Bakhtin's Carnivalesque : 'Slime Piss' still saving more kiddies annually than Advanced Civilization ever killed

Without today's antibiotics, the dangerous bacterial infections that currently afflict only a child here and a child there would rage freely as epidemics or pandemics, killing millions upon millions of kids.

And when we say 'antibiotics' we basically mean the beta lactams antibiotics - the huge and highly effective family of the penicillin-like antibiotics.

The human use of penicillin (Penicillin G) to save lives is almost ninety years old and yet it is still in every hospital's pharmacy, albeit relatively rarely used.

However, as the starting base to make most all of our other antibiotics, penicillin g is still produced in the tens of thousands of tons.

And still made as it always was - made in incredibly tiny ---natural--- fungus factories invisible to the naked eye.

It is a mere 'secondary' metabolite of the penicillium slime - and for long time the secondary metabolites were considered to be just 'metabolic waste', a fancy grown-up's word for poo and pee.

Considering its liquid nature and its bright yellow color (leaving aside its strong acrid smell for a moment) , the scientists of yesteryear considered it to be nothing more than 'slime piss'.

It took a brave doctor indeed (Martin Henry Dawson) to first inject that foul stuff - raw - into a the bloodstream of a young male, in an attempt to save his life.

But the patient (Charles Aronson) lived and so our Age of Antibiotics began, on Ward G-East, at NYC's Columbia Presbyterian Medical Centre ----- seventy five years ago this October 16th 2015.

In WWII's brutal war of high tech science, this was low tech life saving at its very finest.

A stinging rebuke then, to Scientism at its very apogee of hubris, delivered by the lowest of the low, delivered by slime piss.

So be sure to tell Mikhail Bakhtin (wherever he might be) that it just can't get anymore carnivalesque than that...

Dawson was, in fact, the THIRD (reluctant but duty bound) leader of the tiny Manhattan penicillin Project

In September 1940, fearing the internment of German Jewish refugee scientists - even possibly those with recent American citizenship - was bound to follow the panicky British Empire decision to most of its German refugees from Hitler, biochemist Dr Karl Meyer became the first leader of what was to become the four year long Manhattan penicillin Project.

Dr Meyer was determined to find some sort of way to prove to the American war machine that he was too valuable to intern.

And finally purifying a drug that could kill the few militarily important pathogen bacteria that the hot new Sulfa drugs could not, would do just that.

Purifying a natural substance is sometimes by far the most difficult step on the road to then synthetizing and patenting it.

Any clinical testing could wait until the substance was safely purified.

For now, what Meyer and his assistant Eleanor Chaffee needed most from their two microbiologists (doctors Dawson and Hobby) was their highly practised skills in growing microbes.

And then later, their other well honed skill in measuring the bacteria-killing powers of any substances Meyer's chemical skills threw up.

But all that changed in early October 1940, when new patient A. (Leroy) Alston heard of the project and in a very real sense, hijacked the leadership of the project.

Leroy was a young black man from Harlem, dying of then invariably fatal SBE (subacute bacterial endocarditis) the disease that made Rheumatic Fever the leading killer of young people until the 1960s.

Significantly most of those deaths occurred among the poor, immigrants and minorities.

And Leroy didn't like the idea of accepting a SBE death as inevitable, just the assigned fate for America's poor and minorities.

Didn't like it at all - not one bit.

And Leroy was just the sort of person - dying or not - to be able to make significant waves.

He was raised by a poor widow in Harlem who sometimes got waitressing work - but Leroy held down a middle class job at a white commercial insurance firm all through the Dirty Thirties.

A first class athlete in many different sports, he also founded and ran a pioneering track and field club made up of members from the Harlem's black working class.

That club, Harlem's Mercury Athletic Club, competed successfully, not just against the nation's top black (middle class) universities but also against the top white teams as well.

To Leroy, it was always much more than just athletic success - he self consciously sought out obstacles to the ability for blacks to compete on an equal terms with whites - and then challenged them.

In a word, Leroy was a fervent Civil Rights activist - from the Thirties era.

The reason for his unexpected success is best explained by going back to the High Schools that all of us have experienced.

The Jocks cum Preppies in my High School (and probably in your school as well) were indeed mostly made up of kids from the community's best off families - but by no means exclusively.

What they really held in common was not income or race but a winning combination of physical and social agility - they moved gracefully and persuaded gracefully.

By contrast I knew many kids in my high school, from the top families, with all the family resources in the world, were seemingly just born shy, awkward and socially inept.

Leroy was just one of High School Life's natural born leaders and orators.

And in this particular case, this natural born leader had an audience of just one person to persuade : Dr M (Henry) Dawson, senior of the two microbiologists on Meyer's tiny four person team.

Dawson was also the only member with clinical (ward) privileges - and at a relatively high level too.

He was the only one on the team with both the legal right and the practical ability within the hospital culture to inject new untested un-purified medicine to a patient without his superiors putting up (too) much of a fuss.

Even in the most research oriented teaching hospitals, the frontline ward doctor directing patient care stands far higher in the informal hierarchy than does the most senior of the supporting staff, such as the microbiologists and biochemists back in the labs.

And Dawson had just been elevated to associate attending physician status, with an entire admission ward under his direct control and yet he had never really exercised his new powers so far.

Leroy couldn't help noticing all the recent publicity and fundraising dollars devoted to Polio, which killed far less than did Rheumatic Fever/SBE, but affected predominantly white kids from the hyper-clean and spacious suburbs rather than ethnic minorities crowded into inner city tenements.

Rheumatic Fever, by contrast, by 1940 was getting far less attention and funding than had been traditionally the case.

This made him angry and as it happened, it made Dawson even angrier.

Dawson had long seen a long slow shift away from charity to self help cum narrow self interest in the world generally and his belief was well supported by the facts.

The case of polio was particularly instructive.

Usually the March of Dimes is seen as an example of progress in human affairs : the (usually middle class) families of patients with a particular disease banding together to act as a advocacy and fundraising group for their relatives's disease.

But in an earlier age, middle class people donated money freely to help people in need who they didn't even know - this sort of selfless (agape) giving is the true definition of charity - not something you do to help your nearest and dearest or to get a tax deduction.

Hospitals - like Columbia Presbyterian where Dawson worked - had once freely treated those in most need of help with the least funds to pay for it.

Now it only treated the poor if their cases were unique enough to teach the (mostly middle class) medical students well enough to ensure them of a lifetime high income and higher status.

Similarly nations had once went to war - heedless of the cost - to battle to defend the rights of the smallest,weakest nations like Belgium to survive.

Now nations stood silently, bystanders, as Belgium and other small nations got gobbled up, saying it wasn't in their nation's self interest to intervene.

And America's medical schools, like Columbia Presbyterian, in that Fall of 1940, were moving away from their increasingly weak efforts towards Social Medicine (medical research aiding the weakest members of society, regardless of their ability to pay).

Instead they were moving towards War Medicine (medical research oriented to aiding the most fit members in society - her soldiers.)

But Dawson's anger - though in keeping with his character he usually kept it carefully reined in and undercover - was also directed at his colleagues for dismissing his research into the ability of microbes to do many things that the most advanced human civilizations were incapable of.

Meyer in a sense was partially a mouthpiece for such conventional beliefs.

The idea that penicillin was not safe to inject into humans until it was purified by humans was hardly his alone - it was universal in the worldwide medical community since 1928.

But Dawson began to reason that the fungus had probably been making penicillin for hundreds of millions of years and had probably got it down to a science.

After all, he probably reminded Meyer, they already successfully made penicillin at normal atmospheric pressures and normal temperatures and without strong expensive toxic reagents - not something Meyer, even if he was to become totally successful, could ever likely claim.

Dawson had two hands - in his quiet passively aggressive way , on a day when no bosses were around - Draft Registration Day October 16 1940, he could give the world two fingers.

Reluctantly, quietly but firmly, Dawson became the third leader of the project.

On that day, Dawson would give the world's first ever penicillin injections, ushering the Age of Antibiotics.

And do so by using (a) a medicine made by conventional evolutionary biology's under-estimated underdogs (tiny penicillium cells) to aid (b) society's under-estimated underdogs - Jewish and black youths from NYC's working class ....

Dr Martin Henry Dawson, MD , LLB (Hon) : always about defending the underdog ?

From would-be lawyer (destined to defend the underdog) to a doctor and scientist defending the underdog ?

With no private papers available, it is hard to know for sure what really motivated pioneering medical scientist Dr (Martin) Henry Dawson, the first person to ever put DNA to work in a test tube and the first to ever inject an antibiotic (Penicillin) into a patient.

Dr Dawson, MD was actually enrolled in Arts at Dalhousie University, before the Great War changed everything.

But, from what we know of his adult personality and from his best marks in university, I would see him, if the war hadn't intervened, more as a university teacher - perhaps in history or perhaps teaching theory in law school.

Unusually for a scientist, he took no sciences courses as an undergraduate - except one in biology (where he topped his class).

His skill in German turned out to be very helpful - no great scientist before 1945 could really succeed if they couldn't read scientific German with smooth facility.

But his best courses are in areas like history, economics and philosophy.

It is important to recall he got his wartime BA degree after attending relatively few classes because he had such good marks in the few courses he did complete, before he left for the effort overseas.

Henry Dawson was far too studious to ever stop at a mere BA and then go on to teach high school - yet he never (so far as we can tell) formally enrolled in the pre-law, pre-engineering or pre-med options at Dal.

But ever loyal to his slightly older brother Howard, he might have joined him at law school but for the war.

Yet he didn't seem to have the commanding personality needed to be a successful courtroom lawyer defending the underdog.

And he certainly never ever wanted to be well off, let alone rich, as in 'rich corporate lawyer'.

But while at Dal, Dawson was busy helping teaching English to various foreign seamen at the YMCA mission to seamen, perhaps parallel to his brother Howard's similar involvement in evangelical good works.

And for what it is worth, his older brother Frank, while an engineering Dean in the American Mid West, so impressed a pioneering black engineering student with his non-prejudiced kindnesses, that the man fulsomely remembered Frank Dawson years later in his autobiography.

