Sunday, October 31, 2010

Penicillin, from EROS to AGAPE : synthetic crystals to the natural mold

Anders Nygren,1890-1978, Swedish theologian and pharmacologist ?!

Why not ?

His seminal text of 1932, "Eros and Agape", does offer an unique way to compress the long wartime penicillin saga into something vividly digestible.

On one side, we have Professor Florey.

He basically ignores that:

 (a) there is a war on and people are dying daily from infected wounds from the Blitz
 (b) that natural impure penicillin had no toxic effects from its impurities and is available - now - to help those Blitz victims.

Despite this,Florey and his wartime coterie of Platonists and New Alchemists wasted their time and ours seeking after the chimera of a 100% pure --- all white---- crystalline penicillin for their Scientific monstrance, to hold aloft before the adoring Faithful.

Its just the sort of New Age nonsense we've come to expect from the hardheaded science departments of Oxford University.

And I really do think that its a 'guy thing' ,this growing of crystals.

Women prefer to grow living things: plants, pets and above all their own children.

But crystals are about the only non-living object that grows before your very eyes.

They don't lay you up for nine or more months,change your shape, never wake you at night, never have to have their diapers changed.

What is there not for men to like ?

And if your vision of BEAUTY sees it as a pure, austere, hard-edged sort of mechanical regularity, you will find it best displayed in crystals.

In Nygren's definition of human EROS love, EROS is found whenever humans seek to ascend to a 'god-like' status , by demonstrating their love for (and ability to grow) beautiful (literally beauty-filled) objects - in this case crystals.

They take in/ draw down some of that beauty
and by loving beauty,add some of its value to their own worthfulness.

But Nygren contrasts this to AGAPE love - a spontaneous, undignified, excessively operatic, self-denying,heart-on-our-sleeve love of the unloveable - with our enemies being the best possible objects of our agape out-flowing.

We don't draw down some of BEAUTY's perfection and purity to give us additional value and to help us ascend upwards.

Instead we give away love -and our life if necessary - down to the 'ugly' and the evil and they gain BEAUTY by our doing so.

We become "like God" by descending to the level of the ugly, flawed and evil and giving them all our love nevertheless -- just as Jesus did.

In 1940 ( as it is in 2010) people tended to see that gooey smelly mold ruining their basement walls and fixtures as something almost evil and definitely ugly and unloveable.

It took a special sort of person to see the worthfulness of the penicillium mold - that person being Doctor Dawson.

His co-worker Gladys Hobby writes of his tiny band of followers creating their own Monstrance of the furry, blue-green, smelly, mold with its clear urine-like drops of yellow penicillin, holding it aloft daily before the unlovable SBE patients, to give them courage and comfort in this world - and in the Next.

And because of Dawson's AGAPE love of this humble mold, millions of other beings - human beings - had their chance to live out their three score and ten.....

Saturday, October 30, 2010

1945: how the Official Histories of wartime MODERNITY fabricated victory from the wreckage of defeat

  ABSTRACT: When WWII Modernity's PLAN A failed in 1944, a totally different (and postmodernist) PLAN B stepped in at the last minute to save the day.
   After the war, (modernist) Official Histories from organizations like the OSRD recast the methods and motivations of PLAN B organizers to make them appear to have been part of PLAN A all along.
  Meanwhile, the original PLAN A ( and PLAN B for that matter ) were relegated to mere footnotes.
  It is time overdue for a more accurate retelling, keeping PLAN A and PLAN B to their original separate (but parallel) paths.


If I had to paraphrase all the Official Histories of World War Two Big Science organizations to a terse Hollywoodian 'High Concept Moment', it would sound like this:
 "Thanks to Allied Big Science (cue 'Hands Across the Water'), a Norden bombsight could flawlessly drop an A-Bomb into the centre of a deep barrel of fermenting - but very pure - penicillin from 15,000 feet ." 

Friday, October 29, 2010

AGAPE penicillin: Nature Won; Modernity Zero

Sixty five years later is Einstein's famous formula still the one that best describes 1945 ?

ie  E=MC

Or was the most lasting impact of  1939-1945's MODERN-WORLD war the fact that yesterday's Big MO (Modernity) lost.

And that Nature won.

And that in 1945, out of the resulting wreckage crawled PostModernity, aka us PO folk (the baby boom generation and our children and children's children ) ?

(Sadly resigned godparents: Adorno and Horkheimer.)

IE, is  "WWII=MOgoesPO"   today's best short, short,
short but correct formulaic answer to the exam request to sum up mankind's biggest, bloodiest war ever ?

who lost the last MODERN--WORLD war, 1939-1945 ?

You mean the one where Modernity (Big MO) warred with the World?

Big MO lost and lost badly.

 'Nature Bats Last' (and Nature bats long and deep) .

 And in 1945, out of the resulting wreckage crawled PostModernity, aka POMO or simply PO.

All of us alive today - all of us - have spent the majority of our lives  as 'PO folks' in the 65 years since 1945.

Our godparents ?

Some folks called Adorno and Horkheimer.

Forget the claim that modernist claim that 1945 means E=MC2.

Time has revealed that 1945's actual formula to be this:


Thursday, October 28, 2010

Tentative titles and dates for my 16 novellas

As always, I think of the novella 'as a container, not its contents'.

Similar to Edgar Allan Poe, I like best a text (cum book) that you can read in one sitting and which results in one overall impression upon the reader.

So I have stolen the term 'novella' from the literary types, who use it most consistently for fictional work of between roughly 12,500 words and 25,000 words.

In practice, a novella today is usually around 19,000 words long.

(I think most of us regard fiction between 7500 words to about 15,000 words as either a novelette or a long short story, just as we tend to regard fiction over 30,000 words in length as a short novel.)

In terms of work that isn't fully or overtly fictional, like my work, this results a book of between 50 and 120 pages, depending on illustrations and formatting.

I think most of us can read a book like this, if it is clearly written and attractively laid out, in between 75 and 150 minutes - the same  range of length as most movies/plays/ musicals and concerts.

My 'book' ,  "MO goes PO, 1939-1945" , is actually a series of 16 separate but connected essays easy of novella length.

Hopefully each will average around 12,500 words, giving an overall length for the entire series of 200,000 words.

I have had to condense the story greatly.

 This meant I had to pick just sixteen key days, over a war that lasted six years and raged over 2000 separate days.

As a result, I have gone back 'n' forth/ forth 'n' back over the specific sixteen dates, so I can still tell the story succinctly but accurately and dramatically.

So here are my tentative dates and titles - always subject to further change, of course:

January 1st 1941 : "We Are The Dead".

March 15th 1941 : "Synthetic Hope".

May 20th 1941: "Life Unworthy" .

September 30th 1941 : "Thank You - And GOODBYE" .

January 30th 1942 : "Kristall Lust" .

March 12th 1942 : "Patient Betrayal" .

June 30th 1942 : "Censored" .

November 6th 1942 : "Going Native" .

January 29th 1943 : "Hill Of Beans" .

June 14th 1943 : "When Doctors Gossip" .

August 11th 1943 : "Fire This Time" .

October 30th 1943 : "Patricia, Harriet and Mae" .

January 25th 1944 : "Saved By Face" .

March 19th 1944 : "The Great White Hope" .

June 23rd 1944 :  "Lazarus, Too" .

August 15th 1944 : "Blanket Harbour" .

Some will also have explanatory subtitles ...

Thursday, October 21, 2010

'AGAPE penicillin' project was ALL about smallness and simplicity

Manhattan's other Project was one of World War Two's smallest projects in what turned out to be History's biggest ever human effort; our biggest effort - if one of our least moral - by what ever measure is taken.

Smallest is rarely an indicator of importance, and never less so than when set against the world's largest ever war.

In addition, this small project happened seventy years ago, and great distance back in time tends to render small projects even less of importance to us.

Everything about World War Two was gigantic.

Armed military occupied the deeps of the middle of the oceans, the heights of the skies and the tops of mountain ranges. They were found in the high Arctic and the deep Antarctica - in fact for the first time ever war touched every continent on earth simultaneously.

