Bacteria, individually, are incredibly tiny, (about 1 picogram - one trillionth of a gram) (or 600 billion daltons in molecule talk).
Tiny, even when compared to a typical human red blood cell (which are about 30 times heavier).
Just as penicillin molecules are tiny compared to average large biological molecules like human blood hemoglobin
(it would take about 200 penicillin molecules to weigh as much as one hemoglobin molecule.)
(And human titin molecules can weigh almost 4 million daltons !)
But perhaps the most useful index is to compare the size of the tiny penicillin (300 daltons) or sulfa molecule (250 daltons) to the tiny bacteria organism it is trying to kill.
At least a billion times smaller.
That makes them highly diffusible, in theory.
Because the danger is always that once inside a living body, they will be more attracted to other molecules than to their designated target molecule. A very common situation that remains one of the great uncertainties of drug discovery.
Still they are pretty diffusible, all in all - approaching the real tiny and hence very highly diffusible molecules like water (18 daltons).
And to chemists, trying in the interwar years to determine the molecular structure of big biological molecules like hemoglobin, the tiny sized penicillin seemed as easy to synthesize as the similarly sized synthetic sulfa drugs.
(Or their most recent biological synthesis success - man-made Vitamin C, weighing in at about 200 daltons.)
But quinine also weighs about the same as penicillin and the best chemists throughout history had failed to synthesize it commercially.
Size, it turned out was not the best indicator of the complexity of making penicillin molecules synthetically....
Showing posts with label sulfa. Show all posts
Showing posts with label sulfa. Show all posts
Saturday, June 20, 2015
Monday, September 8, 2014
Twelve year resistance against injecting crude natural penicillin was normal...science
Doctors Alexander Fleming and Howard Florey did nothing at all about injecting crude natural penicillin into patients to try and save lives during the 12 long years between the Fall of 1928 and and the Fall of 1940.
But they did nothing more (less ?) than did all the other doctors in the world.
Their (lack of) response to the great potential in a crude penicillium liquid that was very non-toxic to primates and very toxic to death-dealing bacteria was perfectly normal..science.
Because doctors - just like the rest of us - also have unconscious Ids and also have unconscious fears about monsters.
Back in that era - pace H P Lovecraft and innumerable horror movies - the unconscious monster feared the most were the slime beings lying an uneasy halfway between stable solids and mobile liquids.
The scientific reluctance to inject the poop and pee of slime molds into the temple of the human body might have had a multiple of scientific excuses to support it but let's be frank - it was really was just an Id thing .
After all , doctors had no such reluctance to inject all sorts of man-made chemicals into the body - very dangerous chemicals like Salvarsan and Sulfa drugs.
They also had no reluctance to inject dangerous horse serum into humans.
These too were biological products like the much avoided penicillin juice.
But in the case of serums and vaccines the paradigm shift over using deadly bacteria and foreign serum as internal medicines had been heavily fought over (and settled) centuries earlier with Jenner's first successful smallpox treatment.
Today, of course, doctors (often indeed the children and grandchildren of the earlier generation of reluctant doctors) routinely inject medications taken from various slimy members of the fungal family without ever blinking an eye.
It's all perfectly normal...science.
But let us recall the doctor who first flaunted his willingness to break this taboo.
After a five month effort, Fleming and his two young assistants had concentrated and semi-purified penicillium juice to a point similar to that reached by Florey 12 years later.
Despite this great advance, Fleming would still only use it cautiously , on external infections, and he also cautiously declined to give many details of this clinical work in his initial paper.
By contrast, after just five weeks of work, a much less refined penicillium juice concentrate was available to Dr (Martin) Henry Dawson.
The word he used publicly to describe it was "crude" - the first time this normally pejorative term was ever used to describe penicillin , albeit by a firm proponent of penicillin !
Nevertheless , he eagerly injected it into some patients on October 16th 1940.
While one survived his invariably fatal disease, Dawson frankly indicated in the resulting published paper (May 5 1941) that there had been no reduction in the number of bacteria colonies in the man's blood after the treatments.
Dawson did not decline to discuss his dismal clinical results nor did he choose to bury them in a relatively obscure journal.
Instead he released his results before eight hundred research doctors at one of North American medicine's most important traditional big international conferences held every Spring in Atlantic City*.
(*Largely held there each year because Prohibition (along with laws against gambling and prostitution) was never enforced in Atlantic City - research doctors drink just as much as the rest of us - as well as having Ids and fearing monsters.)
There it proved a surprise hit with various science reporters, was given a big headline in the New York Times and Newsweek, was picked up by the wire services , and reported upon in a medical journal in faraway South Africa.
Most importantly, this sort of important international conference attracted ambitious drug companies eager to get a jump on their competition by learning early about drug breakthroughs.
In Dawson's case, the firm he impressed the most was Pfizer - then tiny , today huge thanks largely to this early teaming up with Dawson which led Pfizer to be WWII's by far biggest producer of penicillin .
Natural penicillin...naturally.
Because Fleming backed three wrong horses with regards to penicillin - the most important one perhaps being that he insisted it would only work (and even then only as a minor antiseptic) if it was a patentable chemical synthetic : no slime juice in the human temple for him.
But with Pfizer's unexpected success - thanks mostly to a big big assist from Miloslav Demerec - the paradigm shifted and natural was , if not totally rad cool, at least passably coolish...
But they did nothing more (less ?) than did all the other doctors in the world.
Their (lack of) response to the great potential in a crude penicillium liquid that was very non-toxic to primates and very toxic to death-dealing bacteria was perfectly normal..science.
Because doctors - just like the rest of us - also have unconscious Ids and also have unconscious fears about monsters.
Back in that era - pace H P Lovecraft and innumerable horror movies - the unconscious monster feared the most were the slime beings lying an uneasy halfway between stable solids and mobile liquids.
The scientific reluctance to inject the poop and pee of slime molds into the temple of the human body might have had a multiple of scientific excuses to support it but let's be frank - it was really was just an Id thing .
After all , doctors had no such reluctance to inject all sorts of man-made chemicals into the body - very dangerous chemicals like Salvarsan and Sulfa drugs.
They also had no reluctance to inject dangerous horse serum into humans.
These too were biological products like the much avoided penicillin juice.
But in the case of serums and vaccines the paradigm shift over using deadly bacteria and foreign serum as internal medicines had been heavily fought over (and settled) centuries earlier with Jenner's first successful smallpox treatment.
Today, of course, doctors (often indeed the children and grandchildren of the earlier generation of reluctant doctors) routinely inject medications taken from various slimy members of the fungal family without ever blinking an eye.
It's all perfectly normal...science.
But let us recall the doctor who first flaunted his willingness to break this taboo.
Henry Dawson breaks the slime taboo
After a five month effort, Fleming and his two young assistants had concentrated and semi-purified penicillium juice to a point similar to that reached by Florey 12 years later.
Despite this great advance, Fleming would still only use it cautiously , on external infections, and he also cautiously declined to give many details of this clinical work in his initial paper.
By contrast, after just five weeks of work, a much less refined penicillium juice concentrate was available to Dr (Martin) Henry Dawson.
The word he used publicly to describe it was "crude" - the first time this normally pejorative term was ever used to describe penicillin , albeit by a firm proponent of penicillin !
Nevertheless , he eagerly injected it into some patients on October 16th 1940.
While one survived his invariably fatal disease, Dawson frankly indicated in the resulting published paper (May 5 1941) that there had been no reduction in the number of bacteria colonies in the man's blood after the treatments.
Dawson did not decline to discuss his dismal clinical results nor did he choose to bury them in a relatively obscure journal.
Instead he released his results before eight hundred research doctors at one of North American medicine's most important traditional big international conferences held every Spring in Atlantic City*.
(*Largely held there each year because Prohibition (along with laws against gambling and prostitution) was never enforced in Atlantic City - research doctors drink just as much as the rest of us - as well as having Ids and fearing monsters.)
There it proved a surprise hit with various science reporters, was given a big headline in the New York Times and Newsweek, was picked up by the wire services , and reported upon in a medical journal in faraway South Africa.
Most importantly, this sort of important international conference attracted ambitious drug companies eager to get a jump on their competition by learning early about drug breakthroughs.
In Dawson's case, the firm he impressed the most was Pfizer - then tiny , today huge thanks largely to this early teaming up with Dawson which led Pfizer to be WWII's by far biggest producer of penicillin .
Natural penicillin...naturally.
Because Fleming backed three wrong horses with regards to penicillin - the most important one perhaps being that he insisted it would only work (and even then only as a minor antiseptic) if it was a patentable chemical synthetic : no slime juice in the human temple for him.
But with Pfizer's unexpected success - thanks mostly to a big big assist from Miloslav Demerec - the paradigm shifted and natural was , if not totally rad cool, at least passably coolish...
Thursday, August 21, 2014
NATURAL vs SYNTHETIC ---- what war time audiences were really talking about when they talked about penicillin
My book "MANHATTAN NATURAL" isn't really a book about wartime penicillin --- there have already been dozens of those , all claiming they've covered the waterfront thoroughly.
Instead it is a book about the deep emotional wellsprings wartime audiences were inadvertently revealing as they debated whether or not "crude natural penicillin, now !" was preferable to "pure synthetic penicillin (maybe) sometime in the future".
So I have drawn great inspiration from Klaus Theweleit's classic "MALE FANTASIES".
In particular, I admire his bravery in speculating widely and wildly about the connections between post-WWI trashy/sub-literate Freikorps novels and the mindset of Modernity itself - and not just as Modernity as manifest in the Nazi regime.