The entire family was not military minded but when they were needed - when poor little bleeding Belgium was betrayed by the Hun - all five boys stepped into the breach.

Belgium - again an underdog.

Henry was a (medically untrained) private in a university organized overseas military hospital at first.

Later Dawson was made an officer in the infantry and while badly wounded in the foot, still gave up his place in a stretcher for another much more wounded ordinary soldier, (an underdog) this after solving a battlefield crisis by running about on his wounded foot for ten hours.

His foot never really recovered as a result, but he received the Military Cross with citation for this selfless act.

Then at the very end of his wartime service and wounded yet again, Dawson changed his peacetime occupation from just "student" to "medical student".

His career changed - but I argue - not his urge to helping the underdog.

His lifelong concerns, as a ward doctor, were the chronically ill poor - then as now a low priority in high prestige teaching hospitals.

Underdogs of the medical world.

As a medical scientist, his interest was in the underdogs of the underdog microbes - then universally seen as primitive, primeval, weak, simple, small --- the ultimate in the living fossils.

So why then were they still here ?

If evolutionary theory was correct, Dawson wondered, shouldn't the weak and the small have long ago been vanquished by the big and the brutal ?

The microbes were once again the underdogs, the Rodney Dangerfields, of the Living World.

As a medical scientist, Dawson was particularly concerned about the harmless - hence uninteresting to other medical scientists - avirulent commensal bacteria.

Avirulent versions of 'normally' pathogenic bacteria were considered to be defective versions (of a lifeform already -see above - considered to be a living fossil).

So why then ,asked Dawson, were they still here inside us, often inside us for perhaps our entire lives -- undestroyed ?

Here is the contemporary explanation that Dawson objected to - see if you too can see its flaws in basic logic :

(1) The pneumonia bacteria can only survive in or on us - we are its only home.

(2) The normal variant of the bacteria that causes lung pneumonia and blood poisoning is deadly virulent and lives alone, floating in the blood and human intercell liquids, usually killing us (and them) in a week or two.

(3) The disease of lung pneumonia is not really contagious -- we can't really catch it from the coughing of a dying man -and remember with his death, so to die the bacteria (see #1 above).

(4) The abnormal, defective, avirulent, version harmlessly exists in tight massive colonies on the inner surfaces of our nose and throat - sometimes for our whole lives, without ever making us sick.

(5) We all have these harmless pneumonia bugs in our noses some of the time -  some of us all our lives - and when we have them, we are known as 'carriers' of these harmless commensal pneumonia bacteria.

Dawson wondered how a short life of a week or two in the lungs or blood streams of just a few of us (for even before penicillin, pneumonia bugs only killed perhaps 8% of us) could qualify as the normal form of existence for this bug.

All this, when 100% of us had the abnormal quote unquote bug in our noses for periods ranging from months and months to decades and decades ?

Haven't the normal definitions of usual and unusual been deliberately up-ended to suit an universally accepted but ultimately bizarre medical theory ?

Dawson's alternative explanation was that whether floating about alone in liquid or clinging in masses to walls, these were just normal evolutionary responses to changed niches.

If bacteria do the shapeshifting so quickly, it is not really just that they are much more plastic in the forms that they can adopt than we are capable of - it is also the simple math that a new generation to them can mean 25 minutes later not 25 years later as with us.

As a result, evolutionary response to a new crisis can happen a million times faster with them than us.

If we are honest with ourselves, an evolutionary response time like that is a big advantage and a big reason why these living fossils are still around.

Dawson spent his life tracking down the variants of bacteria that he believed demonstrated why these supposed underdogs were really Life's evolutionary topdogs.

He was the first, or among the first, to look at things like DNA-HGT,quorum sensing, molecular mimicry, CWD bacteria, biofilms and persisters.

Three quarters of a century or more later, those are still cutting edge scientific topics.

In 1940, scientific opinion was again convinced the underdog fungal slimes were incapable of making penicillin as efficiently and as cheaply as the topdog chemists of advanced human civilizations could.

Dawson disagreed - pioneering the Antibiotics Age - when he injected their 'primitive' penicillin into Aaron Alston and Charles Aronson on October 16 1940.

He was right - the topdog chemists failed totally and the underdog slime still makes all the basis of our lifesaving beta-lactam antibiotics to this very day.

When the Allied medical-political elite agreed that wartime penicillin would only go to the topdog frontline troops, Dawson characteristically objected and said all of us, dying for lack of penicillin, should receive it, war or not.

Dawson was himself dying but he gave up his life to - once again - fight for the underdog.

A life full of variations but always with that same consistency of conduct ....

Where and when was first ever intradermal penicillin sensitivity test given ?

At NYC's Columbia-Presbyterian Hospital, on  October 16th 1940.

In fact it was the historical first ever antibiotic injection given to a patient (two patients actually) followed up a few hours later, after no reaction was observed, by a larger (and later still larger) doses given subcutaneously.

Amazingly, Dr Martin Henry Dawson's careful and cautious technique on that historical day are still followed to the letter by all well trained nurses and doctors....

October 16 1940 : ending the era of human-only progress and ushering in our era of bio-diverse cleverness

Purifying and then synthesizing such a comparatively small molecule like penicillin (produced after all by the primitive and simple basement slime) couldn't take very long, said an entire generation of chemists.

And then, and only then, with plenty of pure man-made penicillin at hand, would it finally be safe for clinicians to inject the blessed stuff into a dying patient's bloodstream.

But by mid October 1940, one clinician (Dr Martin Henry Dawson) had had more than enough of waiting for human chemists to put their synthetic money where their hubristic mouth was.

for even his highly talented co-worker, biochemist Dr Karl Meyer, had also failed to make much initial progress on determining the structure of the penicillin molecule.

And Meyer was miles and miles away from attempting to synthesize the stuff.

Dawson had two dying patients before him, for whom he sincerely believed penicillin was their only possible lifeline.

He knew they would need a great deal of clinical penicillin to be saved, but only a little penicillin was at hand.

But a little was better than nothing --- and even a token injection might raise their morale higher even if it did little to lower the microbe count inside their damaged heart valves.

The relatively small amounts of native penicillin that the tiny team at NYC's Columbia Presbyterian medical complex had grown so far had all been divided between Dawson's co-worker Gladys Hobby's microbiological tests and Meyer's (and his assistant Eleanor Chaffee's) chemical tests.

But in 1940, Henry Dawson had a much greater faith in the ability of (raw - impure - natural - native - crude) fungus-made penicillin to cure patients than any other doctor in the world.

Like many other infection experts around the world, he had read of Howard Florey's Oxford team's success with raw penicillin injections in safely curing many experimental infections in many different animals.

But all the other infection experts had read and remained unmoved .

Unmoved to to attempt injecting raw penicillin into humans, whether healthy volunteers or dying patients.

Not so Dawson - he had already had over a dozen years experience confirming that the supposedly simple and primitive microbes had at least as much native chemical ability under their tiny belts as had enormous conference halls filled with chemical PhDs.

His own colleagues had long grown weary of his endless informal lectures on the ability of tiny microbes to practise genetic/chemical engineering (bacterial transformation - HGT) at a skill level that the best human geneticists could only dream of.

The man was not just a bore, he was also 'letting down the side', at least as the Era of Human-Only Progress saw it.

For he had long claimed that the tiny, ancient and simple microbes were much, much cleverer than they were ever given credit for - cleverer than the most civilized of humanity, in many ways.

But he was harmless enough - for all this had only been talk so far.

But on this day - October 16th 1940 - Dawson decidedly 'went off the reservation' and crossed a deep cultural Rubicon.

For on this day, Dr Dawson finally gave his tiny chemists 'a fair go' when he injected SBE patients Aaron Alston and Charles Aronson with fungus-made penicillin.

Thus ending The Era of Human-Only Progress ---- and ushering in our present Era of Bio-Diverse Cleverness...

Age of Antibiotics' Patients Zero : Aaron Alston of St Nicholas Ave, Harlem and Charles Aronson of Vyse Ave, the Bronx

Thanks to the hard work of two relatives of these penicillin pioneers (Claude Jay for Aaron and Lisa Liel for Charles), these forgotten individuals can emerge from the shadows almost fully formed.

We don't know everything about them (we never do about anybody) but we sure know far more about them than we learned from the scanty evidence published up to now.

They were poor, came from unpopular minorities (one black, the other Jewish) and had a disease (SBE) then considered incurable and so they (and thousands like them) were written off by the Allied medical establishment as 'lives unworthy of wasting a lot of medical attention upon during a total war'.

A sentiment that was cheered upon by their counterparts in Germany, Russia and Japan during the same war - and for the same 'eugenic' reasons.

But one individual, Dr Martin Henry Dawson, gave up his own life to fight to keep them and people like them alive.

What good a military victory over Nazi medicine if the Nazi doctors won the moral war when the Allies agreed upon 'discarding the unfit in times of war and stress' ?

Aaron, the super athlete, might have been expected to do better fighting off his disease than the always sickly Charles but in fact he died in January 1941, just as Charles went home cured of his first bout of SBE ---thanks in part to his pioneering penicillin shots.

He had three more years of normal existence granted to him but got a second bout of SBE, which again he and penicillin beat.

But he also survived a severe stroke during the process which left him speechless and paralyzed .

Dawson's JAMA article of 1945 records "CA" as being transferred to an institution for chronic care on August 15 1944.

Since Dawson held a key post at Goldwater hospital, I had always guessed that is where Charles was sent.

Lisa send me Charles's 1951 death certificate which records that her relative went to Goldwater hospital on that exact same date and died there 7 years and a few months later.

Not the ending I - Charles - or anyone  - might have wished for ....

Of all the Charles Aronsons in America in 1940...

Regardless of their age or residence, the 1940 American national census only shows about 38 Charles Aronsons and a half dozen spelled with close variants ---- making the task of finding history's missing Patient Zero of the Age of Antibiotics much easier.


So if mystery patient "CA"*, aged 31 in April 1944 and around 27 in late 1940, was indeed Charles Aronson as Gladys Hobby and Louise Good affirmed in the 1980s, after re-examining contemporary hospital lab records, then he was born close upon either side of 1913.