Fighting occurred year around, night and day, in all kinds of weather, for six long years - fighting in the dry heat of desert sands,  in the cold of ice and snow, in the wet heat of dark jungles.

Geographic spread was matched by the number of people pulled in directly as soldiers, war workers, in occupied nations and as refugee peoples. 

Indirectly, almost everyone on Earth suffered restrictions on where they could travel or what they could buy and at what price.

Globally, about 100 million people either died during the war, or not long after the war, because of wartime conditions.

In terms of non-renewable resources consumed - literally - blown up, burnt up or sunk deep in the ocean, our share of the world's bounty took a hit we will never ever recover from.

We are still paying the debt of fighting the war and for repairing the structures and bodies affected.

The opportunities lost for what we might have achieved, as a human race ,without WWII, can never be known - only regretted.

Set against all these Big Battalions of facts and figures, why should historians, anymore than God, care about a truly tiny project ?

Well, I happen to believe, with all my heart and soul, Napoleon to the contrary, that God is actually totally on the side of the small battalions.

AGAPE penicillin was not just a small project, it was a project  about smallness, all about smallness.

 In fact, it seemed almost designed to defend the worthiness of smallness and simplicity and to rebuke Modernity and WWII's bigness obsession, doing so by both its ends and its means.

The smallness of its ends --- the people it was intended to help -- is blindingly clear.

RHD was the leading killer of working class school kids and the resulting invariably fatal SBE, the leading killer of slightly older working class RHD victims.

 However, the upper middle class medical and scientific leadership of the Allies had determined that the working class SBEs were unworthy of a share of the small amount of natural penicillin the scientific establishment had half-heartedly produced in the 15 years after its discovery.

Dawson and his AGAPE team resolved to make their own semi-concentrated impure natural penicillin to treat these '4Fs of the 4Fs' , these 'lives unworthy of penicillin' - and hence - of life.

But what is my  point in exalting the smallness of the  AGAPE team, the small means to that small end ?

Again, the physical - or surface - smallness of Dawson's project is clearly self evident.

The team consisted of between two and six individuals - but most of the time consisted of just three or four individuals  - people who already had busy jobs in the rest of their work day.

In terms of treating SBE patients - its main emphasis - it treated about 35 patients during World War Two - set that against the seventy million war who died during and because of World War Two.

NONE of those war dead died of SBE - it is doubtful that any sort of war action made an individual's chances of getting SBE any more likely.

In direct terms, the AGAPE project contributed nothing to the direct war effort - and many argued, then and since, that it actually hurt the war effort, albeit in a small way.

The project occupied a small lab or two, the wall of part of a corridor and a typical hospital ward of the smaller sort. (And whatever space they could temporarily scrounge for their equipment - including an outside fire escape.)

AGAPE penicillin consumed a small amount of resources that weren't particularly scarce.

It doesn't seem to have won more than lukewarm support from Dawson's hospital and university colleagues.

 And I have found no evidence of any government agency or large foundation voting to earmark funds specifically for the AGAPE project - so it had not been formally peer-financed/peer-approved by any of the scientific establishment.

Its cost in terms of dollars couldn't have been much - seemingly absorbed out of normal department and clinic budgets.

An impressive catalogue of 'smallness' , but this is not at all what I mean by saying that its means were as small as its ends.

I mean that literally: many of the team members, the biological agent they employed, even their bacterial adversary were all about as 4F as the 4F patients they treated or afflicted.

Henry Dawson - because of his weak lungs - had Terminal-MG-just-waiting-to-happen. He frequently was stuck in an oxygen tent and could only be permitted to get away to work, if he agreed to be tethered to an oxygen tank and mask, probably in a wheelchair.

His soul mate and writing/editing assistant, his wive Marjorie, had a congenital hip problem that was never successfully treated and she needed a cane at times.

His leading clinical aide, intern and then resident Dr Tom Hunter, had had polio and needed two crutches to get about.

His friend when he really needed him,the big industrialist Floyd Odlum had contracted an extremely severe case of Rheumatoid Arthritis --- while employed to worry about the fate of ( irony !) of tiny businesses under a war economy that favoured only the biggest firms.

As a result, he frequently needed to get about with  crutches or a wheelchair.

When 4F patient Charlie Aronson got his SBE-induced stroke, he too got a wheelchair  and his oxygen tank- but among this 4F medical bunch, he'd scarcely stick out !

During most of the war, informed medical opinion rejected the idea that NATURAL impure (but totally safe) penicillin could have any war role.

NATURAL penicillin, not to put too fine point on it, is produced when penicillium molds 'pee'  a yellow liquid  into their own bathwater.

No 'pee water' of dirty, smelly basement molds and fungi
was going to sully the veins of the White Races - anymore than black Negro blood was going to go into those veins, even if needed to save a life.

Artificially made (chemically synthesized like the existing Sulfa drugs) all-white ,crystal pure, 1A penicillin had to be created in mass amounts before the medical and scientific establishment was even going to tell the wartime laity about the wondrous life-saving qualities of natural penicillin.

In a war all about 1A men and 1A chemicals, the penicillium mold was smalltime and 4F.

In fact, it was suspected that very soon, there wouldn't even be an adversary for natural or artificial penicillin to test its mettle against.

Edward Mellanby, the head of Britain's all-powerful MRC and the chief financial backer of Howard Florey, had said in 1937, that in fifty years there wouldn't be any hospitals about devoted to infectious diseases, because they would all such diseases would have been conquered, permanently, by chemical medicines like the thousands of sulfa variants.

So, too, the Strep and other pathogenic bacteria were assigned to the 4F, loser, section of Life.

All penicillin books to date - even that written by AGAPE team member Gladys Hobby's, at least to some extent - devote almost all their length to Howard Florey's effort to create chemically pure penicillin.

But midway through their 300 pages and 120,000 words, they break long enough to devote a paragraph or page to the AGAPE team.

One can accurately summarize all their writing thusly:
"Actually, and unknown to them, the Florey team was not the first to treat a patient with systemic (antibiotic) penicillin. That happened a few months earlier at New York's Columbia University when Dr Martin Henry Dawson gave a small amount of weak penicillin to a patient, Aaron Alston, with incurable SBE.
The amount was far too small to have an affect but was judged to be non-toxic. 
 Alston died and Dawson, already suffering from incurably MG, was too weak to do any further work and also died. His brief report, read before a medical conference, was never published and while noted in the New York Times, had no impact on the further course of wartime penicillin and he necessarily passes out of our story."
None of this was true.

Aaron was treated on that first day back in October 16th 1940, and he did seems to have died, perhaps by February 1941.

 But the first patient ever treated with penicillin was almost certainly Charles Aronson, also treated that same day, with an amount of penicillin that also was far too small to have any effect on his heart bacteria.

But Charlie was made of the stuff God usually assigned to cats with nine lives and the fact that he knew he was getting not the back of medicine's hand but rather receiving the first ever systemic dose of a new wonder drug may have affected his heart - his emotional heart.

In any case, he survived this bout of SBE - a very rare but very real possibility with any case of a supposedly 'incurable' disease - perhaps because this 'boost to his morale' was converted into a 'boost to his immune system'.

This was no temporary event - he remained free of SBE for three years and was cured a second time by Dawson - again with penicillin - and was still alive at the war's end.

In 1945, Charlie could say "I'm still here !", despite being written off years earlier by all the doctors.

Worse, he has been written out of history by stupid,dumb,lazy,f-king brain-dead writers ever since.

(His history, the best recorded of any of Dawson's three dozen SBE patients, can be found in two frequently cited landmark medical articles, easily available to any writer seriously researching Dawson's part in penicillin's story.)

Dawson did get terminal MG a few months after beginning the AGAPE project, but he hung on for four and half years, the normal time patients with serious MG hung on in the early 1940s.

He worked steadily until a month before he died, and the long list of published articles and recorded appearances before public scientific meetings, demonstrates that fact to even today's stupidest,laziest writers - if they hadn't a semi-conscious agenda to bury him even deeper in the ground than any grave digger could arrange.

In early 1945, he also could say "I'm still here !" and point to the fact that not only was he still alive and active, but that even the AMA had accepted his claim that systemic natural penicillin could cure the incurable SBE.

