Wednesday, October 3, 2012

Duhig's Penicillin saved lives where Alexander Fleming failed - because of - not in spite of - "poorer" technology !

GLAXO's moral lowpoint: April '43
Briefly - very briefly - in April 1943, at the height of all the suffering and the dying of WWII, Glaxo the drug company had a tremendous technological success and an enormous moral failure.

Briefly , Glaxo was the world's largest producer of what little penicillin the world produced, 15 long years after its first discovery. But none of that penicillin - zero - went to directly helping World War Two's sick and the dying.

Instead it was all destroyed by Glaxo chemists, as part of in the war-long futile contest to see what drug company would be the first to see MAN make penicillin, instead of some slimey slime.

Much of the story of wartime penicillin was that sordid story.

The dark dirty story of an contest between alpha male chemists and CEOs and chemists manques (in particular), to see who could get the Nobel prize and the glory and the profit for the patentable total synthesis of penicillin --- rather than submerging all that testosterone in an all out attempt to aid the sick and dying now and fuss over the glory later.

95 % of the wartime penicillin story was shabby beyond belief, but 5% was truly heroic medicine at its best

It is a truly shabby tale ---- as shabby as the war itself.

Alexander Fleming was part of that shabby tale : he never deflected from his 14 year old belief that penicillin might be a good antiseptic ( ie not to be taken internally, as life-saving drugs must be), if and only the chemists learned to synthesize it.

Jim Duhig --- once he had learned how people like Henry Dawson had grown their own clinical penicillin and injected it in a semi-purified state into their patients without killing them - went a further step.

He "downmarketed" his technological requirements and didn't bother to even semi-purify his home-owned penicillin.

The penicillin he injected into dying patients in 1943-1944 was cruder than even the semi-purified penicillin that Fleming dabbed around the open wounds of patients in 1928-1929, 15 years earlier.

Fleming reported mostly failures with his semi-purified penicillin while Duhig's totally unpurified penicillin saved the lives of patients all doctors had placed 'beyond hope' !

How on Earth ?!

All attempts at purifying, concentrating or crystallizing penicillin came at great costs: the harsh chemical techniques destroyed most of the delicate penicillin, the efforts wore out the overworked wartime staff and introduced deadly chemicals into the penicillin (when removing deadly chemicals was the original point of the whole exercise ! )

Duhig focussed his tiny overworked crew into merely making more and more raw penicillin - ie in upping raw production - and then in carefully preserving that delicate lifesaver, until it could be quickly poured into the bodies of dying patients.

Per person-hour of effort, I suspect that Duhig got 10 to100 times as much clinical penicillin as Dawson, Fleming , Glaxo, Merck, Florey et all got for all their hard work.

(Dawson being at the 10x end and Florey at the 100x end.)

Only Robert Pulvertaft, despite working in the desert heat (!) of wartime Egypt, probably did as well in turning raw penicillin juice into saved lives , with the minimum of human effort.

The unconscious, untested, assumption had always been that the other materials in raw penicillin juice would cause a deadly allergic reaction in patients unless purified away.

Never considered - except by Henry Dawson's team - was the idea that raw penicillin's other unknown materials might actually help penicillin work - as they certainly rarely seemed to harm the patient.

The jury is still out on that idea --- but un-purified penicillin did in fact rarely, if ever, harm the patients.

But converting penicillin from a weak acid to a salt ( to stabilize it for longterm commercial storage and sales)  does bring the well known dangers of introducing too much salts into the delicate balance of salts in the heart-blood system.

(Since Duhig's totally un-purified penicillin remained a weak acid and not a salt, he could pump simply tremendous amounts of penicillin liquid into patients' blood without killing them.)

And it was only once penicillin was totally purified and given in high doses did some people - a very few people - start dying from an allergic reaction to ------- to PURE penicillin !

Call it groupthink or tunnel vision, but *eugenics' powers over mid century doctors and scientists was so strong, they never asked the most basic of all science questions.

They never asked themselves, " if a mixture of penicillin and impurities sometimes causes a sharp spike in temperature in some patients, is it caused by (a) those particular patients's body chemistry (b) the impurities (c) or the penicillin itself ?"

If only they had, millions of people might have lived out their full lives, starting in 1928.....

* Eugenics was merely the leading edge of a middle class culture obsessed with purity and a hatred of dirt that went beyond all bounds of rationality : only a Mary Douglas could begin to assess what was really going on in the middle class mind in the mid 20th century.

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