And the evidence from the medical article mentioning his various experiences at that hospital, suggests he lived quite close to Manhattan's Columbia Presbyterian hospital between late 1940 and early 1946.

That suggests only one person - Charles Aronson of Vyse Avenue , a lifelong resident of New York, most all of it in the South Bronx area two miles from the hospital, born in mid June 1912.

True ,Charles N aronson was also born in the right time period, in March 1913, but in 1940 he was in the car centre of the world in Pontiac City Michigan.

Charles N Aronson's children told me he was healthy as a horse all his long life and that in late 1944 he was not in a home for chronic care with a paralyzing stroke as stated in the medical article on "CA" but rather was up and about busy inventing and patenting various bits of car parts.

A few other Charles Aronsons were born in years like 1906 or 1917 but were living in states hundreds of miles from NYC in 1940.

Hopefully in a few weeks or months, theNational Archives will be able to provide the draft registration card of CA - showing his ++++BRONX++++ home address......



* First that is together with Aaron Leroy Alston - both injected with penicillin, one right after the other on October 16th 1940 by Dr Martin Henry Dawson

Bickel penicillin book vivid -- at cost in accuracy

Lennard Bickel's 1972 book, "Rise Up To Life", was the first book that covered the wartime saga of penicillin as it occurred around the entire world.

But it was also one of the first written by someone who was not an eyewitness to the actual events.

But Bickel, an Englishman who emigrated to Australia in mid life, was a very good journalist and interviewed all and everyone he could find from the wartime era and got lively quotes from all.

Unfortunately, as a journalist rather than a historian, he sometimes chose to sacrifice all the facts in order to keep things lively and vivid.

I believe that as a result, he chose to detail almost no pioneering penicillin patient -- unless they could be fully named in his account --- regardless how important they actually were in historical terms.

But even back in the more innocent era of the 1940s, peer reviewed medical articles tended to simply describe but not name patients -- or just given them unique numbers or initials.

Revealing full names was simply no indication of relative historic or scientific importance.

How this historical travesty all began :

Bickel, probably in 1971, interviewed American Gladys Hobby, who as a PhD in microbiology had personally witnessed many pioneering wartime penicillin events from late 1940 through to late 1945.

But she recalled them mostly from memory and a few personal papers.

In the early 1970s, she surely knew the birthdate, medical history and the initials (CA) for one patient from wartime's pioneering Patients Zero.

Because she had surely read - many times -  the medical article her friend and co-worker, the late Dr Martin Henry Dawson, had written in late 1944.

The Patients Zero were the first people ever in history to get injections of life saving antibiotics - doing so on October 16th 1940 from Doctor Dawson at New York's famous Columbia Presbyterian hospital.

But she had forgotten what name lay behind those initials CA.

Fatal SBE was their fate

For the first half of the 20th century, Rheumatic Fever was the leading killer of young people.

Most actually died a few years later, when their heart valves earlier damaged due to Rheumatic Fever, failed because of an attack by common and usually harmless mouth bacteria.

The dreaded SBE - then an invariably fatal form of endocarditis - was what was due to shortly kill this historic duo of patients.

Hobby remembered the other Patient Zero well enough.

Aaron Alston, a young black man from Harlem, had received quite extensive penicillin treatment from Hobby's teammates while Hobby was employed at the hospital but had still died in late January 1941, despite all her's and their best personal efforts.

Louise Good to the rescue

It wasn't till the 1980s, while writing her own book on wartime penicillin, that Hobby contacted a Columbia Presbyterian Hospital employee named Louise Good, who did have access to more detailed contemporary records.

Good revealed that CA was Charles Aronson and confirmed that Hobby was correct in believing that the other was Aaron Alston.

Charles Aronson was actually treated far more extensively with penicillin than Alston - but treated in 1944, when Hobby was then employed elsewhere.

Employed at Pfizer, which had earlier worked very closely with her and Dawson.

Still, she stayed in very close touch with Dawson's team and had certainly read the medical article describing CA's extensive second penicillin treatment.

But that wasn't the same as actually being there at his bedside, daily for months, to burn his real name permanently into her memory.

Bickel lays his thumb on the history balance

This was unfortunate, because Bickel - for reasons perhaps not altogether honourable - chose to focus only on Hobby's fully named patient, the one who died.

By not also including the patient with only initials, the one who survived his invariably fatal disease twice thanks to Dawson's penicillin, he tilted his account of Dawson's work to the side of failure.

Failure, rather than the actual facts - which was that five years of life-costing hard work by Dawson - and Dawson alone - had made an once common and then invariably fatal heart disease the most curable heart condition known.

Bickel's brief account of Alston's early death - followed by Dawson's 'early' death, became the gospel on the whole fascinating penicillin story at Columbia-Presbyterian and Pfizer to generations of writers.

I will satisfy the natural curiosity

I fully and truly understand the curiosity that drives people to inquire as to who is the real person behind mysterious initials .

That is why I have worked so hard to recover the lost story of CA - and of Alston and the handful of other patients of Dawson who were given full names names in Hobby's 1985 book, "Penicillin : Meeting the Challenge" ...

Antibiotics' Patients Zero, part 2

In the end, finding out about the Patient Zero I knew the least about, Aaron Alston, turned out to be by far the easiest.

But first I had to make all sorts of naive mistakes.

I knew that if an acute case of Rheumatic Fever attacks a young child's heart, they can quickly die, without prompt and appropriate medical intervention.

But if they don't die, most of the attacked heart tissue will more or less heal - unless the area attacked is the very delicate and extremely vital heart valves.

You can literally hear damaged heart valves.

Many people have harmless heart murmurs but these particular stethoscope sounds tell a doctor that the valves are damaged and the entire heart is straining in overtime, to pump blood through these only partially closed/open doors.

So doctors will then strongly advise the parents to not tax this particular child's heart.

So no strenuous sports - later on, no vigorous dancing, no passionate sex acts, pregnancies are very dangerous, chasing after toddlers is too stressful, etc.

While my brother Bruce had childhood Rheumatic Fever and was left with a heart murmur and damaged valves, ironically enough he was the only athletic member of our extended family !

Though small, he was eager to try out for high school football and was a city level long distance running champion.

So you'd think I would have known better about Rheumatic Heart Disease (RHD) and young athletes.

In my defence, I had just assumed that the heart valves of Rheumatic Fever patients who go on to develop life-ending subacute bacterial endocarditis (SBE) were far more damaged than most RHD patients - so obviously far less capable of championship level athletics.

But this simply isn't so - SBE, like cancer, has a pronounced stochastic (for PhDs) or random (for ordinary folk) nature to it : sheer bad luck as well as bad valves plays a part.

Dawson treated patients who got SBE fifty or more years after their childhood heart valves were first damaged and some who got SBE only a year or two after first getting Rheumatic Fever.

But most patients get SBE ten or twenty years after their valves are first attacked.

Still, when I did find an Aaron Alston finishing in the top level in NYC wide races in 1930, ten years before my Aaron Alston first got SBE, I dismissed that it might be him.

I also got search results for A. Alston too : an A. Leroy Alston also winning athletic events.

I just felt I had got nowhere with Alston - the lack of his birthdate was so crippling.

As I described in an earlier blog, knowing first and last name, residence in greater NYC area in 1940, and birthdate, usually means that 140 million possible American patients is reduced down to one or two.

Without a birthdate, it goes up to at least a hundred possible names.

But in 2014, I suddenly realized I probably did have a death date on him as well.

For his brief medical history made it clear he was going to get all the penicillin Dr Dawson's team had (they were making themselves) but suddenly all the penicillin was switched to another patient.

Alston had obviously died, died in mid January 1941, and almost certainly while undergoing treatment in Dawson's hospital, ie in the borough of Manhattan.

Now a search for an index of NYC death certificates seemed easier.

Well, thanks to many tireless volunteers, it certainly was.

I din't really need a specific borough or specific day or month - a volunteer-run online death index for NYC in the first half of the twentith century, didn't show tons of deceased Aaron Alstons in all of 1941 in all boroughs - just him !

With his death certificate number in hand and because he had died before 1948, I a white stranger from Canada could order up the death certificate of someone who was probably a black man from Harlem.

When the certificate copy arrived, it wasn't as detailed as many death certificates I had seen - but his mother's maiden last name Glaze was one I had never seen - rare maybe enough to find her on on Google Search ?

I kept typing in Louise Glaze Harlem or variations thereof and presto one evening, a website came up of her nephew talking about her - i had found one of Aaron's living cousins !

I phoned him (Claude Jay of Harlem My Love) and first I astounded him and then he astounded me --- because he knew of Aaron as Leroy - or more formally as A. Leroy Alston.

He said he was a big athlete.

A person who used his middle name and not his first name - well who would have thought ?!

Well, my wife's huge family has many who do just that - and Dr Martin Henry Dawson was alway Henry - from birth.

Armed with this unexpected information, I soon found tons of material on Aaron Leroy Alston - some in his own voice.

And Claude made it clear Aaron had hundreds of living relatives all over the US.

I astounded Claude again - discovering Aaron Leroy wasn't widowed as his mom said on the death certificate - Claude thought he was always single.

Instead Leroy and Charlotte Lee had been married in the good times of 1930 but the couple were living back with their separate mothers in 1940 when Leroy was too sick to provide an income.

(Both families, once doing okay, were unbelievably poor in 1940 thanks to the Great Depression, racism and early deaths/severe illness of breadwinners.)

I gave all my information to Claude and tried not to research too much further.

I don't feel, as a white Canadian, that I should tell the story of a black man from Harlem - Claude is a relative, journalist, activist and author - he'll tell the full story well I am sure.

Now I turned my hand to another named SBE patient of Dawson - known only as Mr Conant.

(I came to assume that the highly unusual use of that word Mr meant he probably wasn't a young black or Jewish charity case but that he was a private patient, middle class,middle aged and white, from outside NYC)and treated in January 1941.

I searched for a middle aged dead Mr Conant, Manhattan, early 1941, in the NYC death index and up came George M Conant.

