Sunday, January 20, 2013

Wartime penicillin's biggest secret was "hidden in plain sight", on the pages of the very first article on penicillin

The real reason why the tortoise Henry Dawson, despite starting almost three years late, beat the hare Howard Florey to become the first ever to put an injection of an antibiotic into a human patient, is to be found inside wartime penicillin's biggest secret.

Unexpectedly, wartime penicillin's biggest secret was not stamped "TOP SECRET" and was not buried under lock and key in some government cabinet in Washington or London.

Instead, Henry Dawson discovered it in October 1940, incredibly enough "hidden in plain sight" , on the pages of Alexander Fleming's very first article on penicillin from back in 1929.

Hidden from even its own author for all those years ; remaining hidden to almost everyone ever since - except for a very few caring and observant wartime doctors.

The great secret is all about non-toxicity and natural penicillin.

No, no , no, ---- don't jump the gun.

Its not that penicillin is non-toxic (because in some crucial ways it is not).

Rather more surprising, the great secret turns on the lucky fact that natural penicillin's natural impurities are so relatively non-toxic.

Fungus are very much a mixed bag on the toxicity front. Lots of them are so non-toxic that we love to eat them as our daily food : bread, beer, cheese, mushrooms, tofu and treated milk products.

Others release tiny amounts of toxins (mycotoxins) so toxic they rate up there with the most deadly poisons we know, by weight.

Back to 1928.

After about ten days of activity, and after a good straining through a lab filter to remove all solids, a gram of Fleming's 1928 penicillium liquid medium contained one part per million of penicillin -- one microgram of penicillin , ie about 1.6 units of bacteria killing activity .

97% of that gram was pure water and the remaining 3% were natural impurities - mostly organic acids.

We humans eat organic acids all the time - particularly in preference to their alkaline opposites, the bases.

Unfortunately, in a the world obsessed with eugenic purity, the good news ended with this particular penicillium strain's thankful lack of general toxicity.

The Age of Modernity liked things to be distinct and separate, not buried together in mixtures : it demanded purity in everything, from the German race to the Allied brand of penicillin.

Unfortunately for this obsession with purity, those various natural acids produced by the penicillium were so much like penicillin chemically (though not at all in anti-bacterial activity) that they were almost impossible to separate from penicillin without either destroying it and or losing it along the way.

In September 1940, at the start of their teaching hospital's first term, Henry Dawson had agreed to restrain his instinct to try and save lives.

Restrain himself, until his fellow team member, chemist Karl Meyer, had purified their penicillin (that the tiny team was home- growing) to a point where it was judged 'pure' enough to inject safely in a human body.

The projected launch date was the start of next school term, in early January 1941: ironically the exact same time Howard Florey's team was scheduled to start injecting their 'purified' penicillin into humans ! Dawson's team didn't know this, how close they came to be 'also-rans' .

Florey thought his team so far ahead he felt no particular urgency to rush into saving lives ; purity and not humanity, was always more his 'thing' anyway.

But ultimately Dawson couldn't stand to stand idly by as two young boys died needlessly from the dreaded and invariably fatal SBE (subacute bacterial endocarditis).

Not when he was convinced that penicillin's unique combination of non-toxicity, potency and diffusibility  could save them.

He had not much literature on penicillin to read and re-read while waiting for the difficult process of purification to succeed , not in October 1940: only five articles .

Suddenly he realized that there was a possible solution to his moral dilemma , in that literature and right there under his nose all the time.

 All five authors, beginning with Fleming, had mentioned that natural penicillin's natural impurities were not really toxic - at worse, a minor irritant.

So why continue to purify and purify penicillin - at an enormous cost in labour and in penicillin losses?

Why labour to purify it past the point where it could be concentrated (like orange juice),  just enough to have a useful therapeutic effect without literally drowning the body in excess water ?

At that time, Dawson team was often making penicillin brew so weak that pouring it directly into a human body (by IV drip) would require putting a kilo of water into the blood stream for every 1000 units of penicillin activity !

But one go around of initial concentration cum purification might result in a little dirty brown powder that assayed 8 units per mg (one thousands of a gram) - 50 mgs of this powder dissolved in a gram of a suitable liquid, 3 times a day, would give the patient 1200 units of penicillin --- without the risk of drowning them internally.

And so on October 16th 1940, Henry Dawson jumped the gun and launched the Age of Antibiotics three months ahead of schedule.

Later on, by mid 1942, the raw penicillin juice made in hospitals assayed at around 40 units per ml of medium (about 25 times as pure) and it no longer needed to be even concentrated like orange juice (because even that resulted in heavy losses and needless additions of chemical contaminants).

It could simply be strained of solids, bottled and stored in a cold dark refrigerator until injected into a patient (and not merely dabbed into the patient's open wound, which was as far as most other penicillin pioneers were willing to go with non drug-company made penicillin.)

This is what a few brave penicillin pioneers (salute their heroic efforts please !) did : Robert Pulvertaft, James Duhig, and Zinaida Yermolieva.

Admittedly ,the first two did save lives by injecting raw penicillin into patients' blood supply, while still expressing some reluctance to do so  - by contrast, the soviet team led by Ms Yermolieva  did so routinely - all the more praise to them !

An unnecessary penicillin holocaust ...

If  only crude raw penicillin had been used to save lives, starting in 1928, millions of people would not have needlessly died world wide , in  a totally unnecessary holocaust bigger than anything Hitler had planned for the Jews .....

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