Further, his close medical companion, the penicillium mold, if it could only speak, could also claim that it too was "still here !"

Florey's seven year effort to find chemically pure penicillin to inject into patients had failed - synthetic penicillin was a disaster in terms of yield and even in terms of its chemical rationality.

Naturally produced penicillin was the only penicillin used to save lives during World War Two--- and in the seventy years ever since.

And Dawson's first time use of systemic (internal) penicillin to treat human disease had not only ended up near the business pages of the New York Times - it had influenced at least some of those all important men-with-money.

A then small 'fine chemical' company with only a toe hold in the outskirts of the drug business (Pfizer) answered his clarion call for help.

 Eventually, moved emotionally ( just like Charlie) by the AGAPE project, they betted their house on the unpopular NATURAL penicillin and won big - they ended up producing most of the penicillin of World War Two.

Today they are not just one of the biggest drug companies in the world , they are one of the biggest companies in the world, period.

Dismissed by Florey, in preference for 1A chemically-oriented MERCK , Florey never even visited Pfizer in 1941.

But in 1944 he simply HAD to go to Pfizer driven there by the dictates of the PR battle touting the hope of penicillin as the best single reason for everyone to hang on until the war's end.

So there he was, standing beside the AGAPE project's Gladys Hobby, and pretend to be moved by all the vials of natural penicillin tumbling off their production line while his own baby, synthetic penicillin, lay stillborn.

Pfizer too could say in 1945, "we may have been judged 4F by Howard Florey, but we too 'are still here' !"

Even Dawson's adversaries, the bacteria, could prove Edward Mellanby's proud boast wrong by 1945.

 Even in 1945, sulfa and penicillin-resistant bacteria were abundant -- and the situation is even more serious today -  so the small bacteria too could say "I'm still here !"

And of course ( because there always is a 'of course' in my blog entries) of course PostModernity is all about smallness, localness, variety, diversity, alternative modes of existence --- just as Modernity is all about 'bigger always being better'.

AGAPE penicillin - in all its dimensions - was the first successful postmodernist rebuke of the life-hostile ethics of Modernity and the Modernist war that was WWII.....

Wednesday, October 20, 2010

1A strong chemical purity versus dirty weak 4F 'fungus water'

Why was NATURAL (impure but totally safe*) penicillin unacceptable as a frontline live-saving medicine throughout most of the war?

Why was it treated like a 4F or a 'useless mouth' - or like a Roma or  Jew ?

Why the obsession with 'All White'  Penicillin, (the so called A1 or Aryan Penicillin) ; why the obsession with it having to be 100% pure and 100% artificially made by Man, before it was safe enough to inject into the average WASP's veins?

Why the American Red Cross obsession that no black blood be mixed with white blood before a blood transfusion was acceptable ?

Were our great great grandparents nuts or Nazis or both or what ?

Why did these High Modernists think the way they did - and why do we Partial Post Modernists find them so hard to understand or to stomach ?

And when it all begin to change from them to us, anyway ?

* Nobody ever died of impure penicillin - the rare penicillin allergy deaths only began when patients began receiving massive doses of pure penicillin----- before being tested first for a possible allergy reaction.

Tuesday, October 19, 2010

God Knows What Dr Dawson Did With Penicillin...

.... and HE doesn't need a book to remind HIM.

But perhaps our new health science grads could still use a little inspiration....

God Knows What Henry Dawson,Robert Pulvertaft,Rudy Schullinger,Frank Queen And Jim Duhig Did With Penicillin...

... and now you are about to find out as well.

There have been many,many books written about PHASE I Penicillin : about the discovery of penicillin by Alexander Fleming.

( And not enough books written as to why it then lay about unused for 12 years...)

Similarly there have been many books and articles written about PHASE II penicillin : the scientific research and development of penicillin by Howard Florey.

Supporters of both men have spent the 75 years ever since, fighting in print over which one deserves the most glory.

Very little - or nothing - has been written of  PHASE III penicillin.

('Agape penicillin').

'Agape penicillin' occurred when a few isolated individuals gave their arm and heart and brain - and sometime even their life - not to discovering or researching penicillin, but simply to using penicillin to save lives.

Saving lives with penicillin as fast and as hard as they could, with whatever penicillin they could make or take, regardless of its 'purity' or lack there of.

Since no one else is writing their story, I am.

My qualifications are not that I am a doctor or scientist or even a published author.

It is simply that I am a former 'penicillin patient' (and aren't we all ?).

As such I care greatly about the stories of the first all-out efforts to take penicillin out of the science lab, to put it to work, inside patients, saving lives.

This is a book oriented towards readers who are or were patients receiving antibiotics, written by a former patient, rather than a book written by a scientist, academic or professional author.

If 'amateur author' means a book written out of love and gratitude , then I am an amateur for sure.

I started thinking about writing this book in 2005, in reaction to the aftermath to the events of 9/11. A lot of people - not just Moslems - seemed down on Manhattan, mostly for its global financial influence and partly for its part in the development of nuclear weapons during World War Two.

I decided the world needed to be reminded that not everything Manhattan did between 1941 and 1945 led to more killing and suffering.


The Manhattan Project had many connections to Manhattan Island and the surrounding Greater New York City area - as did the 'agape penicillin' project.

But the Manhattan Project leading to nuclear warfare was one of the biggest projects (in terms of money and manpower) - and certainly the best known, of all the projects of World War Two.

By contrast, the 'agape penicillin' project was one of the smallest and least known projects during the war.

Think of it, perhaps, as Manhattan's other Project.

If size matters to you above all else, this isn't likely to interest you.

But the 'agape penicillin' story is a truly epic story of courage arising above adversity to change our world forever, for better.....

God Knows What Henry Dawson Did With Penicillin...

...and HE doesn't need a gaggle of academics - or me - to remind HIM.

Monday, October 18, 2010

*In ferrum pro libertate rueban

It is thin comfort when you lose your dad or husband at an young age to note that his death had its poetic dimensions to it.

But just as Dr Martin Henry Dawson began his independent career with his work on the dagger shaped S pneumococcus, so those bacteria also brought his career to an end.

 These sword-shaped bacteria - 'the old man's friend' - hastened his end when a final Myasthenia Gravis Crisis, two and a half years after his initial diagnosis, led to aspiration pneumonia which developed into full blown bacterial pneumonia.

This was the usual time period - and manner - in which people with severe MG died , before changes in emergency crisis treatment in the late 1950s greatly reduced fatal outcomes from 80% to 5%  (and that 5% usually from the severely ill elderly with MG.)

A further poetic dimension to Dawson's life and death is that the man spent his whole scientific career focused on mucus -  strep bacterial mucus to be exact.

(From the lifetime he spent plowing this narrow, boring-seeming furrow, Dawson nevertheless spun off HGT and Recombinant DNA, Q-sensing, Molecular Mimicry induced Autoimmune disease, and Biofilm colonies destroyed by Systemic Natural penicillin - basically the entire field of  current bio medicine.)

Not bad !

But in the end, it was his own thickened mucus that his MG crisis produced but that his weak gag reflex could not expectorate that led to the aspiration pneumonia that resulted in his death.

Dawson lived for his (bacterial) mucus and he died by his (own) mucus...

* "For Freedom, They Rushed the Sword" : Virgil's AENEID

Laconia: DELIBERATE friendly fire is modernist utilitarianism

I do not find it at all impossible to comprend why so many Germans found it easy to cold-bloodedly murder millions of 'useless' outsiders, whom they hated and feared, after learning that they first killed hundreds of thousands of their 'own kind of people', kinfolk that they regarded as 'useless mouths' impeding an all-out total war effort.

While these numbers killed dwarf any other killings during the last War, they do not seem to me to plump the depths of the evil that modernist utilitarianism proved capable of during Modernism's big war.

As just one example,German soldiers east of Berlin, near the end of the war, followed orders to blow up a river bridge to stop the Russians coming over it, despite the fact that the bridge was loaded with hundreds of German civilians.

I call this 'deliberate friendly fire' (and I do not consider fragging as friendly fire at all).

