Many a well-intentioned PhD supervisor, hoping to help their student across the mine-field of a PhD thesis which casts its net too widely, steers the student to a subject that has an existing treasure trove of unexamined (or under-examined) archival material.
But taken too far, this attitude kills good history stone dead.
Extensive archive materials for an individual often suggest a subject who was inordinately vain (or whose spouse is determined to burnish their light after death).
The ability to retain (and store) a lifetime of records for an individual suggests someone who was wealthy enough to afford a big home, someone who didn't move much and had the work space and the secretarial assistance needed to maintain work files.
Everything about such a person suggests "elite" : far more likely to find such materials for a long time department head than a brilliant but controversial scholar who drifted from one to another non-tenured jobs from continent to continent.
But that footloose scholar might have tossed off a totally new paradigm while the other department head just produced reams and reams of humdrum "normal" science .
What sort of institution has hundreds of shelving feet of records - and what sort does not ?
Again on that is wealthy and secure in its funding and elite support, versus a group of young firebrands operating on pennies out of shoebox offices in ghetto storefronts.
But again, their long term historical importance may not match the influence both had when in existence.
How then to write about the sub-surface paradigm breakers and makers, when your kindly supervisor steers you to the 'usual suspects' with well funded, well maintained archives all neatly gathered up for you in one spot ?
And does the supervisor consider whether potential archival material have been so thoroughly pre-vetted by an earlier elite of that institution to remove all material that casts a darker light on their activities as to render it particularly suspect as a source to write good history ?
I like the prefaces to two contemporary historians' best known books, because they have been particularly frank in stating important subjects aren't always neatly enveloped in a few "official archives".
Aaron Bobrow-Strain has complied his social history of the store-bought white bread loaf from the oddest nocks and crannies of life.
While he doesn't make this explicit , he could only do so because he had the time, money and authority of being an established author,expert and tenured professor in the general area of food to spend years going all over the world and receiving warm helpful assistance from librarians and archivists everywhere.
Any 25 year old PhD candidate will tell you it rarely works that way with them.
Christina Cogdell ("Eugenic Design") tied her can to an even wilder alley cat : she tried to find hints of deep eugenic thinking in the behaviour of ordinary citizens who could truthfully say they had barely read anything on formal eugenics.
She speculated widely in tying hints in all sots of material to a wide claim indeed : that far from declining in the years between 1925 and 1945, eugenics became part of the general thinking of white middle class people throughout America.
I had always felt this to be the case, in a vague sort of 'back of the mind' feeling, so I was an easy sell.
But I can't imagine the resistance of others, who felt more comfortable with work like that of Daniel Kelves, who did pioneering work in the history of American Eugenics by the conventional route - burying himself for years in the record rooms of the elite eugenic bodies.
By their own standards - their own harshest critic ! - these eugenic organizations felt they had badly failed.
Cogdell, by contrast, felt they had succeeded far more than they knew.
I can argue that she came to this conclusion being being forced to consult wider sources - as opposed to becoming simply another "embedded historian".
I think of an "embedded historian" as being one who spends years mining one powerful institution's massive but unexploited archives, not quite believing their luck that no one more senior hasn't been there first, but who in the process, starts absorbing that institution's
archival 'rhetoric'.
No collection of important archival material from important people and institutions is ever just a neutral collection : "the facts and nothing but the facts".
It has always been culled carefully before being 'archived', in a manner to flatter the current powers-to-be , be they the original individual, their surviving family, or the institutional powerful at the time the archives were created.
Lots of things slip by - no one has a perfect record at predicting what future audiences will view as evidence of unflattering behaviour on the part of the people whose work is in the archives.
But , to point to an example in the field of penicillin , Vanevar Bush, Alfred Richards and Chester Keefer , all from the OSRD ,left plenty of evidence that they carefully stage managed the release of information - during and after the war - on the role (if any !) the OSRD had in its final, unexpected, wartime success.
They turned the biggest failure of the OSRD (the five year American failure to make synthetic penicillin) into the OSRD's biggest success : mass produced un-synthetic penicillin, by carefully massaging the truth.
They could have had little expectation that their distortions would survive them years after their own deaths.
But thanks to the embedded nature of most academic and popular writing on penicillin, it has done so.
Mostly this is because these embedded historians haven't seen themselves in that light at all : they feel they are busy correcting historical distortions.
To put it in over simple terms, they feel that either Fleming or Florey (or one of their co-worlers or supporting institutions) has been ill-served by the writing done to date and wish to correct the situation.
They have all succeeded in their stated aims, but they are really just nibbling at the edges.
For none - has refuted or even thought of refuting - the central claim of the wartime penicillin myth , that it was the OSRD intervention that led to the final success of wartime penicillin.
Peter Neushul thus stands unique because he has (in "Science, Government and Penicillin") undercut the myth of the OSRD being vital, but without actually putting the knife in decisively.
But we all owe him a great credit for the detective work he did do when he ventured off the well trodden path to the usual suspect archives on wartime penicillin ...
Wednesday, December 12, 2012
Tuesday, December 11, 2012
Illinois credits CORN liquor, Wisconsin DAIRY sugar for success of wartime penicillin
Call me cynical, but if Florey had been steered to the University of Wisconsin in Madison in 1941 instead of to the USDA lab in Peoria , we might have gotten wartime penicillin in serious production a whole lot quicker.
Albeit with only one (ahem) drawback: we'd all be deaf hearing how it was the addition of lactose than finally made penicillin production commercially viable - and hear virtually nothing about the addition of corn steep liquor to the happy mix !
The Peoria team was backed by a Washington scientific organization (the OSRD) whose research was so so but whose postwar PR efforts were first class.
By contrast, Madison was also hooked up with a Washington scientific body (the OPRD) whose science was A1, but who lost out badly in that always crucial press-agency side of serious, fundamental ,science.
In applied science, a process or machine either works or it doesn't.
But in fundamental science, the theories only grow on their listeners if well supplied with plenty of bullshit.
Or steep corn liquor......
Illinois has a few houses and peolpe but otherwise is mostly tens of thousands of square miles of corn fields (and pig barns).
Wisconsin , by contrast, is all grass and cows.....
Albeit with only one (ahem) drawback: we'd all be deaf hearing how it was the addition of lactose than finally made penicillin production commercially viable - and hear virtually nothing about the addition of corn steep liquor to the happy mix !
The Peoria team was backed by a Washington scientific organization (the OSRD) whose research was so so but whose postwar PR efforts were first class.
Peoria boss Robert Coghill had spent much of the war backing the wrong (synthesis) approach to penicillin, then deserted that sinking ship and began touting corn steep liquor....
By contrast, Madison was also hooked up with a Washington scientific body (the OPRD) whose science was A1, but who lost out badly in that always crucial press-agency side of serious, fundamental ,science.
In applied science, a process or machine either works or it doesn't.
But in fundamental science, the theories only grow on their listeners if well supplied with plenty of bullshit.
Or steep corn liquor......
Illinois has a few houses and peolpe but otherwise is mostly tens of thousands of square miles of corn fields (and pig barns).
Wisconsin , by contrast, is all grass and cows.....
ROP on this penicillin milch cow is beyond astounding : and it is all down to lactose intolerance !
Ironic isn't it ? Hundreds of millions of people have enjoyed longer lives thanks to the lactose intolerance of some slimy little mold.
That mold makes penicillin : in the beginning, very little, only converting about one millionth of the war-rationed sugar that was so lovingly fed into penicillin.
Turns out that was the biggest part of our problem : we were feeding it far too well, on easy-to-digest sugars and so it failed to produce any penicillin.
But as soon as we learned to starve it slowly, by giving it milk sugar, (lactose) a sugar it didn't exactly live to eat , it started into giving us tons of penicillin.
Lactose stresses the diets of molds something wicked and when they get food-stressed, but not to the point of actual starvation, they play defence .
The penicillin they start making kills and keeps at bay possible bacteria competitors for what little suitable food the mold can lay its threads upon.
But actually starve a mold (and early researchers often accidentally did that), and they started to rapidly self-suicide themselves in despair.
But feed it lousy lactose, just at the right time, just after its had a day or two of easy living on some nice sugar and protein, and it will produce tons of penicillin.
Literally : annual penicillin product induced by human industry is now at least 20,000 metric tonnes a year.
In 1928, it was about one micro-gram. That's about what Fleming saw in the bottom of his petri dish and it was about as much penicillin as was used in its first cure : curing a newborn baby of a lifetime of blindness , in 1930.
A micro gram is 1 millionth of a gram , so there are a billion of these tiny micro grams in a kilogram of penicillin ( ie about 2 pounds of penicillin). And a trillion of them in a metric tonne of penicillin ( ie about 2000 pounds of penicillin if you are old school.)
So we now produce 20,000 thousand trillion times as much penicillin today as we did 85 years ago.
Fleming's particular penicillium mold was actually very good producer - seemingly the best in the world for 15 years, but only produced one micro gram of penicillin in every gram of liquid medium.
That is a million parts junk to one part money ratio, unbelievably dismal in comparison to every other fermentation process in commercial use at the time.
Today, we get 50 milligrams of penicillin per gram of medium : that is 50,000 times better.
That is a 5,000,000 percent improvement in about 50 years.
Think your grandfather's prize milk cow had an outstanding ROP improvement ?
Try this rapid a percentage improvement on for size !
The main reason why we didn't see this sort of improvement for almost 20 years after Fleming found his mold is because we let chemistry guide our thinking ; trying hard to extract ever more of the penicillin we did manage to produce.
But as I used to say to the CUPE picketeers whenever the Gerry Regan government boasted of the size of its final, final, contract offer : " ten percent of nothing is .... still nothing" .
Only by learning to starve penicillium molds, which we had done by late 1944, did we begin to see enough penicillin to make the stuff a paying proposition , not a charity case, for Big Pharma.
But you can read all the best known books on war time penicillin - and I believe I have - and yet never read one word said about starvation of the molds.
The same goes for present day articles from historians and social scientist about wartime penicillin.
Only articles and books from physical scientists actually working in the fermentation industries routinely mention starvation stress in regards to being essential to penicillin production but even they seem to quote articles from the early 1950s as being the first to signal this fact.
But what then to make of little gem from July 26th 1941 from a letter from Norman Heatley to Howard Florey, just three weeks into Florey's effort to get American Big Pharma to make penicillin on at least a pilot plant scale?
Heatley is at a spanking brand new research facility in Peoria, set up by the US Department of Agriculture to find new uses for farm surpluses - particularly surpluses of low value farm wastes.
He is working with Andrew Moyer : one part mold genius to two parts paranoid nutter.
Already, just ten days after looking at penicillin for the first time, Moyer hazards a guess that penicillin production might be dependent on a starvation metabolism.
If Moyer had only been listened to - and there is no sign that any scientist or bureaucrat then - or historian since - ever did, we might have had commercial penicillin flowing by the Fall of 1941 not the Fall of 1944.....
That mold makes penicillin : in the beginning, very little, only converting about one millionth of the war-rationed sugar that was so lovingly fed into penicillin.
Turns out that was the biggest part of our problem : we were feeding it far too well, on easy-to-digest sugars and so it failed to produce any penicillin.
But as soon as we learned to starve it slowly, by giving it milk sugar, (lactose) a sugar it didn't exactly live to eat , it started into giving us tons of penicillin.
Lactose stresses the diets of molds something wicked and when they get food-stressed, but not to the point of actual starvation, they play defence .
The penicillin they start making kills and keeps at bay possible bacteria competitors for what little suitable food the mold can lay its threads upon.
