Wednesday, August 18, 2010

a patient died with every Alumina run

During the thick of the fiercest combat in WWII, the entire US Navy got the same amount
of scarce purified patient-ready penicillin as did just nine American Drug Companies , "for their own use".

I've read this statement in dozens of penicillin accounts without asking - "why so much patient-ready penicillin for just nine companies and what on earth did they need it for?"

After all, other patient-ready penicillin was being allocated for clinical trials run by a separate organization, the NAS-COC - the drug firms had no hand in it.

Their routine testing for anti-bacteria activity took incredibly tiny amounts of penicillin - about one millionth the amount allocated to them.

What these accounts have elided out of their story is that all of this patient-ready penicillin was being destroyed in experiments to totally purify and totally synthesis penicillin, at a time when patients were dying because of lack of penicillin.

"The Chemistry of Penicillin", a massive monograph released by Hans Clarke of Columbia University in 1949, was the official history of the six year long unsuccessful effort to synthesis penicillin in commercially-salable quantities, an effort that involved thousands of chemists and technical workers, millions of dollars and the best university and industry teams in the Allied countries.

In every way, it was a parallel effort to the Columbia University-based portion of the Manhattan Project.

 Not just in its scale but also in the fact that it too started with a yellow powder consisting of a mixture of substances that were 99.99% alike and could only count itself successful when it ended up with one shiny clear crystal that was 100% pure.

The Bomb would have dropped on Hiroshima with or without success from Columbia's chemists --- but the Cold War wouldn't have happened if they had failed.

All the Cold War Bombs, on all sides, were built with molecule-separation technology perfected at Columbia during WWII.

By contrast, the molecule-separation technology that gave us pure crystals of penicillin came from the Wool Institute of Northern England in 1938 and proved useful enough to win a Nobel prize for its two developers.

And if you hear me once, you'll hear me a million times - their work was not peer-reviewed-grant-based research  - (ie,it wasn't DIGNIFIED SCIENCE  but OPERATIC SCIENCE  to use my own terms).

The origins of this technique (chromatography) are even more interesting - they came from a Russian botanist and were long ignored by chemists because, (a) well he was a botanist after all and (b) it was all way too easy.

Chemists adhere to the notion that if you aren't in pain after you exercise, you haven't done it enough - every chemist's scientific papers are a testosterone-rich tale of endless amounts of back-breaking effort and mounds of chemical reagents used up to achieve the end result.

But chromatography worked so well it is now one of the most widely used chemical techniques - it relies on the fact that even molecules that almost totally alike are still absorbed onto other molecules at ever so slightly different rates.

(Note that in separating the two types of almost similar uranium for the Bomb, it was known they had slightly different weighs and sizes and so it was hoped they would tend to go through tiny holes at slightly different rates .)

They did, but sooooooooo slowly that some molecules put into the production line in the mid-1940s were still inside the same production line 40 years later when the Cold War ended !

Now it is true that this is a physical process ,not a chemical process, in the final analysis but the effort to make it all happen was really a physical chemist's type of work, rather than something a regular physicist would excel at.

In Dutch, the word for Chemistry is Scheikunde - "the art of separation" - a very good way to describe much of chemistry - and frequently the part of it judged most useful/most profitable to industry and society.

Back to the process by the Wool Institute's Synge and Martin, as applied to penicillin.

In this process, during each run of the process, 5 to 7 grams of patient-grade penicillin  (that is between 2.5 and 25 million units of penicillin depending on the year the work was done) was poured down a column of alumina or silicon gel, and the penicillin separated itself out into various colored bands.

These different colored bands of sticky wet alumina were carefully cut apart with a knife
and then the biologically most active colors were used in further tests to get almost pure samples of various types of penicillin.

Think about how those chemists must have felt as they performed each run- they weren't heartless men and women.

They knew that each run used up and destroyed enough patient-grade penicillin to save the life of  six children with blood poisoning or one young adult with SBE (sub acute bacterial endocarditis). Sulfa drugs weren't working - so no penicillin meant death.

The Chemistry of Penicillin describes many of these runs and the specific amounts of penicillin used in each run.

I love facts and figures and dates and prices (up to a point) and hate the fact that most accounts of penicillin either avoid them - or worse - screw them up by factors of one thousand or more ( mistaking grams for milligrams is routine, for example).

The facts and figures in this massive tome of a book look reliable to me and I feel that it -and they - are underused resources.

Even more useful are the facts and figures that are not there.

The firm (Pfizer) that produced most of World War II's penicillin, the firm that was the first to make patient-ready penicillin, a firm early into the blessed circle of synthesis research, is almost totally absent from this book in any meaningful way.

It had a vast amount of experience, having worked with penicillin almost longer than anyone else and it was making lots of money and taking on lots of talented staff during the war.

It even got the second or third largest allocation of penicillin to play with.

Yet with all these advantages, it produced almost nothing remotely useful towards the synthesis of penicillin.

This isn't just me (a totally non-chemist) saying this.

Accounts years later that tend to give an summary overview of the road to synthetic penicillin, written by penicillin chemists with no axe to grind, see nothing in Pfizer's work to highlight. Even very minor penicillin players get more attention than Pfizer.

So where did all that Pfizer experimental penicillin go then, if not into useful synthesis work?

John L -(John L Smith ,head of Pfizer's penicillin efforts) -care to explain ?

"I secretly broke my solemn signed agreement with my government and diverted the penicillin away from synthesis to give to patients dying of SBE, patients that that very same government had refused to treat."

Why ?

"Because I had just bet the farm and Pfizer's entire fate on the guess that my biologists on this side of the Hudson could make deep tank penicillin successfully - and make it better and quicker than Merck's chemists could make artificial penicillin on their side of the Hudson. I was betting that soon there would be more penicillin than we would know what to do with - plenty for Second Front soldiers AND SBEs here at home."

"Was I right; was I right ?!"

Yes, you were. And some SBE patients and their families are very grateful you bucked your wartime government and diverted penicillin towards dying SBE patients.

"Well, I must say I learned how to divert penicillin and 'buck' from the best - Henry."

Dawson ?

"Yes,the old stubborn mule, Henry Dawson ..."

No comments:

Post a Comment