My definition of deliberate friendly fire : "you know there are people from your side - soldiers or civilians - in the very small area you are accurately aiming your weapons at, and you fire away anyway and kill many of your own side while attempting to kill the enemy".

It is fairly well known that naval escorts were routinely under orders to never stop to pick up convoy survivors in the freezing North Atlantic waters but rather to abandon them (to likely die), while they chased subs instead.

Sometimes they had to be even more brutal - dropping depth charges in among survivors ,knowing many would die from the blast.

In September 1942, the converted Cunard liner LACONIA, which had frequently docked in Halifax during the war,
was sunk by a U-boat off Africa.

She was an armed warship, so this was fully allowed under the rules of war, though the U boat thought she was a troop carrier, not an  armed naval vessel.

The U boat captain got a shock when he heard the survivors in the water speak Italian and learned that there were 1500 Italian POWs on board, along with Allied women and children.

He told Berlin he was going to signal his position in clear language and try and arrange a rescue trip, under the flag of the Red Cross, to a neutral (Vichy) port.

The British ,suspecting a trap, didn't fully inform a near by
American fighter bomber base, who decided to bomb the U-boat, even though it would mean the death of many near-by allied sailors and families - as it did.

The ultimate decision was apparently made by one plane's bomb sighter's adamant eagerness to drop bombs on civilians, if needed to record a u-boat kill.

His personal decision led first the Germans and then the US to create a formal and public "sink everything without warning or rescue"  submarine policy worldwide - leading to hundreds of thousands of extra civilian deaths - many of them being innocent people 'from their own side'.

My partner Rebecca, without giving it much thought, said things like this happen - 'sometimes you must kill a few to save the many' .

I told her I rejected utilitarianism absolutely and decided to write this blog entry to try and explain why to her.

World War Two was many kinds of war.

After all, it was the same war that saw Americans unwilling to send healthy young fathers off to fight till forced to in late 1943.

They also rejected using the one in ten Americans who were black in combat roles and they rejected a wider use of women to replace men to go off and fight.

They objected to almost every rationing rule with real bite.

This unwillingness to fully engage their national resources, if doing so led to inconveniencing civilian lifestyles and upsetting prewar civilian norms, meant that America couldn't put up enough military resources to stop the relatively small number of U boats wrecking havoc all over the Atlantic.

This, in turn, led to these brutal 'kill our own side if need be to kill the enemy' orders as Allied commanders tried everything to try and keep the U boats from winning the war on their own.

Everything? Did I say that ?

I didn't mean that Allied commanders were willing to put a serious number of their longest range bombers on U-boat patrol - the one thing needed to stop the U boats cold.

No, those were saved for the glamorous (but mostly useless) high tech bomber war against Germany itself - not the boring but useful patrols over the Atlantic.

I say that utilitarianism is never moral - even if we ( literally all of we - from child to grandmom) all agreed to draw straws.

Straws to see who goes off to die in the infantry and who gets to stay home.

This total utilitarianism without limits would end up consuming itself until we, on all sides, would literally fight to the last person.

But we haven't seen - Thank God ! - this kind of utilitarianism - yet.

What we got in World War Two was selective use of total utilitarianism, almost always invoked by the higher-ups and almost always inflicted upon those lower down.

In 1942-1943,during the same time as the Laconia Incident, thsat same US government also decided to deny penicillin to the SBEs that Dawson championed.

The small supply of penicillin would go instead to quickly cure GIs in Italy who had deliberately incurred cases of VD to get out of the constant killing zone that was the American front line.

Once quickly cured in a day or two by penicillin, (the old protocol took months to get a full cure), they could be ordered back to fight - to fight until they died thanks to the American 'no rotation' rule'.

This was all decided so that American civilians back home won't have to be called up to fill out their depleted ranks.

This penicillin decision likely meant death for both SBE and GI.

A selective, lethal, slice of 'total war' was applied there, on these few people, so that a less lethal slice of total war did not have to be applied here, among many people.

I find it a horrifically cynical policy but it has its defenders, even today.

The right policy would have been to issue the threat of a government factory to supply this miracle drug, if the private drug companies proved too slow.

The fear that a Democrat government factory would have ended up getting the credit for "supplying the miracle", rather than private enterprise, would have lit a fire under the backside of Republicans like George W Merck as nothing else could.....

Saturday, October 16, 2010

First ANTIBIOTIC use 70 years ago today lifted youth off his deathbed

Forget the famous February 1941 story of a poor policeman dying from the scratch of a rose.

Its bull - bullfeathers.

Totally bogus - at least as a founding legend of penicillin.

You know the one, where our policeman dies, despite the desperate attempts to save his life with the 'first ever' needles of penicillin by an Australian born doctor named Florey.

Dig deeper and there is lots about that story to question - but that's for another day.

Today we are to celebrate , not to criticize.

The "first ever" use of an antibiotic by needle to save a human life actually happened months earlier and an ocean away and that needle was given by a Canadian-born doctor named Martin Henry Dawson.

Most importantly, that first ever patient, a 27 year old youth named Charles Aronson, walked away from his deathbed !

 (Charlie was suffering from an invariably fatal disease called SBE, the final stage of Rheumatic Fever).

The amount of penicillin given to him was far far far too small to kill his biofilmic bacteria around his heart valves ---- but it might have affected his heart greatly nevertheless : his emotional heart.

It lifted his morale and that way enough for this boy with a cat-like nine lives when it came to Strep bacteria attacks.

When last contacted in early 1946, Charlie was still alive, still here !

Truro, Nova Scotia ( Dawson's hometown) take a bow .....your boy did us all proud....

Friday, October 15, 2010

the epic triumph of DEMAND SIDE penicillin

All penicillin histories - to date - have been about what I call "SUPPLY SIDE" penicillin.

"Brilliant scientists, working day and night in the 15 years since September 1928, once again totally surprised humble but ever grateful lay people all over the world."

"They did so by dropping the new miracle cure penicillin  upon them, out of the blue, in September 1943."

This version of the saga says penicillin is best told in two competing stories or parts.

 But both parts are united in being all about active scientists --- with no role what so ever for us, the totally passive and inert citizenry, or in our roles as patients and patients' families.

Part One ,(1928-1937), features Dr Fleming - discoverer of penicillin - with far too many pages devoted to the mysteries of that discovery and with too few of the rest devoted to his efforts to bring his penicillin juice forward to the point of actually saving lives -----when used as an antiseptic.

Part Two, (1937-1940), features Dr Florey of Oxford University (all bow) and his years of wartime work on the chemistry of penicillin - all about his troubles extracting and purifying and synthesizing penicillin.

My book will be about Part Three, (1940-1943), the era of "DEMAND SIDE" penicillin. It will be all about the life-saving done by early penicillin doctors (not scientists), on the rare occasions when penicillin was diverted to the ward bedside and away from the synthetic chemists.

 It will focus on Dr Dawson - the patient. Yes, the patient.

Dawson was not unique in deciding to become a doctor after months spent in a hospital - Dr Colitti ( of Patty-Malone-and-penicillin fame) resolved to become a doctor after his own childhood bouts in hospital dealing with his spinal TB that left him a permanent hunchback.

For Dawson, his insights as a doctor dealing with chronically and terminally ill SBE patients could only have deepened when he himself became a chronically and terminally ill MG patient at about the same time.

Actually I will focus on Dawson, on his first penicillin cure Charlie Aronson, on Baby Patricia Malone's family and on the mother of a dead child he never got to save - Mae Smith, wife of Pfizer chief John L Smith.

In August 1943,Dr  Dante Colitti - inspired by Dawson's illegal SBE successes (an early example of ACTING UP) at another hospital a mile away, got Mr and Mrs Malone to also 'ACT UP' and publicly demand penicillin for their dying child.

Soon hundreds of families were doing the same all over North America and when enough Doctor Moms kicked up a fuss, even the stupidest men in Washington or Brooklyn listened - penicillin production really got moving, after 15 years of male excuses for 'not taking out the trash'.


Med Schools in that era - and perhaps even today - hated the chronically ill because they refused to die or get better, within the only school term that could be devoted to that particular form of illness.