But actually starve a mold (and early researchers often accidentally did that), and they started to rapidly self-suicide themselves in despair.
But feed it lousy lactose, just at the right time, just after its had a day or two of easy living on some nice sugar and protein, and it will produce tons of penicillin.
Literally : annual penicillin product induced by human industry is now at least 20,000 metric tonnes a year.
In 1928, it was about one micro-gram. That's about what Fleming saw in the bottom of his petri dish and it was about as much penicillin as was used in its first cure : curing a newborn baby of a lifetime of blindness , in 1930.
A micro gram is 1 millionth of a gram , so there are a billion of these tiny micro grams in a kilogram of penicillin ( ie about 2 pounds of penicillin). And a trillion of them in a metric tonne of penicillin ( ie about 2000 pounds of penicillin if you are old school.)
So we now produce 20,000 thousand trillion times as much penicillin today as we did 85 years ago.
Fleming's particular penicillium mold was actually very good producer - seemingly the best in the world for 15 years, but only produced one micro gram of penicillin in every gram of liquid medium.
That is a million parts junk to one part money ratio, unbelievably dismal in comparison to every other fermentation process in commercial use at the time.
Today, we get 50 milligrams of penicillin per gram of medium : that is 50,000 times better.
That is a 5,000,000 percent improvement in about 50 years.
Think your grandfather's prize milk cow had an outstanding ROP improvement ?
Try this rapid a percentage improvement on for size !
The main reason why we didn't see this sort of improvement for almost 20 years after Fleming found his mold is because we let chemistry guide our thinking ; trying hard to extract ever more of the penicillin we did manage to produce.
But as I used to say to the CUPE picketeers whenever the Gerry Regan government boasted of the size of its final, final, contract offer : " ten percent of nothing is .... still nothing" .
Only by learning to starve penicillium molds, which we had done by late 1944, did we begin to see enough penicillin to make the stuff a paying proposition , not a charity case, for Big Pharma.
But you can read all the best known books on war time penicillin - and I believe I have - and yet never read one word said about starvation of the molds.
The same goes for present day articles from historians and social scientist about wartime penicillin.
Only articles and books from physical scientists actually working in the fermentation industries routinely mention starvation stress in regards to being essential to penicillin production but even they seem to quote articles from the early 1950s as being the first to signal this fact.
But what then to make of little gem from July 26th 1941 from a letter from Norman Heatley to Howard Florey, just three weeks into Florey's effort to get American Big Pharma to make penicillin on at least a pilot plant scale?
Heatley is at a spanking brand new research facility in Peoria, set up by the US Department of Agriculture to find new uses for farm surpluses - particularly surpluses of low value farm wastes.
He is working with Andrew Moyer : one part mold genius to two parts paranoid nutter.
Already, just ten days after looking at penicillin for the first time, Moyer hazards a guess that penicillin production might be dependent on a starvation metabolism.
If Moyer had only been listened to - and there is no sign that any scientist or bureaucrat then - or historian since - ever did, we might have had commercial penicillin flowing by the Fall of 1941 not the Fall of 1944.....
Between Wartime Penicillin's initial failure ( Chemistry) and its final success (Biology) stood a third party : the humanitarians
When I call Henry Dawson "Penicillin's Third Man", I am being more than ordinarily facetious.
Penicilin's problem was chemistry-besotted biologists, the solution was biologically-pragmatic chemists and the connecting threat were a tiny group of humanitarian-minded clinicians.
I mean that penicillin's main problem was - dating from September 1928 - was that its initial (biological) investigators -names like Fleming,Florey and Richards spring to mind - tacitly accepted penicillium production levels of one microgram of penicillin per gram of medium as a given.
As a result, they sought - blinker-eyed - only one possible solution : the total chemical synthesis of penicillin.
By contrast, it was chemist Larry Elder who finally pushed mycologists into doing their jobs like people on a mission, not people politely going through the motions.
And it was Larry who sought out "farmer-minded" scientists from any and all fields to up penicillium yields the old-fashioned way, the way farmers had successfully done so with other species for thousands of years : trial and error selective breeding.
But before people like Larry could be called in on the file, the public in September 1943 had to be outraged, ("its been 15 years since penicillin was discovered and its still in desperately short supply !") and demanding that the authorities put new people on the job to finally start making this stuff - now - and in bulk.
The humanitarians like Henry Dawson, Robert Pulvertaft, Rudy Schulinger , Frank Queen and Dante Colitti all pushed the civil and military powers to be to make penicillin available for all who are dying - now !
And when the purple-toned slash yellow press of Citizen Hearst picked up on their efforts, all the pieces fell into place.
In less than six months, the government of America was pulling a little bit of its money out from making nuclear bombs and germ warfare and towards saving lives and the job was done.
America - and soon the world - would be awash with cheap naturally-breed penicillium-made penicillin....
Penicilin's problem was chemistry-besotted biologists, the solution was biologically-pragmatic chemists and the connecting threat were a tiny group of humanitarian-minded clinicians.
I mean that penicillin's main problem was - dating from September 1928 - was that its initial (biological) investigators -names like Fleming,Florey and Richards spring to mind - tacitly accepted penicillium production levels of one microgram of penicillin per gram of medium as a given.
As a result, they sought - blinker-eyed - only one possible solution : the total chemical synthesis of penicillin.
By contrast, it was chemist Larry Elder who finally pushed mycologists into doing their jobs like people on a mission, not people politely going through the motions.
And it was Larry who sought out "farmer-minded" scientists from any and all fields to up penicillium yields the old-fashioned way, the way farmers had successfully done so with other species for thousands of years : trial and error selective breeding.
But before people like Larry could be called in on the file, the public in September 1943 had to be outraged, ("its been 15 years since penicillin was discovered and its still in desperately short supply !") and demanding that the authorities put new people on the job to finally start making this stuff - now - and in bulk.
Elder, Colitti, Queen, Hearst never get the credit they deserve
The humanitarians like Henry Dawson, Robert Pulvertaft, Rudy Schulinger , Frank Queen and Dante Colitti all pushed the civil and military powers to be to make penicillin available for all who are dying - now !
And when the purple-toned slash yellow press of Citizen Hearst picked up on their efforts, all the pieces fell into place.
In less than six months, the government of America was pulling a little bit of its money out from making nuclear bombs and germ warfare and towards saving lives and the job was done.
America - and soon the world - would be awash with cheap naturally-breed penicillium-made penicillin....
Sunday, December 9, 2012
For the middle class of the Modernist Age, being double-dipped for their daily bread was a honor not a curse : hence their horror of hospital-made penicillin
Hard to believe that our grandparents were glad to be first soaked by milling corporations for the firms' processing away of life-giving vitamins from their flour and bread and then soaked a second time when the millers' added expensive man-made processed vitamins back in again.
It was called "Progress" and it was good.
Mom's home-made bread, prepared right in front of her kids in the kitchen, just had to be crawling with lethal germs might even be made with (horrors) healthy vitamin-rich whole wheat flour), so it was much wiser to buy some factory-made white trash at the store.
Likewise, what family would allow their own family doctor to safely make penicillin up ( by themselves !) , to inject into a dying patient they had treated faithful for 35 years ?
Hoisted on their own modernist cum pharmaceutical petard, middle class patients between 1928 and 1943 didn't want hospital-made penicillin, even if they wound die without it ....
It was called "Progress" and it was good.
Mom's home-made bread, prepared right in front of her kids in the kitchen, just had to be crawling with lethal germs might even be made with (horrors) healthy vitamin-rich whole wheat flour), so it was much wiser to buy some factory-made white trash at the store.
Likewise, what family would allow their own family doctor to safely make penicillin up ( by themselves !) , to inject into a dying patient they had treated faithful for 35 years ?
Hoisted on their own modernist cum pharmaceutical petard, middle class patients between 1928 and 1943 didn't want hospital-made penicillin, even if they wound die without it ....
To a hammer, everything is a nail - to a thermometer everything is fever: but was penicillin fever BAD ??
Fever is closely associated with virtually any and every kind of illness - but does it make the disease worse or is it one of its cures ?
After the introduction of clinical thermometers in the 1870s, this fundamental question became moot.
Doctors and nurses took up this new hammer with great enthusiasm and soon saw nails everywhere.
They couldn't actually do much for most illnesses but now the carefully kept temperature chart's hills and valleys allowed them to semi-accurately predict that the patient was going to get better or go downhill.
A few doctors actually tried to raise a fever for a therapeutic purpose ,with mixed results, but most felt honour-bound to keep it down at normal at all costs.
Any drug they introduced into a patient that raised their temperature, even if only a few degrees for a few hours, made most medical staff recoil in horror.
But did it actually harm the patient ?
No one knew and no one cared to find out.
Few asked if a bacteria infection or a foreign protein (introduced accidentally along with a pneumonia serum for example) was the instigator of a temperature change, why then was fever itself always created by the body ?
Created for its own reasons - perhaps even its own good reasons.
The claim that any "non-store-bought" penicillin (rather like mom's home-made bread) was potentially lethal, was all down to reports that a sometimes a patient's temperature went up a few degrees for a hour or so, after an injection with hospital-made penicillin.
(And very often with store-bought industrial penicillin as well, in point of fact !)
This sort of minor side effect was not uncommon with many drugs and penicillin patients could in fact count themselves lucky.
There is no drug without side effects - never has been, never will be.
These side effects - often far more lethal than a short sharp temp rise - must always be judged as to their absolute danger and frequency.
And then also weighed, relatively speaking, against the alternative choices - which could be the untreated condition rapidly sliding into death.
"Penicillin Fever" was just an excuse, an excuse for hundreds of thousands of doctors world-wide between 1928 to 1943 to explain away why they choose not to inject un-refined hospital-made penicillin into their dying patients.
But I rather doubt that the doctor St Luke and his boss will buy that sort of excuse....
After the introduction of clinical thermometers in the 1870s, this fundamental question became moot.
Doctors and nurses took up this new hammer with great enthusiasm and soon saw nails everywhere.
They couldn't actually do much for most illnesses but now the carefully kept temperature chart's hills and valleys allowed them to semi-accurately predict that the patient was going to get better or go downhill.
A few doctors actually tried to raise a fever for a therapeutic purpose ,with mixed results, but most felt honour-bound to keep it down at normal at all costs.
Any drug they introduced into a patient that raised their temperature, even if only a few degrees for a few hours, made most medical staff recoil in horror.
But did it actually harm the patient ?
No one knew and no one cared to find out.
Few asked if a bacteria infection or a foreign protein (introduced accidentally along with a pneumonia serum for example) was the instigator of a temperature change, why then was fever itself always created by the body ?
Created for its own reasons - perhaps even its own good reasons.
The claim that any "non-store-bought" penicillin (rather like mom's home-made bread) was potentially lethal, was all down to reports that a sometimes a patient's temperature went up a few degrees for a hour or so, after an injection with hospital-made penicillin.
(And very often with store-bought industrial penicillin as well, in point of fact !)
This sort of minor side effect was not uncommon with many drugs and penicillin patients could in fact count themselves lucky.
There is no drug without side effects - never has been, never will be.
These side effects - often far more lethal than a short sharp temp rise - must always be judged as to their absolute danger and frequency.
And then also weighed, relatively speaking, against the alternative choices - which could be the untreated condition rapidly sliding into death.
Fever was just an excuse
"Penicillin Fever" was just an excuse, an excuse for hundreds of thousands of doctors world-wide between 1928 to 1943 to explain away why they choose not to inject un-refined hospital-made penicillin into their dying patients.
