Penicillin, as from the Old Testament : capricious to the greedy and the hubristic ; malleable to the righteous

Psalm 51:7 -----  Purge me with Hyssop

To the large (government and industry supported) research teams privately committed to turning natural penicillin into a highly profitable patented MAN-MADE drug with a long shelf life, crude penicillin was a capricious, labile substance with a habit of disappearing as soon as it was produced.

As both their contemporary scientific articles and their later memoirs and biographies made abundantly clear.
Alexander Fleming and Howard Florey, for example, were for once fully in agreement on this accord.

But to the small unofficial clinically-oriented teams solely concerned with saving lives in the here and now, penicillin's reputation for instability was vastly overrated .

One even gets hints that they wondered if this well-publicized reputation of instability was a deliberate lie fostered by people like Florey, Fleming, Merck and the OSRD to keep later competing teams from seriously investigating the wonder drug.

The clinically-oriented teams' contemporary articles found first that the varying PH requirements of the rapidly growing and then hard starving penicillium fungus had to be well regulated, if the penicillin was not to be accidentally destroyed by the fungus itself, as fast as it was produced.

And then if the resulting crude penicillin liquid was kept very cold in a refrigerator, at the appropriate PH for penicillin, it would easily last the few days or weeks needed for it to be used externally or injected via IV/IM drip, on site at their hospital.

Any competent lab tech could handle the whole affair, is how one Australian team described what they felt was the largely routine growing, extraction and storing process.

Amazingly, both accounts of crude penicillin behavior are actually fully correct.

For example, by at least keeping their impure penicillin free of any external chemical reagents, the clinically oriented teams ensured their patients didn't suffer from the many man-made chemical impurities so commonly found in the supposedly purer commercial penicillin !

And they certainly didn't routinely lose most of the crude penicillin - and consume much scarce people-power - trying to extracting all of the harmless water in crude penicillin, merely to later add it all back in again as part of the injection process.

Because one can't inject dry penicillin ----- or dry anything.

Injections need plenty of fluids - basically water dressed up in a fancy name.

And in particular, penicillin works best if very very slowly dripped into a person's blood stream --- that means that crude penicillin is itself already at the right proportions of medicine and water to work well as a slow drip IV or IM.

Impure penicillin is a lot like the impure orange juice that traditionally supplied us with our Vitamin C needs - that tasty fruit juice works at least as well as today's little white synthetic Vitamin C pills do --- and has done so for millions of years.

So what was the reason for the endless mantra (cum lame excuse) of the Allied medical world needing pure penicillin and needing dry penicillin before it could begin to save the dying ?

G R E E D  &  H U B R I S   ---- impure and un-simple.

The only reason why 'pure' penicillin was needed was that pure penicillin is the only form of penicillin that can then be successfully broken down into its constituent parts - and only its constituent parts.

With all - and only all - of its parts known, chemists then thought they could quickly make a patented highly profitable analogue of natural penicillin, much much cheaper than the fungus could.

Americans and the English would hold those patents and then hold the rest of the world to ransom after the war.

But vast amounts of crude penicillin were accidentally destroyed in the processing along the way to yield up a gram or two of nearly 100% pure penicillin.

Then the chemists deliberately destroyed all that pure penicillin, to then look at the resulting constituent sub-parts.

Every one of their many experiments, from start in processing to finishing in destruction, wasted much clinically useful penicillin that could have saved many many precious lives.

Again, for example, briefly in the Spring of 1943 Glaxo was the world's leading penicillin producer - but almost all of that penicillin was then deliberately destroyed in the chemists' fruitless efforts to do something better than stupid little fungus.

Because, yes, old men in white lab coats and sporting PhDs from the best universities, in the middle of a deadly war, are just as capable of indulging in a useless pissing contest as a bunch of teenage louts.

All because they were determined not to let 'stupid' 'simple' fungus (their words) best 'the smartest chemists in the universe'.

Rather than simply buckling down to work with the fungus, as chemists, in an all out effort to make as much natural penicillin as possible - right now ! - to save all the war's dying.

For twenty long wasted years (1928-1948) the world of chemists tried to do something better that the tiny penicillium was already doing perfectly well, before finally publicly admitting defeat.

And the obsession with dry penicillin ?

Well, perfectly dry and hence perfectly stable penicillin was essential if a few huge drug factories were to supply all the vast world's continuing penicillin needs.

Most of the world's penicillin would have to remain viable for months or even years, as it waited to be transported around the world and then sit on warehouse shelfs until needed.

The same reason why most of our food is stuffed with preservative chemicals and shipped in, using much fossil
fuel, from warehouses a world away ----- the greed for seeing all the profits of the food business sit in fewer and fewer hands.

As a Christian, I like to think God took an early private revenge on all these greedy and hubris souls, before a second and more final round at Judgement Day.

Because Man has never been able to commercially best the humble fungus in making penicillin and crude penicillin is still the substrate for 90% of all of today's antibiotics .....

wartime penicillin's Progressives vs Naturalists

The Progressives (people such as Sir Howard Florey, the OSRD and Merck) literally intended to RE-FORM things, wholesale - the human body in particular.