The chronically ills' failure to get better 'put paid' to the notion that Science was always successful.

And Society in general packed the chronically ill of low income families away in large impersonal institutions with too many patients and too little money.

It got worse in wartime - a lot worse. A lot of people feel free to unleash their inner evilness in wartime and the helpless are a safe target.

In Hitler's Germany, the chronically ill were actively gassed - particularly those 'useless mouths' type patients like the SBEs (Charlie) and MGs (Dawson) who needed lots of repeated interventions of  high tech medical care without any hope they would eventually recover and start back at productive war work.

In Vichy France or in the US, it was more subtle - the eugenics of benign neglect.

Budgets were cut for the chronically ills day to day living expenses so more money could go to the war, or simply back to the well to do taxpayer when no one was able to complain.

Many chronically ill in institutions died of hunger-induced  infections while the budget-cutters' consciences could remain unsullied.

 Chronic illness research efforts were re-directed away from these useless mouths 4Fs towards the 1As and war medicine.

 Many patients were conscripted,without their informed consent, in some very dangerous experiments for the war - humans being as badly and baldly treated and cast off as laboratory white mice usually are.

Dawson and his supporters rejected the artificial divide between Social Medicine and War medicine, between social penicillin and war penicillin.

They said , against Hitler and Tojo, social medicine was war medicine,in fact the best kind of war medicine.

They said are we fighting Hitler simply because he took raw materials and markets we once regarded as ours or rather because we detest his values with all our hearts?

If it truly was the latter - FDR's Four Freedoms -  we should contrast how we treat our old and weak against how Hitler treated his.

For we will all become old and weak someday.

By 1943-1944, a lot of people saw that Dawson was right - and penicillin's promise was held out to people in the occupied ,enemy, allied and neutral nations as a symbol of the rightness of the Allied Cause.

Until then it had been treated as one of the Allies' best war weapons - a strange term for a life-saver .

 Yes, Dr Dawson probably did 'go a little native' when he got MG and became a perpetually ill patient as well as life-saving doctor -----but Thank God for that !

In January 1945, when AMA boss Morris Fishbein, the American medical censor, finally let Dawson tell American GPs about his five years of successfully curing SBE with penicillin, Dawson could reflect he hadn't done too badly for a chronically ill 4F.

Most histories of penicillin - to date - act like Dawson withdrew to a shadow world of chronic illness and inactivity after he got his MG diagnosis around May 1941, so the authors can return to focus on his rival Florey.

But in the Spring of 1945, Dawson could say, like a lot of chronically ill people who kept on being highly productive despite the pain, "*I'm Still Here - and so is my penicillin !"

Partially because of Dawson and Colitti's ACTING UP, patients today are much more likely to demand quick relief rather than simply waiting for the desultory scientists to get it all perfect and pure before dropping it into our grateful little hands - and Thank God for that, too....

* "I'm Still Here !" is a copyrighted expression and used with the kind permission of the late copyright holder, Margo Takacs Marshall, 1928-2010

Tuesday, October 12, 2010

Florey,Dawson's clashing business models

Florey and his many scientific supporters have always said that his interest in penicillin, beginning in early 1938, was the fact that it killed staph bacteria while the sulfa drugs did not.

Staph was not a big killer back then - not like strep bacteria - at least not in peacetime.

It tended to do its worst when it settled deep into big bones that weren't well supplied with blood - making it hard for white blood cells and sulfa molecules to get at the bacteria.

This condition is called acute or chronic osteomyelitis and it was rampant among the young children of the poor - in peacetime.

In wartime, surviving victims of war wounds - or the surviving wounded from the Blitz - often had huge deep wounds that involved their leg bones - a hard-to-get-at location that was ideal for staph bacteria to settle in for a long stay.

Patients affected went back and forth from convalescence bed to hospital bed while doctors and nurses strived to prevent the patient from getting worse in the hope the body would eventually seal off the infection without crippling the patient in the process.

Often they survived but were left crippled - other times the patient's resistance weakened and the staph spread widely till the patient died of general blood poisoning.

In war time, deep bone wounds infected by staph represented a massive cost to the military medical system - consuming resources for years while the affected soldier was unlikely to ever to return to full service. Blitz victims similarly taxed the overworked civilian medical system.

So Florey's business model for "war penicillin" - penicillin as a mere supplement for the sulfas, its wartime use to be strictly limited to healing military patients with deeply set staph infections of the bones and limbs - how did it sell ?

It didn't.

There is no record in all his biographies that any military medical types ever visited him until 1943 - nor is it recorded anywhere that he visited military doctors and was turned down.

Curious - the Navy, Air Force, 8th Army in North Africa, the Blitz victims - they had no end of deep staph infections of the bones to treat from September 2nd 1939 to September 2nd 1942 (three years - half of the entire war) but they avoided penicillin like it was plagued.

Florey was set up to supply an non-existent market.

By contrast,from 1940 to 1942, Dawson's main market had more customers than he could hope to fill.

Florey,Fleming, Heatley, Merck, Dawson of course, they all got requests (from around the world) for penicillin to treat SBE after Dawson announced that he had hopes to cure SBE with the new drug.

Dawson's business model for penicillin could not have been more different from Florey's.His Social Penicillinhe wanted to be made by a government factory and made available to all ( civilians and soldiers) in quantity and at a reasonable price - and made available like yesterday.

He thought penicillin could replace sulfa, not just supplement it, and used to kill all bacteria that was sensitive to it - not just staph.

Florey didn't directly treat any cases - he had no hospital rights unlike Dawson.

But the twenty serious systemic cases he
indirectly treated were almost all staph infected - so he kept to his business model in his own practise.

Similarly, Dawson had about 125 serious systemic cases that he directly dealt with and he too kept to his business model.

Those cases included all the types of bacteria that penicillin could kill---with about a third of them SBE cases.

Penicillin was promised to the military in mid-1943 after they finally decided that they wanted it ,by seeing it work well in military staph wounds in early 1943.

Score one for Florey.

But it only actually got delivered to the military and to the civilians when Dawson's
SBE success produced a patients' revolt across America and Canada ----inspiring Pfizer to go for broke.

Credit that to Dawson's business model--- and lets recall that by 1950 penicillin had completely replaced ,not supplemented, the mighty sulfas.....

Recombinant DNA and HGT's contribution to the penicillin saga

Where does one begin?

The beta-lactam molecular 'core' was originally created by bacteria and was only later was moved by HGT/ recombinant DNA into some fungi .

Those fungi then created the penicillin-variants of that very special fused beta-lactam ring .

But while this HGT operation was obviously fundamental to there being a penicillin saga to begin with, it had little direct impact on how the 1929-1944 penicillin saga actually unfolded.

But the four years of hard work and disappointments that Martin Henry Dawson endured between the Fall of 1926 and the Fall of 1930  working on HGT and recombinant DNA exchanges did make him the best qualified researcher in the world to put up with the temperamental penicillium between the Fall of 1940 and the Fall of 1944.

 His pioneering work with R to S type  (and S to S type) HGT exchanges between Strep pneumococcus bacteria made him eminently qualified to stand up to all the difficulties in growing penicillium to produce penicillin.

Dawson was the first in the world, together with Richard Sia, to successfully induce R to S pneumococcus HGT DNA exchanges in a test tube after most other researchers threw up their hands in despair and moved onto other research.

But he was no quitter and he pulled it off after years of failure.

Dawson then went on, with Agnes Warbasse, to do the same with S to S HGT DNA exchanges and this remains extremely difficult to do naturally, as Dawson did it.

He then went on to successfully grow colonies of M and L types of bacteria, all part of his effort over the roughly 15 years between 1926 and 1941 to establish that R,M,L were fully co-equal equivalents or alternatives to S types of bacteria - not defective or deficient versions of it.

This postmodernist notion naturally was seen as bizarre or worse in the strongly modernist atmosphere of medical research between the wars.

I see it as the bacterial equivalent of Dawson treating 4F civilians as the exact moral equivalent of 1A soldiers, not as defective 'useless mouth' variants,  despite the reign of Total War Utilitarianism ruling western medicine between 1940 and 1945.

