Forget the famous February 1941 story of a poor policeman dying from the scratch of a rose.
Its bull - bullfeathers.
Totally bogus - at least as a founding legend of penicillin.
You know the one, where our policeman dies, despite the desperate attempts to save his life with the 'first ever' needles of penicillin by an Australian born doctor named Florey.
Dig deeper and there is lots about that story to question - but that's for another day.
Today we are to celebrate , not to criticize.
The "first ever" use of an antibiotic by needle to save a human life actually happened months earlier and an ocean away and that needle was given by a Canadian-born doctor named Martin Henry Dawson.
Most importantly, that first ever patient, a 27 year old youth named Charles Aronson, walked away from his deathbed !
(Charlie was suffering from an invariably fatal disease called SBE, the final stage of Rheumatic Fever).
The amount of penicillin given to him was far far far too small to kill his biofilmic bacteria around his heart valves ---- but it might have affected his heart greatly nevertheless : his emotional heart.
It lifted his morale and that way enough for this boy with a cat-like nine lives when it came to Strep bacteria attacks.
When last contacted in early 1946, Charlie was still alive, still here !
Truro, Nova Scotia ( Dawson's hometown) take a bow .....your boy did us all proud....
Saturday, October 16, 2010
Friday, October 15, 2010
the epic triumph of DEMAND SIDE penicillin
All penicillin histories - to date - have been about what I call "SUPPLY SIDE" penicillin.
"They did so by dropping the new miracle cure penicillin upon them, out of the blue, in September 1943."
This version of the saga says penicillin is best told in two competing stories or parts.
But both parts are united in being all about active scientists --- with no role what so ever for us, the totally passive and inert citizenry, or in our roles as patients and patients' families.
Part One ,(1928-1937), features Dr Fleming - discoverer of penicillin - with far too many pages devoted to the mysteries of that discovery and with too few of the rest devoted to his efforts to bring his penicillin juice forward to the point of actually saving lives -----when used as an antiseptic.
Part Two, (1937-1940), features Dr Florey of Oxford University (all bow) and his years of wartime work on the chemistry of penicillin - all about his troubles extracting and purifying and synthesizing penicillin.
My book will be about Part Three, (1940-1943), the era of "DEMAND SIDE" penicillin. It will be all about the life-saving done by early penicillin doctors (not scientists), on the rare occasions when penicillin was diverted to the ward bedside and away from the synthetic chemists.
It will focus on Dr Dawson - the patient. Yes, the patient.
Dawson was not unique in deciding to become a doctor after months spent in a hospital - Dr Colitti ( of Patty-Malone-and-penicillin fame) resolved to become a doctor after his own childhood bouts in hospital dealing with his spinal TB that left him a permanent hunchback.
For Dawson, his insights as a doctor dealing with chronically and terminally ill SBE patients could only have deepened when he himself became a chronically and terminally ill MG patient at about the same time.
Actually I will focus on Dawson, on his first penicillin cure Charlie Aronson, on Baby Patricia Malone's family and on the mother of a dead child he never got to save - Mae Smith, wife of Pfizer chief John L Smith.
In August 1943,Dr Dante Colitti - inspired by Dawson's illegal SBE successes (an early example of ACTING UP) at another hospital a mile away, got Mr and Mrs Malone to also 'ACT UP' and publicly demand penicillin for their dying child.
Soon hundreds of families were doing the same all over North America and when enough Doctor Moms kicked up a fuss, even the stupidest men in Washington or Brooklyn listened - penicillin production really got moving, after 15 years of male excuses for 'not taking out the trash'.
CHRONICALLY ILL are always 4F
Med Schools in that era - and perhaps even today - hated the chronically ill because they refused to die or get better, within the only school term that could be devoted to that particular form of illness.
The chronically ills' failure to get better 'put paid' to the notion that Science was always successful.
And Society in general packed the chronically ill of low income families away in large impersonal institutions with too many patients and too little money.
It got worse in wartime - a lot worse. A lot of people feel free to unleash their inner evilness in wartime and the helpless are a safe target.
In Hitler's Germany, the chronically ill were actively gassed - particularly those 'useless mouths' type patients like the SBEs (Charlie) and MGs (Dawson) who needed lots of repeated interventions of high tech medical care without any hope they would eventually recover and start back at productive war work.
In Vichy France or in the US, it was more subtle - the eugenics of benign neglect.
Budgets were cut for the chronically ills day to day living expenses so more money could go to the war, or simply back to the well to do taxpayer when no one was able to complain.
Many chronically ill in institutions died of hunger-induced infections while the budget-cutters' consciences could remain unsullied.
Chronic illness research efforts were re-directed away from these useless mouths 4Fs towards the 1As and war medicine.
Many patients were conscripted,without their informed consent, in some very dangerous experiments for the war - humans being as badly and baldly treated and cast off as laboratory white mice usually are.
Dawson and his supporters rejected the artificial divide between Social Medicine and War medicine, between social penicillin and war penicillin.
They said , against Hitler and Tojo, social medicine was war medicine,in fact the best kind of war medicine.
They said are we fighting Hitler simply because he took raw materials and markets we once regarded as ours or rather because we detest his values with all our hearts?
If it truly was the latter - FDR's Four Freedoms - we should contrast how we treat our old and weak against how Hitler treated his.
For we will all become old and weak someday.
By 1943-1944, a lot of people saw that Dawson was right - and penicillin's promise was held out to people in the occupied ,enemy, allied and neutral nations as a symbol of the rightness of the Allied Cause.
Until then it had been treated as one of the Allies' best war weapons - a strange term for a life-saver .
Yes, Dr Dawson probably did 'go a little native' when he got MG and became a perpetually ill patient as well as life-saving doctor -----but Thank God for that !
In January 1945, when AMA boss Morris Fishbein, the American medical censor, finally let Dawson tell American GPs about his five years of successfully curing SBE with penicillin, Dawson could reflect he hadn't done too badly for a chronically ill 4F.
Most histories of penicillin - to date - act like Dawson withdrew to a shadow world of chronic illness and inactivity after he got his MG diagnosis around May 1941, so the authors can return to focus on his rival Florey.
But in the Spring of 1945, Dawson could say, like a lot of chronically ill people who kept on being highly productive despite the pain, "*I'm Still Here - and so is my penicillin !"
Partially because of Dawson and Colitti's ACTING UP, patients today are much more likely to demand quick relief rather than simply waiting for the desultory scientists to get it all perfect and pure before dropping it into our grateful little hands - and Thank God for that, too....
"Brilliant scientists, working day and night in the 15 years since September 1928, once again totally surprised humble but ever grateful lay people all over the world."
"They did so by dropping the new miracle cure penicillin upon them, out of the blue, in September 1943."
This version of the saga says penicillin is best told in two competing stories or parts.
But both parts are united in being all about active scientists --- with no role what so ever for us, the totally passive and inert citizenry, or in our roles as patients and patients' families.
Part One ,(1928-1937), features Dr Fleming - discoverer of penicillin - with far too many pages devoted to the mysteries of that discovery and with too few of the rest devoted to his efforts to bring his penicillin juice forward to the point of actually saving lives -----when used as an antiseptic.
Part Two, (1937-1940), features Dr Florey of Oxford University (all bow) and his years of wartime work on the chemistry of penicillin - all about his troubles extracting and purifying and synthesizing penicillin.
My book will be about Part Three, (1940-1943), the era of "DEMAND SIDE" penicillin. It will be all about the life-saving done by early penicillin doctors (not scientists), on the rare occasions when penicillin was diverted to the ward bedside and away from the synthetic chemists.
It will focus on Dr Dawson - the patient. Yes, the patient.
Dawson was not unique in deciding to become a doctor after months spent in a hospital - Dr Colitti ( of Patty-Malone-and-penicillin fame) resolved to become a doctor after his own childhood bouts in hospital dealing with his spinal TB that left him a permanent hunchback.
For Dawson, his insights as a doctor dealing with chronically and terminally ill SBE patients could only have deepened when he himself became a chronically and terminally ill MG patient at about the same time.
Actually I will focus on Dawson, on his first penicillin cure Charlie Aronson, on Baby Patricia Malone's family and on the mother of a dead child he never got to save - Mae Smith, wife of Pfizer chief John L Smith.
In August 1943,Dr Dante Colitti - inspired by Dawson's illegal SBE successes (an early example of ACTING UP) at another hospital a mile away, got Mr and Mrs Malone to also 'ACT UP' and publicly demand penicillin for their dying child.
Soon hundreds of families were doing the same all over North America and when enough Doctor Moms kicked up a fuss, even the stupidest men in Washington or Brooklyn listened - penicillin production really got moving, after 15 years of male excuses for 'not taking out the trash'.
CHRONICALLY ILL are always 4F
Med Schools in that era - and perhaps even today - hated the chronically ill because they refused to die or get better, within the only school term that could be devoted to that particular form of illness.
The chronically ills' failure to get better 'put paid' to the notion that Science was always successful.
And Society in general packed the chronically ill of low income families away in large impersonal institutions with too many patients and too little money.
It got worse in wartime - a lot worse. A lot of people feel free to unleash their inner evilness in wartime and the helpless are a safe target.
In Hitler's Germany, the chronically ill were actively gassed - particularly those 'useless mouths' type patients like the SBEs (Charlie) and MGs (Dawson) who needed lots of repeated interventions of high tech medical care without any hope they would eventually recover and start back at productive war work.
In Vichy France or in the US, it was more subtle - the eugenics of benign neglect.
Budgets were cut for the chronically ills day to day living expenses so more money could go to the war, or simply back to the well to do taxpayer when no one was able to complain.
Many chronically ill in institutions died of hunger-induced infections while the budget-cutters' consciences could remain unsullied.
Chronic illness research efforts were re-directed away from these useless mouths 4Fs towards the 1As and war medicine.
Many patients were conscripted,without their informed consent, in some very dangerous experiments for the war - humans being as badly and baldly treated and cast off as laboratory white mice usually are.
Dawson and his supporters rejected the artificial divide between Social Medicine and War medicine, between social penicillin and war penicillin.
They said , against Hitler and Tojo, social medicine was war medicine,in fact the best kind of war medicine.
They said are we fighting Hitler simply because he took raw materials and markets we once regarded as ours or rather because we detest his values with all our hearts?
If it truly was the latter - FDR's Four Freedoms - we should contrast how we treat our old and weak against how Hitler treated his.
For we will all become old and weak someday.
By 1943-1944, a lot of people saw that Dawson was right - and penicillin's promise was held out to people in the occupied ,enemy, allied and neutral nations as a symbol of the rightness of the Allied Cause.
Until then it had been treated as one of the Allies' best war weapons - a strange term for a life-saver .
Yes, Dr Dawson probably did 'go a little native' when he got MG and became a perpetually ill patient as well as life-saving doctor -----but Thank God for that !
In January 1945, when AMA boss Morris Fishbein, the American medical censor, finally let Dawson tell American GPs about his five years of successfully curing SBE with penicillin, Dawson could reflect he hadn't done too badly for a chronically ill 4F.
Most histories of penicillin - to date - act like Dawson withdrew to a shadow world of chronic illness and inactivity after he got his MG diagnosis around May 1941, so the authors can return to focus on his rival Florey.
But in the Spring of 1945, Dawson could say, like a lot of chronically ill people who kept on being highly productive despite the pain, "*I'm Still Here - and so is my penicillin !"
Partially because of Dawson and Colitti's ACTING UP, patients today are much more likely to demand quick relief rather than simply waiting for the desultory scientists to get it all perfect and pure before dropping it into our grateful little hands - and Thank God for that, too....
* "I'm Still Here !" is a copyrighted expression and used with the kind permission of the late copyright holder, Margo Takacs Marshall, 1928-2010
Tuesday, October 12, 2010
Florey,Dawson's clashing business models
Florey and his many scientific supporters have always said that his interest in penicillin, beginning in early 1938, was the fact that it killed staph bacteria while the sulfa drugs did not.
Staph was not a big killer back then - not like strep bacteria - at least not in peacetime.
It tended to do its worst when it settled deep into big bones that weren't well supplied with blood - making it hard for white blood cells and sulfa molecules to get at the bacteria.
This condition is called acute or chronic osteomyelitis and it was rampant among the young children of the poor - in peacetime.
In wartime, surviving victims of war wounds - or the surviving wounded from the Blitz - often had huge deep wounds that involved their leg bones - a hard-to-get-at location that was ideal for staph bacteria to settle in for a long stay.
Patients affected went back and forth from convalescence bed to hospital bed while doctors and nurses strived to prevent the patient from getting worse in the hope the body would eventually seal off the infection without crippling the patient in the process.
Often they survived but were left crippled - other times the patient's resistance weakened and the staph spread widely till the patient died of general blood poisoning.
In war time, deep bone wounds infected by staph represented a massive cost to the military medical system - consuming resources for years while the affected soldier was unlikely to ever to return to full service. Blitz victims similarly taxed the overworked civilian medical system.
So Florey's business model for "war penicillin" - penicillin as a mere supplement for the sulfas, its wartime use to be strictly limited to healing military patients with deeply set staph infections of the bones and limbs - how did it sell ?
It didn't.
There is no record in all his biographies that any military medical types ever visited him until 1943 - nor is it recorded anywhere that he visited military doctors and was turned down.
Curious - the Navy, Air Force, 8th Army in North Africa, the Blitz victims - they had no end of deep staph infections of the bones to treat from September 2nd 1939 to September 2nd 1942 (three years - half of the entire war) but they avoided penicillin like it was plagued.
Florey was set up to supply an non-existent market.
By contrast,from 1940 to 1942, Dawson's main market had more customers than he could hope to fill.
Florey,Fleming, Heatley, Merck, Dawson of course, they all got requests (from around the world) for penicillin to treat SBE after Dawson announced that he had hopes to cure SBE with the new drug.
Dawson's business model for penicillin could not have been more different from Florey's.His Social Penicillinhe wanted to be made by a government factory and made available to all ( civilians and soldiers) in quantity and at a reasonable price - and made available like yesterday.
He thought penicillin could replace sulfa, not just supplement it, and used to kill all bacteria that was sensitive to it - not just staph.
Florey didn't directly treat any cases - he had no hospital rights unlike Dawson.
But the twenty serious systemic cases he
indirectly treated were almost all staph infected - so he kept to his business model in his own practise.
Similarly, Dawson had about 125 serious systemic cases that he directly dealt with and he too kept to his business model.
Those cases included all the types of bacteria that penicillin could kill---with about a third of them SBE cases.
Penicillin was promised to the military in mid-1943 after they finally decided that they wanted it ,by seeing it work well in military staph wounds in early 1943.
Score one for Florey.
But it only actually got delivered to the military and to the civilians when Dawson's
SBE success produced a patients' revolt across America and Canada ----inspiring Pfizer to go for broke.
Credit that to Dawson's business model--- and lets recall that by 1950 penicillin had completely replaced ,not supplemented, the mighty sulfas.....
Staph was not a big killer back then - not like strep bacteria - at least not in peacetime.
It tended to do its worst when it settled deep into big bones that weren't well supplied with blood - making it hard for white blood cells and sulfa molecules to get at the bacteria.
This condition is called acute or chronic osteomyelitis and it was rampant among the young children of the poor - in peacetime.
In wartime, surviving victims of war wounds - or the surviving wounded from the Blitz - often had huge deep wounds that involved their leg bones - a hard-to-get-at location that was ideal for staph bacteria to settle in for a long stay.
Patients affected went back and forth from convalescence bed to hospital bed while doctors and nurses strived to prevent the patient from getting worse in the hope the body would eventually seal off the infection without crippling the patient in the process.
Often they survived but were left crippled - other times the patient's resistance weakened and the staph spread widely till the patient died of general blood poisoning.
In war time, deep bone wounds infected by staph represented a massive cost to the military medical system - consuming resources for years while the affected soldier was unlikely to ever to return to full service. Blitz victims similarly taxed the overworked civilian medical system.
So Florey's business model for "war penicillin" - penicillin as a mere supplement for the sulfas, its wartime use to be strictly limited to healing military patients with deeply set staph infections of the bones and limbs - how did it sell ?
It didn't.
There is no record in all his biographies that any military medical types ever visited him until 1943 - nor is it recorded anywhere that he visited military doctors and was turned down.
Curious - the Navy, Air Force, 8th Army in North Africa, the Blitz victims - they had no end of deep staph infections of the bones to treat from September 2nd 1939 to September 2nd 1942 (three years - half of the entire war) but they avoided penicillin like it was plagued.
Florey was set up to supply an non-existent market.
By contrast,from 1940 to 1942, Dawson's main market had more customers than he could hope to fill.
Florey,Fleming, Heatley, Merck, Dawson of course, they all got requests (from around the world) for penicillin to treat SBE after Dawson announced that he had hopes to cure SBE with the new drug.