They advocated a sort of 'synthetic autarky' with Man replacing everything that came from Mother Nature with a better and cheaper & quicker to make artificial form.

But such re-forming, in practise, often broke down the very old fashioned farming practise of culling out whatever was regarded as 'unfit' and selecting and favouring whatever was regarded as the 'fittest'.

(Here cue the word : Eugenics.)

But with eyes only for the future, no Progressive would ever publicly admit to using such old fashioned farming techniques.

Clinging to such vestiges of the past were supposed to be the preserves of their opponents, the Naturalists, people such as Florey's opponent, Dr Martin Henry Dawson, the OPRD and Pfizer.

But all efforts - by  hundreds of the smartest chemists in the universe with money to burn- to synthesize commercial penicillin failed.

Instead, a few Naturalists, with very little resources, patiently picked the best of the best of the best of the best penicillin producing penicillium molds to greatly up penicillin yields at the point of the cow's utter rather than in improving the machinery in the milk factory.

Only near the end of the war, did a scientist finally get the chance to set a $20 UV heat lamp (bog ordinary variety !) upon a sample of the naturally best penicillin producing molds.

All this to deliberate fry the poor penicillium's DNA with UV rays, in the hope that among the dead and living dead offspring, a few fully alive cells' DNA might be altered (re-formed) to produce even more penicillin.

He indeed found these winners by the old fashioned farmers' method of patiently picking the most likely big producers and putting them to it - the proof was in the penicillin they did produce.

Against the Progressives' 'terrible simplicities', my brief account shows the unexpected wartime success of natural penicillin was a bit more complicated than might be expected ----- as usual ....

History's first ever antibiotics injections were expected to be of pure synthetic penicillin

Back at the start of the 1940s, two highly skilled biochemists (Karl Meyer and Ernst Chain) both confidently expected to quickly synthesize artificial penicillin, as they knew natural penicillin was a relatively small biological molecule of only about 350 Daltons.

After 100 weeks of hearing this reoccurring promise of quick results from Chain, his imperious boss, Howard Florey, reluctantly decided to inject his first human patients in February 12th 1941 with still-impure natural penicillin.

Henry Dawson, normally the most diffident of men, changed his mind about waiting till  co-worker Meyer's synthetic penicillin arrived in January 1941, and after only five weeks into their joint penicillin efforts and without so much as a backward glance, injected his first patients with impure natural penicillin on October 16th 1940.

Why did Dawson uncharacteristically proceed to Plan B so very much quicker than Florey?

Partially it was because Dawson was so angry on his return to his medicine school from his vacation in September 1940 to discover that all American medicine was using the excuse of preparing for war medicine to drop their feeble efforts at social medicine aimed at improving the health care of the poor and the weak.

But it also seems from Dawson's own words that it was a civil rights activist and dying SBE patient, Aaron Leroy Alston from Harlem, whose angry eloquence on this neglect of the poor and minorities that so moved Dawson.

Moved him to defiantly thumb his nose at an uncharitable world by deliberately treating two 4F SBE patients with this historical first ever injected antibiotics, on the very day when all of the rest of America was focused only upon its 1A population ...

The Manhattan (natural penicillin) Project : Googling up a Ghost

How an amateur historian in a small city used the new Google Search tools to recover the lost story of wartime penicillin

 

I first fell upon the lost story of wartime penicillin way back in the Dark Ages --- late in 2004.

My computer way back then was a Mac Plus with 1 meg of RAM and a 20 meg hard drive. My internet access was via dialup and I used text-base Lynx as my search engine.

With this primitive setup , I had still managed to play an important role in a highly successful national political campaign across the vastness of Canada.

I live in Halifax Canada, a small city by world standards, with at best a metro population of only about 300,000.

It holds Canada's biggest defence base, is one of Canada's five regional administrative capitals and is a major university town with half dozen universities.

But despite the fact that all the province's universities pool their libraries into one lending consortium, they collectively still don't rate as even a middle level research university library by Canada's modest standards, let alone by world class standards.

I had a BA from Halifax's Dalhousie University, nominally in political science, but really in Nova Scotian culture and history.

Locally I was considered to be a knowledgable amateur historian, particularly about the under-explored oddities of Nova Scotia history.

In fact, I only got interested in the history of early DNA and later wartime penicillin (of which I knew little and cared less about at the time) because three of the most notable figures were Nova Scotians - albeit all living and researching in New York City.

Now my on-the-ground knowledge of London UK is considerable - particularly compared to the sum total of seven busy hours I have spent to date on the ground in NYC !

But I must say that like any well educated English speaker worldwide, I feel I know the different neighbourhoods of both NY and London quite well thank you very much - from my lifetime of reading, watching movies and listening to music.

Like almost all historians, I was completely certain that any amount of physical walkabout over the geography of 21st century NYC would have still told me very little about how people in 1930s NY once felt and acted.