Google gave me him in spades - his small town daily describing his SBE illness and his treatment at Columbia Presbyterian at the right dates.

I found Dawson's death certificate and that of little Patty Malone as well - but no Charles Aronson.

That was because he had survived into 1949 at least and NYC death certificates after that date were hard to locate and even harder to gain a legal right to access...

Now read Antibiotics' Patients zero, part 3

Antibiotics' Patients Zero , part 1

When I began the search for Antibiotics' Patients Zero ten years ago, I very naively thought like a historian, not a genealogist, and as a result, I got precisely nowhere for ten wasted years.

Professional historians are taught to distrust family oral histories and to put all their faith in official paper documents.

Professional genealogists tell their clients to do exactly the opposite: don't quickly dismiss old family tales as myths and legends and never simply take the evidence of official documents at face value.

I also made a fundamental error in math which I suspect you and 99% of the world would do at first try.

If about all you knew about a missing antibiotics' patient zero was that they were 31 in 1944, quickly, what year do you think they were born ?

1913, of course.

And if they were born on January 1st 1913, that fact is always true, no matter when in 1944 the question is raised.

But what if, like my sister Margo, they were born on December 27th ?

Strictly speaking, wouldn't she also be 31 for 99% of 1944, though born in 1912 ?

I had also assumed wrongly, for ten years, that the doctor (Martin Henry Dawson) making this statement about his patient's age was calculating it from late 1944, as he was finalizing the submission of an very important scientific article on this man and others.

But doctors are very busy people and the only time they tend to ask you your age is on admission.

This man (Charles Aronson) was admitted in April 1944 but his birthday was in June 1912, as it turns out.

Further mistake : I took on faith the claim made by many (without any backing evidence - whatsoever) that this patient's doctor long had an overwhelming interest in curing patients with invariably fatal SBE (a form of endocarditis brought about by Rheumatic Fever.)

The strongest claim about this was made by his closest colleague, a colleague for almost all of his scientific career : so a claim hard to dismiss.

But as Google Search got better and as I gathered up all of this doctor's public utterances in articles, at conferences, in textbooks etc, in 2014 I was suddenly struck by the fact that he never once talked about endocarditis -- despite having considerable freedom to do so.

I also now knew that his first antibiotics efforts with patients came just after he had finally moved up from assistant attending physician at a huge research and teaching hospital (aka dogsbody) to associate attending physician, in charge (more or less) of one public charity ward.

Admitting patients to world class teaching hospitals is never easy for 99.9% of doctors - patients themselves are never the priority, to put it bluntly but truthfully.

In a 24 hours a day, seven days a week teaching hospital, most patients are considered for admission when any particular doctor is at home or busy working in another part of the hospital.

The priority for the admitting doctor - a medical student of a sort themselves - is always, 'do my teachers need a patient with this condition - right now - to fit in with the teaching schedule for us medical students' ?

Followed by, 'or would this sort of patient and illness fit in with the research work of the more senior and powerful teacher-researchers here', people who can make or break my future career?

The known wishes of the thus usually absent Dr Dawson, being in charge of a world class outpatient clinic for people with arthritis - would have had considerable sway in the admission process of (private or charity) patients with rare forms of arthritis but that is all.

The only SBE cases he would have any say over occurred whereever seriously ill people simply arrive at the hospital doorstep and basically had to be admitted right away,regardless, for humanitarian reasons.

If they arrived at the one charity ward Dawson was mostly in command of, he not their lowly GP, would have the most say of their medical care.

After all, the patient and their GP were not paying the medical piper.

And I now knew that Depression Era patients seeking admission to Manhattan hospital charity wards almost always came from just a few convenient miles away by bus, subway or even foot - their families were too poor to own a car and worked at tiring physical jobs.

Their frequent, easy, presence at the hospital was a key emotional asset in the patients' speedy recovery --- or in their last days on earth.

Only when a poor person, with an unique set of medical conditions, in a distant community came to the attention of a powerful doctor with good personal and professional connections with the top doctors at a big teaching hospital in Manhattan, could they secure admission on that hospital's charity ward, regardless of the opinion of the ward's attending physician in charge.

And then, be assured, that attending physician would have little say in their treatment : the various Drs Big from outside and inside the hospital would take over !

I now sensed that unless the available evidence suggested otherwise , as it did with history's third antibiotics' patient, the first two patients zero probably came from about a three mile radius around Dawson's hospital (the world famous Columbia Presbyterian Medical Centre in upper Manhattan.)

His hospital had no shortage of very poor people near by in 1940 - blacks in Harlem and Jews in South Bronx.

Research and teaching hospitals can really only thrive if large supplies of poor patients are near by.

These poor, in return for advanced medical care for free, agree to be constantly examined and probed by huge numbers of strangers and agree to submit to new, scary and painful treatments.

Almost all I knew about Dawson's Patient Zeros was their names : Aaron Alston and Charles Aronson.

Alston was/is a common black name in Harlem New York, ditto Aronson was then a common Jewish name in South Bronx --- both places just two or three miles from Dawson's hospital.

But Google provided too many Aaron Alstons (I had no birthdate on him) to narrow my search easily and only one Charles Aronson born in 1913 in the whole USA.

Dawson's Aronson had spent so much of his young life in hospitals fighting off death so many times that I doubted he could have lived too many years past 1945.

(In his last known illness known to me, he had such a severe stroke that he was left paralyzed on one side and speechless as well.)

But when I tracked down the sons of one American Charles Aronson born in 1913 and they said he had been healthy as a horse, all his very long life, and was not in a hospital in NYC in 1940 or 1944.

By this time, some American census results came up in Google search : a Charles Aronson in the Bronx in 1940, but with a birthdate of 1915 not 1913.

But it was close enough for me - because it soon became clear that in all of 1940 USA and searching very generously for birthdates between 1908 and 1918 ,there was only three Charles Aronsons, period - two far from NYC and one in the Bronx.

But the historian in me soon drew a blank .....

See part two

October 16th 2015 'Red Letter Day' for Selective Service System AND Medicine !

Two extraordinary anniversaries -----connected by two extraordinary individuals

On October 16th 1940, 75 years ago this year, America's system of registering for selective service began - a process that continues to this very day.

On that very same day, 75 years ago, the Age of Antibiotics began.

Unlikely as it may seem, both events are intimately united in the persons of patients Aaron Alston and Charles Aronson.

For these two received history's first ever injections of penicillin at Columbia Presbyterian Hospital in New York on October 16 1940 ---- and then were immediately registered for selective service by a special team of hospital visiting registrars on that same day.

Both young men were suffering from subacute bacterial endocarditis.

The much dreaded "SBE" was then regarded as invariably fatal  --- the terminal disease that made Rheumatic Fever - not Polio - the leading killer of school age children throughout the western world.

Regardless of their likely fate in a few weeks or months, the selective service law was firm : both men must be registered ---- and so they were.

Born in 1910, Alston had been an almost Olympics class boxer and a winning track coach - he would have made an excellent leader of soldiers.

But neither he or the penicillin could fight off these strep bacteria and so he died in January 1941.

In his own quiet way, Aronson was also quite a fighter.

Born in 1912, he had already survived three frequently fatal childhood illnesses. He grew up to join the National Guard and hold down a full time job as a teletype operator at a newspaper.

And with the help of penicillin, he went on to survive not just one, but two bouts, of SBE. He then suffered a severe stroke that left him paralyzed and unable to speak.

But he bravely battled on for seven more years and then died in October 1951.

No important anniversaries should go un-noted, as these two anniversaries appear about to be, least of all when both anniversaries are united in the most extraordinary and unlikely of circumstances....

October 15 1940 : a Fighting 69er fights SBE instead ?

Almost everyone dimly recalls hearing about New York's famous "Fighting 69ers" / "the Fighting Irish" - an infantry regiment more formally known as the 165th (infantry) Regiment, New York State National Guard,--- part of New York State's 27th Division.

Though a state regiment, it in fact recruited exclusively from NY City.

On October 15th 1940, the day before America's first ever peacetime draft registration, the day before History's first ever antibiotic shots, it was 'federalized' and began moving to the US Army's Fort McClellan in Alabama.

And there by hangs yet another intriguing tale in the wartime penicillin saga.

For at the very beginning of 1932 (January 4th), an eighteen year New Yorker old named Charles Aronson joined its Company K - which recruited from the eastern part of the city.

The extreme earliness of this date in the year means statistically he was almost certain to be born in 1913.

That recruitment area and the age of this recruit makes him very likely to be my "dying of heart disease" Charles Aronson.

My Charles Aronson was a young man who had just survived a series of life threatening diseases that left him with a permanently weakened heart but not too weak to work - first as a office boy and then as a teletype operator in a newspaper office.

I no longer doubt - just because of his past illnesses - that he couldn't possibly join an infantry unit.

Not after my refusing for years to believe that a top champion athlete named Aaron Alston could possibly be my "dying of heart disease" Aaron Alston - except that he was.

So - possibly - Charles Aronson had to hear on the radio of his old unit leaving to possible fight for America, just as he was fighting for his own life and about to enter history as one of the two people who were the first ever to receive an antibiotic (penicillin).

So on October 16th 1940, the very next day, as he was supposedly just about to die and receiving an historic - and desperate -  first ever shot of penicillin, the draft registration team visiting his ward probably mentally marked him down as 4F, in fact a 4F of the 4Fs.

But for the grace of an accidental and recent infusion of tooth bacteria into his bloodstream however, tooth bacteria perhaps received from brushing his teeth too vigorously, he would never been fighting this fatal disease in October 1940.

Instead he would have been regarded as a 1A member of the federalized National Guard ---- bad heart and all.

Life is funny isn't it?

Because later in the war, the united Allied scientific and medical elite, taking a leaf out of the Nazi playbook, decided that young people like Charles and Aaron were useless because they couldn't possible fight.

They then ruled them as 'lives unworthy of lifesaving penicillin' and so sentenced them to a death as certain as any trip to Auschwitz.