Dawson's business model for penicillin could not have been more different from Florey's.His Social Penicillinhe wanted to be made by a government factory and made available to all ( civilians and soldiers) in quantity and at a reasonable price - and made available like yesterday.
He thought penicillin could replace sulfa, not just supplement it, and used to kill all bacteria that was sensitive to it - not just staph.
Florey didn't directly treat any cases - he had no hospital rights unlike Dawson.
But the twenty serious systemic cases he
indirectly treated were almost all staph infected - so he kept to his business model in his own practise.
Similarly, Dawson had about 125 serious systemic cases that he directly dealt with and he too kept to his business model.
Those cases included all the types of bacteria that penicillin could kill---with about a third of them SBE cases.
Penicillin was promised to the military in mid-1943 after they finally decided that they wanted it ,by seeing it work well in military staph wounds in early 1943.
Score one for Florey.
But it only actually got delivered to the military and to the civilians when Dawson's
SBE success produced a patients' revolt across America and Canada ----inspiring Pfizer to go for broke.
Credit that to Dawson's business model--- and lets recall that by 1950 penicillin had completely replaced ,not supplemented, the mighty sulfas.....
Recombinant DNA and HGT's contribution to the penicillin saga
Where does one begin?
The beta-lactam molecular 'core' was originally created by bacteria and was only later was moved by HGT/ recombinant DNA into some fungi .
Those fungi then created the penicillin-variants of that very special fused beta-lactam ring .
But while this HGT operation was obviously fundamental to there being a penicillin saga to begin with, it had little direct impact on how the 1929-1944 penicillin saga actually unfolded.
But the four years of hard work and disappointments that Martin Henry Dawson endured between the Fall of 1926 and the Fall of 1930 working on HGT and recombinant DNA exchanges did make him the best qualified researcher in the world to put up with the temperamental penicillium between the Fall of 1940 and the Fall of 1944.
His pioneering work with R to S type (and S to S type) HGT exchanges between Strep pneumococcus bacteria made him eminently qualified to stand up to all the difficulties in growing penicillium to produce penicillin.
Dawson was the first in the world, together with Richard Sia, to successfully induce R to S pneumococcus HGT DNA exchanges in a test tube after most other researchers threw up their hands in despair and moved onto other research.
But he was no quitter and he pulled it off after years of failure.
Dawson then went on, with Agnes Warbasse, to do the same with S to S HGT DNA exchanges and this remains extremely difficult to do naturally, as Dawson did it.
He then went on to successfully grow colonies of M and L types of bacteria, all part of his effort over the roughly 15 years between 1926 and 1941 to establish that R,M,L were fully co-equal equivalents or alternatives to S types of bacteria - not defective or deficient versions of it.
This postmodernist notion naturally was seen as bizarre or worse in the strongly modernist atmosphere of medical research between the wars.
I see it as the bacterial equivalent of Dawson treating 4F civilians as the exact moral equivalent of 1A soldiers, not as defective 'useless mouth' variants, despite the reign of Total War Utilitarianism ruling western medicine between 1940 and 1945.
Dawson's pioneering HGT DNA/ Q-sensing work taught him ethics and it taught him technical skills - both which he called upon to get penicillin successfully launched......
The beta-lactam molecular 'core' was originally created by bacteria and was only later was moved by HGT/ recombinant DNA into some fungi .
Those fungi then created the penicillin-variants of that very special fused beta-lactam ring .
But while this HGT operation was obviously fundamental to there being a penicillin saga to begin with, it had little direct impact on how the 1929-1944 penicillin saga actually unfolded.
But the four years of hard work and disappointments that Martin Henry Dawson endured between the Fall of 1926 and the Fall of 1930 working on HGT and recombinant DNA exchanges did make him the best qualified researcher in the world to put up with the temperamental penicillium between the Fall of 1940 and the Fall of 1944.
His pioneering work with R to S type (and S to S type) HGT exchanges between Strep pneumococcus bacteria made him eminently qualified to stand up to all the difficulties in growing penicillium to produce penicillin.
Dawson was the first in the world, together with Richard Sia, to successfully induce R to S pneumococcus HGT DNA exchanges in a test tube after most other researchers threw up their hands in despair and moved onto other research.
But he was no quitter and he pulled it off after years of failure.
Dawson then went on, with Agnes Warbasse, to do the same with S to S HGT DNA exchanges and this remains extremely difficult to do naturally, as Dawson did it.
He then went on to successfully grow colonies of M and L types of bacteria, all part of his effort over the roughly 15 years between 1926 and 1941 to establish that R,M,L were fully co-equal equivalents or alternatives to S types of bacteria - not defective or deficient versions of it.
This postmodernist notion naturally was seen as bizarre or worse in the strongly modernist atmosphere of medical research between the wars.
I see it as the bacterial equivalent of Dawson treating 4F civilians as the exact moral equivalent of 1A soldiers, not as defective 'useless mouth' variants, despite the reign of Total War Utilitarianism ruling western medicine between 1940 and 1945.
Dawson's pioneering HGT DNA/ Q-sensing work taught him ethics and it taught him technical skills - both which he called upon to get penicillin successfully launched......
Leonard Colebrook is CENTRAL CASTING's penicillin hero
Time to wake up.
This isn't Hollywood.
"This Reality talking: Put your hands in the air and move slowly away from the World of Fiction".
In the World of Reality, Leonard Colebrook actually did bugger-all to advance the development of penicillin.
But Hollywood isn't totally wrong - he should have been the one to make penicillin a world wide success by 1932 or so.
He actually did do so in 1936 with a later - and lesser - 'miracle drug' : the sulfa family of drugs.
He did it by using some of the first commercially available sulfa to reduce childbed fever deaths to a very low figure - a feat that alone should have earned him immortality from grateful young mothers and families.
Childbed fever - actually commensal GAS strep bacteria (long term residents of the throats of the many attending doctors and nurses) settling in on the huge wound that is every new mother's uterus - is a particularly dreaded form of infectious death.
The death itself is often very painful. By definition the patient is relatively young (ie in her child-bearing years) . The death leaves a new born baby to be raised alone by a grieving young father and his young family.
Next Colebrook went on to pioneer new techniques to combat other forms of cross-infections that frequently develop in hospitals - starting with World War Two burn victims.
Even in retirement he led yet another crusade to modify the ubiquitous space heater so they all had clothing guards installed by law. Until this law was in place, thousands of people a year - in the UK alone - got severely burned or died, when their night clothing got set alight when it got entangled on the bare heating element.
His parents had raised him to be a Non Conformist missionary and reformer. In the event,Colebrook did as many would-be missionaries did at the turn of the last century - he channelled his missionary impulses into the field of medicine.
His highly moral impulse remained as intense as ever in everything he did.
He joined the Territorial (Reserve) Army and when he was called up in 1914, was prepared to go to the front as an infantry officer, not as a doctor.
But he was judged too valuable as a medical researcher to remain on the front lines - he spent the rest of the war in the rear echelons, with Fleming and Wright.
But at least- and unlike Fleming or Florey - he was willing to go to the Front.
In World War Two, he was again at the front, in a medical military capacity - teaching medical teams how to use sulfa powder in new war wounds ( he knew little more they did !) - and as the Front Line dissolved and became meaningless in the Battle for France he had a number of very close escapes.
He was 57 years old - and still at the front, still in the thick of it, trying to save lives 'right here, right now'.
Colebrook was the near-perfect example of the type of doctor I call the ward-doctor type.
This type of doctor may suffer from EED (Empathy Excess Disorder), in that they care too much for the patient, feel too much of their pain.
When they see patients dying needlessly around them, they are inclined to throw themselves even deeper into the battle at the bedside level - trying to use any or all of the best available techniques as best they can, as hard as they can.
What they can not see themselves doing, is beating what they'd call 'a cowardly retreat' to the quiet of a laboratory to 'study' the disease at its most fundamental level, hoping to find a cure - 'sure ,in about 6 years time'.
JV Duhig, Robert Pulvertaft, RH Boots, Perrin Long, Frank C Queen and even Karl Meyer are all doctors in the penicillin saga that fit this type.
There is a totally different type of doctor I will call a lab doctor. They probably suffer, to some extent, from EDD (Empathy Deficiency Disorder).
They too find it very hard to see patients dying needlessly, but they reject 'simply' providing 'band aid' palliative care for those who are dying without a cure in sight.
They spend their careers in the laboratory seeking the fundamentals of a disease and its cure in the universalities of chemistry and physics - as far as possible away from living, breathing, capricious individual human beings.
They may serve - if they must - in the military but they contrive that it is done in the rear echelons.
However, once over draftable age, they frequently display a newly bellicose attitude to war service that one rarely find among the ex-veterans who actually faced death on the front lines.
I am thinking of Fleming, Florey, Keefer, Richards, and their ilk.
Now they may have something to offer society as scientists, despite the negative picture I paint of them.
They are no more quitters in the lab than the clinician doctors are on the ward.
They might have the skills to grow something as difficult as penicillium and the strength to hang in there when their first ten months of efforts are marked by nothing but failure.
One could see Florey and Colebrook as the perfect combination of two men who are incomplete as individuals, when it comes to successfully developing penicillin.
Colebrook would be too focused on 'saving this patient - today' to ever set aside the months of time needed for the effort in the lab to learn how to grow penicillin.
Florey ,on his own, would be too focused on purifying penicillin to 100% pure to remember that there is a war on and patients dying while he fiddles.
But Florey and Colebrook had nothing in common, in terms of their personalities---- I couldn't see it ever happening.
Colebrook, by contrast, had worked successfully for years with Fleming at St Mary's but the relationship had soured when Fleming moved to displace Colebrook in Wright's affections.
Colebrook regarded Wright as his second father and could never forgive Fleming for this.
Besides, Fleming clearly lacked the drive to do hard work for months on end, needed if a hospital lab was to produce enough penicillin for human trials.
Colebrook succeeded with sulfa where he failed with penicillin because sulfa was abundantly and cheaply available in a stable form, ready to have any nurse give the patient as a pill as scheduled.
Penicillin had to be grown by the doctor determined to use it - as no drug company was really that willing to help.
He or she would have to concentrate and purify it and then preserved this highly labile drug long enough for it to make it to the patient's arm. It had to be given IV, and hence by doctor,likely themselves in fact ,a needle every three hours around the clock for weeks at a time.
Few doctors - even of the heroic cast like Colebrook or his American counterpart Perrin Long - were up for this.
Only Martin Henry Dawson combined the rare strengths of Fleming/Florey and Colebrook /Long in just one person.
That is why 70 years ago this week ,it was he - and him alone - that gave that long awaited first ever needle of penicillin, that sent a young boy named Charles Aronson home from his expected deathbed.....
This isn't Hollywood.
"This Reality talking: Put your hands in the air and move slowly away from the World of Fiction".
In the World of Reality, Leonard Colebrook actually did bugger-all to advance the development of penicillin.
But Hollywood isn't totally wrong - he should have been the one to make penicillin a world wide success by 1932 or so.
He actually did do so in 1936 with a later - and lesser - 'miracle drug' : the sulfa family of drugs.
He did it by using some of the first commercially available sulfa to reduce childbed fever deaths to a very low figure - a feat that alone should have earned him immortality from grateful young mothers and families.
Childbed fever - actually commensal GAS strep bacteria (long term residents of the throats of the many attending doctors and nurses) settling in on the huge wound that is every new mother's uterus - is a particularly dreaded form of infectious death.
The death itself is often very painful. By definition the patient is relatively young (ie in her child-bearing years) . The death leaves a new born baby to be raised alone by a grieving young father and his young family.
Next Colebrook went on to pioneer new techniques to combat other forms of cross-infections that frequently develop in hospitals - starting with World War Two burn victims.
Even in retirement he led yet another crusade to modify the ubiquitous space heater so they all had clothing guards installed by law. Until this law was in place, thousands of people a year - in the UK alone - got severely burned or died, when their night clothing got set alight when it got entangled on the bare heating element.
His parents had raised him to be a Non Conformist missionary and reformer. In the event,Colebrook did as many would-be missionaries did at the turn of the last century - he channelled his missionary impulses into the field of medicine.
His highly moral impulse remained as intense as ever in everything he did.
He joined the Territorial (Reserve) Army and when he was called up in 1914, was prepared to go to the front as an infantry officer, not as a doctor.
But he was judged too valuable as a medical researcher to remain on the front lines - he spent the rest of the war in the rear echelons, with Fleming and Wright.
But at least- and unlike Fleming or Florey - he was willing to go to the Front.
In World War Two, he was again at the front, in a medical military capacity - teaching medical teams how to use sulfa powder in new war wounds ( he knew little more they did !) - and as the Front Line dissolved and became meaningless in the Battle for France he had a number of very close escapes.
He was 57 years old - and still at the front, still in the thick of it, trying to save lives 'right here, right now'.
Colebrook was the near-perfect example of the type of doctor I call the ward-doctor type.
This type of doctor may suffer from EED (Empathy Excess Disorder), in that they care too much for the patient, feel too much of their pain.
When they see patients dying needlessly around them, they are inclined to throw themselves even deeper into the battle at the bedside level - trying to use any or all of the best available techniques as best they can, as hard as they can.
What they can not see themselves doing, is beating what they'd call 'a cowardly retreat' to the quiet of a laboratory to 'study' the disease at its most fundamental level, hoping to find a cure - 'sure ,in about 6 years time'.
JV Duhig, Robert Pulvertaft, RH Boots, Perrin Long, Frank C Queen and even Karl Meyer are all doctors in the penicillin saga that fit this type.
There is a totally different type of doctor I will call a lab doctor. They probably suffer, to some extent, from EDD (Empathy Deficiency Disorder).
They too find it very hard to see patients dying needlessly, but they reject 'simply' providing 'band aid' palliative care for those who are dying without a cure in sight.
They spend their careers in the laboratory seeking the fundamentals of a disease and its cure in the universalities of chemistry and physics - as far as possible away from living, breathing, capricious individual human beings.
They may serve - if they must - in the military but they contrive that it is done in the rear echelons.
However, once over draftable age, they frequently display a newly bellicose attitude to war service that one rarely find among the ex-veterans who actually faced death on the front lines.
I am thinking of Fleming, Florey, Keefer, Richards, and their ilk.
Now they may have something to offer society as scientists, despite the negative picture I paint of them.
They are no more quitters in the lab than the clinician doctors are on the ward.
They might have the skills to grow something as difficult as penicillium and the strength to hang in there when their first ten months of efforts are marked by nothing but failure.
One could see Florey and Colebrook as the perfect combination of two men who are incomplete as individuals, when it comes to successfully developing penicillin.
Colebrook would be too focused on 'saving this patient - today' to ever set aside the months of time needed for the effort in the lab to learn how to grow penicillin.
Florey ,on his own, would be too focused on purifying penicillin to 100% pure to remember that there is a war on and patients dying while he fiddles.
But Florey and Colebrook had nothing in common, in terms of their personalities---- I couldn't see it ever happening.
Colebrook, by contrast, had worked successfully for years with Fleming at St Mary's but the relationship had soured when Fleming moved to displace Colebrook in Wright's affections.
Colebrook regarded Wright as his second father and could never forgive Fleming for this.
Besides, Fleming clearly lacked the drive to do hard work for months on end, needed if a hospital lab was to produce enough penicillin for human trials.
Colebrook succeeded with sulfa where he failed with penicillin because sulfa was abundantly and cheaply available in a stable form, ready to have any nurse give the patient as a pill as scheduled.
Penicillin had to be grown by the doctor determined to use it - as no drug company was really that willing to help.
He or she would have to concentrate and purify it and then preserved this highly labile drug long enough for it to make it to the patient's arm. It had to be given IV, and hence by doctor,likely themselves in fact ,a needle every three hours around the clock for weeks at a time.
Few doctors - even of the heroic cast like Colebrook or his American counterpart Perrin Long - were up for this.
Only Martin Henry Dawson combined the rare strengths of Fleming/Florey and Colebrook /Long in just one person.
That is why 70 years ago this week ,it was he - and him alone - that gave that long awaited first ever needle of penicillin, that sent a young boy named Charles Aronson home from his expected deathbed.....
The Mystery of Penicillin's 18 missing years
I believe that all of the penicillin books up to now - and there have been hundreds of them - have basically been a series of 100,000 word excuses - "the dog ate my penicillin homework".
Excuses to us - the lay public - on behalf of Science in general or on behalf of one or other early penicillin researchers in particular.
But eighty years later, we lay people still want to know why it was that the best life saving medicine this world will ever see took an eighteen year vacation (from September 1928 till about September 1946) before local doctors around the world could routinely prescribe it to save a life.
Whether they are from the pen of a medical historian seeking to defend all of Science/a particular team effort or the effort of a lay author defending an individual scientist they particularly admire, all those apologies basically come down to this:
(It will actually highly technical and highly accurate at times---- but only when needed to refute technical excuses and bromides.)