Author Thomas Hager (in his DEMON UNDER THE MICROSCOPE) quotes Nobel winning biologist Peter Medawar as recalling wartime chemists dismissing natural penicillin as sort of dire relic from the Dark Ages, peasant medicine made by witches brewing it up in cauldrons in dark hidden basements somewhere.
This association of basements and working class rural uneducated women and natural penicillin runs right through almost every penicillin book - particularly in the selection of illustrations.
Photos of working class women are shown growing natural penicillin in dark deep dank cellars versus news-story-and-ad illustrations of educated men in white coats doing penicillin chemistry in pristine labs or turning electronic dials in porcelain white deep tank penicillin factories.
Briton Ronald Hare , a former co-worker of Fleming who had already had his own run-ins with Howard Florey in mid-1941 over his employer (Toronto's Connaught Labs) unwillingness to grow penicillin for Florey.
Now in late 1943, Hare had his shining moment (much against his will) as Canada's chosen man to visit the American effort to grow massive amounts of natural penicillin.
His 1970 book , THE BIRTH OF PENICILLIN , reflects none of the new PC-ness of that period.
His book is brisk, witty, vivid , wise but it sometimes jars - never more so than when he talks of visiting a penicillin plant in Brooklyn.
Wild emotion bubbles forth from deep inside his Edwardian childhood as he babbles about giant negresses labouring deep in the Stygian (Hades or underworld) gloom.
Penicillium juice (the original penicillin was not today's drug but rather the mostly water-based liquid that the penicillium mold had grown in) was widely - if incorrectly - seen by most scientists and doctors simply as the daily waste byproducts of slimy mold.
The fungus were known to 'foul their own nests' (as do all non-mobile micro beings) and the liquid itself was coloured a thick bright yellow very much like a mixture of baby poop and pee.
(Actually the drug penicillin itself is only produced by the fungus when it is stressed - usually when its food source is in short supply and it needs to keep bacterial competitors at bay.)
There is a long folk association of women as being at one with the dark wet places and processes located below the belt .
An association of women with the primitive, the emotional and irrational (intuition rather than logic), of the animal , of being putting on earth only to make babies and then change their nappies .
Set against it is the association of males as being above the belt - way above the belt - beings of the brain and the mind not of the heart and emotions, of mental processes not physical processes,creatures of urban civilization rather than of rural and animal like settings.
So we only see women workers in penicillin stories as the ones nurturing baby penicillium spores in dark dank basements, collecting basement slime mold poop.
By contrast, the men are always in white lab coats worked in pristine labs thoughtfully examining the contents of a chemical beaker while puffing thoughtfully on a pipe.
Klaus Theweleit would have no problem understanding why natural penicillin slime poop juice was not injected into the pristine temples of the human body to save lives for twelve wasted years - and still not widely used for another five to ten years.
He'd see it as much as about men fearing women as in collective humanity fearing the (non-existent) toxicity of natural penicillin.
Thomas Hager again : Nobel winning Gerhard Domagk from Germany spent two years after penicillin's triumph in 1945 still trying to prove that his man-made chemical synthetic sulfa drugs were far superior to this naturally produced slime poop.
One can imagine Domagk fuming that it is impossible for any primitive slimy creature from the deep to be smarter than the best of civilized mankind from the land that gave the world Mozart , Beethoven, Goethe, Kant and Hegel.
Put that way, one wonders why a cheap horror movie was never made in the Fifties about the penicillium slime that took over the world , roused from the dank depths by a massive atomic explosion.
Maybe they already have . And again. And yet again.
Now natural penicillin-hater Howard Florey never saw a b-grade horror movie in his life but he too shared this widely held horror at the sight or thought of slime .
Why ?
Klaus Theweleit again : the core of Modernity was a fear of the loss of firm borders - with littoral substances like mud and slime being at the symbolic heart of that phobia.
Littoral as in being neither 100% liquid or 100% solid but having indefinitely varying qualities of both.
Clever slime from the muddy depths was this phobia - in spades - and no wonder it made teeners quake with fear at a 1954 drive-in as much as it made Florey quake with fear at a natural penicillin nursery in 1944.
Now I think the explanation for the sharp rise of this slime phobia was the the plenitude of experiences thrown up in the explosive birth of Modern Global Progress in the very few years between 1875 and 1915.
I do not think any set of humans has ever experienced as much rapid and extensive change as the people living through that period did.
They reacted badly much of the time - rabid racism and eugenics being only part of their response.
Not nice, not acceptable but understandable.
And innocent life-saving penicillin simply got caught in the cross hairs....
Instead it is a book about the deep emotional wellsprings wartime audiences were inadvertently revealing as they debated whether or not "crude natural penicillin, now !" was preferable to "pure synthetic penicillin (maybe) sometime in the future".
So I have drawn great inspiration from Klaus Theweleit's classic "MALE FANTASIES".
In particular, I admire his bravery in speculating widely and wildly about the connections between post-WWI trashy/sub-literate Freikorps novels and the mindset of Modernity itself - and not just as Modernity as manifest in the Nazi regime.
Author Thomas Hager (in his DEMON UNDER THE MICROSCOPE) quotes Nobel winning biologist Peter Medawar as recalling wartime chemists dismissing natural penicillin as sort of dire relic from the Dark Ages, peasant medicine made by witches brewing it up in cauldrons in dark hidden basements somewhere.
This association of basements and working class rural uneducated women and natural penicillin runs right through almost every penicillin book - particularly in the selection of illustrations.
Photos of working class women are shown growing natural penicillin in dark deep dank cellars versus news-story-and-ad illustrations of educated men in white coats doing penicillin chemistry in pristine labs or turning electronic dials in porcelain white deep tank penicillin factories.
Briton Ronald Hare , a former co-worker of Fleming who had already had his own run-ins with Howard Florey in mid-1941 over his employer (Toronto's Connaught Labs) unwillingness to grow penicillin for Florey.
Now in late 1943, Hare had his shining moment (much against his will) as Canada's chosen man to visit the American effort to grow massive amounts of natural penicillin.
His 1970 book , THE BIRTH OF PENICILLIN , reflects none of the new PC-ness of that period.
His book is brisk, witty, vivid , wise but it sometimes jars - never more so than when he talks of visiting a penicillin plant in Brooklyn.
Wild emotion bubbles forth from deep inside his Edwardian childhood as he babbles about giant negresses labouring deep in the Stygian (Hades or underworld) gloom.
Penicillium juice (the original penicillin was not today's drug but rather the mostly water-based liquid that the penicillium mold had grown in) was widely - if incorrectly - seen by most scientists and doctors simply as the daily waste byproducts of slimy mold.
The fungus were known to 'foul their own nests' (as do all non-mobile micro beings) and the liquid itself was coloured a thick bright yellow very much like a mixture of baby poop and pee.
(Actually the drug penicillin itself is only produced by the fungus when it is stressed - usually when its food source is in short supply and it needs to keep bacterial competitors at bay.)
There is a long folk association of women as being at one with the dark wet places and processes located below the belt .
An association of women with the primitive, the emotional and irrational (intuition rather than logic), of the animal , of being putting on earth only to make babies and then change their nappies .
Set against it is the association of males as being above the belt - way above the belt - beings of the brain and the mind not of the heart and emotions, of mental processes not physical processes,creatures of urban civilization rather than of rural and animal like settings.
So we only see women workers in penicillin stories as the ones nurturing baby penicillium spores in dark dank basements, collecting basement slime mold poop.
By contrast, the men are always in white lab coats worked in pristine labs thoughtfully examining the contents of a chemical beaker while puffing thoughtfully on a pipe.
Klaus Theweleit would have no problem understanding why natural penicillin slime poop juice was not injected into the pristine temples of the human body to save lives for twelve wasted years - and still not widely used for another five to ten years.
He'd see it as much as about men fearing women as in collective humanity fearing the (non-existent) toxicity of natural penicillin.
Thomas Hager again : Nobel winning Gerhard Domagk from Germany spent two years after penicillin's triumph in 1945 still trying to prove that his man-made chemical synthetic sulfa drugs were far superior to this naturally produced slime poop.
One can imagine Domagk fuming that it is impossible for any primitive slimy creature from the deep to be smarter than the best of civilized mankind from the land that gave the world Mozart , Beethoven, Goethe, Kant and Hegel.
Put that way, one wonders why a cheap horror movie was never made in the Fifties about the penicillium slime that took over the world , roused from the dank depths by a massive atomic explosion.
Maybe they already have . And again. And yet again.
Now natural penicillin-hater Howard Florey never saw a b-grade horror movie in his life but he too shared this widely held horror at the sight or thought of slime .
Why ?
Klaus Theweleit again : the core of Modernity was a fear of the loss of firm borders - with littoral substances like mud and slime being at the symbolic heart of that phobia.
Littoral as in being neither 100% liquid or 100% solid but having indefinitely varying qualities of both.
Clever slime from the muddy depths was this phobia - in spades - and no wonder it made teeners quake with fear at a 1954 drive-in as much as it made Florey quake with fear at a natural penicillin nursery in 1944.
Now I think the explanation for the sharp rise of this slime phobia was the the plenitude of experiences thrown up in the explosive birth of Modern Global Progress in the very few years between 1875 and 1915.
I do not think any set of humans has ever experienced as much rapid and extensive change as the people living through that period did.
They reacted badly much of the time - rabid racism and eugenics being only part of their response.
Not nice, not acceptable but understandable.
And innocent life-saving penicillin simply got caught in the cross hairs....