It didn't really matter to their doctor, Dr Martin Henry Dawson, whether or not they had been infantry soldiers, champion athletes or lifelong invalids - to Dawson all people was worthy of lifesaving penicillin.

Charlie beat this first bout of invariably fatal SBE endocarditis and did so again in 1944, with Dawson's penicillin, He survived the war too - living at least into the 1950s.

Meanwhile Dawson gave up his own life in his belief in the worthiness of all human life ---and finally won his point, just before his own premature death in April 1945 ....

Genealogy, like melodies, is all about those 'permutations and combinations' we learned in school

Every wonder how a composer get a endless stream of unique melodies from 'just seven notes' ?

 Ever wonder how researchers find people lost to history, with only a tiny handful of facts to guide them ?

Math popularizers explain all those wonderfully different melodies and all those wonderful genealogical successes by the simple arithmetic of combinations and permutations.

Why all melodies are so unique

First, remember that most successful melodies don't actually stay in just one key and one octave, which is where all this hot-aired talk about 'only seven (diatonic) notes' comes from.

They always have a few accidentals (chromatic notes) added and usually extend the melody range up to one octave and a fifth --- giving us about 20 notes to work with on each step of the melody.

In reality, to be successful, each new note in a melody is best restricted to a handful of choices most of time (the interval between two successive notes is more likely to be some kind of a third or a second than a flat seventh for example).

But good melodies are good mostly because they do throw in unexpected surprises, in the interval department among others.

So for any average note, the next note can truly be any of ten notes higher or lower in pitch.

(It can also remain at the same pitch or even remain silent.)

In an average dozen note long 'tune', that is already billions of choices (basically 20 x 20 x 20 x 20 x 20 x 20 x 20 x 20 x 20 x 20 etc) - and we haven't even considered the fact that each note can be one of about a dozen common durations.

(Half notes, 16th notes, tied notes, triplets,swing 8ths, etc - on and on.)

Now we're up to trillions of choices.

Thrown in the fact that every successful tune has a meter and musical style indicated at the top of the score sheet that imply* a built in set of expectations of varying accents (loudness,brightness,forcefulness) on each note.

Accents that we are also free to ignore, momentarily, to provide some more of those wonderful musical surprises.

Now we're climbing into the cosmos of infinite choices.

While melody building adds choice , genealogical research reduces choice

Genealogy also starts with just a few notes, err, facts.

Say just a person's first name, last name, year of birth and the area where they lived.

So Columbia Presbyterian hospital SBE patient Charles Aronson, born 1913 and living in the New York City area in October 1940 and again in April 1944.

But a melody is truly unique only over the run of its dozen or so notes - it builds up it uniqueness.

By contrast, finding a lost historical figure requires , in a real sense, that each note in a tune be totally unique in its pitch x duration x accent - it seeks to cut down a long long humdrum melody to a single unique note.

Genealogy is helped by the fact that the choices for each of its equivalents to pitch, duration and accent are much, much larger than that of music.

For at any moment in time there are only about 100 possible birth years involving living people.

But with the sort of dead people that we can hope to find more about (say the fairly recent past of the last 200 years), we now get a choice of several hundred birth years.

Even when shared amongst ten billion people (counting everyone who ever lived in the past 200 years), we still find that , on average, only about 50 million people shared each birth year.

But that reflects today's huge populations and drop in childhood deaths --- probably only a million people worldwide survived childhood to share the birth year of 1913 by the year 1940.

We also have a first name.

Now Charles is a very common name in western culture - but there are literally hundreds of names as common as Charles in our culture and in total tens and tens of thousands of possible first names worldwide.

Let us guess wildly and say  100,000 people in 1940  had the name Charles.

Aronson is a relatively uncommon last name in a world of tens and tens of thousands of last names.

Uncommon except among Eastern European Jews immigrants - two million who lived in NYC area between 1913 and 1940.

Maybe 100,000 people were named Aronson worldwide in 1940.

So say 5000 people named Aronson lived in NYC area in those years and 20,000 in total in the two Americas.

(In wartime, I don't feel anyone but from the two Americas would have/could have travelled to New York to treat an illness --- particularly a disease mostly found among the poor.)

How many were both Charles and Aronson in all of the two Americas ?

At best, I feel maybe 400.

How many are Charles Aronsons in the Americas  born in 1913 ?

Two.

At least as far as I have found by searching the half dozen national and local census produced between 1915 and 1940 in the US and Canada.

One born and raised in the NYC area and living on Vyse Avenue in the Bronx in 1940 , the other born in the Mid-West who wandered widely over his life - living in the metropolitan Detroit area in 1940.

Now it is still a very, very remotely possible the Detroit Charles Aronson might have travelled specially a thousand miles, only to end up to a public (charity) ward in a 1940 NYC hospital.

There to be treated as extensively as all public charity cases are always treated (joke !).

And to treated for a rapidly invariably fatal disease by a doctor who had never been known for treating this disease, until now.

But it doesn't seem likely, now does it - if one is going to die at the hands of a relative amateur - why not do so more cheaply and comfortably at home ?

And remember the known medical history of our Charles Aronson is relatively extensive and seems to indicate he remained in close contact with the doctors at Columbia Presbyterian in 1940-1941 and 1944-1945 - again suggesting he was from the NY area.

(For wartime travel was almost as difficult within America as it was travelling to America in the war years.)

So of the literally thousands of metropolitan areas in the two Americas, I have further restricted my choice down to just one - albeit by far the biggest one, if looking for Aronson names !

These are the cumulative reasons  why I have focussed all my efforts in finding the Charles Aronson who was the first patient in history to receive an antibiotic, upon this Bronx Charles Aronson.....

* My good friend, Queens Professor Margaret Little , had a good classical education on piano but had never heard any Rolling Stones songs and tried, one day in 1980, to play some of their songs from a conventional piano score.

She accurately followed the score, including the meter, but did not understand the implied musical conventions. The results were - my other good friend Paul Withers would agree - interesting !

They sounds totally not at all like the actual tune.

The Double V victory : the Last shall be First

On October 16th 1940, it is said, Dr Martin Henry Dawson gave history's first ever antibiotic injections to a black man, Aaron Leroy Alston and to a Jew, Charles Aronson.

"And" : not "and then to".

But how ? How on earth do you give two injections at the same time ?

I struggled recently with the actual mechanics while thinking how to present this event as a single painted image.

Eventually I realized that a painting of this athletically double-jointed historic event might also symbolize the ambiguous "Double V victory" of Manhattan's two biggest war projects : the autarkical A-Bomb and Dawson's openly commensal natural penicillin.

My proposed image for the first volume of my book Janus Manhattan's Children ?

It shows the soon-to-be-injected arm of Alston (to the left) and Aronson (to the right) joined at their hands, making one natural "V".

Above them, the limitations of human anatomy ensures that the arms of Dr Dawson (preparing to inject the penicillin into each patient's arm at the same time) would also form another natural "V" above and inside the patients' "V".

As anyone struggling to emulate Dawson's twin effort soon realizes, it is probably easiest and most natural to let their left hand inject rightward and their right hand inject leftward --- the twin hypo needles crisscrossing at the hands.

The criss crossing also helps emphasize Dawson secondary goal.

On that October 16th, he particularly wanted to exalt the 4Fs of the 4Fs, the smallest, sickest and weakest ("The Last") among 1940 America's minorities.

Because on this day, set aside in law for the first ever peacetime draft registration, the rest of America was otherwise exalting the biggest and the strongest (the 1As) among its population.

True, the 1As might do all the actual military fighting overseas to end Nazi mistreatment of minorities.

But Dawson and others realized that all the 1As' deaths and the eventual victory would be useless, if at home the values of the Nazis continued in America's treatment of its own minorities.

To really put paid to Hitler, we needed to defeat his thinking, abroad and at home.

But instead, American medical conservatives
were moving to emulate Hitler even more !

They had long been hostile to 1930s liberals and their efforts to try and save all of the dying even if they couldn't pay for their treatment (Social Medicine).

Hitler's Aktion T4 program had begun in September 1939, deliberately using the cover of war efforts to begin the killing off all of Germany's handicapped.

So too, these American conservatives were actually using the medical preparations for a possible war with Hitler (War Medicine) as an excuse to cut off medical efforts towards the poorest minorities !

So with 'enemies' like the AMA's Morris Fishbein leading the charge, Hitler hardly needed friends.

Instead, on this day, he got a moral enemy in Dr Dawson ...

Three of four pioneering SBE patients (first patients ever to be treated with penicillin injections) still alive at first published report

I know two* and believe possibly three of Martin Henry Dawson's first four SBE patients treated with the first ever injections of penicillin were still alive at the time of his May 5th 1941  paper on this project.
But none had shown a lasting benefit from receiving this new treatment for SBE (subacute bacterial endocarditis - the then invariably fatal disease that made Rheumatic Fever a feared word for all parents).

That they received an indirect benefit is always possible and even likely - because we well know that a freshly uplifted mind assists the body to better fight off illnesses.

So Dawson was rightly low key in his public presentation, in regards to these four patients.

He only emphasized that repeated and varied penicillin injections did not harm them in any way.

This was a clear rebuke to the world's doctors for the 12 years of their collective neglecting to use penicillin injections to save countless millions of lives.

I see nothing in his published statement to indicate that all four patients had died at the time of his report - those historians who state that are simply wrong.

* Charles Aronson and George M Conant were certainly alive on May 5th. Aaron Leroy Alston had died January 25th 1941.

Amazingly, even the various doctors and nurses (cum eye witnesses) on the team could not recall anything of the fourth (almost certainly also male) patient, even a few short years later !

75 years ago, on a day supposedly devoted to 1As, two New York City 4Fs made medical history instead

It is an irony beyond all measure that on America's first ever peacetime Draft Registration Day, October 16th 1940, a day designed to separate the 1A sheep from the 4F goats, two 4Fs (a black man from Harlem and a Jew from the Bronx) instead made medical history by ushering in our current Age of Antibiotics !

And they made history not by accident of sheer coincidence either.