THE FIRST MORAL HISTORY OF PENICILLIN
Mine will be a Moral History of penicillin - it will lay out a thesis that it was moral failings, not technical difficulties, that delayed penicillin becoming popularly know and commonly prescribed during all those years of death and suffering that we now call The Great Depression and World War Two.
The two events caused an excess of 100 million premature deaths over what might have been expected in that 16 year period.
Even if we content to 'merely' reduce those excessive deaths and not seek to prevent many of the so-called normal infectious deaths, how millions might penicillin have saved if it was readily available by 1929-1930?
Or consider this: despite the new global threat from nuclear weapons, the Cold War period from 1945 till 1985 was actually an incredibly optimist period in world human history.
The promise of 1945's penicillin was sufficient, all by itself, to overcome the fear induced by 1945's A-Bomb.
For a generation, penicillin kept most of us buoyed up about ourselves and the world around us.
Could those good vibes - induced in 1928-1929 instead of twenty years later - have been enough, by themselves, to prevent the worst of the Great Depression and World War Two from even happening ?
We will never know.
But I believe these questions are still big enough,eighty years on, for it to be worthwhile to re-examine the early penicillin saga to see if there is another explanation for the delay. One that will finally convince most lay people - and hopefully - even convince a few of the scientists.
DUHIG IS PROSECUTION'S KEY WITNESS
In the Fall of 1943, in Brisbane Australia, 15 years after Fleming discovered penicillin, Dr J V Duhig saved the lives of a dozen seriously ill people using a form of penicillin juice no more sophisticated than what Fleming had on hand in November 1928.
This the single hard, hard, hard, hard ,hard, historical stone against which I am going to grind every author and every account that claims that there were 'technical complications' why the world had to wait 15 or more years to put the life-saving effects of penicillin to work.
Until and unless they can explain to everyone's satisfaction why Duhig could do this - but why Fleming/Florey and Dawson et all couldn't - I will not relent.....
Excuses to us - the lay public - on behalf of Science in general or on behalf of one or other early penicillin researchers in particular.
But eighty years later, we lay people still want to know why it was that the best life saving medicine this world will ever see took an eighteen year vacation (from September 1928 till about September 1946) before local doctors around the world could routinely prescribe it to save a life.
Whether they are from the pen of a medical historian seeking to defend all of Science/a particular team effort or the effort of a lay author defending an individual scientist they particularly admire, all those apologies basically come down to this:
The 18 year delay was due to technical difficulties, not moral failings - at least not the moral failings of my hero.My book, by contrast, is not going to be a technical book - at least in its intentions.
(It will actually highly technical and highly accurate at times---- but only when needed to refute technical excuses and bromides.)
THE FIRST MORAL HISTORY OF PENICILLIN
Mine will be a Moral History of penicillin - it will lay out a thesis that it was moral failings, not technical difficulties, that delayed penicillin becoming popularly know and commonly prescribed during all those years of death and suffering that we now call The Great Depression and World War Two.
The two events caused an excess of 100 million premature deaths over what might have been expected in that 16 year period.
Even if we content to 'merely' reduce those excessive deaths and not seek to prevent many of the so-called normal infectious deaths, how millions might penicillin have saved if it was readily available by 1929-1930?
Or consider this: despite the new global threat from nuclear weapons, the Cold War period from 1945 till 1985 was actually an incredibly optimist period in world human history.
The promise of 1945's penicillin was sufficient, all by itself, to overcome the fear induced by 1945's A-Bomb.
For a generation, penicillin kept most of us buoyed up about ourselves and the world around us.
Could those good vibes - induced in 1928-1929 instead of twenty years later - have been enough, by themselves, to prevent the worst of the Great Depression and World War Two from even happening ?
We will never know.
But I believe these questions are still big enough,eighty years on, for it to be worthwhile to re-examine the early penicillin saga to see if there is another explanation for the delay. One that will finally convince most lay people - and hopefully - even convince a few of the scientists.
DUHIG IS PROSECUTION'S KEY WITNESS
In the Fall of 1943, in Brisbane Australia, 15 years after Fleming discovered penicillin, Dr J V Duhig saved the lives of a dozen seriously ill people using a form of penicillin juice no more sophisticated than what Fleming had on hand in November 1928.
This the single hard, hard, hard, hard ,hard, historical stone against which I am going to grind every author and every account that claims that there were 'technical complications' why the world had to wait 15 or more years to put the life-saving effects of penicillin to work.
Until and unless they can explain to everyone's satisfaction why Duhig could do this - but why Fleming/Florey and Dawson et all couldn't - I will not relent.....
why MUCOID mattered: Henry Dawson and Rheumatic Fever
Recently having had a sore throat or tonsillitis - when it is caused by our normally throat and nose inhabiting (commensal) strep bacteria- is the only way you can get Rheumatic Fever.
There has never been a confirmed incident when huge life-threatening amounts of virulent strep bacteria rolling about in a gaping wound (the type of dramatic situation that makes strep the most feared word in the medical lexicon) has ever caused a single case of life-threatening Rheumatic Fever.
Rheumatic Fever (RF) is (and was) a very serious and very common disease, yet it begins with the quietest possible onset - one third of all its victims can't even remember having had a recent sore throat.
'Sore throat', undefined, is so common throughout all our lives, that we find it hard to tell those ones that were caused by strep bacteria from those that weren't.
The safest rule is if the sore throat hurts much and hangs on more than a day or two - run to a doctor and ask for a swab test.
If we are very unwell and have had endless rounds of sore throats and even previous bouts of RF, probably almost any strain of strep can cause another round of RF.
But for most of us that are healthy and well fed, being in an stressful new situation in an enclosed space for weeks at a time with a particularly virulent strain of strep running from person to person back to person, is our only way to get it.
I mean a wartime military recruit camp - the best possible natural laboratory we have ever had to see just how many people can get RF if the conditions are perfect.
The observed percentages are high enough, often enough, to put real fear into that doctors that do statistics and are paid to keep an eye on epidemics ---this despite the fact that RF is almost totally gone in the western world.
(It is still common in third world countries that until fairly recently historically never saw a case of it.)
We still don't know enough about it, to be terribly confident that it will remain beaten here in the western world.
Currently, the biggest focus of research effort is something that Martin Henry Dawson would not have found surprising : it is the fact that it is the most heavily mucoid of hemo strep colonies that seem to cause RF among populations normally felt to be at least risk.
Mucoid heavy strains of hemo strep turn RF from a social disease affecting the poor mostly, to something that could kill any or all of us.
A deep interest in raising the awareness of the virulence of Mucoid colonies of GAS strep generally (along with his pioneer use of penicillin to cure RF's final effect, SBE) was Dawson's particular contribution to the world wide effort to explain and prevent RF from the 1920s to the 1960s.
I do not believe that Dawson had actually pinpointed mucoid strains of hemolytic strep as the leading agents of the most deadly versions of RF - he simply knew that mucoid colonies were usually the most deadly agents in all of the dozens of serious diseases that strep deals out to us humans - and in the 1930s, RF was the most important hemo strep disease around.
Having his thesis proven in the case of acute RF wouldn't have surprised Dawson - but it would have pleased him.
His 1930s mucoid work, sandwiched as it was between his pioneering work on recombinant DNA in the 1920s and his pioneering penicillin work in the 1940s has naturally been overshadowed by these two, the two biggest medical stories of the entire 20th century and beyond.
But to explain how in 1940 that an arthritis 'aspirin doctor' ended up in the area of endocarditis, today the domain of heart surgeons, we need to see this intellectual connection between mucoid hemo strep causing RF, which in turn led to SBE.......
There has never been a confirmed incident when huge life-threatening amounts of virulent strep bacteria rolling about in a gaping wound (the type of dramatic situation that makes strep the most feared word in the medical lexicon) has ever caused a single case of life-threatening Rheumatic Fever.
Rheumatic Fever (RF) is (and was) a very serious and very common disease, yet it begins with the quietest possible onset - one third of all its victims can't even remember having had a recent sore throat.
'Sore throat', undefined, is so common throughout all our lives, that we find it hard to tell those ones that were caused by strep bacteria from those that weren't.
The safest rule is if the sore throat hurts much and hangs on more than a day or two - run to a doctor and ask for a swab test.
If we are very unwell and have had endless rounds of sore throats and even previous bouts of RF, probably almost any strain of strep can cause another round of RF.
But for most of us that are healthy and well fed, being in an stressful new situation in an enclosed space for weeks at a time with a particularly virulent strain of strep running from person to person back to person, is our only way to get it.
I mean a wartime military recruit camp - the best possible natural laboratory we have ever had to see just how many people can get RF if the conditions are perfect.
The observed percentages are high enough, often enough, to put real fear into that doctors that do statistics and are paid to keep an eye on epidemics ---this despite the fact that RF is almost totally gone in the western world.
(It is still common in third world countries that until fairly recently historically never saw a case of it.)
We still don't know enough about it, to be terribly confident that it will remain beaten here in the western world.
Currently, the biggest focus of research effort is something that Martin Henry Dawson would not have found surprising : it is the fact that it is the most heavily mucoid of hemo strep colonies that seem to cause RF among populations normally felt to be at least risk.
Mucoid heavy strains of hemo strep turn RF from a social disease affecting the poor mostly, to something that could kill any or all of us.
A deep interest in raising the awareness of the virulence of Mucoid colonies of GAS strep generally (along with his pioneer use of penicillin to cure RF's final effect, SBE) was Dawson's particular contribution to the world wide effort to explain and prevent RF from the 1920s to the 1960s.
I do not believe that Dawson had actually pinpointed mucoid strains of hemolytic strep as the leading agents of the most deadly versions of RF - he simply knew that mucoid colonies were usually the most deadly agents in all of the dozens of serious diseases that strep deals out to us humans - and in the 1930s, RF was the most important hemo strep disease around.
Having his thesis proven in the case of acute RF wouldn't have surprised Dawson - but it would have pleased him.
His 1930s mucoid work, sandwiched as it was between his pioneering work on recombinant DNA in the 1920s and his pioneering penicillin work in the 1940s has naturally been overshadowed by these two, the two biggest medical stories of the entire 20th century and beyond.
But to explain how in 1940 that an arthritis 'aspirin doctor' ended up in the area of endocarditis, today the domain of heart surgeons, we need to see this intellectual connection between mucoid hemo strep causing RF, which in turn led to SBE.......
Friday, October 8, 2010
Sir Robertson's curious letter and curiouser claim
Late August and early September 1942 saw a furious burst of letters to the editor directed at The Times of London, provoked by an August 27th editorial in paper concerning penicillin.
The three hundred word effort echoed an earlier editorial from The Lancet , and supported their claim that the drug was non toxic and more active than sulfa drugs and that its production should be greatly expanded and quickly.
Since penicillin looked to be a real comer with much 'moral capital' accruing to the companies or institutions that best claimed the laurels for first developing it, naturally all the major bodies involved had to elbow their way forward to stake their claim - the current 'all-for-one' war effort not withstanding.
(A note to errant historians and authors: the drug companies' penicillin research arm, the TRC,were actually the first to gave themselves credit. Only then did St Mary's Hospital step in to also seek some glory.)
Sir Robert Robertson, the world famous Oxford chemist , spoke for the Oxford team.
Some of what he claimed were mere weasel words.
Dawson published the results of his treatment of 12 patients by May 1941, Florey his results on ten patients in August 1941.
Both were admirably cautious in assessing what if anything penicillin had done for their patients.
Dawson was actually the first to treat a patient and see that patient go home from his deathbed --- so Robertson was content to use weasel words that Florey was the first to "demonstrate the value
(of penicillin) clinically."
'Demonstrate' is a subjective term - in the eyes of the beholder - and Robertson knew it.
So, he had as well admitted that Fleming discovered penicillin and that Dawson had been the first to use it clinically as a life-saving systemic antibiotic.
What credit left for Oxford?
Robertson then told the bare-faced lie that toxic materials were produced by the penicillium mold, along with penicillin.
Florey was therefore to be praised for being the first to separate the unsafe impurities from the safe pure penicillin so that it could be at last safely used on humans. (But wasn't, not by Florey - at least not right away ...!)
Nobody who ever worked with penicillin-producing penicillium , starting with Fleming in 1928 and carrying right on through twenty years later, ever saw enough of anything harmful, at levels enough to be toxic.
All made a point to note that the raw penicillin juice was not toxic even when injected in huge quantities by normal medical standards.
Foremost among these supporters of the use of semi-purified or raw penicillin was one Howard Florey.
He publicly marveled that in hundreds of IM injections, no damage was ever seen at the site of the needle - not even in babies. The impure preparations he rated at 10% pure at the max (actually 3% pure) yet their impurities ( 97% of the dose) were non toxic - even when given in huge dosages.
It is hard to imagine a better test for proving the impurities were NOT toxic --- I can not,myself, imagine one.
What was going on then - in the mind of Professor Robertson and his chemist-manque Dr Florey ?
If Robertson and Florey had made any headway on synthesizing penicillin, I am sure this would have been their sole claim to glory.
But they hadn't.
So what can chemists do?
They can separate substances, even if they can't synthesize them, and even if the substances didn't need separating !
A nice meal does not improve when a chemist burns it all and then pours acid over the remains, to separate it into its constitute elements.
Penicillin juice - as Australian Dr James Vincent Duhig demonstrated in Brisbane in the Fall of 1943, doesn't need to be separated from its impurities at all, in order to save lives safely.
When it comes to questions of health, trust Duhig,MD over chemist Robertson PhD.
I don't expect Oxford University's academics to ever set the scholastic record straight about what Oxford did and didn't do with penicillin.
Claiming a leading role in developing the best lifesaver the world will ever know is simply too much of a money spinner for Oxford and the entire Thames Valley community.....
The three hundred word effort echoed an earlier editorial from The Lancet , and supported their claim that the drug was non toxic and more active than sulfa drugs and that its production should be greatly expanded and quickly.
Since penicillin looked to be a real comer with much 'moral capital' accruing to the companies or institutions that best claimed the laurels for first developing it, naturally all the major bodies involved had to elbow their way forward to stake their claim - the current 'all-for-one' war effort not withstanding.
(A note to errant historians and authors: the drug companies' penicillin research arm, the TRC,were actually the first to gave themselves credit. Only then did St Mary's Hospital step in to also seek some glory.)
Sir Robert Robertson, the world famous Oxford chemist , spoke for the Oxford team.
Some of what he claimed were mere weasel words.
Dawson published the results of his treatment of 12 patients by May 1941, Florey his results on ten patients in August 1941.
Both were admirably cautious in assessing what if anything penicillin had done for their patients.
Dawson was actually the first to treat a patient and see that patient go home from his deathbed --- so Robertson was content to use weasel words that Florey was the first to "demonstrate the value
(of penicillin) clinically."
'Demonstrate' is a subjective term - in the eyes of the beholder - and Robertson knew it.
So, he had as well admitted that Fleming discovered penicillin and that Dawson had been the first to use it clinically as a life-saving systemic antibiotic.
What credit left for Oxford?
Robertson then told the bare-faced lie that toxic materials were produced by the penicillium mold, along with penicillin.
Florey was therefore to be praised for being the first to separate the unsafe impurities from the safe pure penicillin so that it could be at last safely used on humans. (But wasn't, not by Florey - at least not right away ...!)
Nobody who ever worked with penicillin-producing penicillium , starting with Fleming in 1928 and carrying right on through twenty years later, ever saw enough of anything harmful, at levels enough to be toxic.
All made a point to note that the raw penicillin juice was not toxic even when injected in huge quantities by normal medical standards.
Foremost among these supporters of the use of semi-purified or raw penicillin was one Howard Florey.
He publicly marveled that in hundreds of IM injections, no damage was ever seen at the site of the needle - not even in babies. The impure preparations he rated at 10% pure at the max (actually 3% pure) yet their impurities ( 97% of the dose) were non toxic - even when given in huge dosages.
It is hard to imagine a better test for proving the impurities were NOT toxic --- I can not,myself, imagine one.
What was going on then - in the mind of Professor Robertson and his chemist-manque Dr Florey ?
If Robertson and Florey had made any headway on synthesizing penicillin, I am sure this would have been their sole claim to glory.
But they hadn't.
So what can chemists do?
They can separate substances, even if they can't synthesize them, and even if the substances didn't need separating !
A nice meal does not improve when a chemist burns it all and then pours acid over the remains, to separate it into its constitute elements.
Penicillin juice - as Australian Dr James Vincent Duhig demonstrated in Brisbane in the Fall of 1943, doesn't need to be separated from its impurities at all, in order to save lives safely.
When it comes to questions of health, trust Duhig,MD over chemist Robertson PhD.
I don't expect Oxford University's academics to ever set the scholastic record straight about what Oxford did and didn't do with penicillin.
Claiming a leading role in developing the best lifesaver the world will ever know is simply too much of a money spinner for Oxford and the entire Thames Valley community.....
