Tuesday, December 4, 2012

1942's key question : not can penicillin save lives but can SULFA still save lives ...

wartime PENICILLIN's unlikely saviour
Popular and academic historians alike continue to treat the histories of wartime penicillin and wartime sulfa as if they existed on separate universes, when, in fact , they were fierce, close competitors.

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......

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