But I rather doubt that the doctor St Luke and his boss will buy that sort of excuse....
Dawson,Humphrey & Chisholm : the three Canadians who helped formulate the final Allied 'war aims'
Dawson, Humphrey & Chisholm sounds like - to Atlantic Canadians of a certain age - more like a small town firm of accountants or insurance agents than a trio of 1940s Canadians who changed the world as we know it very much for the better.
Nova Scotia born Henry Dawson is surely no stranger to the pages of this blog.
His October 1940 war aims (that the single best way to beat the Nazis was in contrasting publicly how we treated our least and weakest members with their ruthlessness towards the weak) had by October 1943 started to become a solid part of the Allied Nations' new war aims.
John Humphrey, bullied as a kid in New Brunswick, grew up determined to never see anyone else bullied - and his draft of his ideas became the United Nations' Human Rights Declaration.
G Brock Chisholm , Ontario born, was like Dawson a WWI veteran and a lifelong strong advocate of Social Medicine (as was Dawson and Humphrey) and got to put his ideas into the very genome of the World Health Organization (WHO) as its first director-general.
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| Henry Dawson |
His October 1940 war aims (that the single best way to beat the Nazis was in contrasting publicly how we treated our least and weakest members with their ruthlessness towards the weak) had by October 1943 started to become a solid part of the Allied Nations' new war aims.
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| John Humphrey |
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| Brock Chisholm |
Canadians weren't really key to winning WWII , but they sure were prominent in winning the peace
Canada wasn't as important in winning WWII as it was in winning WWI, but with these three Canadians' individual efforts, it had a great role in securing the peace....
George Redmayne Murray : moral predecessor to Dawson,Duhig & Pulvertaft's penicillin efforts
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| moral predecessor to Henry Dawson |
Thyroid conditions in his day, the 1890s, were started to being treated by grafting new thyroid glands from animals into the bodies of people with diseased ones.
It sort of worked - heroic medicine indeed.
This concept was more or less how Banting originally planned to cure diabetes.
But when Murray read of one such effort is Lisbon, he noted the results came far too immediately - the same day in fact - for new blood vessels to have had time to grow for the organ to spread the juice of the gland into the body.
The juice must have diffused outward from the new organ, on its own.
In which case, the juice alone, from ground-up animal organs, might work - without the need for an expensive and dangerous major operation to insert the organ itself.
(And let us not go into rejection problems !)
And here is where the application to chivalrous penicillin came in : he immediately extracted the juice of animal thyroid, added a little of a bog-common preservative to the juice to kill off any bacteria within, and injected it cautiously, just under the skin, into a patient with thyroid disease.
It worked -- she recovered her strength- and the first ever successful hormone deficiency treatment had happened for the price of a hot dinner, and in about the same time period it takes to eat a hot dinner !
Insight and drive - not money - more often than not, really drives medical advances
Dawson, Duhig, Pulvertaft also injected their crude substance (penicillin juice) via this method : cautiously just under the skin ( the safest form of injection) and with a simple common preservative to kill any potential pathogens.
Advances in medicine don't always require armies of the ambitious (more eager to produce endless papers than to help patients) and factories full of equipment.
It sometimes just takes deep insight and a moral drive : Murray , like Dawson, clearly had both....
Saturday, December 8, 2012
WWII : penicillin as punishment for self-inflicted wounds - or for saving lives ?
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| In WWII, they used PENICILLIN , instead.... |
Were the Allies to devote a limited amount of resources to producing just enough penicillin to use as a punishment in cases of self-inflicted wounds such as VD , as Florey and his mentor Dr AN Richards acquiesced in or advocated ?
Or were the Allies to devote resources to produce enough penicillin - not in spite of it being wartime, but particularly because it was wartime - to treat all people dying of disease (regardless of income, race or gender) as a highly popular and public example of the ethical nature of Allied War Aims, as advocated and practised by Henry Dawson ?
Penicillin only became popular among the military elite of Britain, Canada and America in 1943, when it became apparent that combat troops in the European Theatre, fearing the worst against the tough Germans, were deliberately infecting themselves with VD, in hopes of a two month treatment away from the upcoming invasion of Sicily.
Deliberately getting VD, by not using Army-provided free condoms was considered a Self-Inflicted Wound, SIW, and during WWI made a Capital Offense punishable by death by firing squad.
Even during the Second World War, it could mean being sent to the dreaded Glasshouse military prisons, where the policy was to inflict punishment so severe that potential death at the front was considered a better alternative.
Unfortunately from the senior officers' point of view, many still preferred the Glasshouse, so punishment for VD cases of SIW was considered counter-productive, as it led to severely deplete ranks among the combat elite forces who faced the highest chances of dying in the invasion of Sicily.
If these combat troops were out of action, other men's sons ( like their own) would simply be 'called up' in their place and so using penicillin as a punishment was wildly popular among the officer class in the rear echelons of wartime reality.
Rather than waste penicillin on saving the lives of men so seriously wounded they would never return to fight and who - if they survived - would simply become 'useless mouths' consuming medical resources and pension funds, divert the penicillin to rapidly curing non-fatal cases of gonorrhoea among the elite combat troops.
A two day cure ( with painful penicillin shots) and they'd be back in the Front.
Why bother to waste bullets on an Allied firing squad for the offense of SIW : why not let German combat bullets do the job instead ?
We must never forget that both sides practised the policy of death for 'useless mouths' : the Allies made it "death by neglect", the Nazis "death by deliberate murder".
Deliberately limiting resources for the production of wartime penicillin was the Allies' Aktion T4
To Dawson, and to me, the notion of killing of the weak because they are considered useless as war workers and just a burden on the wartime economy is simply wrong, no matter how it happens.
Death is death.....
Friday, December 7, 2012
HMS Birkenhead & HMS Nova Scotia: connecting the highs & lows of human behaviour to Star Wars
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| frequent visitor to Halifax Nova Scotia ends up the victim of Allied brutality |
When the troopship Birkenhead hit a rock not far off the rocky shore of Capetown in 1845, there wasn't enough lifeboats for the entire crew and passengers and what lifeboats there was, were in very bad repair.
So the soldiers stand to, firmly at attention, on the deck as the women and children are put safely aboard the few small boats that could float and could be launched.
Then the ship sank into the stormy depths and most of the men drowned.
The chivalrous Victorian Age loved the story of "Women and Children First" (the so called Birkenhead Drill) and paintings and prints of the men at attention as the ship goes down hung in many homes around the British Empire before WWI.
It is hard to account for the tens of thousands of incidents of incredible heroism that were almost routine on the Western front without knowing a little of the sinking of the troopship HMS Birkenhead.
Cut to the WWII, (thankfully) the world's only modernist war, a wicked evil war from beginning to end on all sides, in part because the world had come to reject chivalry as an ideal , preferring variants of Social Darwinism instead.
(Modernists, it is said often enough to be a cliche, had come to reject chivalry as a result of the blood and the mud of the Somme and Passchendaele.)
But bits of chivalry still hung about at the beginning of WWII, even among the Nazis.
So it was in September 1942, when U-156 torpedoed the former Cunard liner Laconia, now a troop ship with 2800 people on board, off Africa, that the U-boat captain Werner Hartenstein immediately signalled other German U-boats, Italian submarines and even the neutral Vichy French and his enemy the Allies, to come help save lives.
Hartenstein didn't know who was on board, it was enough that they were people and their lives deserved to be saved.
As a troop ship, it fell out of the rules of war, and so he didn't have to rescue anyone, legally.
He flew the Red Cross , while towing lifeboats filled with survivors and with other survivors crowded on his submarine's narrow little deck.
His decision to attempt a rescue was even backed up by the supreme U-boat commander Donitz, who ordered seven other U-boats to back off attacks and come help the rescue.
U-156 even broadcasted an open language and a English language appeal for anyone to come help in the rescue, and that he and the other U-boats would not attack rescuers.
Despite this, an American B-24 Liberator bomber flew over intend on bombing the sub, but hesitated to shot on seeing the Red Cross flags.
But eventually it was ordered to do so by a young officer back at base, Robert C Richardson III, who ordered them to sink the U-boat, Red Cross flag and survivors on board and in towed lifeboats or not.
Remember that odious name : Robert C Richardson III because he has much more evil left to do, before he died very honoured and very old, in his bed.
The B-24 returns home a hero, for claiming it had definitely sunk an enemy sub ,when in fact it only sunk a few lifeboats filled with Allied personnel and Italian POWs.
Most of the thousands of souls about to be saved by a multi-nation humanitarian effort, instead died horrible slow deaths at sea.
As a result of the Americans trying to sink a rescue operation, the German naval command said no more of these chivalrous attempts at life saving.
(The Americans had never practised chivalry in submarine warfare, but up till then , many of the British Commonwealth and Germans sea commanders had.)
As a result of one junior officer's freelance decision, at least a hundred thousand people died needlessly at sea in the remaining years of the war, as huge shiploads of people were sunk without efforts to get rescuers to the scene by all sides.
Often the survivors were further machine-gunned in the water, again by both sides.
The next incident off of Africa occurred just a few weeks later when the former Furness liner Nova Scotia, which had spent decades going from Liverpool to America and back, via Halifax Nova Scotia and St John's Newfoundland, was sunk as a troopship off Durban with 900 dead --- the biggest ever marine disaster in South African waters.
Again, no one was signalled to come to the survivors' rescue and the sun and sharks got most of them. Again, like the Laconia, the U-boat had sunk a ship filled with POWs from the Axis forces as well as men, woman and children from all over the British Commonwealth.
The infamous Laconia Incident wasn't enough ; Richardson then invented "Star Wars"
Richardson was unpunished then, and in fact ended up a general after a long career, all the while insisting he'd make the same decision again, regardless of who was in the water.
He was a famous cold war hawk from the earliest days, an expert on thinking about winnable nuclear wars and a consultant to many right wing /free enterprise Republican Party oriented think tanks.
So it was only consistent with his wartime brutality, that in retirement, he fathered the Star Wars pipe dream : if it had come to fruition, the deaths of the 2500 on the Laconia would be but a drop in an ocean of death.
General Richardson died a year ago, age 93.
I hope and pray he is in Hell's hottest fires this very moment, as I write.....
The battle over wartime penicillin, EUGENICALLY speaking : who makes it and who gets it ?
 |
| Eugenics dominated ALLIED war aims |
These emotions lay just below conscious thought, but were often behind conscious deed.
But in practise, even semi-conscious eugenic emotion divided into soaring rhetoric and sagging reality.
Modernity/Eugenics/Triage/Conscription (the four terms are basically 100% interchangeable) was consumed with the thought of competition ; with the mighty and the wise usually winning out over the weak and the foolish.
War, of course, was the ultimate form of competition for survival.
In theory, only the 1As of the world went to war, to defend the 4Fs of the world who were too weak and /or too cowardly to defend themselves.
But in practise, modernity's wars were "a competition too far" to mis-use Cornelius Ryan's phrase : modern war was too competitive, often resulting in as many deaths on the side of the winners, as on the side of the losers.
In the minds of popular eugenics , sending our 'best blood' off to defend the country, meant only the loss of our best blood while those of 'weaker blood' stayed home - safe - and multiplied their offspring even more than normal.
Too many successful wars, and soon our nation would be overrun by imbeciles and their children !
So bravery in war had to be divided into physical bravery (actually going into battle against bullets and shells with only your serge cloth uniform as your armour) and leadership bravery (inspired military leadership, from safely well behind the front lines.)
This latter definition of bravery proved a morally slippery slope.