CRITICAL biography of Norman Heatley long, long overdue
I don't think Norman Heatley (1911-2004) did as much to advance penicillin as he thought he did.
I think a more balanced collective biography of the entire Oxford team might better spread the credit (and blame) about.
It seems to me that Glister and Sanders did far more, and Heatley far less ,to get penicillin production actually working and producing.
Norman himself conveyed to the world his view that he felt he was no longer a key member of the Oxford penicillin team after 1943 - as the historical blue plaque on his home so indicates.
(He even tried to apply for a job at a drug firm far far from the Dunn in 1944 !)
The Oxford team kept up their penicillin work up to the war's end in 1945 and beyond -I am curious to know what it was that Heatley felt he was doing at the Dunn between 1943 and 1946, if it didn't involve penicillin.
Sanders and Glister and all the rest - except Florey and Heatley -were never very interested to tell their part in the penicillin saga at Oxford.
So in this land of the blind, the one-eyed Heatley became king - particularly in the 36 years after Florey's death.
Heatley grew ever bolder in his claims ,as more and more of
'the old gang' passed on beyond the point of rebuttals via 'letters to the editor', directed at The Times.
The Oxford community, still unable to understand how credit for penicillin was taken up by a Scotsman (Alexander Fleming) and a parvenu American soda pop company (Pfizer), fully supported Heatley in this effort.
I don't expect my biography of another penicillin pioneer, close associate of Pfizer, and a Scotman, Martin Henry Dawson, to be any more popular in Oxford.....
I think a more balanced collective biography of the entire Oxford team might better spread the credit (and blame) about.
It seems to me that Glister and Sanders did far more, and Heatley far less ,to get penicillin production actually working and producing.
Norman himself conveyed to the world his view that he felt he was no longer a key member of the Oxford penicillin team after 1943 - as the historical blue plaque on his home so indicates.
(He even tried to apply for a job at a drug firm far far from the Dunn in 1944 !)
The Oxford team kept up their penicillin work up to the war's end in 1945 and beyond -I am curious to know what it was that Heatley felt he was doing at the Dunn between 1943 and 1946, if it didn't involve penicillin.
Sanders and Glister and all the rest - except Florey and Heatley -were never very interested to tell their part in the penicillin saga at Oxford.
So in this land of the blind, the one-eyed Heatley became king - particularly in the 36 years after Florey's death.
Heatley grew ever bolder in his claims ,as more and more of
'the old gang' passed on beyond the point of rebuttals via 'letters to the editor', directed at The Times.
The Oxford community, still unable to understand how credit for penicillin was taken up by a Scotsman (Alexander Fleming) and a parvenu American soda pop company (Pfizer), fully supported Heatley in this effort.
I don't expect my biography of another penicillin pioneer, close associate of Pfizer, and a Scotman, Martin Henry Dawson, to be any more popular in Oxford.....
Thursday, October 7, 2010
it was the patients' MOMS who brought penicillin to the DOCTORS
The private discovery of penicillin happened in September 1928, the public discovery in June 1929 when it was published in an important, peer-reviewed scientific journal.
But then it just sat there for twelve to fifteen years.
So your great grandfather or great aunt died needlessly because the doctors and the scientists did nothing with penicillin, after that public discovery.
In August and September 1943, however, your grandmother "popularly" discovered penicillin when she read about Baby Patricia in some newspaper articles in some of the Hearst publications.
Now the fur really flew, as your grandmother demanded to know why your uncle, off wounded in a hospital in the South Pacific, wasn't getting any of this penicillin.
Her Mom-like anger and urgency finally got the men moving and before long her doctor and every other doctor had penicillin to treat patients.
So don't go tell me that doctors bring penicillin to patients.
Publication in a scientific journal (aka making something public as the scientists say) is not the be all and end all of effective science, as satisfying as it is to scientific egos.
The most influential scientific publication of Doctor Martin Henry Dawson was an oral, not printed, account of the first human cases ever treated with systemic penicillin, given at an Annual Meeting of the Society of Clinical Investigators in May 1941 in front of hundreds of the world's leading medical scientists from all over the world.
Did he publicize his work with penicillin ? We laypeople might think so.
Howard Florey, however, sensed a loophole.
He chose to regard an oral presentation of a paper at an conference, and subsequently published on paper in July 1941, as 'not a scientific publication' and ignored all mention of Dawson's breakthrough in his own references to his subsequent August 1941 paper on penicillin.
Thankfully, Dawson's work got written up in the New York Times ---near the business section --- not a scientific publication, admittedly.
However when the people in charge of the chequebook at Pfizer read it, they saw to it that their Brooklyn Crude penicillin was there to save the wounded on the D-Day beaches and ever after, until the war's end.
Florey continued to publish scientifically on his synthetic penicillin (Oxford Pure)---- but he never actually delivered any.
Pfizer never did publish on its safe, effective Brooklyn Crude.
They just delivered to the beaches, on time, and in quantity.
If you were a soldier in the Princess Louise Regiment (PLF) regiment lying on the Gothic Line, wounded, which would you prefer: British published talk or unpublished American walk ?
Well I was a (post war) member of the PLF and I bloody well know which one I'd prefer.
"OXFORD talks, but BROOKLYN walks..."
But then it just sat there for twelve to fifteen years.
So your great grandfather or great aunt died needlessly because the doctors and the scientists did nothing with penicillin, after that public discovery.
In August and September 1943, however, your grandmother "popularly" discovered penicillin when she read about Baby Patricia in some newspaper articles in some of the Hearst publications.
Now the fur really flew, as your grandmother demanded to know why your uncle, off wounded in a hospital in the South Pacific, wasn't getting any of this penicillin.
Her Mom-like anger and urgency finally got the men moving and before long her doctor and every other doctor had penicillin to treat patients.
So don't go tell me that doctors bring penicillin to patients.
Publication in a scientific journal (aka making something public as the scientists say) is not the be all and end all of effective science, as satisfying as it is to scientific egos.
The most influential scientific publication of Doctor Martin Henry Dawson was an oral, not printed, account of the first human cases ever treated with systemic penicillin, given at an Annual Meeting of the Society of Clinical Investigators in May 1941 in front of hundreds of the world's leading medical scientists from all over the world.
Did he publicize his work with penicillin ? We laypeople might think so.
Howard Florey, however, sensed a loophole.
He chose to regard an oral presentation of a paper at an conference, and subsequently published on paper in July 1941, as 'not a scientific publication' and ignored all mention of Dawson's breakthrough in his own references to his subsequent August 1941 paper on penicillin.
Thankfully, Dawson's work got written up in the New York Times ---near the business section --- not a scientific publication, admittedly.
However when the people in charge of the chequebook at Pfizer read it, they saw to it that their Brooklyn Crude penicillin was there to save the wounded on the D-Day beaches and ever after, until the war's end.
Florey continued to publish scientifically on his synthetic penicillin (Oxford Pure)---- but he never actually delivered any.
Pfizer never did publish on its safe, effective Brooklyn Crude.
They just delivered to the beaches, on time, and in quantity.
If you were a soldier in the Princess Louise Regiment (PLF) regiment lying on the Gothic Line, wounded, which would you prefer: British published talk or unpublished American walk ?
Well I was a (post war) member of the PLF and I bloody well know which one I'd prefer.
"OXFORD talks, but BROOKLYN walks..."
Tuesday, October 5, 2010
Oct 16 1940 : the disease was MODERNITY
A marvellously effective drug lay on a British shelf, unused, for twelve long years --- 'a miracle cure in search of a disease' --- on October 16th 1940 in a Manhattan hospital it finally found it : the disease was MODERNITY and the cure was penicillin.
The nominal disease Dr Martin Henry Dawson was seeking to cure that day (almost exactly 70 years ago) with the first ever needleful of the antibiotic penicillin was SBE, an invariably fatal calcination of the heart valves.
However the real disease he was seeking to heal was modern utilitarianism, aka stone-heartedness.
Neither Fleming or Florey - to put it mildly - were up for this job.
In a few weeks,Dawson discovered he himself was dying as well but he felt duty-bound to carry on helping the helpless and the hopeless, despite a 'Total War' atmosphere which assigned 'useless mouths' like the SBEs to baneful neglect --- or worse.
The nominal disease Dr Martin Henry Dawson was seeking to cure that day (almost exactly 70 years ago) with the first ever needleful of the antibiotic penicillin was SBE, an invariably fatal calcination of the heart valves.
However the real disease he was seeking to heal was modern utilitarianism, aka stone-heartedness.
Neither Fleming or Florey - to put it mildly - were up for this job.
In a few weeks,Dawson discovered he himself was dying as well but he felt duty-bound to carry on helping the helpless and the hopeless, despite a 'Total War' atmosphere which assigned 'useless mouths' like the SBEs to baneful neglect --- or worse.
Sunday, October 3, 2010
Dying Doctor goes 'Over the Top' in WWII to save his patients
This is the plot of "MO goes PO" in "Hollywood High Concept", with the movie retitled as
"Penicillin Stat! : Dying Doctor goes 'Over the Top' in WWII to save his Patients."
As his skeptical medical critics saw the situation , Henry Dawson went completely 'Over the Top' in 1940, in his quest to save terminally ill SBE patients with his penicillium juice.
But then he had gone already 'Over the Top' in 1917 - and again in 1918 (while, by contrast, they had sat out the war ambitiously pushing ahead amid the deleted numbers of wartime grad school) so I suppose he earned the right to do the same in WWII.....
"Penicillin Stat! : Dying Doctor goes 'Over the Top' in WWII to save his Patients."
As his skeptical medical critics saw the situation , Henry Dawson went completely 'Over the Top' in 1940, in his quest to save terminally ill SBE patients with his penicillium juice.
But then he had gone already 'Over the Top' in 1917 - and again in 1918 (while, by contrast, they had sat out the war ambitiously pushing ahead amid the deleted numbers of wartime grad school) so I suppose he earned the right to do the same in WWII.....
Friday, October 1, 2010
Florey: if patents fail, try trademarks
By March 1941, Howard Florey ( the son of an industrialist who made his fortune through his knowledge of patents, trade secrets and trademarks ,as both a buyer and a seller ) knew that no drug firm was likely to take out a license on his penicillin purification process, even if he did get Oxford University or the MRC to patent it.
Taking it as a given that no one applies for a patent for a process that does not work at all, the usual delay and expense is over determining whether the process is truly novel.
The question as to whether it is truly commercial is left to the market.
A process that costs more to yield less product than an existing process, is not going to find any licensees even if the fees were pennies per annum.
Pfizer had citric acid, Florey had COKE
But Florey had basically kept his (highly inefficient) process highly secret - and an inefficient process that remains a trade secret, combined with a lot of chutzpah and legwork, can still make for a perfectly viable and profitable trade mark.
You simply claim that your product is superior than anyone else's because of your secret formula ,kept in a bank vault, ( Coke anyone?) and so is worth a superior price.
You simply substitute the power of saturation advertising when saturation catalyst chemistry fails to produce the expected yield.
This is what Florey commenced to do on his trip to America - insist that only Oxford University brand penicillin was the one and only true penicillin - just as the world had gotten used to being told that Oxford had the only real English bible and the only real English dictionary and the only real English accent.
I couldn't see this going down a ton in Plymouth,UK, a Royalist stronghold in the (English) Civil War, but at Yale and Harvard USA where the American rebels had fought and won a revolution against Oxford imposing its religious and cultural values on other faiths, this sort of stuff was a big hit.
I am sorry to say this - but when it comes to truly sucking up to any and every aristocrat - our American friends are suckers of the first water.
The chimera of penicillin
'Penicillin' doesn't actually exist - at least not as a single entity : rather it is the overall name for a large sub family of an even bigger family of antibiotics called the beta-lactams.
Almost all of these penicillins are defined as being hydrophobic (ie having non-polar side chains) antibiotics produced by fungi ,not bacteria ,that act mostly on gram positive bacteria and contain at their core the vital beta-lactam structure.
Reverse most of this, but leave the beta-lactam core and you have the cephalosporins antibiotic sub family.
Florey would rant at anyone who produced different results (like his long suffering friends at Merck) that their penicillin couldn't possibly be the real penicillin if it wasn't like his.
But it could be and was - different food mediums and conditions produced different types of beta-lactams and also differing amounts of antiobiotics that were not beta-lactams, from the same strain of penicillium.
In addition the penicillium frequently and rapidly mutated into different strains that could produce differing amounts of different penicillins in response to a fixed /standard set of conditions and food mediums.
Aaaaarrrgh !!!!!
In real life, outside the lab, reality was often as messy and untidy as real Australia was from its citizens' visions of a pure white only Australia.
Florey was a purity-wonk
Unfortunately, unlike his pragmatic Dad, Florey's main motif throughout his life was to seek out purity in all its forms - moral as well as chemical - we see this repeatedly referenced in his letters to his future wife Ethel from the 1920s.
I think Florey's barnstorming of America worked - he couldn't claim he had been the first in anything important in penicillin beyond the mouse test - Fleming, Paine and Dawson saw to that - but he could at least claim he had the purest penicillin on Earth.
To save lives, penicillin dose size, not quality, matters more...
I'll say it again - pure is a relative term, a percentage term - bacteria die and people's lives are saved only by large absolute amounts of penicillin - regardless of their relative purity.
Florey's all out pursuit of purity quality over penicillin quantity was a moral failing of the highest possible order.
In the war against Hitler and his racist purity views, to work full out, from 1938 to 1945, on finding an all-white penicillin was as obscene as as seeking to preserve an all-white Australia --- or an all-white Germany......
Taking it as a given that no one applies for a patent for a process that does not work at all, the usual delay and expense is over determining whether the process is truly novel.
The question as to whether it is truly commercial is left to the market.
A process that costs more to yield less product than an existing process, is not going to find any licensees even if the fees were pennies per annum.
Pfizer had citric acid, Florey had COKE
But Florey had basically kept his (highly inefficient) process highly secret - and an inefficient process that remains a trade secret, combined with a lot of chutzpah and legwork, can still make for a perfectly viable and profitable trade mark.
You simply claim that your product is superior than anyone else's because of your secret formula ,kept in a bank vault, ( Coke anyone?) and so is worth a superior price.
You simply substitute the power of saturation advertising when saturation catalyst chemistry fails to produce the expected yield.
This is what Florey commenced to do on his trip to America - insist that only Oxford University brand penicillin was the one and only true penicillin - just as the world had gotten used to being told that Oxford had the only real English bible and the only real English dictionary and the only real English accent.
I couldn't see this going down a ton in Plymouth,UK, a Royalist stronghold in the (English) Civil War, but at Yale and Harvard USA where the American rebels had fought and won a revolution against Oxford imposing its religious and cultural values on other faiths, this sort of stuff was a big hit.
I am sorry to say this - but when it comes to truly sucking up to any and every aristocrat - our American friends are suckers of the first water.
The chimera of penicillin
'Penicillin' doesn't actually exist - at least not as a single entity : rather it is the overall name for a large sub family of an even bigger family of antibiotics called the beta-lactams.
Almost all of these penicillins are defined as being hydrophobic (ie having non-polar side chains) antibiotics produced by fungi ,not bacteria ,that act mostly on gram positive bacteria and contain at their core the vital beta-lactam structure.
Reverse most of this, but leave the beta-lactam core and you have the cephalosporins antibiotic sub family.
Florey would rant at anyone who produced different results (like his long suffering friends at Merck) that their penicillin couldn't possibly be the real penicillin if it wasn't like his.
But it could be and was - different food mediums and conditions produced different types of beta-lactams and also differing amounts of antiobiotics that were not beta-lactams, from the same strain of penicillium.
In addition the penicillium frequently and rapidly mutated into different strains that could produce differing amounts of different penicillins in response to a fixed /standard set of conditions and food mediums.
Aaaaarrrgh !!!!!
In real life, outside the lab, reality was often as messy and untidy as real Australia was from its citizens' visions of a pure white only Australia.
Florey was a purity-wonk
Unfortunately, unlike his pragmatic Dad, Florey's main motif throughout his life was to seek out purity in all its forms - moral as well as chemical - we see this repeatedly referenced in his letters to his future wife Ethel from the 1920s.
I think Florey's barnstorming of America worked - he couldn't claim he had been the first in anything important in penicillin beyond the mouse test - Fleming, Paine and Dawson saw to that - but he could at least claim he had the purest penicillin on Earth.
To save lives, penicillin dose size, not quality, matters more...
I'll say it again - pure is a relative term, a percentage term - bacteria die and people's lives are saved only by large absolute amounts of penicillin - regardless of their relative purity.
Florey's all out pursuit of purity quality over penicillin quantity was a moral failing of the highest possible order.
In the war against Hitler and his racist purity views, to work full out, from 1938 to 1945, on finding an all-white penicillin was as obscene as as seeking to preserve an all-white Australia --- or an all-white Germany......