For their doctor, Martin Henry Dawson of Columbia University's Presbyterian medical campus,was incensed that his colleagues were using the move to a War Medicine footing (of which the separating of valued 1As from unvalued 4Fs was but one part) as an excuse to drop Social Medicine - the extending of life-saving medical care to those in need, regardless of their income, color or origins.

Dawson felt that a Double V Victory was needed to defeat the hold that Fascist values held among much of the world's Neutral nations - both a military defeat and a moral defeat.

Abandoning America's weakest and the smallest to medical benign neglect, just as the Nazis were currently doing with their own weak and small, was no way to win the 'hearts and minds' of the neutral nations.

These two young New York City boys, famed athlete Aaron Leroy Alston of St Nicholas Avenue and teletype operator Charles Aronson of Vyse Avenue, were dying of then invariably fatal subacute bacterial endocarditis, known to all as SBE, the disease that made Rheumatic Fever the most feared and fatal of all school age children's diseases.

It was also known as "The Polio of the Poor", which gives an indication that minorities , immigrants and the poor were the hardest hit by it.

For these two reasons, people with it were judged, by a medical establishment echoing the Manhattan of Gordon Gekko, to be of no value to the military or to hard-slog war-factory work ---- and so best left to die.

But Dawson, perhaps channelling the spirit of Manhattan's equally famous Emma Lazarus, saw the pair as worth saving and their disease as curable if only.

If only, twelve long years after penicillin's non toxic and bacteria killing nature were first discovered, some doctor plucked up enough courage to test its toxicity in the human blood stream.

Dawson did that crucial test - injecting it in himself.

Convinced it was safe, he then injected his team's home made penicillin into the pair and quietly, off stage in all that day's media splash, made history.

For journalistic hindsight is always 20/20, but back then it seemed clear that reporting upon possible student resistance (on the same Columbia campus) to the draft registration process was a far,far bigger story.

Hopefully, this time around, on the October 16th 2015 seventy fifth anniversary of those historic pair of antibiotic injections,  the NYC area media will run with the ball ...

First injection of penicillin into patients : October 16th 1940 New York

The first penicillin needle into a patient, ushering in our present Era of Antibiotics, was one of the most signal events in all medical history and it happened exactly 75 years ago this Fall.

Yet, until this present article, even the barest of its bare facts have never been publicly reported accurately - not even by the three key team leaders that first performed them !

Here is how it went, based on cross-checking the various published report by the three team leaders against public records and newspaper accounts:

On October 15th 1940, after a hectic six weeks learning from scratch just where to find the right strain of penicillium and then how to coax the temperamental  fungus to produce raw penicillin juice, the three key members of the tiny team at New York's Columbia Presbyterian Medical Centre were finally ready.

The team leader (Nova Scotia born and raised Dr Martin Henry Dawson) would inject the penicillin into himself, a healthy volunteer, to test whether the never-before injected drug was dangerous to human life once in the bloodstream.

If he survived unharmed, the team planned to use the free time provided the next day by the university's registration of students and young staff in America's very first peacetime Draft to inject some penicillin into two young male patients dying of then invariably fatal SBE.

More formally known as subacute bacterial endocarditis, SBE was the then common disease that made Rheumatic Fever the leading killer of the young.

So only October 16th (in between the two dying boys being registered for the Draft) and once again on October 17th 1940, Dr Dawson injected some of the team's hospital brewed penicillin into the two young men.

One was a young black star athlete , Aaron Leroy Alston born 1910 and residing on St Nicholas Avenue in Harlem and the other was a deathly-sick-all-his-life young Jewish man, Charles Aronson, born 1913 and residing on Vyse Avenue in the Bronx.

Next, the two young men got a much longer and and a much larger regime of oral Sulfa drugs.

Unexpectedly, the Sulfa worked on the sickly Aronson and he went home apparently cured, on a maintenance dose of Sulfa, in late December.

His cure held and he survived alright for three and a half years until another bout of SBE brought him back to Dawson.

This time Dawson had plenty of penicillin to cure SBE reliably and he did so again with Aronson.

Unfortunately, star athlete Alston did not respond to Sulfa drugs (more accurately his particular strain of SBE-causing Viridans Strep didn't respond) and Dawson started him again on a larger and longer regime of stronger injected penicillin on December 31st 1940.

He died mid-treatment in mid January 1941 and his tragically short sports career was celebrated and mourned by many sports fans across the city.

The penicillin brewed for him but not used was given to a third patient, a young middle class salesman in his thirties from upstate New York - Middletown to be precise ; his name George Milton Conant.

He got at least one course of Dawson's penicillin in late January.

He died on May 31st 1941 -nearly a month after Dawson gave a cautious report May 5th on his treatment of four SBE patients with penicillin , delivered before a huge convention of medical researchers at Atlantic City and given extraordinary wide coverage in the news media.

I (and even the team itself) know nothing of the fourth patient - but Dawson's May 5th report specifically says four were treated ( thus treated between between October 16th 1940 and late April 1941).

(It is is worth remarking, given the canonical status and wide circulation of this newspaper, that The New York Times' science correspondent William L Laurence (who wrote the famous eye-witness account of the first atomic explosion ,"Dawn Over Zero") reported the next day that he had heard  Dawson saying that he had treated 4 patients suffering from SBE with his penicillin.)

As of the May 5th date, we know for sure that only one patient had definitely died but Dawson refused to crow about his small successes ---- or give specifics of just when the first injections were given and to how many patients.

Dawson later referred , in his 1944 JAMA article, to treating five SBE patients with early hospital brewed penicillin, of a potency not stated.

This allows us to assume that the fifth patient was probably treated very early in the Fall of 1941.

Because that was before Dawson had been introduced, after a visit from Norman Heatley, to the idea of calibrating the biological activity of penicillin by using Oxford units - as we still do to this day.

(The team seems to have stopped making penicillin during the high summer months because the temperature in the hospital, anywhere than in a bottom basement room, was far too high to successfully grow penicillium that would give off penicillin juice.)

Later he and his fellow team mates bacteriologist Dr Gladys Hobby and chemist Dr Karl Meyer would all give partially accurate and incomplete public accounts of those early (clearly non-dramatic) days - so who could blame the lay press or science historians for repeating their errors and adding some of their own ?

First antibiotic penicillin patient : when did we learn his name?

How do we know what we know ?

I am very confident that the very first patient of the Antibiotic Era was a young black man named Aaron (Leroy) Alston and that he lived on St Nicholas Avenue in Harlem, New York City.

But when I was asked recently by one of Aaron's relatives (journalist Claude Jay) to demonstrate my proof, I was momentarily nonplussed.

That was when because I initially came across the statement that Aaron was the first systemic penicillin (penicillin-the-antibiotic) patient in history in early 2005, it was in about a dozen different books, all read at the exactly the same time.

(People who know what a bookworm I am, will not find that last statement at all incredible !)

I gradually assembled more information about that historic event and on Aaron himself , from scattered bits of evidence here and there - material I realized had never been assembled into a coherent and self-confirming whole.

My biggest breakthrough - discovering Aaron's death certificate - was quickly followed by my second biggest breakthrough , discovering Claude Jay himself.

That is because, outside of his medical records, Aaron was generally known to the world as Leroy, or more formally, as A. Leroy Alston.

Aaron Leroy Alston was a superb athlete  -- not just someone who died to furnish a footnote to someone else's story

I had held a strong clue that could have led me/ should have led me to Leroy years earlier.

But I discounted the evidence : that an A. Alston had won some very big amateur races in the NYC area.

I mistakingly assumed that anyone who had had acute rheumatic fever leading to severe heart valve damage, as Leroy/Aaron had to have had, couldn't possibly go on to be a top runner.

Now that I knew Aaron was also a Leroy Alston or an A. Leroy Alston and a great athlete to boot, I quickly found a good deal more about Leroy from newspapers of the day.

So I spent last week trolling through my files and the books on penicillin and rheumatic heart disease at Dalhousie University's medical library, trying to establish a timeline as to when the world first knew that Aaron was Patient One of the penicillin-the-antibiotic era.

I found nothing that named Aaron in the books and medical reports and newspapers of the war years.

NY World-Telegram first to get it (partially) right

But on the premature death of Aaron's penicillin doctor Martin Henry Dawson in April 1945, one New York newspaper, the World-Telegram, did correctly mention that his first penicillin patient was a Negro, as well as claiming that Dawson was the first to treat a patient with penicillin in the USA.

But the story not only does not name that patient, it confuses his story with that of the other first penicillin patient of Dawson's, Charles Aronson !

(Yes, Aaron was the first patient selected to receive systemic penicillin, but as the fates would have it, on the day he first received it, a new fellow sufferer (Charles) also got it at the very same time.)

The story describes Aaron as being 27 and being cured - that age and fate correctly belongs to Charles because sadly Aaron died despite the penicillin.

Now Dawson and his closest fellow worker, his lab chief Dr Gladys Hobby, were modest to the point of giving me a stroke.

The pair knew, when they initially read Howard Florey's August 1941 article on his team's first clinical use of systemic penicillin in February 1941, that Dawson's team had beat him by four months in first using penicillin systemically.

But maddeningly, they still modestly claimed only to be the first to do so in North America , in any newspaper interviews or medical articles published during the war years.

Hobby, I sense, had no great memory.

This is because already by 1949 (only 8 years later) and after consulting her own personal records (!), Hobby writing in a report for her then employer, Pfizer, says the first injection only happened on January 11th in 1941 !

Reading her later - more accurate - accounting, I can only suggest that in 1949 she meant to say that January 11th marked the first day of intravenous injections.

This after a series, in the months earlier, of first intracutaneous injections, then sub -cutaneous and then intramuscular injections.

(As doctors will know, there are actually dozens of different forms of medical injections - varying by both site and method.)

Hobby went to her grave also convinced that Dawson gave the first penicillin shots on October 15th 1940 - a statement she repeatedly gave to fellow penicillin historians who dutifully spread it far and wide.

I don't believe it --- and neither should you.

For nowhere in her ultimately relatively detailed chronological account of the first days of penicillin-the-antibiotic does she indicate when the totally new drug was first tested on a healthy volunteer before being injected into the two severely ill patients for real.