Because soon scientific efforts and organizational planning of production and logistics in modernity's wars became almost as important as mere generalship.
Soon, appearances to the contrary, a well educated healthy, wealthy young 1A man safe behind a desk in Washington wasn't evading the draft, he was - in fact - 'winning the war !'
And to the middle-class, middle-aged men running the local draft boards, it didn't seem fair that only their well-fed, well-educated sons met the draft requirements of a modern mechanized armed forces.
(This was all thanks to the dozen years of the Great Depression reducing the health and occupational skills of the working class and poor.)
So soon those failing the first draft calls : those illiterate, in indifferent health, in jail, black, latino and aboriginal were lifted and they were being drafted as fast as possible.
They were to provide the physical bravery in the front lines, at the pointy end of America's big stick.
Donkeys.
But these quasi 4Fs couldn't be led (aka pushed) without inspired bravery from the 1As in the rear, the lions.
So the sons of the middle class and sons of the upper ends of the prosperous working class got exemptions from the draft ; they were needed at home to provide the skills to create the mechanical equipment that would really win the war.
(The donkeys in the infantry would merely form the occupation garrison after the real battle was won.)
The middle class has always loved mechanized war, the more high tech the better: it lowers their chances of actually having to die in the front lines to a much lower level.
Old fashioned infantry wars come down to personal bravery and this , eugenically speaking, should be found more in the middle class 1As than in the 4Fs of the poor - so as in the 19th century myth, the middle class would have had to dominate the front lines of every infantry battle.
There were just a few flies in this happy middle class ointment.
( I won't discuss the most ironic one : that the supposedly safe middle class military occupation of driving a high tech plane dropping bombs on civilians 3 miles below you, turned out to be even more dangerous than the ultimate low tech job of the poor slobs holding a bolt-action rifle in a foxhole !)
One was that there were never enough well feed well educated young white men freed up to fight America's mechanical war all around the globe.
So one way to free up more such mechanically-trained men was to
say that mom's husband , as well as her sons, should be liable for the draft.
Exempted men opposed this idea strongly, claiming that they weren't being cowardly (they were potentially 1A draft picks after all) but that it was more important that they maintained the home front: their daughters really needed a father to see they weren't off running round with 4f boys.
Or worse : getting a factory job.
Because some patriotic fools wanted to see draft-free women do many of the industrial jobs that men had always traditionally done and were still doing in wartime.
Men literally rioted over this threat to their safety, though they were careful not to put it in those terms.
Women, they exclaimed, were too physically weak, intellectually weak, above all too emotionally weak : they'd wet their pants, trying to tighten the bolts on the outside of an armoured car.
In fact the real fear was "that if women got my job, I could now be drafted and end up in that same armoured car, under enemy fire, wetting my pants !"
This reminds us to never take people's surface reasons for their actions at face value, but to probe the real, often hidden, reasons for their behaviour.
Finally, at long last, to wartime penicillin and the words of those two famous penicillin lions, Dr AN Richards and Dr Howard Florey.
The normally highly-combative Howard Florey, on his trip to the combat zone of the Middle East and Sicily, quietly knuckled under to the dictate that precious penicillin wasn't to be wasted on soldiers dying of wounds.
(I take that to mean that his initial protests were mere pro forma and I think that even his most sycophant biographers who agree with me.)
The thinking was that these wounds were so severe, that even if they healed, they'd still be discharged and be of no further use to the army.
and from then on , they'd just a burden to the decent middle class people at home who fund the military pension plan.
(Oh no, they'd never be so blunt as that - in public - but even a fool could follow their drift.)
Instead, the dictate read - use your precious penicillin on men who already have several alternative treatments for their non-fatal disease, the clap.
So why in earth use precious penicillin on their non-fatal wounds while letting other brave soldiers die of their combat wounds?
Because front line soldiers - like the paratroopers - by some strange coincidence - proven very likely to contract non-fatal VD (despite their free condoms) just when there were strong rumours a big push was about to begin.
(The morality of them being unfaithful to wife or girlfriend back home didn't enter into the discussion till later when the scandal went public ; for now, this was just man-to-man locker room talk.)
The treatments of VD, before penicillin, did work but involved toxic drugs and months away from the front line as careful needle followed careful needle -- by contrast, non-toxic penicillin could cure in 2 days.
Result ? The hapless paratrooper couldn't avoid possible death in the big battle , but would soon be back in the thick of it.
He mightn't be happy, but from Sicily back to Iowa, other men would sigh in silent relief : ' better him than me in the line of fire and near-certain death.'
Because if our reputed brave but clapped-out paratrooper wasn't dying for his country, who would take his place ?
Yep, chump, you would !
America's penicillin czar - the closest man to filling Dr Florey's role in the UK on penicillin - was another 'doctor' : AN Richards, part time head of the (in) famous OSRD's medical division and full time shill for Merck.
He , like Florey, cheerfully admitted that his interest in penicillin hadn't been humanitarian.
His explanation is often glossed over, so let us parse it carefully.
His interest, he wrote, wasn't in saving German or Japanese lives which is why he claimed he censored news of penicillin ( untrue - he censored only its patentable, post-war commercial aspects: in this his real enemy was his Allies' own pharmaceutical industries).
He wasn't interested in saving Allied civilians lives - which is why he never pushed for an all out effort at production of imperfect, impure, natural (again non-patentable) penicillin.
He wasn't even interested in saving Allied soldiers' lives, he wrote.
His only priority was 'getting (wounded) allied soldiers back to the front' : better your son die there, than mine, in other words.
Morally, this sort of triage: saving only those soldiers lightly wounded and thus capable of going back to the front in place of my as-yet-un-drafted son, is a very slippery moral slope.
We can beat the Nazis by being beastly, like the Nazis....
Morality, once upon this slope, ends up sliding down to a railway siding outside Oswiecim Poland , where doctors like Florey and Richards, in jackboots and whips triage the descending passengers of trains like some satanic football coach : you, to work out on the field, you, to the showers.
Doctor Henry Dawson, by way of total contrast, won his Military Cross for rebuking this heartless form of triage in WWI and from October 1940 onwards, gave up his life during WWII to rebuking it with regard to wartime penicillin ,both as to who made it and who got it.
We can only win by being as moral as the nazis are immoral...
His October 1940 war aims were not yet the Allied war aims, but that too would change - in time......
Wednesday, December 5, 2012
Dawson jumps the gun on Meyer's penicillin project
Henry Dawson does not deserve the credit he always gets for starting the wartime penicillin project at Columbia University.
(Honoured for taking control of it and making it into something to be universally and eternally admired, is a different story.)
Karl Meyer started it up - pure and simple. And as it happens, purity and simplicity were also the goals of his penicillin project.
Here's how it allcame about, as I see it ,though I should say in advance that I wish to thank three other historians for discovering the important pieces needed to solve the puzzle.
(My interpretation of their findings is, of course, not something I can blame them for !)
I the order that I came across their work, let us start with David T Durack ,writing a relatively brief article detailing the history of the early work curing endocarditis with antibiotics.
"Early Experience in the Treatment of Bacterial Endocarditis"
Durack says that in August 1940, Meyer was reading the new copy of Lancet and comes across a report by Ernst Chain and others on the substance penicillin.
The Oxford team demonstrated the efficacy of semi-purified penicillin in stopping bacteria stone cold in vitro ( ho hum) and in experimentally induced massive infections in mice ( new - long overdue - and important).
( I personally think this issue wouldn't likely have arrived in New York from London ,in wartime, in less than about two weeks - so assuming it was first issued in London close to its cover date of August 24th, Chain was reading his New York copy on about September 7th.)
Durack got from Karl Meyer the frank admission ( 30 years or more after the original event) that Chain had gotten him all rilled up.
Meyer and Chain had probably met earlier in germany while both were training to be biochemists and frankly, Chain got a whole lot of people rilled up pretty easily.
In this case, Meyer who had done a lot of original work with lysozyme (along with Fleming, Florey and Chain and Leslie Epstein), felt that Chain had denied Meyer his rightful priority on some aspects of the research in Chain's own articles on lysozyme.
Clearly the August 24th article indicated Chain wanted to totally purify and then hopefully totally synthesize penicillin. But Chain was a fool - Meyer felt sure he could quickly solve the problem ahead of Chain.
Chain and Meyer were not technically enemy aliens, but as Germans and Jews and left wing (ish) recent naturalized citizens they both felt insecure in their new homelands.
It was only natural both were hoping to do some big piece of research that would ensure they weren't discharged during some security scare.
(Remember, the only reason so many German Jewish refugee scientists ended up doing atomic bomb research was because they weren't trusted to do the real important research --- on radar and asdic !)
This background made the story plausible to me when I came across it seven years ago --- besides, it hardly flattered Meyer so why tell it unless it was true ?
Next up is Ronald Bentley recounting the story of young Leslie Epstein ( later Leslie Falk), an American Jewish - left wing - Rhodes Scholar who is in Oxford working with Ernst Chain in Florey's lab.
Florey didn't have much time for more than about three dozen people on the whole Earth --- so him not much liking left wing American Jews was par for him - but he was willing to work with them ---- if they brought badly needed money and pairs of hands into his hard-pressed institute.
Falk had done large scale biological work with Chain (highly unusual for biochemists) growing massive amounts of the bacteria that lysozyme consumed, in a successful efforts to find the exact substrate that this enzyme broke up - and how it did so.
They had tried the same method, beginning in early 1938, to grow large amounts of penicillin - with less than no luck.
This penicillin work had only been done in fits and starts, because lysozyme was more important.
But once lysozyme was solved and the war arrived, along with a large grant for penicillin work, Epstein carried on with lysozyme for his thesis while Chain and Heatley set to growing penicillin.
So Epstein was a second hand witness to all the key events of the oxford team , up to about June 1940 where he was orderd home after the Fall of France.
Home turned out to be Johns Hopkins in Baltimore, via New York.
While in New York ( and perhaps on summer return trips), Epstein spent time with another Jewish , mildly left wing, biochemist interested in lysozyme : Karl Meyer , Chain's rival !
Kudos to Bentley for noting Epstein thanking both Chain and Meyer in his final published October 1940 article and chasing down Epstein's biography for the full story.
I believe Epstein told Meyer of what his supervisor, Chain, wanted him to say about Meyer's role in lysozyme ( ie to be dismissive) and that Chain was having success with penicillin and an articles was due soon in one of the three or four important British medical cum scientific journals.
That is why, I believe, Meyer both found the article so quickly and was so quick to react to it in an organized manner.
To purify penicillin, Meyer did not need clinical work stealing the penicillin he needed for his destructive chemical studies.
But he did need Dawson to grow the stuff and test it against bacteria in vitro and in artificially infected mice and to compare the potency level of each new purified sample.
dawson had great skill and experience in all these areas - [articularly in his pioneering work on recombinant DNA (aka bacterial transformation) .
Meyer might need to do a few limited clinical trials to justify his wages as purifying penicillin was hardly a big concern of an eye institute.
But he could use expect to only use tiny amounts ( a few units per treatment - ie about the amount grown in a single one litre flask ) of very crude penicillin to successfully treat simple eye infections topically.
(From Cecil Paine's unpublished work, we know this amount would have given clinical successes.)
But find the purity and the amount needed to cure - by needle - multiple cases of adults with invariable fatal SBE ; that was like racing up and down Everest before you could even crawl !
No , I believe Meyer made a bargain with Dawson and then Hobby : help me purify penicillin ( I expect success in about four months) and i will give you more pure penicillin than you can use for whatever clinical cases you want.