Thursday, September 12, 2013
Fred J Stock : righteous among the nations ? (Part I)
Part I : the Era of Sulfa has run out of steam...
In May 1943, almost 15 years after the world's best lifesaver - Penicillin G - was first discovered , the whole world was making about a 100 million units of it a month.
That sounds like a lot but it is not at all - that amount of Penicillin G today would be only sufficient to treat one ordinarily sick patient requiring it !
A severely ill patient today requiring penicillin G might need a whole year's worth (1200 million units) at May 1943 production rates.
But May 1943 was hardly ordinary times with ordinary patients - it was the height of WWII , the biggest deadliest war ever seen : a seven ring circus of sickness and injury where the box office never closed.
The only other lifesaver around at that time - the wonderful sulfa drugs - had had a great five year run of success (cheap and easy to make in huge amounts, easy to give to patients) but had now run out of steam and were in grave danger of collapse.
By the Fall of 1942 , the chemists had a convincing scientific explanation for why they had run out of places on the basic sulfa ring to insert new additional "side chain" molecules, to provide additionalanti-bacterial action via new variants of sulfa.
So : no new sulfa drugs for germ-killing ---- ever .
The existing ones were now meeting unexpectedly rapid bacterial resistance - the normal solution : up the dosage amount and duration of treatment to overcome that resistance - had revealed just how dangerously toxic the safe sulfa drugs could be at high and prolonged dosages.
A repeat of WWI's deadly combo pandemic of Spanish (viral) Flu and (bacterial) Pneumonia and maybe this time more than a 100 million people (one in twenty) might die.
A huge potential disaster loomed, just offstage.
The problem , as always , was that scientists were in charge of public policy on penicillin - not politicians.
The academic scientists - on penicillin - had made common cause with their normally mortal enemies : Big Pharma.
Penicillin had long been ready to report for war duty - but only as a public domain natural substance made up in medieval brews by rural peasant midwives from mold slime ( I am paraphrasing the scientists' and CEOs' mutual objections here.)
The CEOs were chemically-minded as only executives matured during the chemistry-made interwar years could be and really wanted a synthetic penicillin.
Synthetic means man-made means patents : patents to raise prices and secure world markets free from profit-cutting competitors.
The scientists claimed to abhor profit-making but loved reputation making instead.
And for scientists still unsure if their new found high social status was really secure , it would be a retrograde step for the world's best ever lifesaver to be seen as something a housewife could brew up in their kitchen and apply directly.
Because that meant all its lifesaving prestige would bypass both the male academic basic scientist and the male applied scientists in medical labs and hospital wards.
(For the Gender War raged on , military war or not.)
The OSRD/NAS in America and the MRC in the UK ,dominated by Republican/Conservative Party scientists (for virtually all tenured academics in those years voted Republican or Conservative), controlled the production of penicillin until May 1943.
Their conservative views even continued to dominate the Conservative Ministry of Supply in the UK.
But in America they were soon to be defeated - in great part because they were now to deal with the very New Deal and Democratic Party-oriented War Production Board (WPB) and the formidable head of its Drugs and Cosmetics Branch, Fred J Stock.....
Thursday, June 27, 2013
WWII's Opium Wars : Britain's efforts to weaponize life-saving penicillin
The shabby ways in which the Churchill Conservatives, coupled loosely with Republican friends in the American OSRD, conspired to weaponize life-saving wartime penicillin should not surprise anyone with any historical knowledge.
Britain was a past-master at using life-strangling blockades of someone else's civilian population to substitute for the possible combat deaths of the officer sons of the British elite.
Napoleon had been defeated by just such a blockade policy and the Opium Wars against China had shown just how effective covert drug warfare can be in de-stabilizing a nation's populace.
(A lesson hardly lost on the OSRD's successors in the CIA et al.)
But Churchill and Britain were playing with fire when they attempted to severely limit the production of penicillin and restrict its use to only those frontline Allied sick combatants deemed recoverable for further combat.
Because in the 1940s we did not have the arsenal of about 100 viable antibiotics that we have today.
We had only a half dozen members of the Sulfa drug family and they were all rapidly failing --- due to overuse bringing on rapid bacterial resistance.
Wars bring on sudden pandemics - like WWI's horrific Spanish Flu.
One wonders what would the world response had been to Sir Winston Churchill (the Harry Lime of British politics) if tens of millions of people had needlessly died, before penicillin production was brought up to speed ?
The world was very lucky indeed that Henry Dawson was not so callous as Churchill and the Allied scientific establishment on the turning a precious lifesaver into a weapon of war...
Britain was a past-master at using life-strangling blockades of someone else's civilian population to substitute for the possible combat deaths of the officer sons of the British elite.
Napoleon had been defeated by just such a blockade policy and the Opium Wars against China had shown just how effective covert drug warfare can be in de-stabilizing a nation's populace.
(A lesson hardly lost on the OSRD's successors in the CIA et al.)
But Churchill and Britain were playing with fire when they attempted to severely limit the production of penicillin and restrict its use to only those frontline Allied sick combatants deemed recoverable for further combat.
Because in the 1940s we did not have the arsenal of about 100 viable antibiotics that we have today.
We had only a half dozen members of the Sulfa drug family and they were all rapidly failing --- due to overuse bringing on rapid bacterial resistance.
Wars bring on sudden pandemics - like WWI's horrific Spanish Flu.
One wonders what would the world response had been to Sir Winston Churchill (the Harry Lime of British politics) if tens of millions of people had needlessly died, before penicillin production was brought up to speed ?
The world was very lucky indeed that Henry Dawson was not so callous as Churchill and the Allied scientific establishment on the turning a precious lifesaver into a weapon of war...
Friday, May 24, 2013
WWII's the Mighty and the Wise "confounded" by bacteria and bazooka Resistance Movements
It is clear now that WWII's twin defeats of Sulfa drugs and Armoured tanks by the bacterial and bazooka "Resistance Movements" spelt the beginning of the end for prewar Reductionist cum Constructionist Modernity.
(Martin) Henry Dawson could publish endless articles on the commensality of reality till the end of time ,but they cut no ice with the Mighty and the Wise compared to the short sharp lessons they learned at the great university of real life that was WWII.
Sir Edward Mellanby , mentor of Dawson's rival Sir Howard Florey and head of Britain's agenda-setting MRC (Medical Research Council) from 1933 to 1949, famously claimed in the late 1930s that the synthesis of the sulfa drugs meant we could soon close all our infectious hospitals and kiss infection deaths goodbye.
But by 1943, Bacterial Resistance rendered the sulfa drugs almost useless and allowed penicillin's vast family of antibiotics to become the first port of call for the never ending new strains of bacterial death , though we are still racing very hard to produce new antibiotics to match ever new bacterial resistance.
And always will : that is the way of Commensality Modernity , the way of real reality.
The armoured tank, immune to mere infantry weapons and the indirect fire of artillery, was widely proclaimed as the major reason why the Great Powers would always quickly and easily overrun small powers, particularly those small powers without natural barriers to easy tank passage.
But by 1943 the Bazooka Resistance, today represented by the soviet-era RPG 7 anti-tank rocket propelled grenade seen in every revolution and insurrection, transformed that certitude.
The light, man-carriable , easily concealed bazooka-style anti-tank weapons ensures that an invading Great Power would now have a very tough time invading and successfully occupying a small power.
Tanks would now have a tough time evading the lethal bazooka --- particularly in rocky hilly mountain valley roads, in muddy swamps and while making their way along narrow forests and jungle trails.
Above all the tank was now incredibly vulnerable to hand-held anti-tank weapons while threading their way through the built-up urban areas found in even the flattest, smallest and barest of small powers.
Reductionist/Constructionist Modernity held that effectively reality was binary, with Particle Physicists at one end and Plasma Particles at the other, and everything else in between being basically useless mouths or useless molecules.
But the medium sized stuff in between had proved unwilling to just go away and had gummed up the works of both the Axis and Allied great powers during WWII, again and again.
I rather doubt that commensal expert and infantry veteran Henry Dawson was truly surprised.....
(Martin) Henry Dawson could publish endless articles on the commensality of reality till the end of time ,but they cut no ice with the Mighty and the Wise compared to the short sharp lessons they learned at the great university of real life that was WWII.
Sir Edward Mellanby , mentor of Dawson's rival Sir Howard Florey and head of Britain's agenda-setting MRC (Medical Research Council) from 1933 to 1949, famously claimed in the late 1930s that the synthesis of the sulfa drugs meant we could soon close all our infectious hospitals and kiss infection deaths goodbye.
But by 1943, Bacterial Resistance rendered the sulfa drugs almost useless and allowed penicillin's vast family of antibiotics to become the first port of call for the never ending new strains of bacterial death , though we are still racing very hard to produce new antibiotics to match ever new bacterial resistance.
And always will : that is the way of Commensality Modernity , the way of real reality.
The armoured tank, immune to mere infantry weapons and the indirect fire of artillery, was widely proclaimed as the major reason why the Great Powers would always quickly and easily overrun small powers, particularly those small powers without natural barriers to easy tank passage.
But by 1943 the Bazooka Resistance, today represented by the soviet-era RPG 7 anti-tank rocket propelled grenade seen in every revolution and insurrection, transformed that certitude.
The light, man-carriable , easily concealed bazooka-style anti-tank weapons ensures that an invading Great Power would now have a very tough time invading and successfully occupying a small power.
Tanks would now have a tough time evading the lethal bazooka --- particularly in rocky hilly mountain valley roads, in muddy swamps and while making their way along narrow forests and jungle trails.