Even in the relatively relaxed medical research atmosphere of the 1940s, that would never have happened.

Durack and Bentley provide more clues

Let us turn first to a little known medical paper by Dr David T Durack, who based his article in part on a personal conversation with the biochemist of Dawson's tiny four person team, a person moreover who started Columbia's pioneering penicillin effort even before Dawson joined it.

Around 1980, Durack contacted that biochemist Karl Meyer, a distinguished scientist then in his early fifties and in full control of his faculties and memory.

(Durack's article was published before Hobby published her definitive 1986 book on penicillin but was never mentioned by Hobby - signalling to me that Hobby and Meyer were hardly close after Dawson's death.)

Durack's article, "Review of Early Experience in treatment of bacterial Endocarditis, 1940-1955", I found in the book "Treatment of Infectious Endocarditis", edited by Alan L Bisno.

Meyer's story at first seemed incredible to me, but as I gathered up more information here and there, it was confirmed by an article by Ronald Bentley at various key points.

Meyer had gone to a Berlin medical school with his fellow (German) (Jewish) student Ernst Chain and I believe had taken a mild dislike to him, something very easy to do with the mercurial Chain.

Now in September 1940 he had learned (directly via Chain's former graduate student, Jewish American Leslie Epstein*) that Chain was taking credit for important work first done by Meyer on Lysozyme and that he was now trying to synthesize penicillin.

*Read Bentley's fascinating account of Leslie Epstein Falk struggling with Chain to grow a little penicillin in the Fall and Spring of 1939-1940 and when Epstein is ordered out of Oxford only months before finishing his PhD, how he completes it partly thanks to a stay with Meyer at Columbia.

For both Chain and Meyer, I believe an elbows- out attitude, even against fellow German Jewish emigre scientists, was morally right in 1940.

Both knew that if they didn't prove themselves quickly to be top scientists in some way, they would end up interned by the German-and-Jew-distrusting Anglo-Saxon government elites, stuck in miserable prison camps along side Nazi Germans.

Meyer and Chain both thought synthesizing a small (350 Dalton weight) molecule like penicillin would be a breeze.

Meyer simply involved Dawson to do the early biological activity tests and then to do the much later clinical trials, after the drug had been synthesized.

Dawson jumped Meyer's gun, insisting on testing the drug's efficacy inside the human body long before it was synthesized.

Why?

Partly to save the lives of two young men before him who he thought were being discarded by a medical establishment using the excuse that they were gearing up for total war.

Partly to secure Meyer's flank, because the biochemist was working after all in a hospital, a workplace oriented strongly to instantly applied science, not in a more leisurely basic research lab.

So Meyer tells Durack, on October 15th 1940, penicillin was indeed injected for the very first time, as Hobby (and all those after her) claimed.

But not injected into a patient.

Injected instead by Dawson into Dawson acting as the human guinea pig to test it for human toxicity - Dawson believing it was better that he the doctor died than the patient doing so.

(Entirely typical of the decorated war hero Dawson, as was entirely typical the decision of war shirker Sir Howard Florey not to risk his 'valuable' life testing his penicillin on himself !)

But Durack reports (indirectly - no names are used) that Dawson only injected Charles Alston, not on Charles and Aaron.

This could be because he also interviewed Dr Thomas T Hunter.

Hunter was a later member of Dawson's team, who never met Aaron but who did meet Charles many, many times.

He first met him in the Spring of 1944 when he came back with a second attack of endocarditis and was cured by Dawson yet again, this time by penicillin alone instead of with a little penicillin and a lot of sulfa drugs.

Hunter did further checkups on the health of Charles until early 1946 at least - so his story naturally stuck in Hunter's mind years later.

Hobby was not on the team - but still in close touch - when Charles returned in the Spring of 1944 - maybe why she remembered him much less.

This raises a significant point - why do almost all writers choose to mention just Aaron or just Charles instead mentioning both ?

Penicillin writers and their hidden agendas

Because most writers have a not so hidden agenda.

(Mine is that I think Dawson got a raw deal from history for his pioneering HGT and Penicillin work.)

To date, most others writing about wartime penicillin have sought, above all else, to exalt Howard Florey over the man who they feel wrongly gets the credit for penicillin-the-antibiotic, Sir Alexander Fleming.

They are equally worried that the real credit should not slip off of Fleming's mantle only to fall onto that of the colonial Henry Dawson.

Like Florey, and unlike Dawson and Hobby , they realize Dawson was the first to ever give a needle of penicillin-the-antibiotic and hence it was he who ushered in our Age of Antibiotics.

Further they know that Dawson championed natural penicillin (and it is worth noting that most of our current antibiotics are still based on the original natural penicillin), to be made by Pfizer and others.

Florey and Fleming, by pointed contrast, strongly championed synthetic penicillin, to be made by ICI (Imperial Chemical Industries) and others.

ICI never made a single commercial drop of the synthetic stuff - no one ever has - and 80% of all the penicillin landed on D-Day and there after came from Pfizer alone.

Seemingly hard then not give Dawson the lion's share of the wartime penicillin glory - but it can be done, if you work at it.

So these agenda-driven writers dutifully note, in almost footnote fashion, that Dawson indeed gave history' first (very small) penicillin injection.

They then decide to focus on just one of the two initial patients (Aaron), the one that died.

Next they note that Dawson quickly got Myasthenia Gravis and that he also died.

All half truths, but enough truth in them so they feel they needn't cover his four further years* of clinical penicillin activities between April 1941 and April 1945.

*Dawson had much, much longer period of clinical involvement with wartime penicillin than did either Florey or Fleming.

Hunter and Durack, by contrast, want to see Dawson's first medical glass as half full.

So they focus on Charles (the other one of the original pair, the one who lived) as the first patient to ever receive penicillin.

Someone, they imply, as a result went on to survive a hitherto invariably fatal disease.

The truth is that two low status young men - one a black and another a Jew - got history's first penicillin shots basically out of the agape concern of a doctor who wasn't even their lead doctor or a specialist in their disease.

One patient, Aaron, was extensively treated with penicillin but still died, while the other patient Charles was responsive to sulfa (unlike Aaron) and lived.

The little penicillin Charles got had almost no effect clinically but it sure boosted his morale and that might have helped save him as much as the massive sulfa doses.

Bickel to the rescue

Now we move ahead in time to about 1970, when Australian write Lennard Bickel decides to write a biography* of Australian born penicillin pioneer Sir Howard Florey, who had just died in 1968.

"Rise up to Life", first published in 1972.

He interviews anyone who he can find who was there at the time to talk about wartime penicillin, tracking down people in America, Britain and Australia.

Many buried names and stories only survive today because of his fine journalistic efforts.

Bickel wanted to exalt his fellow countryman of that there is no doubt, but he did not wish to bury Dawson - in fact he exhumed him from the grave of human forgetfulness.

I do not believe that Hobby would have even written her seminal account of wartime penicillin without Bickel .

His book and the reaction to it, finally convinced her, almost 25 years after the fact, that Dawson had indeed been the first in the world to inject systemic penicillin and hence held a story worth recalling.

Because we know she told Bickel in circa 1970 interviews for his book that she was still convinced that Dawson was merely the first to treat patients in the USA alone with penicillin.

And she - citing her notes - claimed he had treated only one patient on that historic day, which she said was October 15th 1940 - and that the patient died.

But at least and finally, she brought forth his name : Aaron Alston.

And she talks forthrightly about Dawson's fatal Myasthenia Gravis.

But she - and Bickel - make it clear that if he worked less as a result of this crippling disease, he still worked full out on penicillin till his death in the spring of 1945.

Since Bickel became the key - almost primary source level - "go to source" for most of the academic accounts of wartime penicillin, it is remarkable how this clear statement of his four more years of penicillin activities could be so twisted and ignored.

Flash forward to 1985, Hobby has retired after a modestly successful paid career working at at Pfizer on new antibiotics and a Veterans' hospital working on TB and a more successful volunteer career as a editor of various scientific society journals.

She has gotten to know everybody who was anybody in early penicillin in both North America and in Britain.

Yale University* Press, her publisher was admirably demanding and so Hobby trolled deep to firm up her claims - even consulting a Miss Louise Good for her lab records of the early use of Dawson's penicillin.

If only Yale was as demanding upon its own staff, who persist in claiming that their University was the first place to use penicillin in America.

Dawson was their first and was also the first to see cures with local (topical) use of penicillin to treat staph eye infections.

But Yale can rightfully claim a first, for inn March-April 1942, they successfully treated a case and saved a life with the systemic use of penicillin alone.

Charles Aronson's life was saved too, and much earlier - in December 1940 - but by lots of sulfa and perhaps a little contribution from pioneering penicillin.

Good's work

Good seems to be the sole source in Hobby's 1985 book "Penicillin : Meeting the Challenge" of Hobby's new information on Aaron and on who she calls Charles Aronson, his fellow needle pioneer on October 16th and 17th 1940.

Now I could reliably confirm the relatively detailed information on patient C.A. found in Dawson and Hunter's 1945 JAMA article on their clinically successful use of systemic penicillin in curing subacute bacterial endocarditis.

Dawson and Hunter's C.A. had to be Good and Hobby's Charles Aronson, born in 1913 and thus highly likely to be a young Jewish-American man with that name from the Bronx found in the 1940 US Census.

Similarly, it seemed clear from Good's information that Aaron had died in the Columbia-Presbyterian Hospital, in the Borough of Manhattan, in the days around January 18th 1941.

So I could then overcome a problem unique to the New York City death certificate of that era.

They are easy to obtain and quite detailed - but do not give the cause of death, unlike those of most other jurisdictions - that information is given to the city government alone in another document.

So in a city that big, and when one seeks someone with an ethnically common name, one needs the borough the death was registered in and the exact day of death to safely match death certificate of a particular Aaron Alston with the unique penicillin/endocarditis Aaron Alston.

Thanks to Claude, I could now find newspaper accounts of Aaron Leroy Alston getting sick and then dying in the time periods that Hobby and Good address - both sets of data confirming each other.