But for now, let me stall my bosses by helping me work with Phillips Thygeson on some cases of chronic eye infections.
I believe the original agreement was that from October to December, the best purified penicillin went to chemical studies, any crude left over was for Thygeson to trst against minor eye infections.
Come January, Dawson was to get clinical priority , with more and more refined penicillin, suitable for safe injection.
But Dawson jumped the gun, largely for symbolic reasons, by injecting tiny amounts over a brief two day period into two SBEs before they began their normal treatment with massive daily amounts of sulfa drugs sustained for months on end.
After this, from mid october to mid december, what little clinical penicillin was available went to Thygeson's eye infections.
I had long accepted that Meyer not Dawson started the project but that Dawson didn't know why it had been started --- because othrwise Dawson's letters to Chain made no sense.
But i had followed all theother writers' lead that SBE was the original clinical goal and eye infections only added at the end when the supply was too small to really cure SBE.
But the timeline never made any logical sense (not to a PK {Philosopher's Kid} anyway !)
So when I read Mary Ellen Bowden explaining that the move to treat SBEs in October was months ahead of schedule, it all made sense.
For the normally very circumspect Gladys Hobby had fairly broadly hinted that Dawson was very impatient to get started.
And just five weeks from drug discovery to clinical use is certainly
among the most unusual medical processes ever recorded in modern times in a research-oriented hospital.
But I doubt even Hobby really knew what lay behind Dawson's haste: in my next post, let me offer up my explanation....
(Honoured for taking control of it and making it into something to be universally and eternally admired, is a different story.)
Karl Meyer started it up - pure and simple. And as it happens, purity and simplicity were also the goals of his penicillin project.
Here's how it allcame about, as I see it ,though I should say in advance that I wish to thank three other historians for discovering the important pieces needed to solve the puzzle.
(My interpretation of their findings is, of course, not something I can blame them for !)
I the order that I came across their work, let us start with David T Durack ,writing a relatively brief article detailing the history of the early work curing endocarditis with antibiotics.
"Early Experience in the Treatment of Bacterial Endocarditis"
Durack says that in August 1940, Meyer was reading the new copy of Lancet and comes across a report by Ernst Chain and others on the substance penicillin.
The Oxford team demonstrated the efficacy of semi-purified penicillin in stopping bacteria stone cold in vitro ( ho hum) and in experimentally induced massive infections in mice ( new - long overdue - and important).
( I personally think this issue wouldn't likely have arrived in New York from London ,in wartime, in less than about two weeks - so assuming it was first issued in London close to its cover date of August 24th, Chain was reading his New York copy on about September 7th.)
Durack got from Karl Meyer the frank admission ( 30 years or more after the original event) that Chain had gotten him all rilled up.
Meyer and Chain had probably met earlier in germany while both were training to be biochemists and frankly, Chain got a whole lot of people rilled up pretty easily.
In this case, Meyer who had done a lot of original work with lysozyme (along with Fleming, Florey and Chain and Leslie Epstein), felt that Chain had denied Meyer his rightful priority on some aspects of the research in Chain's own articles on lysozyme.
Clearly the August 24th article indicated Chain wanted to totally purify and then hopefully totally synthesize penicillin. But Chain was a fool - Meyer felt sure he could quickly solve the problem ahead of Chain.
Chain and Meyer were not technically enemy aliens, but as Germans and Jews and left wing (ish) recent naturalized citizens they both felt insecure in their new homelands.
It was only natural both were hoping to do some big piece of research that would ensure they weren't discharged during some security scare.
(Remember, the only reason so many German Jewish refugee scientists ended up doing atomic bomb research was because they weren't trusted to do the real important research --- on radar and asdic !)
This background made the story plausible to me when I came across it seven years ago --- besides, it hardly flattered Meyer so why tell it unless it was true ?
Next up is Ronald Bentley recounting the story of young Leslie Epstein ( later Leslie Falk), an American Jewish - left wing - Rhodes Scholar who is in Oxford working with Ernst Chain in Florey's lab.
Florey didn't have much time for more than about three dozen people on the whole Earth --- so him not much liking left wing American Jews was par for him - but he was willing to work with them ---- if they brought badly needed money and pairs of hands into his hard-pressed institute.
Falk had done large scale biological work with Chain (highly unusual for biochemists) growing massive amounts of the bacteria that lysozyme consumed, in a successful efforts to find the exact substrate that this enzyme broke up - and how it did so.
They had tried the same method, beginning in early 1938, to grow large amounts of penicillin - with less than no luck.
This penicillin work had only been done in fits and starts, because lysozyme was more important.
But once lysozyme was solved and the war arrived, along with a large grant for penicillin work, Epstein carried on with lysozyme for his thesis while Chain and Heatley set to growing penicillin.
So Epstein was a second hand witness to all the key events of the oxford team , up to about June 1940 where he was orderd home after the Fall of France.
Home turned out to be Johns Hopkins in Baltimore, via New York.
While in New York ( and perhaps on summer return trips), Epstein spent time with another Jewish , mildly left wing, biochemist interested in lysozyme : Karl Meyer , Chain's rival !
Kudos to Bentley for noting Epstein thanking both Chain and Meyer in his final published October 1940 article and chasing down Epstein's biography for the full story.
I believe Epstein told Meyer of what his supervisor, Chain, wanted him to say about Meyer's role in lysozyme ( ie to be dismissive) and that Chain was having success with penicillin and an articles was due soon in one of the three or four important British medical cum scientific journals.
That is why, I believe, Meyer both found the article so quickly and was so quick to react to it in an organized manner.
To purify penicillin, Meyer did not need clinical work stealing the penicillin he needed for his destructive chemical studies.
But he did need Dawson to grow the stuff and test it against bacteria in vitro and in artificially infected mice and to compare the potency level of each new purified sample.
dawson had great skill and experience in all these areas - [articularly in his pioneering work on recombinant DNA (aka bacterial transformation) .
Meyer might need to do a few limited clinical trials to justify his wages as purifying penicillin was hardly a big concern of an eye institute.
But he could use expect to only use tiny amounts ( a few units per treatment - ie about the amount grown in a single one litre flask ) of very crude penicillin to successfully treat simple eye infections topically.
(From Cecil Paine's unpublished work, we know this amount would have given clinical successes.)
But find the purity and the amount needed to cure - by needle - multiple cases of adults with invariable fatal SBE ; that was like racing up and down Everest before you could even crawl !
No , I believe Meyer made a bargain with Dawson and then Hobby : help me purify penicillin ( I expect success in about four months) and i will give you more pure penicillin than you can use for whatever clinical cases you want.
But for now, let me stall my bosses by helping me work with Phillips Thygeson on some cases of chronic eye infections.
I believe the original agreement was that from October to December, the best purified penicillin went to chemical studies, any crude left over was for Thygeson to trst against minor eye infections.
Come January, Dawson was to get clinical priority , with more and more refined penicillin, suitable for safe injection.
But Dawson jumped the gun, largely for symbolic reasons, by injecting tiny amounts over a brief two day period into two SBEs before they began their normal treatment with massive daily amounts of sulfa drugs sustained for months on end.
After this, from mid october to mid december, what little clinical penicillin was available went to Thygeson's eye infections.
I had long accepted that Meyer not Dawson started the project but that Dawson didn't know why it had been started --- because othrwise Dawson's letters to Chain made no sense.
But i had followed all theother writers' lead that SBE was the original clinical goal and eye infections only added at the end when the supply was too small to really cure SBE.
But the timeline never made any logical sense (not to a PK {Philosopher's Kid} anyway !)
So when I read Mary Ellen Bowden explaining that the move to treat SBEs in October was months ahead of schedule, it all made sense.
For the normally very circumspect Gladys Hobby had fairly broadly hinted that Dawson was very impatient to get started.
And just five weeks from drug discovery to clinical use is certainly
among the most unusual medical processes ever recorded in modern times in a research-oriented hospital.
But I doubt even Hobby really knew what lay behind Dawson's haste: in my next post, let me offer up my explanation....
Did Phillips Thygeson fumble Penicillin in 1940?
Of course he did - but he was hardly alone.
Between 1930 and 1940 a series of unbroken successes with semi-purified penicillin in the treatment of very serious eye infections were unreported by the eye doctors who performed them.
If these striking successes with serious eye infections had been reported, penicillin would have gone into commercial production before the war and saved millions of lives world wide.
Dr Fred Ridley, future eye specialist, was the first to semi-purify penicillin in 1929 while working for Alexander Fleming and he witnessed most of the beginnings of penicillin , including its earliest (unsuccessful) clinical uses.
So he also probably knew of Fleming's only clinical success with his penicillin.
It involved a severe case of pneumococcal conjunctivitis and happened in 1932, according to the patient (Dr Keith Bernard Rogers) or in 1929, according to Fleming's biographer Gwyn MacFarlane.)
I think 1932 more likely by far.
There is a good explanation why Fleming chose not to published this great success : it revealed far too much of his own character.
Though Fleming was the director of a large medical cum commercial enterprise, in many ways he displayed the work ethos of a classic 'lifer'.
He gave a rigid, dutiful, 9-5, Monday to Friday output, but nothing more. No 'heroic medicine' for Fleming.
What he really lived for was in playing - and winning -competitive games ---- after work hours.
He is perhaps the best example we have (outside perhaps of president George W Bush and Mayor Rob Ford) of the dangers society faces when sports-obscessed teenage boys fail to grow up and mature.
When it seemed his all-important rifle team might lose a critical match because its star shot had an eye infection, Fleming dropped everything to cure him with his penicillin and win the match.
(Perhaps if Fleming's brother John, dying of pneumonia, had been about to be involved in an important game, Fleming might have worked equally hard to save his life with penicillin.)
Now, as is well known, Fleming loved messing about and 'playing soldier' with real war rifles; it was equally well known that he disliked the thought of being a real soldier.
This fact was well enough known to be a source of minor comedy to his colleagues.
The outer medical world, reading a published article, might not connect Dr Rogers' marvelous cure with 'Flem' winning his all important rifle shot.
But, soon, potentially all 10,000 or so doctors and nurses in the greater London area would, as the local medical gossip mill ground into overtime, having another joke at Flem's expense.
Earlier,beginning in 1930,just after Fleming's only major penicillin paper was released, another student of his, Dr Cecil G Paine, had a series of successes with his own hospital-made (totally unpurified) penicillin in eye inflections.
Together with eye doctor Albert Nutt, he saved seven newborns from going blind from gnorreal inflections in the eye.
His eighth case involved an almost certain lose of an eyeball (or possible death from general infection) -- a coal mine manager with a fragment of rock having penetrated the eye, allowed colonies of bacteria to form at the site.
(This is a situation very similar to SBE : like eyeballs, heart valves are smooth and bacteria free, unless roughed up by physical damage.)
The pneumococcal bacteria were cleared up by crude penicillin filtrate washes and the foreign object removed. The eye was basically unscarred in healing.
It should have been - to experienced eye doctors anyway- an obvious miracle.
To other doctors, Rogers and the mine manger cures of pneumococcal infections would have suggested that perhaps injected penicillin might cure lobar pneumonia.
In the 1930s, lobar pneumonia was a leading cause of death in people of relatively young age and otherwise good health : the equivalent contemporary emotional effect of such deaths today might be the loss to breast cancer of young mothers in their thirties leaving behind very young children.
In the 1930s, it was the loss of middle aged fathers in one income families, leaving behind teenage children.
Pneumonia deaths were often devastating and totally unexpected.
But neither Fleming or Paine or Nutt published their successes.
