Saturday, August 16, 2014

1940s medical reformers' views on Indie PEN ("crude" penicillin) : 'about as safe as mother's milk ---- and equally unfashionable'

The aesthetic objections to live-saving Indie PEN

The medical reformers controlling the (glacial) pace of the mass introduction of penicillin (from 1928 to 1944) viewed the idea of saving the lives of dying patients with crude (Indie PEN) penicillin with the same sort of distaste they held towards mothers who still breastfed.

They all wanted penicillin that was first of all was pure and stable.

Some further wanted to wait until it was chemically synthesized (patentable) and many others wanted to keep it secret and limit it only for Allied wounded soldiers while the war raged.

And if countless patients died needlessly while they polished the turd - so be it .

The medical phobia against fresh bread

It was an age when all the best educated (with urban medical researchers often in the vanguard) sincerely believed that mothers who made biscuits on the kitchen stove right before her waiting children and then immediately fed it to them were endangering their health.

Much better to feed them factory made biscuits made two thousand miles away and stored for weeks in a warehouse, smothered in chemical preservatives.

For only the old fashioned rural poor still made 'fresh from the oven' home made bread and biscuits.

And all the best educated used baby formula - only country yokels would be so gauche as to breastfed a baby in public.

The less you needed to buy artificial vitamins , the more you bought of them

The best fed and best educated  - who could actually easily afford fresh oranges even when they were most expensive - prided themselves on not getting their daily vitamin C from impure fruit.

For mixed in with the pure vitamin C (that they preferred to get from synthetic pills) natural fruits contained all sorts of impurities.

(Impurities such as tasty juicy fruit sugar water, fibre and  traces of minerals and other vitamins.)

We today who are well educated - we who pride ourselves on our 'advanced thinking' - should view this all as a cautionary tale against the hubris of the well educated who don't realize the sharp limits to their very expensive educations.

But it does help explain the irrational phobias held by well educated doctors had so hampered the mass production of wartime's 'safe enough' penicillin .

Because even in 1944 and the introduction of mass penicillin - high quality commercial penicillin was still at best 85% dross and 15% pure penicillin.

Vincent Duhig, unsung hero of Indie PEN movement

Again, as late as 1944, Vincent Duhig , one of the least known heroes of the Indie PEN movement, was still saving lives with injections of penicillin that were 99.99% dross and one part in a ten thousand pure penicillin.

That is food grade medicine - some cooked fruits and vegetables deliver vitamin C in those same (extraordinarily low) ratios.

But we don't inject those foods directly into a patient's bloodstream via an IV drip.

But that is what Duhig dared to do - plucking a dozen lives back from the grave - patients considered so far gone that all the other doctors permitted Duhig's 'mad' scheme , as a sort of a patient's faint hope clause.

"Heroic medicine" they call it.

But heroic or merely canny ?

Because while Duhig used techniques more primitive than those that Alexander Fleming had rejected 15 years earlier in 1928, he judged them safe enough to use to save the dying who had no other hope and he was proved right, over and over.

Like Martin Henry Dawson, Robert Pulvertaft and some pioneering Russian penicillin doctors, Duhig was near enough to the hospital ward floor and far enough away from the ivory towers of basic research labs to recognize some obvious medical facts of life.

He knew penicillin itself was the most non toxic lifesaver even seen (still true today) and that by great good luck, the impurities in crude natural penicillin juice (like the impurities in crude orange juice) were 'safe enough'.

By contrast, the conventional treatment for most deadly bacterial infections were the all new , all dancing , all synthetic sulfa drugs - the darlings of that era's chemistry-mad medical reformers.

They were cheap, plentiful and often worked without incident.

But for a growing percentage of patients - a figure that rose rapidly as bacterial resistance grew to the sulfas and doses had to get dangerously high to remain effective - sulfas could make the patient painfully sick or damage their kidneys permanently - sometimes even kill them.

Doctors used them because the alternative often was an equally painful death.

The crude compromises of the busy hospital ward

Life on the busy ward floor - unlike inside the lab's pristine porcelain white walls - is always full of tricky compromises.

After all , ultimately doctors gets paid the big bucks above all for their skill in juggling between a drug's dosage being too safe to be effective and a drug's dosage being so high as to kill patient as well as germ.

As it happened, the crude penicillin of Duhig - being totally untreated by any chemical solvents etc - was probably less toxic to patients than the so called purified penicillins were .

That is because all the chemicals used in the purification process often added new impurities in the mix !

Yes ,wartime indie PEN , like wartime breast milk, was crude and impure - but unlike most wartime medical researchers, it was never brain-dead stupid....

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