a human patient. The response cannot be reliably predicted, and even the best extracts may be poorly tolerated or produce abnormal results. Scott asks to receive the treatment despite those risks, reasoning that he cannot be worse off. The extract is administered, but the result is negative. Something in his system is acting against it.

The two failed approaches expose a limit in treating the illness as a simple shortage of growth hormone. Adding a substance associated with growth cannot overcome a disease process that is actively opposing its effects. The failure is not merely the absence of improvement: it directs attention toward an unidentified cause that is interfering with the body’s response.

Diagnosis without a remedy

The search for that cause depends on a sequence of questions and tests rather than a single early insight. Paper chromatography reveals a new toxin in Scott’s system. When the clinicians ask whether he has encountered germ spray or insecticide, he initially cannot recall the relevant events. He then remembers being sprayed by a city truck in a tree-lined alley in Los Angeles, where the mist burned his skin and stung his eyes. The doctors tell him that this incident alone is not the full explanation; something had transformed the insecticide into a much more damaging poison.

A second recollection supplies the missing link. On a boat, Scott had been caught in a curtain of spray that crossed the water. He had tried to avoid it, lost the race, and was soaked. Afterwards he noticed a tingling on his skin. The later investigation identifies the spray as insecticide altered by radiation. The explanation depends on the conjunction of the two exposures and their sequence: the radiation dissipated, while the poison remained. The diagnosis thus gives the treatment problem a more precise target, but it also reveals why the hormonal attempts have failed.

The toxin has not destroyed the pituitary gland outright. Instead, it has progressively damaged the gland’s ability to maintain growth, altered the handling of nitrogen and other elements, and softened the bones by removing calcium. It also produces antihormone action that directly opposes administered extracts. These findings explain the negative response to pituitary treatment, but they do not yet provide an antidote. The medical search has found a cause and a mechanism; it has not found a way to reverse either.

Antitoxin and continued decline

Once the toxin is understood, the remaining strategy is to find an antitoxin. Scott is sent home while the search continues, leaving him to wait for news that could determine whether the explanation has practical value. The waiting becomes part of the ordeal of treatment: he rents a post-office box so that he can receive more frequent deliveries and repeatedly checks for communication from the medical centre. The prospect of a remedy remains present, but it is not yet available to him.

The antitoxin is eventually discovered and administered to Scott three times. It does not work. In retrospect, he remembers this month of treatment as one more failed attempt, but by then exhaustion has changed the way the failure registers. Under the box lid in the cellar, with the spider still nearby and water in the hose, he is too depleted for the memory to provoke the earlier intensity of fear. He considers waiting for the spider to leave and then walking over the cellar cliff, an intention shaped by his immediate exhaustion rather than a successful medical outcome. The antitoxin’s failure closes the last hope represented by that particular treatment.

Consequences and significance

Later, speaking with Clarice, Scott acknowledges that he is incurable. He also recognizes that fear of learning this had contributed to his earlier departure from the doctors before testing was complete. His acceptance does not mean that he has decided to give up; he distinguishes ending the struggle against what cannot be beaten from abandoning life. That distinction follows a course in which each treatment failure has removed a possible means of control without erasing his capacity to choose how he meets the disease.

The episode’s central reversal is therefore not from sickness to recovery, but from diagnosis as promise to diagnosis as limit. Chromatography identifies the toxin; the exposure history explains its origin; the antihormone action accounts for the failure of pituitary extract; and the later antitoxin injections fail to change the outcome. The accumulating knowledge makes the disease more intelligible while leaving Scott’s shrinking unchecked. Treatment fails not because the illness remains wholly mysterious, but because discovering how it works does not provide an effective means of stopping it.