Paine told of his success to both Howard Florey and to Leonard Coldbrook no long afterwards, both both men, neither of them shrinking violets to put it mildly, did not seize this particular nettle.
I suggest a reason why when I try to account for Thygeson's similar reluctant to get into penicillin at the ground floor.
We are left then with Henry Dawson, who proved far more willing to publish his relative failures with penicillin than many others were willing to publish their clearcut successes !
It might be that people like Rodley and Nutt who choose to become eye specialists are retiring types and not likely to stick their necks out.
Above all, unlikely to admit in print that they un-dignified the medical profession by daring to use "home made bread" rather than drug "store bought bread" to cure a patient.
But Phillips Thygeson hardly seemed this type of eye doctor : he had a long career in advanced eye research and his own biographers admit he had a fearsome , explosive temper when crossed.
He, too, had early success with penicillin - treating eight cases of
chronic staphylococcal blepharitis "satisfactory" with natural penicillin semi-purified by Karl Meyer. One case in particular that was resistant to all sulfas showed a prompt respond to penicillin.
We know all of this, only because of Dawson breaking protocol on several occasions to talk up Thygeson's work in public and print, perhaps hoping by doing so to get Thygeson to commit his work to paper. (No luck !)
Thygeson did not like Karl Meyer at all and thought him a paranoid - though many others had no such problem with him.
We know Leonard Colebrook had the strongest possible reasons to dislike Fleming.
He believed that Fleming had deliberately manipulated Colebrook out of the affections of the only 'real' father Colebrook felt he had - his and Fleming's boss, Dr A. Wright.
I don't think I am alone in thinking this is why the crusading doctor Colebrook overlooked using Fleming's penicillin to cure childbirth fever deaths, in the eight long years before sulfa drugs arrived.
Meyer also worked with the eminent eye specialist Ludwig Von Sallman , using penicillin semi-purified by Meyer.
I do not know the time this happened, but am inclined to think it happened after Thygeson left Columbia University.
It probably happened in mid 1942 , while Dawson was away having a serious operation and recovering and was published as soon as the medical censors would allow it - ie from late 1943 onward.
But when did Thygeson's pioneering penicillin work happen ?
My educated guess may surprise penicillin history specialists and is the subject of another blog.
But for now, let me note that Dr John Hedley-Whyte, in his fascinating article, "Lobar Pneumonia treated by Musgrave Park physicians", notes a few other eye related cases that involved pioneering use of early penicillin - and that these were reported (and as a result, we finally got penicillin for all.)
The famous policeman dying in Oxford had seen a minor rosebud scratch infection, over the months of ineffective treatment , go into his eye socket and then into his skull.
SBE, a classic disease of the innermost body ( it affects heart valves) can be detected by many outwardly visible signs, one of them the famous Roth spots in the eyes.
Hedley-Whyte's point and it both unique to him and powerfully insightful, is that penicillin for ten years was an eye doctor's tool and that an informal wash of communications about it, via personal contact and personal letters , went back and forth across the Atlantic from 1929 to 1941.
Hedley-Whyte says this is how Fleming and Florey knew about Dawson's as yet unpublished work with treating SBE in New York in March 1941.
I know his case to be partly true because most printed claims about penicillin being "alway censored during World War Two" is loose historian's bosh.
For example, Leonard Colebrook in Britain in 1940-41, is careful to disguise the word sulfa so as to get past the censors when responding to Perrin Long in America, but has no trouble using the full word penicillin.
Very little about penicillin was actually censored and even this was internal semi-voluntary censorship by editors at the largest scientific journals, acting patriotically under informal pressure from the scientific elites.
All mention of serious chemical synthesis work on penicillin after about late 1942 was withheld by the relatively few teams engaged in this work.
But reporting chemical work to merely semi-purify penicillin at a crude level went uncensored: this is how Duhig in remote Brisbane learned how to make crude penicillin stable enough and safe enough to inject straight into dying patients.
True - that in America and due to the odious, unctuous Morris Fishbein - almost ALL mention of penicillin was withheld from the larger journals and the popular media from the Fall of 1941 till about the Fall of 1943.
Most effected were cases of treatments by semi-purified natural penicillin : Fishbein's committee's apparent hope was that if the public didn't hear about these efforts, pressure to actually make natural penicillin in commercial amounts could be held off until Science laid the marvelous egg of man-made penicillin....
Between 1930 and 1940 a series of unbroken successes with semi-purified penicillin in the treatment of very serious eye infections were unreported by the eye doctors who performed them.
If these striking successes with serious eye infections had been reported, penicillin would have gone into commercial production before the war and saved millions of lives world wide.
Dr Fred Ridley, future eye specialist, was the first to semi-purify penicillin in 1929 while working for Alexander Fleming and he witnessed most of the beginnings of penicillin , including its earliest (unsuccessful) clinical uses.
So he also probably knew of Fleming's only clinical success with his penicillin.
It involved a severe case of pneumococcal conjunctivitis and happened in 1932, according to the patient (Dr Keith Bernard Rogers) or in 1929, according to Fleming's biographer Gwyn MacFarlane.)
I think 1932 more likely by far.
There is a good explanation why Fleming chose not to published this great success : it revealed far too much of his own character.
Though Fleming was the director of a large medical cum commercial enterprise, in many ways he displayed the work ethos of a classic 'lifer'.
He gave a rigid, dutiful, 9-5, Monday to Friday output, but nothing more. No 'heroic medicine' for Fleming.
What he really lived for was in playing - and winning -competitive games ---- after work hours.
He is perhaps the best example we have (outside perhaps of president George W Bush and Mayor Rob Ford) of the dangers society faces when sports-obscessed teenage boys fail to grow up and mature.
When it seemed his all-important rifle team might lose a critical match because its star shot had an eye infection, Fleming dropped everything to cure him with his penicillin and win the match.
(Perhaps if Fleming's brother John, dying of pneumonia, had been about to be involved in an important game, Fleming might have worked equally hard to save his life with penicillin.)
Now, as is well known, Fleming loved messing about and 'playing soldier' with real war rifles; it was equally well known that he disliked the thought of being a real soldier.
This fact was well enough known to be a source of minor comedy to his colleagues.
The outer medical world, reading a published article, might not connect Dr Rogers' marvelous cure with 'Flem' winning his all important rifle shot.
But, soon, potentially all 10,000 or so doctors and nurses in the greater London area would, as the local medical gossip mill ground into overtime, having another joke at Flem's expense.
Earlier,beginning in 1930,just after Fleming's only major penicillin paper was released, another student of his, Dr Cecil G Paine, had a series of successes with his own hospital-made (totally unpurified) penicillin in eye inflections.
Together with eye doctor Albert Nutt, he saved seven newborns from going blind from gnorreal inflections in the eye.
His eighth case involved an almost certain lose of an eyeball (or possible death from general infection) -- a coal mine manager with a fragment of rock having penetrated the eye, allowed colonies of bacteria to form at the site.
(This is a situation very similar to SBE : like eyeballs, heart valves are smooth and bacteria free, unless roughed up by physical damage.)
The pneumococcal bacteria were cleared up by crude penicillin filtrate washes and the foreign object removed. The eye was basically unscarred in healing.
It should have been - to experienced eye doctors anyway- an obvious miracle.
To other doctors, Rogers and the mine manger cures of pneumococcal infections would have suggested that perhaps injected penicillin might cure lobar pneumonia.
In the 1930s, lobar pneumonia was a leading cause of death in people of relatively young age and otherwise good health : the equivalent contemporary emotional effect of such deaths today might be the loss to breast cancer of young mothers in their thirties leaving behind very young children.
In the 1930s, it was the loss of middle aged fathers in one income families, leaving behind teenage children.
Pneumonia deaths were often devastating and totally unexpected.
But neither Fleming or Paine or Nutt published their successes.
Paine told of his success to both Howard Florey and to Leonard Coldbrook no long afterwards, both both men, neither of them shrinking violets to put it mildly, did not seize this particular nettle.
I suggest a reason why when I try to account for Thygeson's similar reluctant to get into penicillin at the ground floor.
We are left then with Henry Dawson, who proved far more willing to publish his relative failures with penicillin than many others were willing to publish their clearcut successes !
It might be that people like Rodley and Nutt who choose to become eye specialists are retiring types and not likely to stick their necks out.
Above all, unlikely to admit in print that they un-dignified the medical profession by daring to use "home made bread" rather than drug "store bought bread" to cure a patient.
But Phillips Thygeson hardly seemed this type of eye doctor : he had a long career in advanced eye research and his own biographers admit he had a fearsome , explosive temper when crossed.
He, too, had early success with penicillin - treating eight cases of
chronic staphylococcal blepharitis "satisfactory" with natural penicillin semi-purified by Karl Meyer. One case in particular that was resistant to all sulfas showed a prompt respond to penicillin.
We know all of this, only because of Dawson breaking protocol on several occasions to talk up Thygeson's work in public and print, perhaps hoping by doing so to get Thygeson to commit his work to paper. (No luck !)
Thygeson did not like Karl Meyer at all and thought him a paranoid - though many others had no such problem with him.
We know Leonard Colebrook had the strongest possible reasons to dislike Fleming.
He believed that Fleming had deliberately manipulated Colebrook out of the affections of the only 'real' father Colebrook felt he had - his and Fleming's boss, Dr A. Wright.
I don't think I am alone in thinking this is why the crusading doctor Colebrook overlooked using Fleming's penicillin to cure childbirth fever deaths, in the eight long years before sulfa drugs arrived.
Meyer also worked with the eminent eye specialist Ludwig Von Sallman , using penicillin semi-purified by Meyer.
I do not know the time this happened, but am inclined to think it happened after Thygeson left Columbia University.
It probably happened in mid 1942 , while Dawson was away having a serious operation and recovering and was published as soon as the medical censors would allow it - ie from late 1943 onward.
But when did Thygeson's pioneering penicillin work happen ?
My educated guess may surprise penicillin history specialists and is the subject of another blog.
But for now, let me note that Dr John Hedley-Whyte, in his fascinating article, "Lobar Pneumonia treated by Musgrave Park physicians", notes a few other eye related cases that involved pioneering use of early penicillin - and that these were reported (and as a result, we finally got penicillin for all.)
The famous policeman dying in Oxford had seen a minor rosebud scratch infection, over the months of ineffective treatment , go into his eye socket and then into his skull.
SBE, a classic disease of the innermost body ( it affects heart valves) can be detected by many outwardly visible signs, one of them the famous Roth spots in the eyes.
Hedley-Whyte's powerful insight into Florey's behavior in April 1941
Hedley-Whyte's point and it both unique to him and powerfully insightful, is that penicillin for ten years was an eye doctor's tool and that an informal wash of communications about it, via personal contact and personal letters , went back and forth across the Atlantic from 1929 to 1941.
Hedley-Whyte says this is how Fleming and Florey knew about Dawson's as yet unpublished work with treating SBE in New York in March 1941.
I know his case to be partly true because most printed claims about penicillin being "alway censored during World War Two" is loose historian's bosh.
For example, Leonard Colebrook in Britain in 1940-41, is careful to disguise the word sulfa so as to get past the censors when responding to Perrin Long in America, but has no trouble using the full word penicillin.
Very little about penicillin was actually censored and even this was internal semi-voluntary censorship by editors at the largest scientific journals, acting patriotically under informal pressure from the scientific elites.
All mention of serious chemical synthesis work on penicillin after about late 1942 was withheld by the relatively few teams engaged in this work.
But reporting chemical work to merely semi-purify penicillin at a crude level went uncensored: this is how Duhig in remote Brisbane learned how to make crude penicillin stable enough and safe enough to inject straight into dying patients.