Above all the tank was now incredibly vulnerable to hand-held anti-tank weapons while threading their way through the built-up urban areas found in even the flattest, smallest and barest of small powers.
Reductionist/Constructionist Modernity held that effectively reality was binary, with Particle Physicists at one end and Plasma Particles at the other, and everything else in between being basically useless mouths or useless molecules.
But the medium sized stuff in between had proved unwilling to just go away and had gummed up the works of both the Axis and Allied great powers during WWII, again and again.
I rather doubt that commensal expert and infantry veteran Henry Dawson was truly surprised.....
Tuesday, March 5, 2013
"The Blitz dog ate my homework" and other tired penicillin-related excuses from UK historians
David Edgerton excepted of course -- he hasn't really written on Britain's deliberately pathetic production of penicillin during the war years but he is unlikely to blame it on the Warfare State's "abject poverty" and "The Blitz".
Let's look at "The Blitz" first.
The German bombing of Britain went on for six years, went on all over Britain, killed 60,000, wounded hundreds of thousands, damaged or destroyed hundreds of thousands of buildings but in all this, actually varied greatly in its specific intensity in time, geography and effort.
The actual Blitz, from September 1940 to May 1941, was in all three senses, intense : it went on steadily for nine months and involved the bulk of the German Air Force, and ranged widely over all of Great Britain.
But until the V-1 and V-2 attacks over south east England from June 1944 till the end of the war in May 1945, subsequent raids (ie from May 1941 till June 1944, also the critical period for developing wartime penicillin) were very much smaller in intensity by number of bombers and tons of bombs.
Most consisted of 'tip and run' raids made by single fighter bombers coming in under the radar and bombing ports on the south coast of England.
A commenter on a blog said it perhaps best when he frankly admitted,that while yes he was a kid in Glasgow during the war, he actually didn't really remember the Glasgow Blitz , because it only happened once and it happened many miles away in a working class/industrial part of that large city.
A child in Belfast might have had the same reaction - it had one big heavy raid on one part of the city, albeit with an extraordinary number of casualties because no one really expected the Germans to bother Northern Ireland.
And Oxford was never bombed.
Though it was basically an outer suburb of metropolitan London (and so very close to German airbases in France), with a large car industry and so surely should have been a suitable target on two counts.
Bombing Britain into defeat was really going to be virtually impossible - like Germany and America it simply had too many alternative metropolitan industrial centres, many with large port facilities, and all well connected to each other by an extensive road and rail network.
Thus the very determined effort to squash the huge port of Liverpool into dust was a wasted German effort : Greenock, Cardiff and Belfast , to name but a few west coast ports in Britain , would have quickly taken up the slack in the receiving of vital convoys from North America.
A pre-war decision to build a number of duplicate shadow assembly plants a maximum distance of about a half hour rail, canal or truck trip from the original centre of a critical war industry helped a lot to reduce the impact of even a direct hit on that vital British 'choke point'.
The Germans knew precisely where all the pre-1939 vital factories were and often hit and badly damaged them - but the shadow plants near by were unknown to them and took up the slack.
In addition , ensuring that sub contractors were neither right next to the original plant nor 500 kilometres away but within that convenient half hour circle of travel led to a virtually bomb-proof but economical dispersal of vital war industries.
The chances of anything, anything but a twenty megaton thermo-nuclear bomb, destroying such a sprawling industrial metropolitan area a hundred kilometres by a hundred kilometres square rendered such British efforts Blitz-proof.
The Germans duplicated these dispersement efforts equally successfully, if much too late in the game --- by pointed contrast the Russians and Americans kept with single huge production 'n' assembly plants : but at inland sites they felt safe from WWII's longest ranging bombers.
ICBMs and nuclear bombs rendered all that moot : goodbye Kansas City as a safe place to build bombers in WWIII.
True, the massive size and complexity of shipyards capable of building battleships and aircraft carriers are not so easily moved about and in addition were so expensive that they could only be a few in number --- even for super-rich nations like America.
But when the non-shipbuilding nation of Canada decided to quickly build a whole lot of ships and yet be safe from any bombing raid, it did so by going down-market in technological complexity.
It beat the Germans (and any possible bombing raids) by focusing instead on building very large numbers of a few very simple merchant ship and escort vessel types.
Thus they could be built at any of about five dozen new shipyards all over Canada --- even in Thunder Bay, a few thousand kilometres from the open sea: redundancy safety plus !
The Russians would understand that sort of thinking --- lots of simple weapons win wars just as well as a few ,very sophisticated, weapons do.
My point is that the Blitz, even if it had gotten much worse, could only be an moderate not fundamental restraint on British war efforts.
Britain during WII was a heavily industrialized nation with the vastest empire even seen to supply the raw resources and manpower to back up that industrial power.
If civilian paper was in short supply during the war (and it definitely was), it wasn't because Britain was poor -- it was because all of its pre-war paper supply was still coming in, but was now diverted to supplying all the bumpf an officious war nation's government could churn out !
Britain was a rich enough nation during WWII to divert the cost of building and maintaining of just one extra squadron of Lancaster bombers to the building instead of several more bottle penicillin plants in early 1943 --- but deliberately chose not to.
If one of the Four Freedoms that Churchill's Conservative party was forced to pretend to publicly accept included the freedom from want of life-saving drugs , a point hit home in the Fall of 1942 by the Beveridge Report, his party chose to deny it in practise.
With existing sulfa drugs failing by the minute (due to bacterial resistance) and with a scientific consensus building by the Fall of 1942 that new anti-bacteria sulfas were unlikely to come along, penicillin was becoming the only , the only , hope for civilians or servicemen dying of blood poisoning.
Surely the most vital of all possible freedoms is the freedom from premature death, but the Churchill government cocked its nose at Beveridge and said 'only enough resources will be diverted from bombers to save just our servicemen with bottle penicillin'.
A-Ha, says the UK historian, says he : a-ha !
Bottle penicillin - we had that and the Yanks had deep tank penicillin - that is why we couldn't match the rich, Blitz-less Americans in penicillin production.
Awkward facts intrude - the British did build a pilot deep tank design very early on - with the Americans also willing to license their deep tank technology at firesale prices - but it was Churchill's Conservative minister in charge of the all-powerful MoS, the Ministry of Supply (to the army), that said no.
And deep tank efforts hardly explain the very much better penicillin records of both Canada and Australia - because these two nations, definitely not scientific or industrial powers in the early 1940s, also used only bottle plants and yet did far better in penicillin production than Britain, per capita.
(In population Britain was about 1/3 the GDP and population of America and about about 7x the GDP and population of Australia and 5x the population and GDP of Canada.)
True, that on one hand these Dominions weren't Blitzed like the British.
But on the other hand they had hardly gained their current wealth from homegrown science or industry, unlike Britain.
I count their wartime technical and financial difficulties in producing bottle penicillin as about equal to that of the UK.
What was really lacking in the whole penicillin shortfall crisis, was the moral will to correct it among the one nation in the four led by a Conservative party during WWII.
So, in mid 1945, the UK was producing 30 billion units of penicillin a month, Australia 10 billion, Canada 20 billion and America 600 billion.
To match the Australians per capita, the UK should of been producing 70 billion units a month, to match Canada a 100 billion units and America 200 billion units.
In addition, Britain had not permitted its many colonies to start their own penicillin plants, so the actual shortfall in its ability to save the lives of its civilians and soldiers from the UK and all its colonies was much much bigger than even this stark contrast in effort among the Allies.
By 1946, the penicillin shortfall crisis in Britain was over and it was producing more than enough penicillin for everyone at home and in the colonies and was eager to start exporting to foreign lands.
But that was way too late for Churchill's Conservative party who had been fragged-in-the-back by voter concern over unequal access to necessary medical care and voted for Labour in the July 1945 General Election.
Hitler couldn't defeat Churchill but penicillin (the unequal lack of access to it) had ...
Let's look at "The Blitz" first.
The German bombing of Britain went on for six years, went on all over Britain, killed 60,000, wounded hundreds of thousands, damaged or destroyed hundreds of thousands of buildings but in all this, actually varied greatly in its specific intensity in time, geography and effort.
The actual Blitz, from September 1940 to May 1941, was in all three senses, intense : it went on steadily for nine months and involved the bulk of the German Air Force, and ranged widely over all of Great Britain.
But until the V-1 and V-2 attacks over south east England from June 1944 till the end of the war in May 1945, subsequent raids (ie from May 1941 till June 1944, also the critical period for developing wartime penicillin) were very much smaller in intensity by number of bombers and tons of bombs.
Most consisted of 'tip and run' raids made by single fighter bombers coming in under the radar and bombing ports on the south coast of England.
A commenter on a blog said it perhaps best when he frankly admitted,that while yes he was a kid in Glasgow during the war, he actually didn't really remember the Glasgow Blitz , because it only happened once and it happened many miles away in a working class/industrial part of that large city.
A child in Belfast might have had the same reaction - it had one big heavy raid on one part of the city, albeit with an extraordinary number of casualties because no one really expected the Germans to bother Northern Ireland.
And Oxford was never bombed.
Though it was basically an outer suburb of metropolitan London (and so very close to German airbases in France), with a large car industry and so surely should have been a suitable target on two counts.
Bombing Britain into defeat was really going to be virtually impossible - like Germany and America it simply had too many alternative metropolitan industrial centres, many with large port facilities, and all well connected to each other by an extensive road and rail network.
Thus the very determined effort to squash the huge port of Liverpool into dust was a wasted German effort : Greenock, Cardiff and Belfast , to name but a few west coast ports in Britain , would have quickly taken up the slack in the receiving of vital convoys from North America.