Thursday, September 30, 2010
"Manhattan Clearing #7":undignified and unprofessional,HEROIC, science
Henry Dawson probably surprised himself as much as he surprised the rest of his battalion, maybe even surprised his hometown community, when he revealed a talent for 'heat of the crisis' gifted improvisation and leadership during the events that led to him winning a Military Cross and Citation for Bravery.
That same talent came to the fore perhaps only two more times in his life - during his work on HGT and again in his efforts with penicillin - both times with high stakes outcomes.
He never was an emergency ward doctor or wartime clearing station doctor but he may have had the talent to excel at it.
He most clearly showed this talent in the hectic five weeks leading up to giving that needle of penicillin to Charlie Aronson, seventy years ago, on October 16th 1940.
Neither Fleming or Florey could have done this work - it simply wasn't in their character. Both were all too aware of the constant need to maintain the public image of dignity and certitude for medical scientists.
Both men also lacked that personal empathy for patients as people that led Dawson to forget his professional dignity as he literally ran about with a needle of penicillin - STAT - in his efforts to save lives....
That same talent came to the fore perhaps only two more times in his life - during his work on HGT and again in his efforts with penicillin - both times with high stakes outcomes.
He never was an emergency ward doctor or wartime clearing station doctor but he may have had the talent to excel at it.
He most clearly showed this talent in the hectic five weeks leading up to giving that needle of penicillin to Charlie Aronson, seventy years ago, on October 16th 1940.
Neither Fleming or Florey could have done this work - it simply wasn't in their character. Both were all too aware of the constant need to maintain the public image of dignity and certitude for medical scientists.
Both men also lacked that personal empathy for patients as people that led Dawson to forget his professional dignity as he literally ran about with a needle of penicillin - STAT - in his efforts to save lives....
for Dawson, Penicillin came with only one possible modifier: "STAT!"
I have said before that the Fall of 1918 was the life-defining moment for both Henry Dawson and Howard Florey.
In September 1918, Florey's family literally tumbled down the social scale.
Down, down, down from wealthy socially prominent Upper Mitcham - sliding quickly back down the social scale to a little cottage in the lower suburbs near the city centre (Fullarton Estates in South Adelaide) rather like the humble cottage where the family had begun its life in Adelaide only 35 years earlier.
No more big mansion, no more grand summer home, no more grand automobile, no more factory and firm, no more money for school fees - all gone in the bankruptcy following his dad's sudden death.
Like Charles Dickens never forgiving his mother from not rescuing him from the blacking factory, Howard Florey never forgave his father for bringing the family firm and name to ruin by not keeping a proper watch on his subordinate employees - the event that the family claimed led to the firm's collapse.
For Dawson,September 1918 meant he was wounded once again - even more seriously this time.
Once more he had months in hospitals recovering and once again he had to endure the yells and smells of the young boys needlessly dying beside him from relatively minor wounds that had become grossly infected with bacteria.
This time, thousands of soldiers were also dying from the bacterial diseases that followed upon the infamous Spanish Flu.
Sometime during those months spent recovering, Dawson stopped referring to himself as a soldier planning to return to an Arts Degree, instead become someone planning to become a doctor.
He became a bacteria specialist in fact.
In 1940, both men got an unexpected opportunity to re-live (and more importantly, to re-do and un-do ) those traumatic events.
Florey turned his Department's entire building at Oxford University into what he called the Dunn "PENICILLIN FACTORY", run by Florey like a factory-operating Victorian paterfamilas, just as his own father had done in the family's halcyon days before the firm became a publicly traded company.
Woe to any member of the Florey family firm at the Dunn, like Norman Heatley, who dared even think of leaving the Dunn factory if Florey didn't want him to.
Leonard Bickel recounts this incident in his "Rise Up to Life" biography of Florey and when I first read it six years ago, I thought how feudal it all sounded.
Rather like the way minor Nova Scotia lumber
barons still treat their employees in backwoods communities where their mill is the only source of work.
About the only thing missing were the annual Florey 'factory family' picnics.
For Dawson, he turned his tiny lab, together with the nearby corridor and ward, into what I call his own MANHATTAN CLEARING # 7 , a sort of civilian casualty clearing post or station rather like the many that Dawson had served in or suffered in during the Great War.
(His lab was was on the Floor G at the Presbyterian Hospital in Manhattan, and G is the seventh letter of the alphabet.
As he had also started his medical career in 1915, as a private (orderly) in the Canadian #7 Stationary Hospital (organized by Dalhousie University's Medical School) - I gave his effort this particular name.)
Unlike a stationary or base hospital much of the time, a Casualty Clearing Station really operates at only one tempo ---- STAT.
This medical term means 'as fast as possible', 'immediately', 'its a clinical life-threatening emergency', all words that aptly describes the type of patients a CCS or CCP got after earlier medical posts sorted out the less wounded.
Florey and Chain openly admit they crafted their penicillin project to be a broad long term investigation on the entire topic of microbial antagonism - designed to bring in lots of work for staff and lots of grants for equipment -- to help make the Dunn into a world class research institution.
This they achieved - penicillin was only one of hundreds of antibiotics they investigated in WWII.
By contrast, Dawson strictly focused, from day one, on saving as many Juvenis Interruptus (SBE) patients as possible, as quick as possible, with penicillin.
STAT was his byword in all things penicillin and in just five weeks he had grown, concentrated, tested and now was saving lives with a substance about almost nothing was known - a record probably no other doctor has excelled.
He was too old and too 'previously wounded' to end up again the the combat front lines, but he was 'still on the job', still saving young lives anyway he could.....
In September 1918, Florey's family literally tumbled down the social scale.
Down, down, down from wealthy socially prominent Upper Mitcham - sliding quickly back down the social scale to a little cottage in the lower suburbs near the city centre (Fullarton Estates in South Adelaide) rather like the humble cottage where the family had begun its life in Adelaide only 35 years earlier.
No more big mansion, no more grand summer home, no more grand automobile, no more factory and firm, no more money for school fees - all gone in the bankruptcy following his dad's sudden death.
Like Charles Dickens never forgiving his mother from not rescuing him from the blacking factory, Howard Florey never forgave his father for bringing the family firm and name to ruin by not keeping a proper watch on his subordinate employees - the event that the family claimed led to the firm's collapse.
For Dawson,September 1918 meant he was wounded once again - even more seriously this time.
Once more he had months in hospitals recovering and once again he had to endure the yells and smells of the young boys needlessly dying beside him from relatively minor wounds that had become grossly infected with bacteria.
This time, thousands of soldiers were also dying from the bacterial diseases that followed upon the infamous Spanish Flu.
Sometime during those months spent recovering, Dawson stopped referring to himself as a soldier planning to return to an Arts Degree, instead become someone planning to become a doctor.
He became a bacteria specialist in fact.
In 1940, both men got an unexpected opportunity to re-live (and more importantly, to re-do and un-do ) those traumatic events.
Florey turned his Department's entire building at Oxford University into what he called the Dunn "PENICILLIN FACTORY", run by Florey like a factory-operating Victorian paterfamilas, just as his own father had done in the family's halcyon days before the firm became a publicly traded company.
Woe to any member of the Florey family firm at the Dunn, like Norman Heatley, who dared even think of leaving the Dunn factory if Florey didn't want him to.
Leonard Bickel recounts this incident in his "Rise Up to Life" biography of Florey and when I first read it six years ago, I thought how feudal it all sounded.
Rather like the way minor Nova Scotia lumber
barons still treat their employees in backwoods communities where their mill is the only source of work.
About the only thing missing were the annual Florey 'factory family' picnics.
For Dawson, he turned his tiny lab, together with the nearby corridor and ward, into what I call his own MANHATTAN CLEARING # 7 , a sort of civilian casualty clearing post or station rather like the many that Dawson had served in or suffered in during the Great War.
(His lab was was on the Floor G at the Presbyterian Hospital in Manhattan, and G is the seventh letter of the alphabet.
As he had also started his medical career in 1915, as a private (orderly) in the Canadian #7 Stationary Hospital (organized by Dalhousie University's Medical School) - I gave his effort this particular name.)
Unlike a stationary or base hospital much of the time, a Casualty Clearing Station really operates at only one tempo ---- STAT.
This medical term means 'as fast as possible', 'immediately', 'its a clinical life-threatening emergency', all words that aptly describes the type of patients a CCS or CCP got after earlier medical posts sorted out the less wounded.
Florey and Chain openly admit they crafted their penicillin project to be a broad long term investigation on the entire topic of microbial antagonism - designed to bring in lots of work for staff and lots of grants for equipment -- to help make the Dunn into a world class research institution.
This they achieved - penicillin was only one of hundreds of antibiotics they investigated in WWII.
By contrast, Dawson strictly focused, from day one, on saving as many Juvenis Interruptus (SBE) patients as possible, as quick as possible, with penicillin.
STAT was his byword in all things penicillin and in just five weeks he had grown, concentrated, tested and now was saving lives with a substance about almost nothing was known - a record probably no other doctor has excelled.
He was too old and too 'previously wounded' to end up again the the combat front lines, but he was 'still on the job', still saving young lives anyway he could.....
Tuesday, September 28, 2010
Boots to Bombsights and back to Boots again !
Howard Florey's father won a massive government contact to supply boots to Australia's Reserve Army in the run up to World War One.
(Under the circumstances, how could he also spare his only son to actually wear one of those pairs of boots?)
Boots, along with shovels, were a big part of World War One, as millions of infantry armed with rifles and shovels were the key to a nation's continued survival and its hopes of ultimate victory.
But by 1940, low tech boots were so yesterday (along with the riflemen who wore them), as high tech bombsights - the Norden in particular - were seen as the key to survival.
In the US military, the infantry were the leftovers after all the other sections of the Army, along with the Navy and Marines, cherry-picked the best and the brightest.
By 1943, a survey revealed that not only were the MOS 745s (the frontline riflemen) less educated and less skilled than anyone else in the entire Military, they were also smaller and lighter.
Remember, these are the guys we all expected to pack on 75 pounds in extra gear and ammo and then run up hill full tilt under enemy fire, with only a millimeter of cotton twill to protect them !
Meanwhile, late in 1943, the rear echlon thumb suckers in Washington finally realized two very important things:
(1) The ultra modern Norden, together with the bomber attached to it, was as useless as a senior Congressman's mouth, when it came to actually making Germany surrender.
It was going to take old fashioned boots and shovels - lots of them - actually astride German soil, to make the Krauts to quit.
(2) There weren't enough infantry riflemen, period - let along top grade riflemen - to do the job. And as the wet, cold Fall 1943 campaign up the Italian Boot revealed, even the American boot wasn't up to the game.
Tens of thousands of the infantrymen already in desperately short supply in Italy were out of action, in hospitals with non-battlefield conditions.
Yes, some were in hospitals to be cured of VD ( much of it self- inflicted to get them out of the never-ending American meatgrinder system of Divisional combat - far worse than anything any army experienced in WWI).
This was well publicized - blaming the victim, in effect.
Less well known was the tens of thousands of foot soldiers in hospital with Trench Foot, produced by poor quality American footwear for wet winter combat conditions .
The nation that later boasted it was the first to put a pair of boots on the Moon, had more problems putting proper boots on its frontline dogfaces in WWII.
Less attention to making the plump perfect Norden mechanical bombsight and a bit more attention making better boot uppers might have been a better application of the vaunted American knowhow.
Perhaps Howard Florey should have given up penicillin and taken up his dad's trade, if he really wanted to aid America....
(Under the circumstances, how could he also spare his only son to actually wear one of those pairs of boots?)
Boots, along with shovels, were a big part of World War One, as millions of infantry armed with rifles and shovels were the key to a nation's continued survival and its hopes of ultimate victory.
But by 1940, low tech boots were so yesterday (along with the riflemen who wore them), as high tech bombsights - the Norden in particular - were seen as the key to survival.
In the US military, the infantry were the leftovers after all the other sections of the Army, along with the Navy and Marines, cherry-picked the best and the brightest.
By 1943, a survey revealed that not only were the MOS 745s (the frontline riflemen) less educated and less skilled than anyone else in the entire Military, they were also smaller and lighter.
Remember, these are the guys we all expected to pack on 75 pounds in extra gear and ammo and then run up hill full tilt under enemy fire, with only a millimeter of cotton twill to protect them !
Meanwhile, late in 1943, the rear echlon thumb suckers in Washington finally realized two very important things:
(1) The ultra modern Norden, together with the bomber attached to it, was as useless as a senior Congressman's mouth, when it came to actually making Germany surrender.
It was going to take old fashioned boots and shovels - lots of them - actually astride German soil, to make the Krauts to quit.
(2) There weren't enough infantry riflemen, period - let along top grade riflemen - to do the job. And as the wet, cold Fall 1943 campaign up the Italian Boot revealed, even the American boot wasn't up to the game.
Tens of thousands of the infantrymen already in desperately short supply in Italy were out of action, in hospitals with non-battlefield conditions.
Yes, some were in hospitals to be cured of VD ( much of it self- inflicted to get them out of the never-ending American meatgrinder system of Divisional combat - far worse than anything any army experienced in WWI).
This was well publicized - blaming the victim, in effect.
Less well known was the tens of thousands of foot soldiers in hospital with Trench Foot, produced by poor quality American footwear for wet winter combat conditions .
The nation that later boasted it was the first to put a pair of boots on the Moon, had more problems putting proper boots on its frontline dogfaces in WWII.
Less attention to making the plump perfect Norden mechanical bombsight and a bit more attention making better boot uppers might have been a better application of the vaunted American knowhow.
Perhaps Howard Florey should have given up penicillin and taken up his dad's trade, if he really wanted to aid America....
Monday, September 27, 2010
Dawson,Florey: wildly different colonial Edwardians
Howard Florey and Henry Dawson were both born in the mid 1890s and grew up in roughly similar upper/middle class circumstances in two small outposts of the Edwardian Era British Empire.
But both took wildly variant approaches to almost every major decision affecting people born in the Edwardian Era.
Most famously, these two Edwardian colonials differed wildly over the best way to quickly get penicillin into wide use during World War Two.
We abuse history if we read too much into the generalities of a particular era and not enough into the particularities of the individuals living in the era.
People, not eras, after all make the choices and do the actions.
If Florey was highly 'typical' of his Era, Dawson definitely was not 'typical' at all : however he still remained, someone from that Era -
a fact we must confront head on.....
But both took wildly variant approaches to almost every major decision affecting people born in the Edwardian Era.
Most famously, these two Edwardian colonials differed wildly over the best way to quickly get penicillin into wide use during World War Two.
We abuse history if we read too much into the generalities of a particular era and not enough into the particularities of the individuals living in the era.
People, not eras, after all make the choices and do the actions.
If Florey was highly 'typical' of his Era, Dawson definitely was not 'typical' at all : however he still remained, someone from that Era -
a fact we must confront head on.....
50 years separate Leaders at top and Teen riflemen at bottom
In every war, the top national leadership are usually in their sixties.
My definition of national leader goes well beyond prime ministers and generals to include the unseen, semi-retired, powers behind the throne: the newspaper owners, the chief shareholders of the largest corporations, the professors emeritus etc.
By contrast, the men at the pointiest end of the stick, the infantry dogfaces armed only with a rifle and a shovel, are often in their teens.
Fifty years, a very long half century, usually separates the men who run the war from those who merely did as they are told.
So a historical approach which focuses too much on the memories of youngest veterans, the ones who survive the longest on civilian street, can seriously distort the historical record.
Yes they actually fought the battles and this makes for dramatic stories.
But, but, but - a focus on their experience comes at a high price.
Babies may experience history but they certainly didn't form it.
We need always to remember that the men who caused World War I - and who led it - had their formative experience of their life in the Pre-Modern Era ( back in 1850s and 1860s).
But their front line teenage soldiers were children of the Modern Era at its most florid - the worldwide Wheat and Rail Boom that led into the Edwardian Era.
So there was a disconnect.
In the Viet Nam War, the leaders were fully from the Modern Era but the teens fighting it were of the Post-Modern Era.
Another disconnect.
However in World War II,our only fully MODERN WAR , both its leaders and its teen soldiers were both fully in the same Modern Era ----albeit up to a point.
After all its leaders grew up in the booming Edwardian Era and the kids fighting in its front lines grew up in the depths of the Great Depression.
Probing further, we can see that the Edwardian Era was one where people were both, at almost the same instant, extremely optimistic and extremely pessimistic.
Progress and Degeneracy were their two bywords.
Most Edwardian Era adults held both views but still leaned consistently more to one side or other side.
I would, for an example, place Howard Florey on the optimistic side and Henry Dawson on the pessimistic side of the Edwardian Era estimation of Man's ability to favourably affect Reality.
My book on the wartime Penicillin Saga will not shortchange the leaders of the various wars it covers.
I will highlight the fact that for most of us, our definitive values-forming experiences occur in our mid teens.