Dawson's pioneering HGT DNA/ Q-sensing work taught him ethics and it taught him technical skills - both which he called upon to get penicillin successfully launched......

Leonard Colebrook is CENTRAL CASTING's penicillin hero

Time to wake up.

This isn't Hollywood.

"This Reality talking: Put your hands in the air and move slowly away from the World of Fiction".

In the World of Reality, Leonard Colebrook actually did bugger-all to advance the development of penicillin.

But Hollywood isn't totally wrong - he should have been the one to make penicillin a world wide success by 1932 or so.

He actually did do so in 1936 with a later - and lesser - 'miracle drug' : the sulfa family of drugs.

He did it by using some of the first commercially available sulfa to reduce childbed fever deaths to a very low figure - a feat that alone should have earned him immortality from grateful young mothers and families.

Childbed fever - actually commensal GAS strep bacteria (long term residents of the throats of the many attending doctors and nurses) settling in on the huge wound that is every new mother's uterus - is a particularly dreaded form of infectious death.

The death itself is often very painful. By definition the patient is relatively young (ie in her child-bearing years) . The death leaves a new born baby to be raised alone by a grieving young father and his young family.

Next Colebrook went on to pioneer new techniques to combat other forms of cross-infections that frequently develop in hospitals - starting with World War Two burn victims.

Even in retirement he led yet another crusade to modify the ubiquitous space heater so they all had clothing guards installed by law. Until this law was in place, thousands of people a year - in the UK alone - got severely burned or died, when their night clothing got set alight when it got entangled on the bare heating element.

His parents had raised him to be a Non Conformist missionary and reformer. In the event,Colebrook did as many would-be missionaries did at the turn of the last century - he channelled his missionary impulses into the field of medicine.

His highly moral impulse remained as intense as ever in everything he did.

He joined the Territorial (Reserve) Army and when he was called up in 1914, was prepared to go to the front as an infantry officer, not as a doctor.

But he was judged too valuable as a medical researcher to remain on the front lines - he spent the rest of the war in the rear echelons, with Fleming and Wright.

But at least- and unlike Fleming or Florey - he was willing to go to the Front.

In World War Two, he was again at the front, in a medical military capacity - teaching medical teams how to use sulfa powder in new war wounds ( he knew little more they did !) - and as the Front Line dissolved and became meaningless in the Battle for France he had a number of very close escapes.

He was 57 years old - and still at the front,  still in the thick of it, trying to save lives 'right here, right now'.

Colebrook was the near-perfect example of  the type of doctor I call the ward-doctor type.

This type of doctor may suffer from EED (Empathy Excess Disorder), in that they care too much for the patient, feel too much of their pain.

When they see patients dying needlessly around them, they are inclined to throw themselves even deeper into the battle at the bedside level - trying to use any or all of the best available techniques as best they can, as hard as they can.

What they can not see themselves doing, is beating what they'd call 'a cowardly retreat' to the quiet of a laboratory to 'study' the disease at its most fundamental level, hoping to find a cure - 'sure ,in about 6 years time'.

JV Duhig, Robert Pulvertaft, RH Boots, Perrin Long, Frank C Queen and even Karl Meyer are all doctors in the penicillin saga that fit this type.

There is a totally different type of doctor I will call a lab doctor. They probably suffer, to some extent, from EDD (Empathy Deficiency Disorder).

 They too find it very hard to see patients dying needlessly, but they reject 'simply'  providing 'band aid' palliative care for those who are dying without a cure in sight.

They spend their careers in the laboratory seeking the fundamentals of a disease and its cure in the universalities of chemistry and physics - as far as possible away from living, breathing, capricious individual human beings.

They may serve - if they must - in the military but they contrive that it is done in the rear echelons.

 However, once over draftable age, they frequently display a newly bellicose attitude to war service that one rarely find among the ex-veterans who actually faced death on the front lines.

I am thinking of Fleming, Florey, Keefer, Richards, and their ilk.

Now they may have something to offer society as scientists, despite the negative picture I paint of them.

They are no more quitters in the lab than the clinician doctors are on the ward.

They might have the skills to grow something as difficult as penicillium and the strength to hang in there when their first ten months of efforts are marked by nothing but failure.

One could see Florey and Colebrook as the perfect combination of two men who are incomplete as individuals, when it comes to successfully developing penicillin.

Colebrook would be too focused on 'saving this patient - today'  to ever set aside the months of time needed for the effort in the lab to learn how to grow penicillin.

 Florey ,on his own, would be too focused on purifying penicillin to 100% pure to remember that there is a war on and patients dying while he fiddles.

But Florey and Colebrook had nothing in common, in terms of their personalities---- I couldn't see it ever happening.

Colebrook, by contrast, had worked successfully for years with Fleming at St Mary's but the relationship had soured when Fleming moved to displace Colebrook in Wright's affections.

Colebrook regarded Wright as his second father and could never forgive Fleming for this.

Besides, Fleming clearly lacked the drive to do hard work for months on end, needed if a hospital lab was to produce enough penicillin for human trials.

Colebrook succeeded with sulfa where he failed with penicillin because sulfa was abundantly and cheaply available in a stable form, ready to have any nurse give the patient as a pill as scheduled.

Penicillin had to be grown by the doctor determined to use it - as no drug company was really that willing to help.

He or she would have to concentrate and purify it and then preserved this highly labile drug long enough for it to make it to the patient's arm. It had to be given IV, and hence by doctor,likely themselves in fact ,a needle every three hours around the clock for weeks at a time.

Few doctors - even of the heroic cast like Colebrook or his American counterpart Perrin Long - were up for this.

Only Martin Henry Dawson combined the rare strengths of Fleming/Florey and Colebrook /Long in just one person.

That is why 70 years ago this week ,it was he - and him alone - that gave that long awaited first ever needle of penicillin, that sent a young boy named Charles Aronson home from his expected deathbed.....

The Mystery of Penicillin's 18 missing years

I believe that all of the penicillin books up to now - and there have been hundreds of them - have basically been a series of 100,000 word excuses - "the dog ate my penicillin homework".

Excuses to us - the lay public - on behalf of Science in general or on behalf of one or other early penicillin researchers in particular.

But eighty years later, we lay people still want to know why it was that the best life saving medicine this world will ever see took an eighteen year vacation (from September 1928 till about September 1946) before local doctors around the world could routinely prescribe it to save a life.

Whether they are from the pen of a medical historian  seeking to defend all of Science/a particular team effort or the effort of a lay author defending an individual scientist they particularly admire, all those apologies basically come down to this:
The 18 year delay was due to technical difficulties, not moral failings - at least not the moral failings of my hero.
My book, by contrast, is not going to be a technical book - at least in its intentions.

(It will actually highly technical and highly accurate at times---- but only when needed to refute technical excuses and bromides.)


Mine will be a Moral History of penicillin - it will lay out a thesis that it was moral failings, not technical difficulties, that delayed penicillin becoming popularly know and commonly prescribed during all those years of death and suffering that we now call The Great Depression and World War Two.

The two events caused an excess of 100 million premature deaths over what might have been expected in that 16 year period.

Even if we content to 'merely' reduce those excessive deaths and not seek to prevent many of the so-called normal infectious deaths, how millions might penicillin have saved if it was readily available by 1929-1930?

Or consider this: despite the new global threat from nuclear weapons, the Cold War period from 1945 till 1985 was actually an incredibly optimist period in world human history.

The promise of 1945's penicillin was sufficient, all by itself, to overcome the fear induced by 1945's A-Bomb.

For a generation, penicillin kept most of us buoyed up about ourselves and the world around us.

Could those good vibes - induced in 1928-1929 instead of twenty years later - have been enough, by themselves, to prevent the worst of the Great Depression and World War Two from even happening ?

We will never know.

 But I believe these questions are still big enough,eighty years on, for it to be worthwhile to re-examine the early penicillin saga to see if there is another explanation for the delay. One that will finally convince most lay people - and hopefully - even convince a few of the scientists.