True - that in America and due to the odious, unctuous Morris Fishbein - almost ALL mention of penicillin was withheld from the larger journals and the popular media from the Fall of 1941 till about the Fall of 1943.
Most effected were cases of treatments by semi-purified natural penicillin : Fishbein's committee's apparent hope was that if the public didn't hear about these efforts, pressure to actually make natural penicillin in commercial amounts could be held off until Science laid the marvelous egg of man-made penicillin....
Tuesday, December 4, 2012
Penicillin : both its mold and its morals seem to hang out in basements and sewers
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| Rollo Martins the Canadian naif to Harry Lime's evil... |
About all I originally knew about wartime penicillin was from recalling a CBC TV production (originally from Britain ?) that involved a policeman dying of a cut from a rose bush and a doctor named Fleming .
(I had seen it in the late 1950s, back when I was about eight years old.)
That and the fact that the peacetime penicillin clan was a firm family friend - having saved my family many times from serious illness.
I had no idea of penicillin's Canadian connection - like virtually everyone I wasn't aware there even was one.
I gradually and dimly recalled penicillin coming up in a great British film called The Third Man.
I looked at a video of it again and then, on a visit to my brother in Britain, read a great book on how the film and novella came to be.
From both video and the book about the film and novella, I got a strong sense of the extraordinary moral over (and under) tones that penicillin has and that the other three hundred or so existing commercial antibiotics completely lack.
I am only guessing why The Third Man is rated , not near the top of the all time best British films (a dead cert that), but at the very toppermost of the very top : but for me it is the penicillin sub-text.
Britain, unlike Japan and Germany, had really and truly lost the war and so its wartime scientific discoveries like penicillin, jets and radar were seen as absolutely essential to retaining the British sense of collective self esteem.
And so for Harry Lime to muddy penicillin's (and Britain's) good name by , in effect, using it to murder helpless kids , was for them a worse crime against humanity than anything short of Auschwitz.
Sewers as a metaphor for both good - and evil
Dark ,cool ,dank, concrete sewers and basements is where penicillin the green and gold agent of life actually originally came from - but it was also the true home of that agent of death, Harry Lime .
This was a masterstroke from Greene and Reed ,the one Ying and Yang symbol that puts this film over the top.....
Was Alexander Fleming a coward ?
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| FLEMING avoided this .... |
Fleming joined an infantry unit when he was 19 and the Boer War was a year old and despite being a crack shot , he never volunteered to go and fight.
He remained with that infantry regiment, the Scottish London Rifles, enjoying laying at war until 1914 when a real war broke out.
He quit the regiment in 1914 (April, apparently) and thus avoided going into battle with them on October 1914 at Messines Ridge.
His regiment is forever remembered for being the first ever Territorial Army unit to go into general war action : but Fleming wasn't among them.
Aged 33 when war broke out, Fleming was young enough to be conscripted but unexpectedly got married - shocking his friends.
(Marriage among lifelong bachelors is always very popular in wartime.)
As a married man ,he needn't fear conscription -- at least until after December 1916, when the marriage exemption was ended. Later the upper limit for conscription was raised from 41 to 51 , but in any case he was well under those limits and healthy as an ox.)
In any case, Fleming was already in military uniform, working at a desk job in a medical lab, well behind the front line.
Fleming and Florey : what a pair !
Howard Florey was equally (not) brave : a first rate, highly competitive athelete, he claimed health reasons for why he didn't join his fellow students in the Australian Army in WWI.
Like Fleming, in WWII now that he was safely too old for combat, Florey was a real chicken hawk on conducting an aggressive war policy when it came to rationing penicillin away from dying civilians and towards unfaithful soldier husbands with a dose of the clap...
Scots wha hae wartime penicillin : chase Fleming's synthetic chimera or save lives with Dawson's shovel-ready ?
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| Dawson vs Fleming decided wartime PENICILLIN |
By unlikely coincidence , our two Scots, Alexander Fleming and Henry Dawson, were both born on August 6th, albeit 15 years apart (1881 and 1896).
Fleming was 18 when the Boer War broke out but refused to go and fight - he loved being in the London Scottish Rifles and was a keen marksman but was not really up for dying and discomfort and all that real chivalry stuff.
Dawson was also 18 when WWI broke out but only joined up in October 1915, after nurse Edith Cavell was murdered by the Germans in Belgium.
Dawson started off in the medical corps as a private and orderly but became a junior officer in the infantry and trench mortar artillery, was wounded twice and got the MC with citation for displaying bravery, chivalry and command despite being badly wounded.
Now it is widely claimed that Modernity repudiated Chivalry, after the horrors of the battles of Somme and Arras during World War One.
Modernity repudiates Chivalry : Chivalry repudiates Modernity right back
But a few writers - like Raymond Chandler and Howard Koch - claim that in World War Two, Chivalry repudiated Modernity and this is a thesis that I also hold - pointing to the Henry Dawson and Patty Malone stories as my prime examples of proof.
Fleming and his ilk : Florey, the NAS/OSRD/MRC et al , were seemingly contend between 1928 and 1945 to keep on polishing a turd, to still chase the chimera of synthetic penicillin for a few years more, while the world all around them burned.
Dawson passionately believed that if impure natural penicillin could save lives now , he had a moral duty to do so - Now !
His penicillin might be quick and dirty and a pain in the butt* for doctors and hospitals to keep in supply but it was shovel-ready, with its sleeves rolled up, ready to save lives : anyone, anywhere, anytime.
Fleming's synthetic chimera won all the early innings but Dawson's shovel-ready came from behind to win the race , in the late months of 1943.
Just as Chandler's Big Sleep had proved an unexpectedly massive hit with the general public and voters, so had Howard Koch's Casablanca and Henry Dawson's shovel-ready attitude of using existing natural - albeit impure - penicillin to save lives of 4F civilians today !
Chivalry - it turns out - was far from dead....
* and often , a literal 'pain the butt' for the patients too !
1942's key question : not can penicillin save lives but can SULFA still save lives ...
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| wartime PENICILLIN's unlikely saviour |
The biggest sin of Allied medical planning bureaucrats and their political masters was not in ignoring the life-saving potential of natural penicillin in mid-1942, but rather in ignoring the awkward fact that their chemical wunderkind sulfa was increasingly starting to fail to save lives.
They could claim that one can hardly go about searching - in the midst of a Total War - for some new knight on a shiny horse, until one knows for sure that the old knight is fading fast.
But in fact the signs were all there - in more and more anguished published reports from frontline clinicians, on the Home Front and in battlefield hospitals - but the planners deliberately ignored them.
They felt they had no choice, because they felt they had to button down some hard medical choices and stick with them regardless, in the reasonable expectation of a late 1942/ early 1943 invasion of Occupied Europe.
The supply chain and taught protocols for frontline medicine for ten million soldiers is not something stopped, started and reversed on a dime.
However, this does not excuse them for not placing lots of large, firm orders (aka big $$$$$$$) for natural penicillin, as it existed in 1942, for use in Home Front hospitals and rear echelon base hospitals.
People were dying from sulfa being no longer always effective - dying by the tens and hundreds of thousands world wide.
But , true to the tenets of heartless war medicine - the bureaucrats stuck to their chemical dogmas and mantras, regardless of new evidence.
Dawson's shovel-ready penicillin vs Fleming's synthetic chimera penicillin
It was probably only the Casablanca Conference's decision, in January 1943, to postpone the planned invasion for at least a year (together with the timely replacing of hidebound American Army Surgeon General James Magee) that ensured that penicillin became a big wartime success (rather than a small post-war success).
This, as much as anything Dawson's shovel-ready penicillin or Fleming's synthetic chimera penicillin did or didn't do......
Sunday, December 2, 2012
Were Stalin's COMMIES the best at making crude penicillin ? Say it ain't so, Joe !
Here is what Howard Florey, normally the most hostile critic of crude penicillin, found in his analysis of the crude Russian penicillin liquids in early 1944: 30 to 40 Oxford units per cc/ml.
Amazing !
It had taken years of hard work from the best American and British researchers, lots of expensive equipment and the best strains of penicillium to get those sort of levels from their own surface production of penicillium juice on an routine factory level.
Apparently, the Russians (a la Dr Duhig) kept things real simple and real efficient : they quickly ran the raw juice through the customary Seitz filter and into 10cc ampoules and then right into the patients' arms -routinely curing serious blood poisoning situations.
When you have 30 plus units of penicillin per cc, a 300 cc drip IV of raw penicillium juice delivers 10,000 units of serious infection-fighting power.
When your juice only has 1.5 units plus of penicillin per cc, ( which is closer to what Dawson and Florey got off their raw juice) 300 cc only gives 500 units in total per IV drip and that only fights very small infections with highly sensitive bacteria.
Not a common situation and also not the sort of situation where the attending doctor would normally even ask for an experimental drug's help.
The strain the Russians used (which they said was a variant of penicillium crustosum) was from basement wall slime they had found in a dark, dank, damp air-raid shelter ......
Amazing !
It had taken years of hard work from the best American and British researchers, lots of expensive equipment and the best strains of penicillium to get those sort of levels from their own surface production of penicillium juice on an routine factory level.
Ruskies outdid even Aussie Duhig !
Apparently, the Russians (a la Dr Duhig) kept things real simple and real efficient : they quickly ran the raw juice through the customary Seitz filter and into 10cc ampoules and then right into the patients' arms -routinely curing serious blood poisoning situations.
When you have 30 plus units of penicillin per cc, a 300 cc drip IV of raw penicillium juice delivers 10,000 units of serious infection-fighting power.
When your juice only has 1.5 units plus of penicillin per cc, ( which is closer to what Dawson and Florey got off their raw juice) 300 cc only gives 500 units in total per IV drip and that only fights very small infections with highly sensitive bacteria.
Not a common situation and also not the sort of situation where the attending doctor would normally even ask for an experimental drug's help.
The strain the Russians used (which they said was a variant of penicillium crustosum) was from basement wall slime they had found in a dark, dank, damp air-raid shelter ......
The Allied governments and Henry Dawson had a serious disagreement on the Allied war aims : but I happen to think that Dawson won the argument...
Superficially ,WWII came down to a physical battle between a democracy that lynched Negroes in Georgia (America) and a dictatorship that hoped to lynch Jews in Georgia ( USSR).
But really it was much more than that.
The bigger, more permanent, conflict was the battle for the hearts and minds of the whole world, fought between the eugenic forces of modernity and the commensality forces of an emerging post-modernity.
If the Allies started out talking a noble rhetoric but acting out a sort of muted Nazi "me too-ism" , by the war's end they had moved much further towards Henry Dawson's September 1940 position.
His patient-oriented penicillin was as much a moral and cultural force as it was a scientific affair...
But really it was much more than that.
The bigger, more permanent, conflict was the battle for the hearts and minds of the whole world, fought between the eugenic forces of modernity and the commensality forces of an emerging post-modernity.
Patient-oriented penicillin vs war-oriented penicillin
If the Allies started out talking a noble rhetoric but acting out a sort of muted Nazi "me too-ism" , by the war's end they had moved much further towards Henry Dawson's September 1940 position.
His patient-oriented penicillin was as much a moral and cultural force as it was a scientific affair...
Like Germany, Howard Florey effortlessly won all the tactical battles, losing only the strategic war to Henry Dawson
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| Eugenics was on the side of the Big Battalions... |
That meant making a virtue of denying aid to dying 4Fs, to give it instead to healthy 1As.