And I will then focus on the paradox that we
only get full rein to impose those teen age values on those younger than us when we are about 50 years older and our victims are themselves in their own mid-teens !
WW II leaders and their populace generally were
less convinced about the effectiveness of War elan and were more convinced of the effectiveness of War Science, in comparison to Great War populations.
This was partly due to the effect of recent experience - elan hadn't worked too well against machine guns in Flanders' Fields.
But it also reflected the intense belief in the 'Power of Science' held by Edwardian Era teenagers who were now running the Second World War at the very top of the food chain...
My definition of national leader goes well beyond prime ministers and generals to include the unseen, semi-retired, powers behind the throne: the newspaper owners, the chief shareholders of the largest corporations, the professors emeritus etc.
By contrast, the men at the pointiest end of the stick, the infantry dogfaces armed only with a rifle and a shovel, are often in their teens.
Fifty years, a very long half century, usually separates the men who run the war from those who merely did as they are told.
So a historical approach which focuses too much on the memories of youngest veterans, the ones who survive the longest on civilian street, can seriously distort the historical record.
Yes they actually fought the battles and this makes for dramatic stories.
But, but, but - a focus on their experience comes at a high price.
Babies may experience history but they certainly didn't form it.
We need always to remember that the men who caused World War I - and who led it - had their formative experience of their life in the Pre-Modern Era ( back in 1850s and 1860s).
But their front line teenage soldiers were children of the Modern Era at its most florid - the worldwide Wheat and Rail Boom that led into the Edwardian Era.
So there was a disconnect.
In the Viet Nam War, the leaders were fully from the Modern Era but the teens fighting it were of the Post-Modern Era.
Another disconnect.
However in World War II,our only fully MODERN WAR , both its leaders and its teen soldiers were both fully in the same Modern Era ----albeit up to a point.
After all its leaders grew up in the booming Edwardian Era and the kids fighting in its front lines grew up in the depths of the Great Depression.
Probing further, we can see that the Edwardian Era was one where people were both, at almost the same instant, extremely optimistic and extremely pessimistic.
Progress and Degeneracy were their two bywords.
Most Edwardian Era adults held both views but still leaned consistently more to one side or other side.
I would, for an example, place Howard Florey on the optimistic side and Henry Dawson on the pessimistic side of the Edwardian Era estimation of Man's ability to favourably affect Reality.
My book on the wartime Penicillin Saga will not shortchange the leaders of the various wars it covers.
I will highlight the fact that for most of us, our definitive values-forming experiences occur in our mid teens.
And I will then focus on the paradox that we
only get full rein to impose those teen age values on those younger than us when we are about 50 years older and our victims are themselves in their own mid-teens !
WW II leaders and their populace generally were
less convinced about the effectiveness of War elan and were more convinced of the effectiveness of War Science, in comparison to Great War populations.
This was partly due to the effect of recent experience - elan hadn't worked too well against machine guns in Flanders' Fields.
But it also reflected the intense belief in the 'Power of Science' held by Edwardian Era teenagers who were now running the Second World War at the very top of the food chain...
Saturday, September 25, 2010
War hospital stays made Dawson bacteriologist not surgeon
Not until February 1919, when the war was over, and Henry Dawson was back in Canada facing discharge, did he say that his civilian occupation was to be a MEDICAL student.
Until then, he was just an Arts student.
With his excellent marks, if in 1915 he had told military recruiters that he was intending to go into med school, he would have been almost 'ordered' to remain in school and become a doctor, as they were so desperately needed .
He spent a year in military hospitals as a buck private orderly, dealing with the severely injured and severely infected wounded coming off the battlefields.
Many other patients ,less dramatically, were
nevertheless dying from diseases they had picked up in other places than from a battlefield wound.
Then he was wounded,once as a infantry officer and then once as an artillery officer, both times fairly severely, and spent long periods in various hospitals.
The only heroes in these wound-oriented hospitals were the surgeons - they saved lives by their skill with a good eye and a steady hand.
The nursing staff might save lives by attention to detail in keeping wounds clean.
But regular (clinician) doctors contributed little towards a cure - they could diagnose but didn't have any medicine to save a patient if severe blood poisoning set in.
Bacteria were more dangerous than German bullets.
Interesting, there is no evidence Dawson decided to try and become a surgeon like all the surgeon-heroes he had met in the hospitals, once he was at McGill's Med School.
Instead Dawson quickly became a bacteriologist-pathologist and remained so all his life.
I think he felt that too many of the healthy young boys around him in his stays in hospital had survived their battlefield wound and had survived the surgery , only to die of bacterial infection.
This, he felt, was medicine's weakest link.
He wasn't seeking to emulate his medical heroes, but rather seeking to reform medicine from within.
I believe he set out with a critical attitude to the existing medical practise - he felt it didn't give enough attention to the successful bacteria's secrets.
I think he saw too many young boys needlessly die who had never danced or ever been kissed...
Until then, he was just an Arts student.
With his excellent marks, if in 1915 he had told military recruiters that he was intending to go into med school, he would have been almost 'ordered' to remain in school and become a doctor, as they were so desperately needed .
He spent a year in military hospitals as a buck private orderly, dealing with the severely injured and severely infected wounded coming off the battlefields.
Many other patients ,less dramatically, were
nevertheless dying from diseases they had picked up in other places than from a battlefield wound.
Then he was wounded,once as a infantry officer and then once as an artillery officer, both times fairly severely, and spent long periods in various hospitals.
The only heroes in these wound-oriented hospitals were the surgeons - they saved lives by their skill with a good eye and a steady hand.
The nursing staff might save lives by attention to detail in keeping wounds clean.
But regular (clinician) doctors contributed little towards a cure - they could diagnose but didn't have any medicine to save a patient if severe blood poisoning set in.
Bacteria were more dangerous than German bullets.
Interesting, there is no evidence Dawson decided to try and become a surgeon like all the surgeon-heroes he had met in the hospitals, once he was at McGill's Med School.
Instead Dawson quickly became a bacteriologist-pathologist and remained so all his life.
I think he felt that too many of the healthy young boys around him in his stays in hospital had survived their battlefield wound and had survived the surgery , only to die of bacterial infection.
This, he felt, was medicine's weakest link.
He wasn't seeking to emulate his medical heroes, but rather seeking to reform medicine from within.
I believe he set out with a critical attitude to the existing medical practise - he felt it didn't give enough attention to the successful bacteria's secrets.
I think he saw too many young boys needlessly die who had never danced or ever been kissed...
Florey family and PATENTS :ducks and water
In the reverential biographies of Howard Florey ( he has never had a critical biography - I hope to inspire one of them though), he is always played as the anti-patent guy on penicillin.
By contrast, Ernst Chain is always played as the greedy pro-patent guy.
Well, he is Jewish after all - he would be the greedy money-grubbing one, won't he ?
Edward Abraham, who was there at the time, says that both were pro-patent to a degree - seeking Oxford University to control it ,(as the University of Toronto did insulin).
I agree.
The assumption was made that because Chain's father was in some sort of chemistry business in Germany Chain the PhD chemist would know all about the importance of patents.
(But we don't actually know if his father was involved in patents.)
But Florey ,the MD, would not anything about patents - against MD ethics in the UK at the time. Etc.
Bull dung !
Florey-the-son had wanted to be a chemist and was only nominally a MD in reality anyway.
His father had made his fortune by being the first into a new cutting edge technology, the first into high tech chemistry and trade marks, and by being the first in his state to obtain exclusive geographic rights to new processes.
Joseph Florey even tried to obtain at least one patent himself - for improvements in pneumatic tyres - applied for in Western Australia on May 16 1996, according to the local daily paper.
Leather making technology hadn't changed in around 10,000 years - so when it did, many in the industry refused to take the first leap.
Beyond how technically challenging the new ways of tanning leather were, was the fact that they were not public domain and free, as the tannin way of leather-making had been for centuries.
Florey took both risks and fell into a hot area of patents and licenses and paying high fees - or ignoring patents and fees and focussing on trade marks instead.
His many ads never claimed he had a patent for his chromella leather or even a patent license with a registered number - merely that he was the exclusive South Australia agent for it and held control of it as a trademark.
I haven't been able to find the original owner of chromella leather, but I believe very much they existed.
Here is why:
Florey's very first time he is mentioned in any newspaper seems to have been the month (October 1894) - even the day - he got that exclusive agency for chromella and he took out ads proclaiming that fact.
The word chromella almost never left the Australian papers, in some form or other, until well after his death.
His wealth seemed to have started around 1894 as well.
Having that chromella agency really seemed to have mattered.
But Joseph Florey having interests in tyres and patents of his own was news to me.
Patent talk would have been mother's milk to his son, Howard.
And I think we all owe Chain a heartfelt apology....
By contrast, Ernst Chain is always played as the greedy pro-patent guy.
Well, he is Jewish after all - he would be the greedy money-grubbing one, won't he ?
Edward Abraham, who was there at the time, says that both were pro-patent to a degree - seeking Oxford University to control it ,(as the University of Toronto did insulin).
I agree.
The assumption was made that because Chain's father was in some sort of chemistry business in Germany Chain the PhD chemist would know all about the importance of patents.
(But we don't actually know if his father was involved in patents.)
But Florey ,the MD, would not anything about patents - against MD ethics in the UK at the time. Etc.
Bull dung !
Florey-the-son had wanted to be a chemist and was only nominally a MD in reality anyway.
His father had made his fortune by being the first into a new cutting edge technology, the first into high tech chemistry and trade marks, and by being the first in his state to obtain exclusive geographic rights to new processes.
Joseph Florey even tried to obtain at least one patent himself - for improvements in pneumatic tyres - applied for in Western Australia on May 16 1996, according to the local daily paper.
Leather making technology hadn't changed in around 10,000 years - so when it did, many in the industry refused to take the first leap.
Beyond how technically challenging the new ways of tanning leather were, was the fact that they were not public domain and free, as the tannin way of leather-making had been for centuries.
Florey took both risks and fell into a hot area of patents and licenses and paying high fees - or ignoring patents and fees and focussing on trade marks instead.
His many ads never claimed he had a patent for his chromella leather or even a patent license with a registered number - merely that he was the exclusive South Australia agent for it and held control of it as a trademark.
I haven't been able to find the original owner of chromella leather, but I believe very much they existed.
Here is why:
Florey's very first time he is mentioned in any newspaper seems to have been the month (October 1894) - even the day - he got that exclusive agency for chromella and he took out ads proclaiming that fact.
The word chromella almost never left the Australian papers, in some form or other, until well after his death.
His wealth seemed to have started around 1894 as well.
Having that chromella agency really seemed to have mattered.
But Joseph Florey having interests in tyres and patents of his own was news to me.
Patent talk would have been mother's milk to his son, Howard.
And I think we all owe Chain a heartfelt apology....
CHEMISTRY made Joseph Florey family rich and famous
Tanning leather is an ancient and highly skilled activity involving many chemical processes --- a process humans have been doing world wide for tens of thousands of years.
But tanning leather by use of formal chemistry (man-made rather than naturally found chemicals) is only about 150 years old and was brand new to the Southern Hemisphere when Joseph Florey set out to make his fame and fortune in the backward colony of South Australia.
This new method was called "chrome leather" and consisted of tanning leather by means of various compounds of the metal chromium.
The traditional, natural way, was via using tannin from the bark of various hardwoods, together with urine,dung and brains of animals and humans, as well as involving a lot of expensive, capricious hand labour.
And a lot of time.
Joseph Florey was also a part owner of a new wattle plantation near Mount Cone in the interior of South Australia.
Wattles make an important variant of leather, suitable where chrome leather was too soft.
Till then, virtually treeless South Australia had to import its tannin at great cost.
Chrome leather, by contrast, was modern, fast, machine-oriented, capital oriented.
It was made without the use of foul-smelling human urine and excrement collected by little poor children on the street corners of the poor neighbourhoods .
The chemically active ingredients of those natural products had been learned and synthetically made equivalents were used instead.
This was Victorian Progress and Joseph Florey never let anyone forget it - it was the focus of his firm's static displays at the Exhibitions of Industry and Progress so beloved by the Victorian and Edwardian middle class.
It was encompassed in his trade mark,Chromella, which he had secured throughout all of Australasia (sic). He repeatedly defended that trademark in expensive court cases.
Joseph Florey hadn't invented chrome leather but he acted as he had.
He successfully won via the courts , at least locally, the right to prevent any other competitor from using any trade name that hinted that their leather was produced by the 'chrome' method - though the patents on the original process had gone by then.
Chemistry - and a very competitive and ligatious nature - made the Florey fortune.
These were lessons learned well by Howard Florey and why he wanted to become a chemist - and why he was so highly competitive.
Ironically, chromium, a heavy metal, in those days and today gives many customers contact dermitious or worse -- it is banned in very young children's shoes.
And its waste products are far worse for the environment than urine and dung ever were.
So today a new progressive modified organic, natural, method called 'wet white' is replacing the Old School chrome, wet blue, method......
But tanning leather by use of formal chemistry (man-made rather than naturally found chemicals) is only about 150 years old and was brand new to the Southern Hemisphere when Joseph Florey set out to make his fame and fortune in the backward colony of South Australia.
This new method was called "chrome leather" and consisted of tanning leather by means of various compounds of the metal chromium.
The traditional, natural way, was via using tannin from the bark of various hardwoods, together with urine,dung and brains of animals and humans, as well as involving a lot of expensive, capricious hand labour.
And a lot of time.
Joseph Florey was also a part owner of a new wattle plantation near Mount Cone in the interior of South Australia.
Wattles make an important variant of leather, suitable where chrome leather was too soft.
Till then, virtually treeless South Australia had to import its tannin at great cost.
Chrome leather, by contrast, was modern, fast, machine-oriented, capital oriented.
It was made without the use of foul-smelling human urine and excrement collected by little poor children on the street corners of the poor neighbourhoods .
The chemically active ingredients of those natural products had been learned and synthetically made equivalents were used instead.
This was Victorian Progress and Joseph Florey never let anyone forget it - it was the focus of his firm's static displays at the Exhibitions of Industry and Progress so beloved by the Victorian and Edwardian middle class.
It was encompassed in his trade mark,Chromella, which he had secured throughout all of Australasia (sic). He repeatedly defended that trademark in expensive court cases.
Joseph Florey hadn't invented chrome leather but he acted as he had.
He successfully won via the courts , at least locally, the right to prevent any other competitor from using any trade name that hinted that their leather was produced by the 'chrome' method - though the patents on the original process had gone by then.
Chemistry - and a very competitive and ligatious nature - made the Florey fortune.
These were lessons learned well by Howard Florey and why he wanted to become a chemist - and why he was so highly competitive.
Ironically, chromium, a heavy metal, in those days and today gives many customers contact dermitious or worse -- it is banned in very young children's shoes.
And its waste products are far worse for the environment than urine and dung ever were.
So today a new progressive modified organic, natural, method called 'wet white' is replacing the Old School chrome, wet blue, method......
Wednesday, September 22, 2010
Pity poor, poor pitiful Florey, surrounded by leftie subordinates
Howard Florey got some very useful advice the day he arrived in America to protect Oxford University's Chromella Brand Penicillin from what he imagined were attacks on his left flank from Henry Dawson and his cohorts in deepest Brooklyn.
"Whatever you do, stay away from taking sides between the advocates of continuing social medicine (people like the US Surgeon General Thomas Parran) and those using the war as an excuse to roll back New Deal medical gains for the poor ( people like AMA godfather Morris Fishbein and the NAS's Lewis Weed.)"
(Dr Weed, upon whom the Hippocratic Oath lay lightly, saw medicines like penicillin and projects like germ warfare as highly useful weapons in a total war - and to test them the poor and the weak would be unwittingly conscripted into the war effort.)
This useful advice from Dr Gregg at the Rockefeller Foundation was wasted on Florey, the son of a hard-nosed industrialist and someone who loathed Blacks, Italians, Jews and trade unionists. (Just for a start.)
In fact, most of the problems that Florey had had with his subordinate Ernst Chain and his co-workers Epstein and Duthie ,had come from of their left-wing social medicine-oriented politics.
Florey rather more preferred men like John Randal Baker, author of the controversial book RACE, if he had a choice as to who he wanted in his Institution.
Leslie Epstein (later Leslie Falk), from the Parran side of the debate, exacted his revenge on Florey by telling all on Florey's secret penicillin work to fellow Jew, Karl Meyer, working with Henry Dawson.
He thus setting into motion the wartime across ocean race to see whether Man or Nature would provide the lifesaving penicillin for the Allied wounded on the beaches of the upcoming Second Front.
And Thomas Parran got his revenge on A N Richards and C S Keffer from the Weed side of the debate, by releasing the penicillin to Baby Patricia which blow the lid off the whole secret effort to keep penicillin hidden until a chemical synthesis had been worked out.