So there you have it - Aaron Alston , the very first to receive penicillin-the-antibiotic is never directly named in any of a dozen or so clinical medical articles published during or just after the war years at the time that do reference him but indirectly.

His name and his connection to the first ever use of penicillin-the-antibiotic is mentioned in dozens of more recent medical history oriented academic articles, all dating after Bickel's pioneering book of 1972.

In addition, Aaron's story is mentioned in least one wire service story from Warren Leary, the AP science reporter.

 In early October 1978, Leary reported that the longstanding belief that the British had been the first to inject penicillin into a patient was wrong.

Leary based his claim on a recent report in the Journal Chemistry from Dr George Kauffman that talked of Dawson's pioneering work.

One suspects Kauffman in turn had recently read Bickel's new book !

Aaron's story is still distorted

Gladys Hobby's penicillin book is probably found in every first class medical research library in the world and she gives the most detail about Aaron Alston - my blog aside.

Problems persist : author and wartime penicillin pioneer John C Sheehan, in a MIT Press* published book, "The Enchanted Ring" , confusingly thinks Aaron Alston is the doctor giving that very first needle to some unnamed patient.

He even regards Dawson's team, operating in the same hospital, as totally separate from 'Dr Alston' and his team !

*New Yorker magazine stories are throughly fact-checked, scientific journal articles a little, university press books by distinguished scholars from the same university as is publishing their book ? Not so much.

Okay, now for the biggest and serious problem : the near universal inclination for all sorts of researchers, even historians who really should know better, to read into Dawson's 1941 claim that he treated four SBE patients with penicillin all unsuccessfully, as meaning they all died.

Yes, SBE was then 99% fatal on its first presentation, but Charles Aronson was in that 1%, cured by sulfa, a little penicillin, God's grace and his own documented ability to survive more lives than a cat.

I know for certain the names of three of Dawson's first five SBE patients, that they were all five clinical failures re treatment with penicillin, that two Aaron Leroy Alston and George M Conant) died for sure, one lived for sure (Charles Aronson).

The other two I know nothing about, except that they were likely young men from the greater NYC area and that their likely months of admission were April 1941 and October 1941.

All the team members that treated them are dead and the hospital records from that time destroyed - we will likely never know more unless some family member remembers a relative dying of SBE around those dates at Columbia Presbyterian.

We have good information on the two dozen later SBEs that Dawson subsequently treated - but only have three full names provided by Hobby's book all which have so far produced dead ends.

What we need most for Aaaron is a picture of him.

I recall much of the fifty year mystery of blue singer Robert Johnson wasn't lack of reliable data about his life, but rather a lack of an ability to put a human face on a terribly interesting individual.

I feel the same about the fascinating Aaron Leroy Alston 1910-1941...

The search for Antibiotics' PATIENT ZERO .... in lead-up to celebration of 75 years of life-saving antibiotics

ABSTRACT : Patient Zero of the Age of Antibiotics (seventy five years young as of October 16th 2015) was Charles Aronson , a Jewish youth from 1202 Vyse Street in East Tremont, Bronx, New York.

Born about 1913, he was a newspaper teletype operator in 1940.

His parents Alex (born in 1889) and Olga (born 1890) were from the old Polish part of the old (pre-Soviet) Russian Empire while he and his sister Lillian (born about 1915) and younger brother Samuel (born about 1920) were born in New York.

Olga was a homemaker and Alex was a ladies coat maker (probably cutting ladies' fur coats at the famous Levine and Smith firm in lower Manhattan) and their two other children were belt-makers.

Charles had a lifelong affinity/weakness for deadly diseases caused by strep throats, combined with an amazing ability to cheat death from them --- over and over.

As a small child , he had a near fatal case of Rheumatic Fever, that affected not only his joints temporarily and his heart valves permanently , but also led to severe neurological effects.

Then he was quickly swept up in the frequently fatal mysterious "sleepy sickness" that ran its course worldwide from 1917 to 1927. Oliver Sacks made it famous in the book and movie called Awakenings.

Those it didn't quickly kill outright, it would often leave in a coma or catatonic state.

Again he survived this disease as he did its frequent Parkinson-like aftereffects.

Despite all these brain-related attacks, he not only managed to finish High School during the hard times of the Great Depression but also to find a good skilled job as a teletype operator at a newspaper.

He then survived two attacks of fatal SBE thanks to receiving history's first penicillin , only to get a severe stroke in 1944 that left him paralyzed and speechless.

Again he survived at least until the beginning of 1949, when he passes out of the public record.

I currently believe he died in October 1951 and is buried at the NEW MONTEFIORE cemetery in West Babylon (Long Island) , along with his parents and two siblings.

****************************

Penicillin-the-Antiseptic was already twelve years old in October 1940 and a relative laggard in the human discovery and use  of antibiotics (maybe antibiotic number twelve ?) --- at least by the dictionary definition of antibiotics.

The dictionaries describe antibiotics as lethal substances produced by one microbe to keep other microbes at bay.

But you and I - mere laypeople and not dictionary editors - know exactly what Antibiotics are and are not (that's a capital "A" there , by the way !)

They are not some minor external antiseptic your mom dabs on your scraped knee when you fall off your tricycle, as penicillin had only been used  for from the Fall of 1928 to the Fall of 1940.

Rather they are highly potent lifesavers that you take internally as a ten day course of pills - or in a real emergency, get many times a day via injections.

In one sense we already know a good deal about injected penicillin's INDEX PATIENT , the individual who started the whole thing by inspiring Dr Dawson to birth the Age of Antibiotics.

His name was Aaron (Leroy) Alston and he had had his 'invariably fatal' condition of SBE (subacute bacterial endocarditis, a Rheumatic Heart Disease usually caused by Rheumatic Fever) for about a year.

The latest conventional treatment was to give the patient as much of the latest (least toxic, most powerful) sulfa drug as their body could endure.

(All sulfa drugs are toxic in high doses  and the size of the doses of sulfa that 99% of SBE cases need for a cure would result in patient death long before they cured.)

Alston had all the latest sulfa drugs and many of the other proposed SBE cures besides and none were working.

But I believe that the first patient to actually get that historic  first needle of penicillin , our historic PATIENT ZERO , even if only moments before Alston, was a last minute patient called Charles Aronson.

If Aaron Leroy Alston had been cured by his historic course of injected penicillin , the ever-present and very jealous Alpha Males among medical scientists would have quickly trashed this claim - crediting sulfa drugs for the success instead.

But if Charles Aronson, a patient so new he hadn't yet had time to be put on the conventional sulfa treatment , was cured of SBE after a course of penicillin , the critics would all be left speechless.

Better then to 'do' him first, to make a stronger lead in the subsequent medical article.

Penicillin did not cure Alston and he died three months later.

Nor did penicillin - alone - cure Aronson.

But a little penicillin (more morale booster than medicine) a lot of sulfa and a miracle from heaven above let Aronson be that very rare person, maybe one in a hundred or one in a thousand who survived more than three years after first contracting SBE.

About four years later , he got an onset of a new SBE attack and this time got a decent amount of penicillin from the same doctor and was cured.

So who was he ?

The doctor who gave those first needles , Dr Martin Henry Dawson, had never been a lead doctor on treating an SBE case before - he was newly appointed to  a middle rank position in the hospital pecking order - only having substantive control over one public (semi-free /teaching) ward.

Such wards tended to attract poor patients and their poor relatives, who liked getting free or cheap treatment in a world class hospital that was only a short bus trip away.

Dawson had no reputation for his SBE work having never dealt with any - so his public ward patients were almost certain attracted to the closest cheapest quality hospital rather than to him personally.

The other historic penicillin patient, Aaron Alston , proved that so - he lived about two miles south of the hospital.

In any case, there were only two men named Charles Aronson in the 1940 national US census that were born around 1913.

I contacted the children of the one who lived a thousand kilometres away from NYC at the time - they said he was never sick - let alone sick with all the severe diseases as described by Dr Dawson's medical report on his Charles Aronson.

The only other Charles Aronson the right age in America in 1940 was lived in the Bronx, a mere four miles directly east of the hospital.

He had to be PATIENT ZERO.

I have already described what we know of him in the abstract above --- basically not much.

For unlike Alston (and the third penicillin-the-Antibiotic patient, George Conant) Charles Aronson and his family seemed to have left almost no mark in the public record.

Even so, it is hard to believe that an entire Jewish family of five that lived in the same part of the Bronx for over fifty years are remembered by no one.

In the 1930s, the Bronx was the world's biggest Jewish community and while those days are long gone , literally millions of North American Jews still have some sort of family link to the pre-war Bronx.

There is something else I should mention.

Dr Dawson, a gentile , literally gave up his life during WWII to save the lives of  Rheumatic Heart Disease patients sentenced to a Code Slow death by an uncaring Allied Anglo-American medical establishment.

We know the names of only six of those patients - and yet four of the six have Jewish sounding names .

Because Rheumatic Fever and SBE hit the poor , minorities and immigrants the hardest and many metro New York area Jews in those days were very poor I suspect this ratio would hold if we knew the names of all those saved from death by his efforts.

(Because Dawson also inspired a then small soda pop supplier in Brooklyn (Pfizer) to develop the natural fermentation process we still use to make 95% of all our antibiotics , we all owe him a big debt of gratitude.)

A direct counterpart to Charles Aronson, a German man named Martin Bader, a man with the same chronic conditions as Aronson and who like Charles was a productive employed citizen , wasn't so lucky.

His condition rendered him in the Nazi mind as a life unworthy of life and he was one of the first killed by the Aktion T4 program as part of the run up to the Holocaust.

Yet America and New York were the ones who actually birthed eugenics , not Germany , and if America was unwilling to directly murder 'unfit' Jews such as Aronson, they came damn close by officially denying them access to wartime penicillin.

Dawson gave up his life to combat these values and in the end he was successful  - the powerful War Production Board  (WPB) reversed course and made penicillin-for-all a vital wartime priority.

So Charles Aronson's story is that distinct rarity , a wartime story of Jews and eugenics that ends up a good news story with world wide benefits for all of us.

Yet another reason to find out more about this elusive PATIENT ZERO of the Age of Antibiotics ....