In the Fall of 1943, in Brisbane Australia, 15 years after Fleming discovered penicillin, Dr J V Duhig saved the lives of a dozen seriously ill people using a form of penicillin juice no more sophisticated than what Fleming had on hand in November 1928.

This the single hard, hard, hard, hard ,hard, historical stone against which I am going to grind every author and every account that claims that there were 'technical complications' why the world had to wait 15 or more years to put the life-saving effects of penicillin to work.

Until and unless they can explain to everyone's satisfaction why Duhig could do this - but why Fleming/Florey and Dawson et all couldn't - I will not relent.....

why MUCOID mattered: Henry Dawson and Rheumatic Fever

Recently having had a sore throat or tonsillitis - when it is caused by our normally throat and nose inhabiting (commensal) strep bacteria- is the only way you can get Rheumatic Fever.

There has never been a confirmed incident when huge life-threatening amounts of virulent strep bacteria rolling about in a gaping wound (the type of dramatic situation that makes strep the most feared word in the medical lexicon) has ever caused a single case of life-threatening Rheumatic Fever.

Rheumatic Fever (RF) is (and was) a very serious and very common disease, yet it begins with the quietest possible onset - one third of all its victims can't even remember having had a recent sore throat.

'Sore throat', undefined, is so common throughout all our lives, that we find it hard to tell those ones that were caused by strep bacteria from those that weren't.

The safest rule is if the sore throat hurts much and hangs on more than a day or two - run to a doctor and ask for a swab test.

If we are very unwell and have had endless rounds of sore throats and even previous bouts of RF, probably almost any strain of strep can cause another round of RF.

But for most of us that are healthy and well fed, being in an stressful new situation in an enclosed space for weeks at a time with a particularly virulent strain of strep running from person to person back to person, is our only way to get it.

I mean a wartime military recruit camp - the best possible natural laboratory we have ever had to see just how many people can get RF if the conditions are perfect.

The observed percentages are high enough, often enough, to put real fear into that doctors that do statistics and are paid to keep an eye on epidemics ---this despite the fact that RF is almost totally gone in the western world.

(It is still common in third world countries that until fairly recently historically never saw a case of it.)

We still don't know enough about it, to be terribly confident that it will remain beaten here in the western world.

Currently, the biggest focus of research effort is something that Martin Henry Dawson would not have found surprising : it is the fact that it is the most heavily mucoid of hemo strep colonies that seem to cause RF among populations normally felt to be at least risk.

Mucoid heavy strains of hemo strep turn RF from a social disease affecting the poor mostly, to something that could kill any or all of us.

A deep interest in raising the awareness of the virulence of Mucoid colonies of GAS strep generally (along with his pioneer use of penicillin to cure RF's final effect, SBE) was Dawson's particular contribution to the world wide effort to explain and prevent RF from the 1920s to the 1960s.

I do not believe that Dawson had actually pinpointed mucoid strains of hemolytic strep as the leading agents of the most deadly versions of RF - he simply knew that mucoid colonies were usually the most deadly agents in all of the dozens of serious diseases that strep deals out to us humans - and in the 1930s, RF was the most important hemo strep disease around.

Having his thesis proven in the case of acute RF wouldn't have surprised Dawson - but it would have pleased him.

 His 1930s mucoid work, sandwiched as it was between his pioneering work on recombinant DNA in the 1920s and his pioneering penicillin work in the 1940s has naturally been overshadowed by these two, the two biggest medical stories of the entire 20th century and beyond.

But to explain how in 1940 that an arthritis 'aspirin doctor' ended up in the area of endocarditis, today the domain of heart surgeons, we need to see this intellectual connection between mucoid hemo strep causing RF, which in turn led to SBE.......

Friday, October 8, 2010

Sir Robertson's curious letter and curiouser claim

Late August and early September 1942 saw a furious burst of letters to the editor directed at The Times of London, provoked by an August 27th editorial in paper concerning penicillin.

The three hundred word effort echoed an earlier editorial from The Lancet , and supported their claim that the drug was non toxic and more active than sulfa drugs and that its production should be greatly expanded and quickly.

Since penicillin looked to be a real comer with much 'moral capital' accruing to the companies or institutions that best claimed the laurels for first developing it, naturally all the major bodies involved had to elbow their way forward to stake their claim -  the current 'all-for-one' war effort not withstanding.

(A note to errant historians and authors: the drug companies' penicillin research arm, the TRC,were actually the first to gave themselves credit. Only then did St Mary's Hospital step in to also seek some glory.)

Sir Robert Robertson, the world famous Oxford chemist , spoke for the Oxford team.

Some of what he claimed were mere weasel words.

Dawson published the results of his treatment of 12 patients by May 1941, Florey his results on ten patients in August 1941.

Both were admirably cautious in assessing what if anything penicillin had done for their patients.

Dawson was actually the first to treat a patient and see that patient go home from his deathbed --- so Robertson was content to use weasel words that Florey was the first to "demonstrate the value
(of penicillin) clinically."

'Demonstrate' is a subjective term - in the eyes of the beholder - and Robertson knew it.

So, he had as well admitted that Fleming discovered penicillin and that Dawson had been the first to use it clinically as a life-saving systemic antibiotic.

What credit left for Oxford?

Robertson then told the bare-faced lie that toxic materials were produced by the penicillium mold, along with penicillin.

 Florey was therefore to be praised for being the first to separate the unsafe impurities from the safe pure penicillin so that it could be at last safely used on humans. (But wasn't, not by Florey - at least not right away ...!)

Nobody who ever worked with penicillin-producing penicillium , starting with Fleming in 1928 and carrying right on through twenty years later, ever saw enough of anything harmful, at levels enough to be toxic.

All made a point to note that the raw penicillin juice was not toxic even when injected in huge quantities by normal medical standards.

Foremost among these supporters of the use of  semi-purified or raw penicillin was one Howard Florey.

He publicly marveled that in hundreds of IM injections, no damage was ever seen at the site of the needle - not even in babies. The impure preparations he rated at 10% pure at the max (actually 3% pure) yet their impurities ( 97% of the dose) were non toxic - even when given in huge dosages.

It is hard to imagine a better test for proving the impurities were NOT toxic --- I can not,myself, imagine one.

What was going on then - in the mind of Professor Robertson and his chemist-manque Dr Florey ?

If Robertson and Florey had made any headway on synthesizing penicillin, I am sure this would have been their sole claim to glory.

But they hadn't.

So what can chemists do?

They can separate substances, even if they can't synthesize them, and even if the substances didn't need separating !

A nice meal does not improve when a chemist burns it all and then pours acid over the remains, to separate it into its constitute elements.

Penicillin juice - as Australian Dr James Vincent Duhig demonstrated in Brisbane in the Fall of 1943, doesn't need to be separated from its impurities at all, in order to save lives safely.

When it comes to questions of health, trust Duhig,MD over chemist Robertson PhD.

I don't expect Oxford University's academics to ever set the scholastic record straight about what Oxford did and didn't do with penicillin.

Claiming a leading role in developing the best lifesaver the world will ever know is simply too much of a money spinner for Oxford and the entire Thames Valley community.....

CRITICAL biography of Norman Heatley long, long overdue

I don't think Norman Heatley (1911-2004) did as much to advance penicillin as he thought he did.

I think a more balanced collective biography of the entire Oxford team might better spread the credit (and blame) about.

It seems to me that Glister and Sanders did far more, and Heatley far less ,to get penicillin production actually working and producing.

Norman himself conveyed to the world his view that he felt he was no longer a key member of the Oxford penicillin team after 1943 - as the historical blue plaque on his home so indicates.

(He even tried to apply for a job at a drug firm far far from the Dunn in 1944 !)

The Oxford team kept up their penicillin work up to the war's end in 1945 and beyond -I am curious to know what it was  that Heatley felt he was doing at the Dunn between 1943 and 1946, if it didn't involve penicillin.

Sanders and Glister and all the rest - except Florey and Heatley  -were never very interested to tell their part in the penicillin saga at Oxford.

So in this land of the blind, the one-eyed Heatley became king - particularly in the 36 years after Florey's death.