After the war Parran and Falk joined up in Pittsburgh, still pushing a social medicine agency during a time in Cold War America the act of providing health care for all was regarded as the work of the Devil, in his human guise as Stalin.
America never did get decent medical care for its poorer citizens.
But hey, "We'll always have Penicillin. "
Won't we America ...?
"Whatever you do, stay away from taking sides between the advocates of continuing social medicine (people like the US Surgeon General Thomas Parran) and those using the war as an excuse to roll back New Deal medical gains for the poor ( people like AMA godfather Morris Fishbein and the NAS's Lewis Weed.)"
(Dr Weed, upon whom the Hippocratic Oath lay lightly, saw medicines like penicillin and projects like germ warfare as highly useful weapons in a total war - and to test them the poor and the weak would be unwittingly conscripted into the war effort.)
This useful advice from Dr Gregg at the Rockefeller Foundation was wasted on Florey, the son of a hard-nosed industrialist and someone who loathed Blacks, Italians, Jews and trade unionists. (Just for a start.)
In fact, most of the problems that Florey had had with his subordinate Ernst Chain and his co-workers Epstein and Duthie ,had come from of their left-wing social medicine-oriented politics.
Florey rather more preferred men like John Randal Baker, author of the controversial book RACE, if he had a choice as to who he wanted in his Institution.
Leslie Epstein (later Leslie Falk), from the Parran side of the debate, exacted his revenge on Florey by telling all on Florey's secret penicillin work to fellow Jew, Karl Meyer, working with Henry Dawson.
He thus setting into motion the wartime across ocean race to see whether Man or Nature would provide the lifesaving penicillin for the Allied wounded on the beaches of the upcoming Second Front.
And Thomas Parran got his revenge on A N Richards and C S Keffer from the Weed side of the debate, by releasing the penicillin to Baby Patricia which blow the lid off the whole secret effort to keep penicillin hidden until a chemical synthesis had been worked out.
After the war Parran and Falk joined up in Pittsburgh, still pushing a social medicine agency during a time in Cold War America the act of providing health care for all was regarded as the work of the Devil, in his human guise as Stalin.
America never did get decent medical care for its poorer citizens.
But hey, "We'll always have Penicillin. "
Won't we America ...?
Tuesday, September 21, 2010
WWII : German tanks mauling Polish horses to Polish horses hauling German tanks...
In September 1939, as reports emerged from neutral American and Italian journalists of 'fast-moving German panzer tanks destroying charges by the lumbering Polish horse calvary', the world's thumb-suckers all agreed: this war would see the Triumph of the Mobile Will over Stolid Matter.
A war of active chemical synthesis over passive biology and agriculture.
Of physics and active weather modification projects over the passive observations and avoidances of meteorology.
A war of fast tanks over slow horses; of high tech bombers and highly trained bomber crews over low tech shovels and the unskilled troops than employ them.
The weight of the Draft and Conscription would lay lightly on the population.
The mostly highly educated wouldn't even be drafted because scientists were too valuable to heft shovels overseas in some trench.
The highly skilled would either received deferments to remain in their home jobs or if drafted, would carry on their skills in the rear echelons of the war zone or would engage in combat from inside a high tech tank, plane or ship.
Only a relatively small number, the unskilled and the uneducated, the small and the thin, would end up assigned as riflemen.
They ,only, would be the ones to see an old fashioned war and to carry a backpack, a shovel and a rifle and to charge up and down hills at a trot and sleep in foxholes in the rain.
The highly scientifically educated A1s were each nation's most valuable asset - their least valuable asset was their chronically ill, medical-resource-consuming, too-sick-to-work, 4Fs.
Resources would be assigned to each, accordingly.
This would be the first fully Modern, first full Modernity, War : that would be the fundamental unity binding together the various combatant nations, despite the surface appearance of deep ideological differences.
Modernity united all combatant nations in this agreement: "There is nothing in Nature that Organized Man can not improve".
Natural Philosophy and active alternation would triumph completely , at long last, over passive Natural History and observation/ avoidance.
It was a time for Big Military Budgets , but relatively small military forces.
A time for Big Governments, Big Foundations, Big Businesses, Big Science.
The God of Modernity, all the thumb-suckers agreed, was on the side of the Big Battalions.
The stage was set so let the drama begin !
But entering Stage Left ,as unobserved as any airborne spore , came :
'the Little Guy from Chrysogenum' ...
A war of active chemical synthesis over passive biology and agriculture.
Of physics and active weather modification projects over the passive observations and avoidances of meteorology.
A war of fast tanks over slow horses; of high tech bombers and highly trained bomber crews over low tech shovels and the unskilled troops than employ them.
The weight of the Draft and Conscription would lay lightly on the population.
The mostly highly educated wouldn't even be drafted because scientists were too valuable to heft shovels overseas in some trench.
The highly skilled would either received deferments to remain in their home jobs or if drafted, would carry on their skills in the rear echelons of the war zone or would engage in combat from inside a high tech tank, plane or ship.
Only a relatively small number, the unskilled and the uneducated, the small and the thin, would end up assigned as riflemen.
They ,only, would be the ones to see an old fashioned war and to carry a backpack, a shovel and a rifle and to charge up and down hills at a trot and sleep in foxholes in the rain.
The highly scientifically educated A1s were each nation's most valuable asset - their least valuable asset was their chronically ill, medical-resource-consuming, too-sick-to-work, 4Fs.
Resources would be assigned to each, accordingly.
This would be the first fully Modern, first full Modernity, War : that would be the fundamental unity binding together the various combatant nations, despite the surface appearance of deep ideological differences.
Modernity united all combatant nations in this agreement: "There is nothing in Nature that Organized Man can not improve".
Natural Philosophy and active alternation would triumph completely , at long last, over passive Natural History and observation/ avoidance.
It was a time for Big Military Budgets , but relatively small military forces.
A time for Big Governments, Big Foundations, Big Businesses, Big Science.
The God of Modernity, all the thumb-suckers agreed, was on the side of the Big Battalions.
The stage was set so let the drama begin !
But entering Stage Left ,as unobserved as any airborne spore , came :
'the Little Guy from Chrysogenum' ...
Monday, September 20, 2010
"Howard Florey stole the true story of wartime penicillin - we're here to steal it back !"
People ask what is the purpose of this blog/book "MO goes PO".
Here it is:
America - and Britain - and a whole lot of other countries made wartime penicillin.
No one stole penicillin (a natural product and hence already in the Public Domain) from anyone else - this was thanks to the pre-war legacy of Alexander Fleming freely spreading his unique strain of penicillium spores world wide.
It is true some - in America - tried to control penicillin by sharing publicly-funded highly productive strains with only themselves and their pals - thankfully that scheme failed to do more than needlessly delay wartime penicillin's wide introduction.
On the other hand, Howard Florey and his post war supporters (many of whom are American) successfully and seemingly permanently 'stole' the true story of wartime penicillin away from America.
There was about nothing as petty as fighting over mere billions in dollars of profits.
This was the world's best known and best loved - and simply 'the best' - medical cure ever.
So it mattered muchly, which individuals, institutions and nations got the bulk of the glory for bringing it forth for All Humanity to enjoy.
This is was a battle over who controlled the Narrative and the Brand of the world's greatest Miracle.
Britain may have lost an Empire and its position as a World Power - but it clung onto penicillin-the-narrative.
All that America got was credit for the Manhattan Project and giving us the terror of Atomic Death to All Humanity.
Hardly a fair exchange.
I merely wish to suggest that the tiny "Manhattan Pilot" project had a very much bigger impact in the popular discovery of - and hence the immediate mass development of - wartime penicillin then it has been given credit for in the Florey-dominated story of wartime penicillin.
So - and to recall Bono's memorable phrase in Rattle and Hum -
"we're here to steal it back !"
Here it is:
America - and Britain - and a whole lot of other countries made wartime penicillin.
No one stole penicillin (a natural product and hence already in the Public Domain) from anyone else - this was thanks to the pre-war legacy of Alexander Fleming freely spreading his unique strain of penicillium spores world wide.
It is true some - in America - tried to control penicillin by sharing publicly-funded highly productive strains with only themselves and their pals - thankfully that scheme failed to do more than needlessly delay wartime penicillin's wide introduction.
On the other hand, Howard Florey and his post war supporters (many of whom are American) successfully and seemingly permanently 'stole' the true story of wartime penicillin away from America.
There was about nothing as petty as fighting over mere billions in dollars of profits.
This was the world's best known and best loved - and simply 'the best' - medical cure ever.
So it mattered muchly, which individuals, institutions and nations got the bulk of the glory for bringing it forth for All Humanity to enjoy.
This is was a battle over who controlled the Narrative and the Brand of the world's greatest Miracle.
Britain may have lost an Empire and its position as a World Power - but it clung onto penicillin-the-narrative.
All that America got was credit for the Manhattan Project and giving us the terror of Atomic Death to All Humanity.
Hardly a fair exchange.
I merely wish to suggest that the tiny "Manhattan Pilot" project had a very much bigger impact in the popular discovery of - and hence the immediate mass development of - wartime penicillin then it has been given credit for in the Florey-dominated story of wartime penicillin.
So - and to recall Bono's memorable phrase in Rattle and Hum -
"we're here to steal it back !"
"Trust only CHROMELLA Brand Penicillin, manufactured in his Oxfordshire factory by Joseph Florey, Junior"
Howard Florey is famous for dismissing outright any idea that he might patent penicillin, or at least patent his extraction process.
Of course he dismissed the idea - he was Joseph Florey's son, and his family were no idiots in matters concerning Trade Patents, Trade Secrets and Trade Marks ---- far, far, far from it.
It had been the entire basis of the considerable Florey family fortune.
And when his father Joseph's industrial empire all came down around the Florey family, it was because the value of the father's most important asset, the reputation for quality engendered in customers' minds when they saw or heard the term Chromella Brand Leather, had been allowed to be be destroyed by Mr Florey, senior.
It was a lesson, Mr Florey, junior never forgot.
The well spring of the entire wartime penicillin saga lies in the murky business practises of the Anglo Saxon businessman in the Edwardian era , when firms were merged holus-bolus by wily operators and their stocks watered as frequently as one's own garden.
Jospeh Florey got very rich very quickly, probably by using the exact same unsavory practises that Max Aitken (Lord Beaverbrook) used to get very rich very quickly at exactly the same time in Halifax and Montreal Canada.
Henry Dawson also knew, at fairly first hand , about fluffed up industrial empires that grew quickly and collapsed like a house of cards.
His mother's cousin - and possibly her own banker-brother - had rapidly created a far flung lumber empire, based on borrowing a lot of a bank's money without normal collateral.
The failure never went public, though all the family knew, and the cousin lived a fraudulent life , very publicly pretending to still own and run the biggest lumber empire in Atlantic Canada, while actually the bank was quietly selling it all off in pieces, trying to recover its losses.
The discovery of anything pre-existing and natural like penicillin or of water or air or sunshine can't be patented - it is inherently PD - in the Public Domain for all to enjoy.
Patenting processes to extract or purify it are possible and were frequently employed.
But the true basis of the economic value (if any) of these patents would not lie in what was written on the patent documents.
No, if you paid the patent royalties faithfully and seemed (a) to be trustworthy and (b) a distantly located competitor, then their real value to someone with a license, was the Trade Secrets the patent-holder would tell you directly by sending over highly skilled employees to train your staff.
Pfizer was not alone in dismissing the worth of costly and hard-to-defend, short-lived Trade patents, preferring keep their complicated and subtle production methods top secret -Trade Secrets - for ever and ever.
There was a third route - the route the two Florey's ultimately took :
Trade Marks, "Branding".
Joseph Florey in his advertising said, in effect, "Everyone knows that the shoes I make are very well made and that they are called Chromella - to be sure the shoes you buy really are well made by seeking out that mark of my work."
He then threw the full weight of the law on anyone who dared to use his mark.
When Howard Florey was only one year old, for example, Joseph Florey brought a competitor ,The Hunter Boot Company, before the Supreme Court in Adelaide,seeking an injunction and 1000 pounds in damages, for inserting Chromella in one of their newspaper ads.
The judge dismissed the case - with all costs to be paid by Florey, finding the insertion an accidental error.
He still probably counted the case a victory though - it had put the Hunter Company to considerable bother defending themselves and no doubt many still felt that the insertion hadn't been a 'accident' in reality - so its reputation never did totally recover.
Any future competitor who was tempted to use the Chromella brand on their boots no doubt noted that Florey would be onto them like an attack dog.
The price wasn't worth the pain.
This is the style of doing business Howard Florey grew up with and this is how he made his fame and fortune when Ernst Chain dropped penicillin in his lap in March 1940.
Florey liked money very well, thank you very much - as did his wive, they obsessed about it in fact.
But it was not vast fortunes they sought, for they could be here today and gone tomorrow, but the lifetime security of a upper middle class professional's salary and pension.
Scientific fame for Howard would bring those kind of professional positions - and it would restore the lost reputation of the Florey family - destroyed throughout Australia by media reports of angry shareholder meetings alleging something was fishy with Joseph Florey's shoe empire.
So first he went the Trade secret route, keeping all information about his extraction methods secret for a year and half, (March 1940-August 1941) despite Britain desperately needing all the
medical help it could get, in those terrible days of the Battle of Britain.
Entirely typical of Florey though - he had avoided WWI's trenches and he wasn't about to do anything extraordinary or risky in WWII either.
He was trying to get one of the drug companies in Britain to commit contractually to his extraction process, not for money directly of course (after all it was Heatley who had actually fine-tuned it, not Florey, by using well known standard chemical techniques suggested to Heatley by others.)
No, Florey would settle for a consultant's role - at a hefty consulting fee of course - that was the honorable way professionals got very rich without violating professional codes of ethics.
Chemically, there was no doubt that his extraction system worked.
But economically - always the weak spot in academic Oxford (see Ivory, Towers, and 'out of it') - it was a bomb, a disaster.
No firm could see it paying, but most - because it was wartime - still offered to voluntarily help improve the process enough to try and get enough penicillin for definitive human clinical trials.
Florey was resigned to this until March 1941 - after all his team had shifted to all out efforts to synthesize penicillin rather than do anymore than the two human cases he had attempted so far.
Then in that March of 1941, he got his own bombshell (Oxford itself was NEVER bombed , not even once) - word of the work of Dawson in New York.
Dawson too had his own penicillin factory - even bigger than Florey's and Dawson had won the race to be the first to put penicillin into a patient by needle - and he had gone public about it, in a public lecture, in February 1941.
He also had treated more patients while focusing on a very well known and very well feared disease - Juvenis Interruptus (Rheumatic Heart Disease) - something that was very media-worthy.
Dawson too had a German Jewish biochemist with a lot bigger
reputation than Chain - in fact this man, Karl Meyer, had long standing contractual links with the American branch of a very famous international drug firm from Germany - Schering Corporation.
Dawson's team might well have beaten him on both patents and trade secrets already.
Florey panicked - ditched his erstwhile British drug company supporters - speeding off to battle Dawson on the grounds his family was most comfortable with - Trade Marks.
His ace in the hole was the unnatural respect every democratic American had for anything British and aristocratic - like the Oxford University Brand.
This brand was a winner world wide, in many areas of education - Oxford textbooks taught one the best way, the only way, to speak English or play music.
Only the Oxford strain of penicillium, combined with the Oxford standard sample of purified penicillin and the Oxford method assay, was real penicillin , said Florey over and over, all through America.
This was total scientific hogwash but the Floreys hadn't climbed to the top of the Spencerian world of Survival of the Fittest by being concerned with niceties.
Off to battle !
Of course he dismissed the idea - he was Joseph Florey's son, and his family were no idiots in matters concerning Trade Patents, Trade Secrets and Trade Marks ---- far, far, far from it.
It had been the entire basis of the considerable Florey family fortune.
And when his father Joseph's industrial empire all came down around the Florey family, it was because the value of the father's most important asset, the reputation for quality engendered in customers' minds when they saw or heard the term Chromella Brand Leather, had been allowed to be be destroyed by Mr Florey, senior.
It was a lesson, Mr Florey, junior never forgot.
The well spring of the entire wartime penicillin saga lies in the murky business practises of the Anglo Saxon businessman in the Edwardian era , when firms were merged holus-bolus by wily operators and their stocks watered as frequently as one's own garden.
Jospeh Florey got very rich very quickly, probably by using the exact same unsavory practises that Max Aitken (Lord Beaverbrook) used to get very rich very quickly at exactly the same time in Halifax and Montreal Canada.
Henry Dawson also knew, at fairly first hand , about fluffed up industrial empires that grew quickly and collapsed like a house of cards.
His mother's cousin - and possibly her own banker-brother - had rapidly created a far flung lumber empire, based on borrowing a lot of a bank's money without normal collateral.