A pre-war decision to build a number of duplicate shadow assembly plants a maximum distance of about a half hour rail, canal or truck trip from the original centre of a critical war industry helped a lot to reduce the impact of even a direct hit on that vital British 'choke point'.
The Germans knew precisely where all the pre-1939 vital factories were and often hit and badly damaged them - but the shadow plants near by were unknown to them and took up the slack.
In addition , ensuring that sub contractors were neither right next to the original plant nor 500 kilometres away but within that convenient half hour circle of travel led to a virtually bomb-proof but economical dispersal of vital war industries.
The chances of anything, anything but a twenty megaton thermo-nuclear bomb, destroying such a sprawling industrial metropolitan area a hundred kilometres by a hundred kilometres square rendered such British efforts Blitz-proof.
The Germans duplicated these dispersement efforts equally successfully, if much too late in the game --- by pointed contrast the Russians and Americans kept with single huge production 'n' assembly plants : but at inland sites they felt safe from WWII's longest ranging bombers.
ICBMs and nuclear bombs rendered all that moot : goodbye Kansas City as a safe place to build bombers in WWIII.
True, the massive size and complexity of shipyards capable of building battleships and aircraft carriers are not so easily moved about and in addition were so expensive that they could only be a few in number --- even for super-rich nations like America.
But when the non-shipbuilding nation of Canada decided to quickly build a whole lot of ships and yet be safe from any bombing raid, it did so by going down-market in technological complexity.
It beat the Germans (and any possible bombing raids) by focusing instead on building very large numbers of a few very simple merchant ship and escort vessel types.
Thus they could be built at any of about five dozen new shipyards all over Canada --- even in Thunder Bay, a few thousand kilometres from the open sea: redundancy safety plus !
The Russians would understand that sort of thinking --- lots of simple weapons win wars just as well as a few ,very sophisticated, weapons do.
My point is that the Blitz, even if it had gotten much worse, could only be an moderate not fundamental restraint on British war efforts.
Britain during WII was a heavily industrialized nation with the vastest empire even seen to supply the raw resources and manpower to back up that industrial power.
If civilian paper was in short supply during the war (and it definitely was), it wasn't because Britain was poor -- it was because all of its pre-war paper supply was still coming in, but was now diverted to supplying all the bumpf an officious war nation's government could churn out !
Britain was a rich enough nation during WWII to divert the cost of building and maintaining of just one extra squadron of Lancaster bombers to the building instead of several more bottle penicillin plants in early 1943 --- but deliberately chose not to.
If one of the Four Freedoms that Churchill's Conservative party was forced to pretend to publicly accept included the freedom from want of life-saving drugs , a point hit home in the Fall of 1942 by the Beveridge Report, his party chose to deny it in practise.
With existing sulfa drugs failing by the minute (due to bacterial resistance) and with a scientific consensus building by the Fall of 1942 that new anti-bacteria sulfas were unlikely to come along, penicillin was becoming the only , the only , hope for civilians or servicemen dying of blood poisoning.
Surely the most vital of all possible freedoms is the freedom from premature death, but the Churchill government cocked its nose at Beveridge and said 'only enough resources will be diverted from bombers to save just our servicemen with bottle penicillin'.
A-Ha, says the UK historian, says he : a-ha !
Bottle penicillin - we had that and the Yanks had deep tank penicillin - that is why we couldn't match the rich, Blitz-less Americans in penicillin production.
Awkward facts intrude - the British did build a pilot deep tank design very early on - with the Americans also willing to license their deep tank technology at firesale prices - but it was Churchill's Conservative minister in charge of the all-powerful MoS, the Ministry of Supply (to the army), that said no.
And deep tank efforts hardly explain the very much better penicillin records of both Canada and Australia - because these two nations, definitely not scientific or industrial powers in the early 1940s, also used only bottle plants and yet did far better in penicillin production than Britain, per capita.
(In population Britain was about 1/3 the GDP and population of America and about about 7x the GDP and population of Australia and 5x the population and GDP of Canada.)
True, that on one hand these Dominions weren't Blitzed like the British.
But on the other hand they had hardly gained their current wealth from homegrown science or industry, unlike Britain.
I count their wartime technical and financial difficulties in producing bottle penicillin as about equal to that of the UK.
What was really lacking in the whole penicillin shortfall crisis, was the moral will to correct it among the one nation in the four led by a Conservative party during WWII.
So, in mid 1945, the UK was producing 30 billion units of penicillin a month, Australia 10 billion, Canada 20 billion and America 600 billion.
To match the Australians per capita, the UK should of been producing 70 billion units a month, to match Canada a 100 billion units and America 200 billion units.
In addition, Britain had not permitted its many colonies to start their own penicillin plants, so the actual shortfall in its ability to save the lives of its civilians and soldiers from the UK and all its colonies was much much bigger than even this stark contrast in effort among the Allies.
By 1946, the penicillin shortfall crisis in Britain was over and it was producing more than enough penicillin for everyone at home and in the colonies and was eager to start exporting to foreign lands.
But that was way too late for Churchill's Conservative party who had been fragged-in-the-back by voter concern over unequal access to necessary medical care and voted for Labour in the July 1945 General Election.
Hitler couldn't defeat Churchill but penicillin (the unequal lack of access to it) had ...
Sunday, January 20, 2013
Pure Sulfa or Salvarsan drugs were far more toxic than impure crude penicillin : so what was the fuss REALLY about then ?
Before 1945, an entire generation of doctors world wide (except for perhaps a half dozen of them) were more willing to put pure but toxic sulfa or salvarsan drugs into their patients than put impure but non toxic penicillin into them.
I will go further: an entire generation of doctors were willing to seen letting their patients DIE, rather than be seen by other doctors as putting an impure substance into those dying patients.
In The Age of Modernity, before 1945, an obsession with purity had its hands tight around the throat of medical morality ....
I will go further: an entire generation of doctors were willing to seen letting their patients DIE, rather than be seen by other doctors as putting an impure substance into those dying patients.
an obsession with Purity - before even the patients' life
In The Age of Modernity, before 1945, an obsession with purity had its hands tight around the throat of medical morality ....
Wednesday, January 2, 2013
Nova Scotia-born Dr Henry Dawson and the wartime re-invention of a military secret weapon into a widely publicized beacon of hope
I am talking about penicillin of course.
What other artifact of war has so abruptly and so totally changed its character over the course of a war ?
In 1941, the British and American medical and military elites were in agreement that the new penicillin's best use in wartime was as a weapon - and that its success as a weapon of war depended on it remaining 'new' and hence relatively secret.
The Allies would gain an absolute advantage over the Axis only if they alone had a cheap, abundant, stable, pure , potent (secret) version of penicillin.
This could only happen if the Axis had to make do with only the increasingly ineffective sulfa drugs or the expensive, scarce, unstable, weak Public Domain (natural) version of penicillin, readily obtainable by consulting the already existing published medical literature on penicillin.
So penicillin had to remain secret in two senses.
First, penicillin had to be synthesized secretly.
This is because the old cliche of the formula stolen out of a safe in the Golden Age of Mystery books really works as a realistic plot device.
Almost all readers were aware that in the real world, without at least a fleeting glance at the synthesis formula for a process, it was almost impossible to begin to make a stab at a rival method for re-creating a man-made chemical.
Nobody steals scientific formulas used in physics, geology, astronomy or biology now do they ?
Secondly, penicillin's unique life-saving abilities had to be kept secret from the world's general public or they would demand it be made in quality for them.
Technically, the synthesizing method would still remain a secret, but alerted by the resulting public clamour, the enemy would try all the harder to match the Allied synthetic penicillin ---- and neither the Germans or the Japanese were slouches in the synthetic department.
And penicillin's actual medical use was also to reveal a distinctly war-like character : it was to be triaged, military style.
That is to say, it was not to be "wasted" (to use Winston Churchill's infamous "green-inked" phrase).
There was simply no military point trying to save the lives of dying ex-combat soldiers who would be of no further military use if they did survive, not when penicillin could be better used to quickly return lightly wounded or infected combat soldiers into battle, so they could get a second crack at dying for their country.
Battles were won or lost by the side that could muster a greater number of their units' total complement into battle.
Penicillin used under such inhuman terms certainly approached the most war-like of war medicines.
War medicines like the amphetamines, ("The Ecstasy of the Einsatzgruppen") , which unlike penicillin was never in short supply on any military front.
Not once the Axis and the Allies alike discovered that like booze, it made combat soldiers more aggressive , more willing to kill or be killed.
Germ, chemical and radiation warfare were other areas where medical expertise helped make war and killing more effective.
By contrast, social medicine can actually exist in wartime : it tries to lessen the number of non-combat deaths in war and it does so not merely by pouring penicillin powder into combat wounds to reduce the chance of infection.
It says instead that all life is worthy of life, regardless of an individual life's current utility to the war effort.
Because most deaths in war occurs not in combat between troops, but when captured troops , enemy civilians and your own civilians are triaged into two piles : those worthy of decent food, shelter, and health care and those deemed unworthy.
Nazis let millions of Soviet POWS starve to death or to die of disease to free up food supplies for the German civilians back home ; they also shot to death millions of Jews for the same reason.
In India, British authorities, not caring greatly about the Bengali poor, also let millions starve to death or die of hunger related disease, in a time and place with plenty of food.
In America, medical authorities considered people with endocarditis to be a burden on scarce medical resources, who even if they did live, could never contribute much to the military or the civilian war effort - best deny them life-saving penicillin and let them die.