Heatley grew ever bolder in his claims ,as more and more of
'the old gang' passed on beyond the point of rebuttals via 'letters to the editor', directed at The Times.

The Oxford community, still unable to understand how credit for penicillin was taken up by a Scotsman (Alexander Fleming) and a  parvenu American soda pop company (Pfizer), fully supported Heatley in this effort.

I don't expect my biography of another penicillin pioneer, close associate of Pfizer, and a Scotman, Martin Henry Dawson, to be any more popular in Oxford.....

Thursday, October 7, 2010

it was the patients' MOMS who brought penicillin to the DOCTORS

The private discovery of penicillin happened in September 1928, the public discovery in June 1929 when it was published in an important, peer-reviewed scientific journal.

But then it just sat there for twelve to fifteen years.

So your great grandfather or great aunt died needlessly because the doctors and the scientists did nothing with penicillin, after that public discovery.

In August and September 1943, however, your grandmother "popularly" discovered penicillin when she read about Baby Patricia in some newspaper articles in some of the Hearst publications.

Now the fur really flew, as your grandmother demanded to know why your uncle, off wounded in a hospital in the South Pacific, wasn't getting any of this penicillin.

Her Mom-like anger and urgency finally got the men moving and before long her doctor and every other doctor had penicillin to treat patients.

So don't go tell me that doctors bring penicillin to patients.

Publication in a scientific journal (aka making something public as the scientists say) is not the be all and end all of effective science, as satisfying as it is to scientific egos.

The most influential scientific publication of  Doctor Martin Henry Dawson was an oral, not printed, account of the first human cases ever treated with systemic penicillin, given at an Annual Meeting of the Society of Clinical Investigators in May 1941 in front of hundreds of the world's leading medical scientists from all over the world.

Did he publicize his work with penicillin ? We laypeople might think so.

Howard Florey, however, sensed a loophole.

 He chose to regard an oral presentation of a paper at an conference, and subsequently published on paper in July 1941, as 'not a scientific publication' and ignored all mention of Dawson's breakthrough in his own references to his subsequent August 1941 paper on penicillin.

Thankfully, Dawson's work got written up in the New York Times ---near the business section --- not a scientific publication, admittedly.

However when the people in charge of the chequebook at Pfizer read it, they saw to it that their Brooklyn Crude penicillin was there to save the wounded on the D-Day beaches and ever after, until the war's end.

Florey continued to publish scientifically on his synthetic penicillin (Oxford Pure)---- but he never actually delivered any.

Pfizer never did publish on its safe, effective Brooklyn Crude.

They just delivered to the beaches, on time, and in quantity.

If you were a soldier in the Princess Louise Regiment (PLF) regiment lying on the Gothic Line, wounded, which would you prefer: British published talk or unpublished American walk ?

Well I was a (post war) member of the PLF and I bloody well know which one I'd prefer.

"OXFORD talks, but BROOKLYN walks..."

Tuesday, October 5, 2010

Oct 16 1940 : the disease was MODERNITY

A marvellously effective drug lay on a British shelf, unused, for twelve long years --- 'a miracle cure in search of a disease' --- on October 16th 1940 in a Manhattan hospital it finally found it : the disease was MODERNITY and the cure was penicillin.

The nominal disease Dr Martin Henry Dawson was seeking to cure that day (almost exactly 70 years ago) with the first ever needleful of the antibiotic penicillin was SBE, an invariably fatal calcination of the heart valves.

 However the real disease he was seeking to heal was modern utilitarianism, aka stone-heartedness.

Neither Fleming or Florey - to put it mildly - were up for this job.

In a few weeks,Dawson discovered he himself was dying as well but he felt duty-bound to carry on helping the helpless and the hopeless, despite a 'Total War' atmosphere which assigned 'useless mouths' like the SBEs to baneful neglect --- or worse.

Sunday, October 3, 2010

Dying Doctor goes 'Over the Top' in WWII to save his patients

This is the plot of "MO goes PO" in "Hollywood High Concept", with the movie retitled as

"Penicillin Stat! : Dying Doctor goes 'Over the Topin WWII to save his Patients."

As his skeptical medical critics saw the situation , Henry Dawson  went completely 'Over the Top' in 1940, in his quest to save terminally ill SBE patients with his penicillium juice.

But then he had gone already 'Over the Top' in 1917 - and again in 1918 (while, by contrast, they had sat out the war ambitiously pushing ahead amid the deleted numbers of wartime grad school) so I suppose he earned the right to do the same in WWII.....

Friday, October 1, 2010

Florey: if patents fail, try trademarks

By March 1941, Howard Florey ( the son of an industrialist who made his fortune through his knowledge of  patents, trade secrets and trademarks ,as both a buyer and a seller ) knew that no drug firm was likely to take out a license on his penicillin purification process, even if he did get Oxford University or the MRC to patent it.

Taking it as a given that no one applies for a patent for a process that does not work at all, the usual delay and expense is over determining whether the process is truly novel.

The question as to whether it is truly commercial is left to the market.

A process that costs more to yield less product than an existing process, is not going to find any licensees even if the fees were pennies per annum.

Pfizer had citric acid, Florey had COKE

But Florey had basically kept his (highly inefficient) process highly secret - and an inefficient process that remains a trade secret, combined with a lot of chutzpah and legwork, can still make for a perfectly viable and profitable trade mark.

You simply claim that your product is superior than anyone else's because of your secret formula ,kept in a bank vault, ( Coke anyone?) and so is worth a superior price.

You simply substitute the power of saturation advertising when saturation catalyst chemistry fails to produce the expected yield.

This is what Florey commenced to do on his trip to America - insist that only Oxford University brand penicillin was the one and only true penicillin - just as the world had gotten used to being told that Oxford had the only real English bible and the only real English dictionary and the only real English accent.

I couldn't see this going down a ton in Plymouth,UK, a Royalist stronghold in the (English) Civil War, but at Yale and Harvard USA where the American rebels had fought and won a revolution against Oxford imposing its religious and cultural values on other faiths, this sort of stuff was a big hit.

I am sorry to say this - but when it comes to truly sucking up to any and every aristocrat - our American friends are suckers of the first water.

 The chimera of penicillin 

'Penicillin' doesn't actually exist - at least not as a single entity : rather it is the overall name for a large sub family of an even bigger family of antibiotics called the beta-lactams.

 Almost all of these penicillins are defined as being hydrophobic (ie having non-polar side chains) antibiotics produced by fungi ,not bacteria ,that act mostly on gram positive bacteria and contain at their core the vital beta-lactam structure.

Reverse most of this, but leave the beta-lactam core and you have the cephalosporins antibiotic sub family.

Florey would rant at anyone who produced different results (like his long suffering friends at Merck) that their penicillin couldn't possibly be the real penicillin if it wasn't like his.

But it could be and was - different food mediums and conditions produced different types of beta-lactams and also differing amounts of antiobiotics that were not beta-lactams, from the same strain of penicillium.

In addition the penicillium frequently and rapidly mutated into different strains that could produce differing amounts of different penicillins in response to a fixed /standard set of conditions and food mediums.

Aaaaarrrgh !!!!!

In real life, outside the lab, reality was often as messy and untidy as real Australia was from its citizens' visions of a pure white only Australia.

Florey was a purity-wonk

Unfortunately, unlike his pragmatic Dad, Florey's main motif throughout his life was to seek out purity in all its forms - moral as well as chemical - we see this repeatedly referenced in his letters to his future wife Ethel from the 1920s.

I think Florey's barnstorming of America worked - he couldn't claim he had been the first in anything important in penicillin beyond the mouse test - Fleming, Paine and Dawson saw to that - but he could at least claim he had the purest penicillin on Earth.

To save lives, penicillin dose size, not quality, matters more...

I'll say it again - pure is a relative term, a percentage term - bacteria die and people's lives are saved only by large absolute amounts of penicillin - regardless of their relative purity.

Florey's all out pursuit of purity quality over penicillin quantity was a moral failing of the highest possible order.

In the war against Hitler and his racist purity views, to work full out, from 1938 to 1945, on finding an all-white penicillin was as obscene as as seeking to preserve  an all-white Australia --- or an all-white Germany......