The failure never went public, though all the family knew, and the cousin lived a fraudulent life , very publicly pretending to still own and run the biggest lumber empire in Atlantic Canada, while actually the bank was quietly selling it all off in pieces, trying to recover its losses.
The discovery of anything pre-existing and natural like penicillin or of water or air or sunshine can't be patented - it is inherently PD - in the Public Domain for all to enjoy.
Patenting processes to extract or purify it are possible and were frequently employed.
But the true basis of the economic value (if any) of these patents would not lie in what was written on the patent documents.
No, if you paid the patent royalties faithfully and seemed (a) to be trustworthy and (b) a distantly located competitor, then their real value to someone with a license, was the Trade Secrets the patent-holder would tell you directly by sending over highly skilled employees to train your staff.
Pfizer was not alone in dismissing the worth of costly and hard-to-defend, short-lived Trade patents, preferring keep their complicated and subtle production methods top secret -Trade Secrets - for ever and ever.
There was a third route - the route the two Florey's ultimately took :
Trade Marks, "Branding".
Joseph Florey in his advertising said, in effect, "Everyone knows that the shoes I make are very well made and that they are called Chromella - to be sure the shoes you buy really are well made by seeking out that mark of my work."
He then threw the full weight of the law on anyone who dared to use his mark.
When Howard Florey was only one year old, for example, Joseph Florey brought a competitor ,The Hunter Boot Company, before the Supreme Court in Adelaide,seeking an injunction and 1000 pounds in damages, for inserting Chromella in one of their newspaper ads.
The judge dismissed the case - with all costs to be paid by Florey, finding the insertion an accidental error.
He still probably counted the case a victory though - it had put the Hunter Company to considerable bother defending themselves and no doubt many still felt that the insertion hadn't been a 'accident' in reality - so its reputation never did totally recover.
Any future competitor who was tempted to use the Chromella brand on their boots no doubt noted that Florey would be onto them like an attack dog.
The price wasn't worth the pain.
This is the style of doing business Howard Florey grew up with and this is how he made his fame and fortune when Ernst Chain dropped penicillin in his lap in March 1940.
Florey liked money very well, thank you very much - as did his wive, they obsessed about it in fact.
But it was not vast fortunes they sought, for they could be here today and gone tomorrow, but the lifetime security of a upper middle class professional's salary and pension.
Scientific fame for Howard would bring those kind of professional positions - and it would restore the lost reputation of the Florey family - destroyed throughout Australia by media reports of angry shareholder meetings alleging something was fishy with Joseph Florey's shoe empire.
So first he went the Trade secret route, keeping all information about his extraction methods secret for a year and half, (March 1940-August 1941) despite Britain desperately needing all the
medical help it could get, in those terrible days of the Battle of Britain.
Entirely typical of Florey though - he had avoided WWI's trenches and he wasn't about to do anything extraordinary or risky in WWII either.
He was trying to get one of the drug companies in Britain to commit contractually to his extraction process, not for money directly of course (after all it was Heatley who had actually fine-tuned it, not Florey, by using well known standard chemical techniques suggested to Heatley by others.)
No, Florey would settle for a consultant's role - at a hefty consulting fee of course - that was the honorable way professionals got very rich without violating professional codes of ethics.
Chemically, there was no doubt that his extraction system worked.
But economically - always the weak spot in academic Oxford (see Ivory, Towers, and 'out of it') - it was a bomb, a disaster.
No firm could see it paying, but most - because it was wartime - still offered to voluntarily help improve the process enough to try and get enough penicillin for definitive human clinical trials.
Florey was resigned to this until March 1941 - after all his team had shifted to all out efforts to synthesize penicillin rather than do anymore than the two human cases he had attempted so far.
Then in that March of 1941, he got his own bombshell (Oxford itself was NEVER bombed , not even once) - word of the work of Dawson in New York.
Dawson too had his own penicillin factory - even bigger than Florey's and Dawson had won the race to be the first to put penicillin into a patient by needle - and he had gone public about it, in a public lecture, in February 1941.
He also had treated more patients while focusing on a very well known and very well feared disease - Juvenis Interruptus (Rheumatic Heart Disease) - something that was very media-worthy.
Dawson too had a German Jewish biochemist with a lot bigger
reputation than Chain - in fact this man, Karl Meyer, had long standing contractual links with the American branch of a very famous international drug firm from Germany - Schering Corporation.
Dawson's team might well have beaten him on both patents and trade secrets already.
Florey panicked - ditched his erstwhile British drug company supporters - speeding off to battle Dawson on the grounds his family was most comfortable with - Trade Marks.
His ace in the hole was the unnatural respect every democratic American had for anything British and aristocratic - like the Oxford University Brand.
This brand was a winner world wide, in many areas of education - Oxford textbooks taught one the best way, the only way, to speak English or play music.
Only the Oxford strain of penicillium, combined with the Oxford standard sample of purified penicillin and the Oxford method assay, was real penicillin , said Florey over and over, all through America.
This was total scientific hogwash but the Floreys hadn't climbed to the top of the Spencerian world of Survival of the Fittest by being concerned with niceties.
Off to battle !
Juvenis Interruptus more accurate for RHD ?
Someone ,who admits they are not a Latin scholar, wondered about my use of Juvenis Rumpo to describe RHD (Rheumatic Heart Disease.)
They thought Juvenis Interruptus seemed a more likely term, based on the much better known phrase coitus interruptus.
They may be right.
About four years ago,I had been reading an account of some
notable early Rheumatic heart Disease (RHD) cases of a doctor who had specialized in that very serious and widespread disease.
He had mentioned RHD was also sometimes called "-------" (a New Latin medical term) which could be translated as Youth Interrupted in English.
I remembered his explanation why this little known term was so appropriate , but not his name or the actual Latin phrase.
I merely tried to translate the English term back into Latin, using a half dozen translation engines to get a consensus.
All used Rumpo ---- but I was concerned that when I back-translated the term back yet again into English - it came out a youth torn into two (!)
Technically accurate, I suppose, to describe the break in youthful activities engendered when your loving parents learned you have had permanent damage to your heart caused by a bout of acute Rheumatic Fever, (RF) and that you must not tax your heart.
My brother, for example, had RF when he was four
and years later,when he was 20, a doctor examining him before he ran in a race, noticed he had a heart murmur.
This was something his parents had not known, so he had not been overly-protected : his youth was not interrupted.
But in English, Rumpo is an unknown Latin term, while Interruptus is in fact a very frequently used term to create cod-latin phrases.
In any case, I will be glad to hear comments from people more familiar with Medical New Latin than me...
They thought Juvenis Interruptus seemed a more likely term, based on the much better known phrase coitus interruptus.
They may be right.
About four years ago,I had been reading an account of some
notable early Rheumatic heart Disease (RHD) cases of a doctor who had specialized in that very serious and widespread disease.
He had mentioned RHD was also sometimes called "-------" (a New Latin medical term) which could be translated as Youth Interrupted in English.
I remembered his explanation why this little known term was so appropriate , but not his name or the actual Latin phrase.
I merely tried to translate the English term back into Latin, using a half dozen translation engines to get a consensus.
All used Rumpo ---- but I was concerned that when I back-translated the term back yet again into English - it came out a youth torn into two (!)
Technically accurate, I suppose, to describe the break in youthful activities engendered when your loving parents learned you have had permanent damage to your heart caused by a bout of acute Rheumatic Fever, (RF) and that you must not tax your heart.
My brother, for example, had RF when he was four
and years later,when he was 20, a doctor examining him before he ran in a race, noticed he had a heart murmur.
This was something his parents had not known, so he had not been overly-protected : his youth was not interrupted.
But in English, Rumpo is an unknown Latin term, while Interruptus is in fact a very frequently used term to create cod-latin phrases.
In any case, I will be glad to hear comments from people more familiar with Medical New Latin than me...
Saturday, September 18, 2010
"JUVENIS RUMPO" : curing RHD, Rheumatic Heart Disease
Another name for Rheumatic Heart Disease, which until the 1950s was our biggest single heart disease, is JUVENIS RUMPO , which can be loosely translated as "Youth ,Interrupted" .
Every mother ,between the 1910s to the 1960s, had to worry about about whether her children would have to endure the consequences of a severe case of acute rheumatic fever.
Some kids got lots of bouts of strep throat but never got rheumatic fever (RF) - others got it so gently that after the fever, sore joints or jumbled nervous system had gone, they had no reminders - and the disease never came back.
Other children got the disease - once - and quickly died . End of story, almost.
Because if one child got it bad enough to die of it, it certainly meant your remaining children might also have the slight but definite genetic affinity for RF.
Similarly, even moms who had one child with a gentle case knew this didn't mean others in the family couldn't get the worse case possible.
And the fact that 4 kids of five didn't get RF ever, didn't mean number five child won't get it bad.
It was the uncertainty as to who and when , and how badly, and how frequently, someone in your family could get RF that made it a Sword of Damocles to all moms in that era.
Stage two worries were almost as bad.
Your child or children did get acute RF and didn't die.
Unfortunately, surviving one attack did not give immunity as it does in most diseases - in fact it means you are likely to get it again but even more intensely.
Get it again and again, each worse than before and you are certain to die.
That's death by acute RF.
More likely by the 1930s, was that you would survive even repeated bouts of acute RF.
But the permanent scars left on your heart muscle and heart valves meant that your mom would fret that if you played sports or did anything too vigorously - including romantic engagements.
It was felt that sexual intercourse might--- and pregnancy and child birth definitely would --- tax your heart murmur and bring on SBE (endocarditis) and death.
So ironically, Mom would take all the joys of youth out of your life in a loving attempt to bring you to adulthood alive.
But why bother if everything a young person liked to do, wanted to do, needed to do, was forbidden ?
This is why RHD was so frequently called Juvenis Rumpo .
Not because RHD killed outright all the young people it effected - it never did kill more than a relatively small number - but because of the huge pall it hung over the 'best years of their lives' for tens of millions of North American teenagers between 1910 and 1960 .
Fear of the Sword of Damocles was more damaging than the actual possibility it would really fall on a vital spot.
Dawson never did get to enjoy his youth times because he
volunteered to serve in the trenches of WWI.
His life mission was to see that as many other young people as possible did not see their youth be interrupted.....
Every mother ,between the 1910s to the 1960s, had to worry about about whether her children would have to endure the consequences of a severe case of acute rheumatic fever.
Some kids got lots of bouts of strep throat but never got rheumatic fever (RF) - others got it so gently that after the fever, sore joints or jumbled nervous system had gone, they had no reminders - and the disease never came back.
Other children got the disease - once - and quickly died . End of story, almost.
Because if one child got it bad enough to die of it, it certainly meant your remaining children might also have the slight but definite genetic affinity for RF.
Similarly, even moms who had one child with a gentle case knew this didn't mean others in the family couldn't get the worse case possible.
And the fact that 4 kids of five didn't get RF ever, didn't mean number five child won't get it bad.
It was the uncertainty as to who and when , and how badly, and how frequently, someone in your family could get RF that made it a Sword of Damocles to all moms in that era.
Stage two worries were almost as bad.
Your child or children did get acute RF and didn't die.
Unfortunately, surviving one attack did not give immunity as it does in most diseases - in fact it means you are likely to get it again but even more intensely.
Get it again and again, each worse than before and you are certain to die.
That's death by acute RF.
More likely by the 1930s, was that you would survive even repeated bouts of acute RF.
But the permanent scars left on your heart muscle and heart valves meant that your mom would fret that if you played sports or did anything too vigorously - including romantic engagements.
It was felt that sexual intercourse might--- and pregnancy and child birth definitely would --- tax your heart murmur and bring on SBE (endocarditis) and death.
So ironically, Mom would take all the joys of youth out of your life in a loving attempt to bring you to adulthood alive.
But why bother if everything a young person liked to do, wanted to do, needed to do, was forbidden ?
This is why RHD was so frequently called Juvenis Rumpo .
Not because RHD killed outright all the young people it effected - it never did kill more than a relatively small number - but because of the huge pall it hung over the 'best years of their lives' for tens of millions of North American teenagers between 1910 and 1960 .
Fear of the Sword of Damocles was more damaging than the actual possibility it would really fall on a vital spot.
Dawson never did get to enjoy his youth times because he
volunteered to serve in the trenches of WWI.
His life mission was to see that as many other young people as possible did not see their youth be interrupted.....
Saturday, September 11, 2010
the moldS in Dr Fleming's letterS
A jab - I admit - at Eric Lax's famous book title, "The Mold in Dr Florey's Coat".
Florey and his team are usually applauded for their
"selflessness" in rubbing brown penicillin liquid/powder/spores (accounts vary in the endless re-tellings) into the seams of their clothing in May 1940.
Their supposed intention was to ensure that precious penicillin could go out into the world to grow anew and save lives everywhere, even if the beastly Nazis did succeed in conquering Britain and the spires of Oxford.
"There will always be an England ...and England's precious gift, to Humanity, Penicillin". Etc.
But what if a single bomb had destroyed their Dunn Pathology Building, killing all the entire team and all their moldy coats?
Or if the Germans invaded Britain as fast as they had overrun the rest of Europe, so that no one from the Florey team got away to what remained of the Free World?
Was there an alternative to these theatrics?
Yes there was.
Three in fact.
(1) Do what Fleming had already done for 12 years and would continue to do - sprinkle a few of his spores into a folded paper as part of an ordinary unremarked-upon letter and mail it to anyone in the world, without charge, upon request.
But because there was an invasion coming, don't just wait for requests - mail out your version of Fleming's spores to all your friends and acquaintances ----- and ask them to store them and hide those precious spores.
Or better yet, mail them Fleming's spores, together with what you have learned so far as how to extract , semi-purify and store dry penicillin and urge them to start their own research efforts based around that work.
(2) A bit late now, but if Florey did really think that Fleming missed the boat back in 1928 by not doing the "animal protection test" why didn't Florey do it in himself in 1929, when he received the manuscript of Fleming's first paper, as an editor of the journal that paper was submitted to?
Or in 1931, when one of his subordinates at Sheffield , Dr Cecil Paine, told him of his success in external applications of liquid penicillin in curing real diseases of human patients.
Why did Florey not immediately follow this up, by seeing if liquid penicillin would work as well in curing artificial internal diseases in lab mice by way of a needle (ie internal application), aka "the animal protection test" ?
Or why did Florey not 'do the mouse' back in 1938, when he first began his research on penicillin -- if it was that apparent that the vital "animal protection test" had been overlooked?
Any of these times would have revealed the power of penicillin as a internal, systemic, cure - ie as the first,best, modern antibiotic, rather than just another also-ran in the overcrowded and ineffective external antiseptic market.
But in 1929,1931 or in 1938, Britain and the world would have had the peacetime resources to quickly bring penicillin to market.
But waiting two years, till the Fall of France, to 'do the mouse' and only doing it because your subordinate, Chain, jumped the gun in a fit of pique hardly shows you were concerned about the fate of a unique life-saving drug.
(3) While retelling the tale of the spores rubbed into your clothing, admit it happened because only you were (inaccurately) convinced that your team were the only scientists in the world with (a) access to these unique penicillin-producing penicillium spores and (b) had found a method of extracting and preserving dry penicillin.
This is why you kept your new penicillin success a secret, even from your prime funder, the MRC, and why you also didn't tell the scientific world of your extraction method in your August 1940 paper in Lancet.
And why as late as March-April 1941, you weren't telling any outsiders the details about your extraction methods --- not even to your many friends and colleagues overseas.
And why you only revealed your extraction methods in August 1941, after it appeared that a competitor in America had already released his own methods of extraction back in February 1941.
If Britain was About to Fall and All Civilization About to Totter, these hardly sound like the actions of a selfless individual.
But they do sound exactly like the lifelong characteristics of one Howard Florey - from ruthless 'take-no-prisoner' teenage tennis competitor to adult scientific 'bushwhacker'.
This is why the lazy, laidback Fleming almost got the only Nobel prize to be awarded for penicillin, instead of it going to the hardworking, ambitious, Florey and his hard-driving team.
You see ,the world had just been through the most brutal war it had ever seen, a war created by a hardworking, ambitious individual.
So, yes, Fleming might well have been lazy on following up on penicillin - he freely admitted as much.
But lazy Fleming had also never denied anyone his unique spores - or sought any payment or even reminded them that he be mentioned in their scientific publications.
(It is worth recalling that until late 1945, those same 'Fleming Spore, albeit a little subcultured and subselected, were still supplying the world all of its therapeutic penicillin--- the many efforts to find better spores and make them workable had failed up until that date.)
And Fleming had never denied anyone his methods he himself had used to extract and preserve penicillin.
That is why he got - and deserved to get - the Nobel Prize for penicillin.
I,then, am also a partisan of Fleming's worth, like Milton Wainwright and Kevin Brown ---- up to a point.
I'd take his freewill "spores in a letter", in a New York instant, over Florey's secretive "spores in a coat", any day.....
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