By contrast, Dawson and his supporters said make lots of penicillin and give it freely to our soldiers ( useless or useful) , to all our civilians at home, to civilians in neutral and occupied countries and even to enemy POWs and civilians.
And then suggest that such a coalition of nations willing to do that is really a coalition worth fighting or dying for, and a coalition worth surrendering to, because you know you will be treated fairly.
Social medicine, said Dawson, was actually the most effective war medicine of them all : and in the end, even Churchill was probably forced to reluctantly agreed, once he got the time to pause and reflect.
And he certainly got plenty of time to reflect, after his surprising post-war election defeat ---- caused in part, I believe, by his government's unwillingness to provide civilian penicillin during the war : his green-inked words had definitely come back to haunt him.....
What other artifact of war has so abruptly and so totally changed its character over the course of a war ?
In 1941, the British and American medical and military elites were in agreement that the new penicillin's best use in wartime was as a weapon - and that its success as a weapon of war depended on it remaining 'new' and hence relatively secret.
The Allies would gain an absolute advantage over the Axis only if they alone had a cheap, abundant, stable, pure , potent (secret) version of penicillin.
This could only happen if the Axis had to make do with only the increasingly ineffective sulfa drugs or the expensive, scarce, unstable, weak Public Domain (natural) version of penicillin, readily obtainable by consulting the already existing published medical literature on penicillin.
Why was penicillin so secret one moment and then the hero of newsreels the next ?
So penicillin had to remain secret in two senses.
First, penicillin had to be synthesized secretly.
This is because the old cliche of the formula stolen out of a safe in the Golden Age of Mystery books really works as a realistic plot device.
Almost all readers were aware that in the real world, without at least a fleeting glance at the synthesis formula for a process, it was almost impossible to begin to make a stab at a rival method for re-creating a man-made chemical.
Nobody steals scientific formulas used in physics, geology, astronomy or biology now do they ?
Secondly, penicillin's unique life-saving abilities had to be kept secret from the world's general public or they would demand it be made in quality for them.
Technically, the synthesizing method would still remain a secret, but alerted by the resulting public clamour, the enemy would try all the harder to match the Allied synthetic penicillin ---- and neither the Germans or the Japanese were slouches in the synthetic department.
And penicillin's actual medical use was also to reveal a distinctly war-like character : it was to be triaged, military style.
That is to say, it was not to be "wasted" (to use Winston Churchill's infamous "green-inked" phrase).
There was simply no military point trying to save the lives of dying ex-combat soldiers who would be of no further military use if they did survive, not when penicillin could be better used to quickly return lightly wounded or infected combat soldiers into battle, so they could get a second crack at dying for their country.
Battles were won or lost by the side that could muster a greater number of their units' total complement into battle.
Penicillin used under such inhuman terms certainly approached the most war-like of war medicines.
War medicines like the amphetamines, ("The Ecstasy of the Einsatzgruppen") , which unlike penicillin was never in short supply on any military front.
Not once the Axis and the Allies alike discovered that like booze, it made combat soldiers more aggressive , more willing to kill or be killed.
Germ, chemical and radiation warfare were other areas where medical expertise helped make war and killing more effective.
By contrast, social medicine can actually exist in wartime : it tries to lessen the number of non-combat deaths in war and it does so not merely by pouring penicillin powder into combat wounds to reduce the chance of infection.
It says instead that all life is worthy of life, regardless of an individual life's current utility to the war effort.
Because most deaths in war occurs not in combat between troops, but when captured troops , enemy civilians and your own civilians are triaged into two piles : those worthy of decent food, shelter, and health care and those deemed unworthy.
Nazis let millions of Soviet POWS starve to death or to die of disease to free up food supplies for the German civilians back home ; they also shot to death millions of Jews for the same reason.
In India, British authorities, not caring greatly about the Bengali poor, also let millions starve to death or die of hunger related disease, in a time and place with plenty of food.
In America, medical authorities considered people with endocarditis to be a burden on scarce medical resources, who even if they did live, could never contribute much to the military or the civilian war effort - best deny them life-saving penicillin and let them die.
By contrast, Dawson and his supporters said make lots of penicillin and give it freely to our soldiers ( useless or useful) , to all our civilians at home, to civilians in neutral and occupied countries and even to enemy POWs and civilians.
And then suggest that such a coalition of nations willing to do that is really a coalition worth fighting or dying for, and a coalition worth surrendering to, because you know you will be treated fairly.
Social medicine, said Dawson, was actually the most effective war medicine of them all : and in the end, even Churchill was probably forced to reluctantly agreed, once he got the time to pause and reflect.
And he certainly got plenty of time to reflect, after his surprising post-war election defeat ---- caused in part, I believe, by his government's unwillingness to provide civilian penicillin during the war : his green-inked words had definitely come back to haunt him.....
Monday, December 31, 2012
The re-invention of a military-only antiseptic into "bedside penicillin for all" creates a global beacon of hope for a world at war
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| the tiny stone the builders rejected |
DNA was discovered in 1860s by an Swiss doctor, but for most of us, it was really only discovered 125 years later in the late 1980s.
That was when it began to first be successfully used to solve unsolved criminal cases, when British researcher Alec Jeffries re-invented 'DNA' as a means to definitely identify biological evidence left at the scene of a crime.
The great medical pioneer Joseph Lister clearly re-invented carbolic acid, when he took it from just one of many industrial solvents and turning it into a global life-saver.
Paul Gelmo "invented" sulfa as man-made chemical in Vienna in 1908 and it was routinely patented in 1909 by Bayer the chemical giant hoping it might yet be a useful chemical intermediate reagent.
But not until Gerhard Domagk , also of Bayer, who systemically tested every one of his firm's new chemical creations for its medical potential, was its life-saving abilities "discovered".
But I still hold this to be a case of re-invention.
It took an awful lot of grit and determination during the Great Depression to waste scarce company money by systemically and thoroughly testing every one of the thousands of chemicals Bayer made, on then very remote possibility one might have medical applications.
The Nobel committee obviously agreed with me - giving Domagk the inventor and not Gelmo the discoverer the Nobel Prize for sulfa.
Alexander Fleming accidentally discovered penicillin in1928 and "discovered" it was only useful as a military-style antiseptic.
In 1940, Florey and Chain accidentally discovered that penicillin also might work as a systemic.
But like Fleming (by 1940) ,they still choose to emphasize its rather limited application against combat wounds infected by staph bacteria : a tiny, tiny, TINY proportion of all the deaths caused by WWII.
They were hardly alone : I was amazed to discover in my research that I could find no penicillin-making researcher between 1928 and 1945 who first put their penicillin to work as a human systemic life-saver, before they also tried it on localized wounds.
With one crucial exception: Henry Dawson.
In October 1940, months ahead of the schedule that he and his three fellow researchers had already worked out, he choose to inject systemic penicillin into two young men suffering from invariably fatal endocarditis.
At least one of the men - unexpectedly - lived.
It wasn't because of Dawson's penicillin : at an estimated 8 units per mg, it was about .56% pure.
Useless Junk ? Or Love, Hope and Charity ?
The rest (99.44%) was junk - or as I like to emphasis : "99 and 44 100ths percent pure love....hope... and charity" -- bedside penicillin.
A good bedside manner has probably saved more lives throughout history than all but a tiny handful of medications.
I contend that Dawson deliberately used his tiny amounts of home-made penicillin as part of his traditional clinician's bedside manner, to rally his patients' own body defences against their disease.
As prove, I offer up Gladys Hobby, a fellow member of his tiny team, who said she daily walked through Henry Dawson's wards, showing the patients the growing penicillium in flasks, hoping their rising interests in their treatment might rally their psychic resources.
Dawson was not content to reserve his invention of "bedside penicillin" to the handful of endocarditis patients that his small home-made supply could hope to treat.
So Dawson quickly told a convention of his colleagues (the world's top clinical researchers) that natural penicillin had "unlimited possibilities", thousands times stronger than the then acclaimed synthetic sulfas, but without their toxic side effects and inability to work well in blood and pus.
These researchers took his claims home to their labs all over the world.
Meanwhile popular media, like the New York Times , Newsweek and the wire services, spread his gospel throughout North America.
He tried to get the American government - in 1941 -(and by extension all Allied governments) to take over the production of penicillin form Big Pharma and mass produce it themselves in quantity.
Instead, wartime government bureaucrats, who were themselves paid consultants to Big Pharma , censored Dawson's conventional scientific methods to spread his good news - by restricting his access to scientific journals and restricting what he could say at scientific conferences.
But in wartime, person-to-person gossip becomes the new telegraph.
So Dawson was able to keep on spreading the word until most all of the doctors in metropolitan New York and beyond had heard of his unexpected successes with systemic natural penicillin, curing incurable endocarditis , the "Gold Standard" of infectious diseases.
Penicillin , he said, didn't have only a limited wartime role, limited to just being applied to local staph infections in combat wounds or to cure self-inflicted military VD cases.
He said it had unlimited possibilities and could cure many of the diseases that plague a peacetime nation or a multi-million man wartime military --- if only government bureaucrats opened their eyes, their hearts and their pockets and gave it a "fair go" .
When the world's general populace, after the story of Baby Patricia broke worldwide, catch Dawson's "vision thing" , governments were forced to play catch up in the production of actual penicillin.
Meanwhile, they too caught Dawson's "vision thing" and governments all over the world turned their propaganda machine full blast to tout penicillin as a beacon of future health and hope for all , if only the Allies win this war.