But as Hitler had earlier found out to his cost, this was not a position designed to win over the small battalions of the world's hearts and minds.
Dawson's Folly
Dr Dawson's 'folly' - by contrast - was to give up his own life, during a Total War against the Ultimate Evil, trying to save the lives of the 4Fs of the 4Fs, those 'useless mouths' young people with SBE.
His folly was near-universally damned by those in America's scientific and medical elite who knew of it.
Only those who the British call "the punters" : ie, the housewives, the customers and the voters all over the world, approved his idea.
They chose not to judge the Allied Cause by when it ventured into Nazi like behavior (denying aid to the weakest) but only in its better moments, as when it changed its mind and came to the aid of the SBEs' small battalions, aiding the least of these.
A small gesture perhaps, but in the end, more than enough ....
The Allied battle for the world's 'hearts and minds' : NS-born Henry Dawson's patient-penicillin vs OSRD war-penicillin
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| Army is - wrongly - blamed for her SBE death |
Presidents John Adams used the phrase "hearts and mind" in this sense early in the 19th century, long before Presidents FDR, Kennedy and Johnson made it famous in the 20th century - and before recent presidents George W Bush and Obama dragged it out of the archives to use in this century.
(And to share the blame around, their wartime Ally Britain also used the phrase during its 1950s war in Malaysia.)
When American finally joined The Coalition of the Willing (December 1941), many of the world's nations still remained strictly neutral in the battle against Nazi evil , or were, at best, nominal friends but in reality merely laying back on the oars.
The world's largest, richest, most militarily-advanced economies in the world (America and the British Commonwealth) had a real job on their hands trying to convince the neutrals (all much smaller and weaker than these two superpowers) that their interests would not be subsumed before the interests of these global colossus.
Unhelpfully, America and Britain's scientific and medical elite - centred in the American National Academy of Science (NAS) and the British Medical Research Council (MRC) made the job much harder.
Reactionaries of all stripes (from Germany to America) had been determined to roll back the1930s move to Social Medicine (the claim that more poor people got sick than rich people because they were too poor to pay for adequate housing, food or routine medical care).
However, the dire effects of the Great Depression had put wind behind Social Medicine's sails and confounded the reactionaries.
Now - Thank God ! - war, or even just the possibility of war, gave the reactionaries new hope.
Hitler killed off his first "useless feeder" the same week that he declared war on the Poles and soon his Aktion T4 program was killing Germany's weakest and smallest members by the tens of thousands.
In America, people like Dr Lewis Weed (a mid-level medical researcher) dropped his unsuccessful research to become a war-medicine advocate at the NAS and its action-oriented NRC (National Research Council).
War medicine wins opening rounds against social medicine
He locked horns with Dr Thomas Parran, the American Surgeon General from 1936 to 1948, who was a strong (and powerfully-positioned) advocate of social medicine.
A war medicine proponent advocates that any nation at war - even the richest, least attacked nation at war - needs to divert resources normally assigned to civilian medicine towards making bullets instead.
In addition, much more money would have to be spent providing for the high medical requirements of an activity (war) whose stated aim is maiming and killing people on muddy fields miles away from the nearest hospital.
Limited research dollars would have to focus on war-related medical needs ( such as finding new ways to keep factory workers and bomber pilots alert for long hours) and put before finding new ways to keep elderly retirees alive) .
War medicine is, in a very real sense, 'eugenics in uniform' : the best citizens (those that are tested and rated physically and mentally to be A1) end up in the military and get top notch medical care at no cost.
Those citizens who fail these tests and end up as 4F, are second rate eugenically and get second rate medical care during the war.
Proudly promote this concept to the outside world - and America's still relatively free press during WWII did just that - and it comes across quite differently in those neutral nations still sitting on the fence with regards to whole-heartedly backing the Allied cause.
As individuals, the elites in these neutral nations could see themselves as A1s --- but as nationalistically minded citizens they could only see their nations as 4Fs in America's eyes : mere inconvenient dirt beneath their advancing wheels.
When the Patty Malone vs Marie Barker debate broke in the United States media (basically, scarce penicillin for dying civilians : yes or no ?) , it broke even bigger overseas, as worried American and British diplomats noted.
Heartless or caring : the public image of the Allied cause had reached past the unimportant front pages and onto the most important page of any newspaper or magazine --- the women's page : home to Doctor Mom.
It suddenly mattered what the mothers and parents and grandparents from neutral nations thought of America and Britain's harsh dictates on penicillin.
Put your small neutral nation, say Eire or Turkey, in the place of the unfortunate Marie Barker and then ask yourself, how would you feel to just be Marie Barker-like 'incidental collateral damage' , on the pathway to the ultimate Allied Victory ?
And the Home Front within the Allied nations was just as caustic about their own governments' inactions : 'penicillin the miracle cure' had been around for 15 years and still no one in charge had bothered making enough of it for all ?
Don't the bosses know "there's a war on" ???!!!
And let us set this debate (occurring between the late Summer of 1943 and the early Spring of 1944) in its full context.
The western Allies still hadn't invaded Europe and left the heavy lifting of killing German soldiers to the beleaguered Russians.
Instead they were busy bombing Europe into rubble : busily killing civilians from both Axis and neutral nations alike.
The Germans and Allies had co-operated on censoring the results of the fire-bombing of Hamburg of July 1943, (right before the story of little Patty Malone broke) but on-site reports from neutral Swedish journalists had laid the whole horrific affair out on the newspaper pages of the world.
It had led to considerable unease - in neutral country and allied country alike.
Hadn't FDR himself raged that the bombing of civilians was a crime against all humanity and now weren't the Americans and British far out-doing the earlier Nazi efforts to bomb enemy and neutral civilians ?
Allied fire bombing of innocent babies in occupied Europe - denying life-saving penicillin to innocent young moms in America so that their unfaithful husbands in Italy could be get a quicker ( via penicillin) cure for the Clap - it all didn't seem morally right.
Perhaps surprisingly, the American Army revealed far greater political and cultural savvy on this matter than American doctors and scientists were capable of.
The Army was sick and tired of being blamed for hogging all the penicillin and refusing to give any to the nation's dying babies.
'For Christ's Sake', they could rightfully protest, 'we can't get anywhere enough penicillin for our own dying boys, and we hadn't even heard of this stuff penicillin till a few months ago --- you ask the drug companies and the doctors what they were doing with the stuff for the last 15 years !'
Somewhere in the American Army Air Force some bright mind (s) decided to solve both PR problems (the fire bombing uproar and the penicillin uproar) at one stroke.
(And before you ask, no .)
No academic historian has yet brought us the true story behind this highly imaginative response: I see a great PhD thesis for some bright light.)
Soon, American Army "heavy" bombers were pulled off their bombing practises and were sent out on a still risky flight (because at top speed and at night) "pounding" across country with a tiny 8 grams of penicillin (instead of the normal 8000 pounds of TNT) to deliver to a dying ten pound patient.
Upon arrival, Klieg lights lit the tarmac as an ambulance, along a police escort with blazing lights and piercing sirens, raced to the hospital and the waiting doctor and patients.
Need I add to this purple-prosed drama that, thoughtfully, the local press had been notified well ahead of time ?
Quickly Army bombers were even on far more perilous missions of mercy, dangerously new cross-ocean flights, from places like San Francisco all the way to Brisbane Australia or from New York to Havana, --- to save dying children.
In 1943, Martin Henry Dawson was dying ,but not quite dead yet, not by a long shot...
Life-saving penicillin had moved 180 degrees from being censored and rationed to being the subject of radio, newsreel and pamphlet propaganda as an example - the example - of the better things ahead if only all joined in to hasten the Allied Cause.
Neutrals could reassure themselves that just like with dying babies and Martin Henry Dawson's useless-mouthed SBE patients, the Allies would do right by all, as they were doing so now for the least of these.
The Allied battle for the world's hearts and minds, had been won (unexpectedly) by the proponents of social medicine - thanks largely to the example of Martin Henry Dawson.
And decades before Joni Mitchell and Woodstock, the American Army Air Force itself turned its shotgun bombers into butterflies, above a wondering nation and world....
Saturday, December 1, 2012
Florey vs Dawson : penicillin to be perfect & a war medicine OR an imperfect but universal medicine ?
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| Baby Patty Malone helped the whole world discover penicillin |
Penicillin-the-molecule was ignored in June 1929, firstly by Alexander Fleming himself and secondly by the world.
This was because Fleming on that date indirectly denied any possibility of penicillin ever becoming a lifesaver, ie a systemic ( spread through the blood system) medication.
As a result, Fleming - and the world - yawned.
Contrast this with Banting team's excited, animated, passionate announcement --- at a Boxing Day medical conference just a few years earlier -- that it was just two weeks away from injecting insulin-the-lifesaver into a dying patient.
(What a Boxing Day present for millions of diabetics and their familes !)
You can just bet that insulin-the-lifesaver and insulin-the-molecule were discovered together, by the entire world, at that moment.
What about Howard Florey then ? Didn't he play some role in penicillin ?
Yes, some role.
But Florey ,along with Fleming, and along with the British and American governments together with the leading firms in the pharmaceutical world, was convinced that penicillin first must be perfected (100% pure, industry-made, probably synthetic, tested-onto-death) before being used on humans .
And even then 'humans' really meant 1A military personnel only, at least during the war.
In addition, they all only saw penicillin as an useful supplement to the existing sulfa drugs - mostly for use in sulfa-resistant staph infections.
Truly a perfectionist and limited vision of wartime penicillin.
One can only begin to imagine the high prices that would be charged governments and patients for such perfect material.
Chain deserved less credit for his chemistry and more for his pushiness , in forwarding the penicillin story to a happy conclusion...
By way of total contrast, only five weeks after learning of penicillin's lifesaving potential (and here Florey and above all Chain deserve the credit) , Dawson was injecting life-saving penicillin into 4F civilians ( Negroes ! Jews !) dying from a strep infection (SBE) , using imperfect , impure, hospital-made, natural, penicillin made by slimey molds.
Yes, like Banting's first insulin injections, Dawson's first penicillin injections 'stung like a bee', from natural impurities still in it. The stings, in both cases, did no permanent (or even temporary) harm.
To Dawson (and to Banting, his model) saving dying patients today with imperfect, impure medication was preferable to letting them die so we can maybe save dying patients, years from now, with a perfected pure medication.
These clashing visions of penicillin ran throughout the war with Florey's vision overwhelming dominant until Dawson's success with -stolen - government issue penicillin on SBE patients inspired another local doctor (Dante Colitti) to jump over the traces for his dying patient as well.
The resulting heart-stirring story of baby Patty Malone ( late August - early September 1943) broke the media floodgates and the entire civilian world began to "ACT UP" and demand Dawson-style penicillin - now !
By 1944, the Allied governments, dragging the still reluctant Big Pharma firms along with them, had caved.
Semi-purifed, semi-perfect - CHEAP- natural penicillin was being mass produced and being made available for all, as fast as that was humanly possible.
And not just Allied civilians as well as Allied military personnel , but for Axis POWs , Neutral nation civilians and ultimately even Axis civilians.
Canadians Banting and Dawson and Canadian Medicare : there is a pattern here : a strong belief in medical care that is universal in theory as to who is permitted to receive it (everyone, anywhere) and universal in practise (as a result of being very inexpensive).
But it wasn't something simply discovered and instantly received with acclaim by everyone - as science historians want you to believe how science works : as a totally bloodless affair.
Instead, it was invented by some humans and contested fiercely by some other humans until finally most humans accepted it.
Invented by people like Banting, Dawson and Douglas ...
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