The key change in the Allied governments' approach was that "for all" as it became clear that the voters did not agree with an Allied war effort that deliberately limited the supply of life-saving medicine and then triaged the world into the people worth saving and those not worth saving.
That - they said - sounded awfully familiar : wasn't that also Hitler's line ?
Well it was certainly Modernity's line : the methods of instrumental rationality ruled all the modern nations from America to Germany.
By contrast, Dawson's general systemic was 'general' in the widest sense of that word.
He thought it was particularly important in a Total War against Absolute Evil to give - and be seen giving - life-saving health care and food & shelter to all : it was the best single reason why people should be willing to fight and die for the Allies' cause.
And seventy five odd years later, was he not right ?
Penicillin has a powerful mystique that tens of thousands of other useful medications ,combined, can't hope to match.
Dawson's crusade to make his inexpensive, abundant, safe "bedside penicillin" a commonplace at hospital beds the world over , in war and in peace , is the major reason we grant penicillin that mystique....
Tuesday, December 4, 2012
1942's key question : not can penicillin save lives but can SULFA still save lives ...
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| wartime PENICILLIN's unlikely saviour |
The biggest sin of Allied medical planning bureaucrats and their political masters was not in ignoring the life-saving potential of natural penicillin in mid-1942, but rather in ignoring the awkward fact that their chemical wunderkind sulfa was increasingly starting to fail to save lives.
They could claim that one can hardly go about searching - in the midst of a Total War - for some new knight on a shiny horse, until one knows for sure that the old knight is fading fast.
But in fact the signs were all there - in more and more anguished published reports from frontline clinicians, on the Home Front and in battlefield hospitals - but the planners deliberately ignored them.
They felt they had no choice, because they felt they had to button down some hard medical choices and stick with them regardless, in the reasonable expectation of a late 1942/ early 1943 invasion of Occupied Europe.
The supply chain and taught protocols for frontline medicine for ten million soldiers is not something stopped, started and reversed on a dime.
However, this does not excuse them for not placing lots of large, firm orders (aka big $$$$$$$) for natural penicillin, as it existed in 1942, for use in Home Front hospitals and rear echelon base hospitals.
People were dying from sulfa being no longer always effective - dying by the tens and hundreds of thousands world wide.
But , true to the tenets of heartless war medicine - the bureaucrats stuck to their chemical dogmas and mantras, regardless of new evidence.
Dawson's shovel-ready penicillin vs Fleming's synthetic chimera penicillin
It was probably only the Casablanca Conference's decision, in January 1943, to postpone the planned invasion for at least a year (together with the timely replacing of hidebound American Army Surgeon General James Magee) that ensured that penicillin became a big wartime success (rather than a small post-war success).
This, as much as anything Dawson's shovel-ready penicillin or Fleming's synthetic chimera penicillin did or didn't do......
Saturday, September 29, 2012
Dr Martin Henry Dawson and the MORAL INVENTION of 4F penicillin ---- during a 1A war (PART 1)
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| Thalidomide has had 9 lives... |
Not in the eyes of 99.9999999% of contemporary (and very grateful) observers. Because what Domagk invented was something called Sulfa-the-lifesaving-miracle.
Though you'd never notice from our "initial discovery" obsessed journalists, many, many important things were invented several times over.
Thalidomide is a particularly spectacular example : it had already had several medical applications ( with good successes but also very severe side effects that were kept secret) before it was promoted to cure morning sickness.
We all know the results that that particular application caused.
But, believe it or not, it is still in use - for forms of leprosy in particular, - and still being investigated for its ability to inhibit some tumours: new uses still being invented for an old "initial invention" .
AZT and carbolic acid were both much later "re-invented" when they were dragged out of the medical gutter and first used for the uses we best know them for today.
We don't - but we should - most highly honor those people who first put a product to its highest use, rather than merely honoring those who first invent or discover it as a mere substance.
Those who only honor those who initially discover or invent something are unconscious devote disciples of Auguste Comte and his dogma of Positivism.
That school of thought, if it can be called that, sometimes assumes that the mere act of discovering or inventing something will also instantly inform that inventor/discoverer as to its many self-evident uses and to its self-evident highest possible use.
Anyone else who later does put it to such uses, in this view, was merely taking advantage of information that is open to all that gaze up the substance---- and hence not worthy of any honor.
Put like that, Positivism use in this case does seem childishly ridiculous - as many unstated assumptions often are - when they are more closely examined.
Most re-inventions are of a technological nature : something long thought capable of merely reducing the pain of leprosy turns out to actually - and unexpectedly - reduce the advance of the disease. ( In this case, the drug in question is thalidomide.)
But probably the most famous medicine and science story of all time also saw a substance re-evaluated for a new use , but for moral reasons.
A doctor's moral anger drove him to break a whole bunch of rules and norms to stick the first ever needle of (dirty) penicillin in a dying patient's arm : and the patient lived.
There had never been any technological barriers to putting Alexander Fleming's penicillium juice in a needle and sticking it in a patient's arm to save their life.
Not even to sticking penicillin into someone's arm to save them from invariably fatal Subacute Bacterial Endocarditis (the dreaded SBE).
Doctors and Scientists' objections to natural (impure) systemic penicillin were only ones of an aesthetic nature
The objections had only been quasi-aesthetic : in a modern scientific age, was it worth the risk to the dignity of the medical profession, to be seen sticking something seen as mostly dirt into the human bloodstream, even if it was in a worthy attempt to save the life of someone otherwise facing immediate death?
Many doctors, faced with lots of patients dying of an invariably fatal disease, will indeed throw a kitchen sink of oddball medical treatments at them, in the hope one will stick. SBE saw many such attempts.
But from September 1928 till October 1940, no doctor in the world ever stuck penicillin in someone's arm, to see if it might save their life --- for any disease. Amazing but true.
Since 2004, I have lived and breathed and dreamt why this might be so - and why the unlikely doctor who finally did so , Martin Henry Dawson, chose to break that mental barrier.
It matters because it is only his Penicillin (Penicillin-the-natural-systemic) that the world has used since 1940 - not Alexander Fleming's Penicillin-the-synthetic-antispetic or Howard Florey's Penicillin-the-synthetic-systemic.
It is his penicillin - and his penicillin only - that we use, but it was those two who got the Nobel Prizes for penicillin.
Dawson probably backed his way into penicillin - driven by his anger over the way that the "4F" in society were so quickly abandoned at the first opportunity --- in this case, in preparing to fight a war using the best "1As" in society.
His special area of interest - Rheumatic Fever (RF) - was mostly a disease of the poor, so the well-off donors to the cause of RF were largely motivated by pure altruism.
But it had been recently replaced (by the Fall of 1940) by Polio as the number one child health "Cause" for America's well off .
Polio deaths were far ,far outnumbered by RF deaths, but polio was a disease of the well off mainly, and this was the first evidence of a now common organization : the patients (families) self-help group : mothers going to door to door to find a cure for a disease that might hit their own children.
We generally think this is a good thing, but it is also another example of a society of individuals increasingly looking out for Number One.
In 1940,mighty America collectively looked out for itself as Number One and did not come to the aid of about a dozen of Europe's small weak nations : Czechs, Poles, Danes , Belgians etc etc.
Dawson who had gone to war to help the people of little Belgium in 1915, was in agony - too old to fight, but also too principled to just sit back.
When he arrived in the Fall of 1940 back at his employer (Columbia University Medical School), he found that the research and teaching efforts were to be dialled back in social medicine (medicine to help the poor) and put into war medicine (making the armed forces better fighters).
By sheer coincidence, his fellow researcher, German Jewish refuge (and potential internment camp alien) Dr Karl Meyer, wanted to revenge himself upon another biochemist who he felt had downplayed Meyer's successes. This biochemist was also a German Jewish refuge and potential alien in an internment camp), Ernst Chain.
Both men were not evil or naive : they simply knew the best way to be kept out of a miserable internment camp in the event of war, was to be judged very useful by their anti-semitic hosts. So they were holding nothing back to avoid an internment camp for themselves and their families.
Meyer thought he was a far better biochemist than Chain (very true !) and could more quickly and easily synthesize penicillin than Chain (very untrue !)
Would his friend, Dawson the bacteriologist and clinician, help out by testing the resulting product ?
Dawson read up on what little there was on penicillin and noticed its unique combination of extreme non-toxicity and extreme diffusiveness could possibly be the best shot in a long time to cure SBE.
Now SBE was usually a matter for the heart specialists (an elite in every hospital) and Dawson's main job was in an arthritis out-patient clinic (at the low end of any hospital's pecking order).
Moreover, some people had made SBE their primary lifelong research and clinical interest and Dawson had never - as far as I can tell - written or spoken on SBE.
To barge into their area of expertise would be a disaster.
I can only presume that Dawson first suggested his idea to SBE and heart experts and then to his contacts at the big Drug Companies.
Only when none responded positively and he had two dying SBE patients in front of him, did he act.
Because he felt that penicillin might save their lives, he pulled out all stops and broke all the rules and norms, to try and save their lives --- with this urgency additionally fueled by his anger at how the 4Fs of society were now being treated.
SBEs, in a month of the first ever peacetime Draft registration ( an entire nation trying to find all the 1As in society), were everyone's 4Fs of the 4Fs : about the most useless to the war effort young males imaginable.
Many medical staff felt they'd only consume precious medical attention for months and then invariably die anyway.
So, when Dawson stuck that first ever penicillin needle into an SBE's arm on that first ever peacetime Draft Registration Day, I feel sure his first finger was cocked in the air while the other four were wrapped around the needle.
"Down goes the needle - and 'up yours' !!!!! " .....
Monday, September 24, 2012
DRUGS and Romney's 47% : AZT, Penicillin and Sulfa once didn't pay federal income tax either
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| AZT once part of the 47% |
Roughly 47% of all of our most famous, best-loved, life-saving drugs were written off as "useless" when first discovered.
In the lexicon of Ryan, Romney and Republicans everywhere : they were part of the "unfit" 47% - well past caring about.
So Sulfa, penicillin and AZT were labelled as "useless" for 30 , 15 and 20 years respectively.
But then some kindly souls picked them up out of the medical gutter and gave them second chance, a second chance to do good and save lives.
AZT, Penicillin, Sulfa later saved the lives of those who earlier wrote them off as "useless" : poetic justice
But revealing once again that God has an infinite sense of irony, He - in his spirit of forgiveness - later permitted those "unfit" miracle-inducing medications to be used to save the lives of Romney, Ryan and all the rest of those church-going Republicans.
All the people who had earlier failed so demonstratively to obey God's command to show mercy to the "unfit" : there is a lesson here - maybe even a sermon (!) : something about how the weak and the useless are sent to humble the mighty and the wise, maybe ...
Wednesday, September 12, 2012
Sulfa's Alexander Fleming : Paul Gelmo, winner of 1939 medical Nobel for discovery of Sulfa
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| Sulfa the MIRACLE drug |
(And in truth Paul Gelmo did not win the 1939 Nobel in Medicine for his discovery. Gerhard Domagk, the actual winner, deserved his Nobel for sulfa about as much as Ernst Chain did his Nobel for penicillin --- which is to say "still in doubt".)
Gelmo invented cum discovered sulfanilamide in 1908 as part of his PhD in organic chemistry, doing what Germans of his generation did best : churn out endless synthetic variants of dyes.
It had no known uses, although 11 years later it was found to have some anti-bacterial quantities by American biochemist Michael Heidelberger.
Voices off, unheard : the cries of the dying
But Heidelberger didn't feel any moral urgency to push to have it tested clinically, to see it it might actually save lives.
(Heidelberger, a later colleague of Martin Henry Dawson , similarly declined to assist Dawson in the development of penicillin - thus missing on the ground floor action of the century's two biggest lifesavers.
Cry not for Michael - he outlived Gelmo and Dawson and died showered in laurels, apparently for never uttering an unconventional thought over his long, long life : an all around, don't-rock-the-boat, team player.)
Domagk did two things with Gelmo's sulfa , one good one bad.
The good thing is that he did what Ernst Chain did ,but which Fleming refused to do : he tested the substance at hand "in living creatures ("in vivo") despite it have failed earlier test tube tests ( "in vitro tests").
Once inside animals, surprise, surprise, it did work and it did fight off the deadliest of infections.
The bad thing he did is that he went along with his employer, I G Farben, when it delayed telling the world about this life-saving drug (the only one available at the time, mark you) for years, while it sought to invent a patentable analog of it.
Neither I G Faben or Domagk felt any moral urgency to put the drug they did have at hand on the market at once, profitably-patentable or not.
The actual dye that Domagk was originally charged with testing consisted of two separate molecules ( one of them sulfa) loosely bonded together to form a beautiful ruby-red dye---- a totally new dye and hence very patentable.
Ie potentially very profitable as a dye - but not as a drug.
This was because "in vitro", bonded together inside a test tube, the two molecule "patentable" ensemble did nothing medically.
But once in a living body,"in vivo", the body's enzymes quickly cleaved the bonds between the two molecules and the sulfa portion - once on its own, quickly brought bacteria growth to a stop.
Sulfa could and did save tens of millions of lives.
But as sulfa was now Public Domain (PD) 25 years after its original discovery, it would make no real money (only worldwide gratitude and acclaim) for I G Faben, and so they stalled releasing this life-saving miracle.
But as they never could find an analogue for sulfa , I G Faben finally and reluctantly released the original 2 molecule dye without telling anyone that it cleaved apart in living bodies and the active ingredient was a dirt cheap, abundant (and PD) byproduct of many dyeing operations.
Domagk-the-hero has to be forever tainted for his part in this delay.
Fleming also never tested his penicillin in a living being with a disease - he just did "in vitro" testing that told him that penicillin killed bacteria slower than it was secreted out of the body - thus to the never-one-to-waste-a-motion Fleming it seemed so useless as a systemic that it was not even worth testing "in vivo".
He felt no moral urgency in "just double checking" his hunch.
When Howard Florey - pushed hard by Chain - did finally test penicillin almost 12 years after it had been first discovered , he found it did kill artificial infections inside animals - it did work , "in vivo" !
But while he was an editor of the journal that Fleming's original 1929 article appeared in and so could have demanded Fleming do the "in vivo" tests to double check Fleming's hunch, he never did so.
That he did so only 12 years later - and this when pushed hard by Chain - hardly displays any moral urgency on his part to test this potential life-saver.
Sulfa and penicillin - successes "in vivo", failures "in vitro".
Like I G Faben , though not because it could be profitably patentable as a result, Fleming and Florey put all their priorities to see penicillin made synthetically before it was given mass distribution.
Martin Henry Dawson was all alone in believing that natural penicillin was perfectly acceptable to be mass produced and put to work right away, because people all around were dying daily without it.
Dawson thus invented a moral reason why natural penicillin should be mass produced "today - if not sooner".
It was this 'moral urgency' that Dawson alone brought to its invention, that finally led to the development of mass produced life-saving systemic penicillin.
A moral urgency that Fleming, Florey,Heidelberger and I G Faben all so obviously lacked.....
Thursday, July 29, 2010
Physics,Chemistry break 1940 promises
At the time of the New York World's Fair, with its theme of a learned gaze into the crystal ball to reveal the America of the 1960s, Big Physics and Big Chemistry made two firm promises:
Physics promised that with nuclear fission newly achieved, by 1960 your family home would be heated and lit by electricity '"too cheap to meter", made by atomic energy.
It also said that this war would be a clean quick war, hitting only military targets, as B-17 bombers, with precision Norden bombsights, would be able to drop a bomb into a pickle barrel ,from 15,000 feet.
Chemistry pledged that your family would be disease free by the 1960s, "with hospitals no longer used for infectious diseases", thanks to pure,defined, man-made chemicals like the growing family of sulfa drugs.
But in 1945, atomic energy was used only to destroy homes (and the families inside).
(And with a bomb that powerful there was no need to aim, which was just as well ,as the Norden bombsights turned out to be useless.)
True, diseases were being held at bay, but not conquered, by 1945.
But not by the toxic and increasingly ineffective sulfa drugs.
Rather the success was due to penicillin - an impure,undefined mixture made by Nature and grown on an impure, undefined mixture of nutritional mediums also made by Nature.
And it was the humble science of biology that helped make it all work - while chemists only got in the way.
World War Two was NOT a triumph of nerdy,weedy scientists in spectacles winning the war when the stud muffin /BMOC /football captains of America proved unable to best the visiting German and Japanese teams out on the field.
This was the official take on World War Two Science, as produced by the leading science bureaucrats in their official and semi-official histories.
Because this 'revenge of the nerds' is so self-flattering to academics, even normally skeptical historians have lapped up the 'official version' like it was mother's milk.
In truth, Science suffered as many defeats to its ego during WWII as any over-confident general ever did.
In 1940, Man may have batted first, but by 1945 it was Nature that bats last: and Nature bats last and Nature bats long ....
It would perhaps be a bit much to ask today's historians to turn their sights on their colleagues and themselves and ask have they probed the truth of the penicillin saga or , to paraphrase Donald J McGraw,("On Leaving the Mine ", 1991) have they been content to merely uncritically retell tales already told too often ?
Physics promised that with nuclear fission newly achieved, by 1960 your family home would be heated and lit by electricity '"too cheap to meter", made by atomic energy.
It also said that this war would be a clean quick war, hitting only military targets, as B-17 bombers, with precision Norden bombsights, would be able to drop a bomb into a pickle barrel ,from 15,000 feet.
Chemistry pledged that your family would be disease free by the 1960s, "with hospitals no longer used for infectious diseases", thanks to pure,defined, man-made chemicals like the growing family of sulfa drugs.
But in 1945, atomic energy was used only to destroy homes (and the families inside).
(And with a bomb that powerful there was no need to aim, which was just as well ,as the Norden bombsights turned out to be useless.)
True, diseases were being held at bay, but not conquered, by 1945.
But not by the toxic and increasingly ineffective sulfa drugs.
Rather the success was due to penicillin - an impure,undefined mixture made by Nature and grown on an impure, undefined mixture of nutritional mediums also made by Nature.
And it was the humble science of biology that helped make it all work - while chemists only got in the way.
World War Two was NOT a triumph of nerdy,weedy scientists in spectacles winning the war when the stud muffin /BMOC /football captains of America proved unable to best the visiting German and Japanese teams out on the field.
This was the official take on World War Two Science, as produced by the leading science bureaucrats in their official and semi-official histories.
Because this 'revenge of the nerds' is so self-flattering to academics, even normally skeptical historians have lapped up the 'official version' like it was mother's milk.
In truth, Science suffered as many defeats to its ego during WWII as any over-confident general ever did.
In 1940, Man may have batted first, but by 1945 it was Nature that bats last: and Nature bats last and Nature bats long ....
It would perhaps be a bit much to ask today's historians to turn their sights on their colleagues and themselves and ask have they probed the truth of the penicillin saga or , to paraphrase Donald J McGraw,("On Leaving the Mine ", 1991) have they been content to merely uncritically retell tales already told too often ?
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