It proved the case - the streets of NYC looked exactly liked the (filmed on location) streets of LAW AND ORDER... that I already knew so well.

But even today in 2015, most archival material in archives or libraries is still not online.

So living in world class cities like NYC, London, Paris, Berlin, Moscow and Los Angeles still allows an amateur researcher take the local bus to do their primary research --- and still come up with a story of interest to an entire world.

The rest of us need to book expensive international flights and pay big city hotel bills for months at a time to do the same amount of research a local amateur (or local professional) historian can do over an extended period of weekends and evenings.

Fortunately I soon realized that while much of the lost history of wartime penicillin indeed lay in the archives of London and New York, where all previous books on wartime penicillin had been researched and written, much of that lost history was lost precisely because it hadn't occurred there.

Of the various earliest penicillin historians, perhaps only Australian science journalist Lennard Bickel (biographer of Nobel-winning penicillin pioneer Sir Howard Florey) back in the late 1960s and early 1970s had actually visited some of the off the beaten path penicillin sites early enough to catch some of their original flavour and speak to still living participants.

The later writers had fewer eye witnesses still alive and so had to hew closer to the physical paper archival sources located (in those pre-internet age) in just a few key cities - London, New York and Washington.

But with various Google search tools coming on stream in the early 21st century and with a better computer with true broadband, I quickly discovered I had better (and free) access to local newspapers' primary accounts of the more obscure aspects of wartime penicillin sitting in my own living room than did professional historians with sizeable research budgets sifting through OSRD penicillin-related vertical files in some Washington DC archives.

I still hadn't gained anything on the local advantage of living in a world class city and researching a world class local story via city bus.

But I had gained the local amateur historians' traditional advantage of having much more time to do research than do typical professionals.

Magazine editors, book publishers, tenure committees are always pushing professionals to conclude their research and publish the results.

All topics are badly under-researched thanks to this pressure. Professionals just hope to go back later for another bite or two at the subject area.

But I had lots of time, for several different reasons.

I faced no tenure committee or granting agency deadline.

All the key participants were dead by the time I had arrived - no longer any urgency to interview before they passed on.

And I was doing paradigm creating research not normal research - to use Thomas Kuhn's terms.

The official version of wartime penicillin had successfully withstood superficial challenges to its myth because it had all its archival evidence favouring its claims in a few large well organized collections --- and historians are only human.

They much rather devote all their energy to extensive close reading of a few big well organized definitives archives on a subject and then call it a day.

Why spend years and much money trying to track down vagaries that might or might not exist in the end?

So most historians - even historians sceptical of the offical version history of penicillin still end up in the same few spots, visiting the usual suspects.

In particular, Washington holding the NRRL, OSRD and NAS COC collections and London (and nearby Oxford) for the Fleming and Florey collections.

In the New York area, Merck (a major keeper of the official version flame) was far more active with its wartime archives than as Pfizer - not really a part of the official version.

By contrast - and almost by definition - those wartime penicillin activities arising up against the OSRD-Oxford cartel had no official Allied governments' support or funding.

And without either, the institutions employing these renegades had no incentive to collect and keep archival records of their wartime penicillin activities.

Anyone doing this type of research was going to have to devote lots of time ferreting out what evidence that could be found here and there and everywhere.

I saw no current researchers who still cared that deeply and exclusively about wartime penicillin - official or un-official version.

I had no competition - I could take my time.

And I needed it : initially I merely suspected mysteries more by the presence of submerged hints and black holes in the evidence than with some sense that I knew exactly what I was looking for and exactly where to find it !

I just sat at my home computer patiently typing in endless variants on the few key words I had, hoping Google would eventually throw up some unexpected new document to point me ever onward.

And a dozen years later, I think I am finally seeing a clearer view of the alternative penicillin history ....

Manhattan's OTHER Project : Gotham's penicillin un-superheroes (and why they are ignored by academics)

If another secretive, undemocratic, big science Manhattan Project is more likely to cause a global environmental disaster (think nuclear winter or geo-engineering) than prevent it - then does the experiences of wartime Gotham have anything at all to still teach us, as we face global climate meltdown ?

Well, unbeknownst to virtually all, Manhattan actually had another ( far different) wartime project that still has lessons for today.

Its global effect were almost as big as that of the much better known atomic Manhattan Project, but by pointed contrast to it, it was near universally always warmly received worldwide.

Because Manhattan's real enduring gift to humanity during and after the war years was not The Bomb (or the infamous Norden Bombsight) but rather bog-ordinary cheap available-to-all public domain natural penicillin. You know - the stuff the academics are always telling us that the British gave us.

Now I sometimes joke that the only reasons the Scandinavians didn't give a joint Nobel Peace Prize to Stalin and Hitler was because the Nordics ran out of time - the guys died first.

But joking aside, the Nobel prize choices have rarely stood up well to the test of time.

Admittedly, Mr Nobel's naive requirements that everything significant that is discovered or invented was brought to mass use or mass knowledge by no more than three (still living) individuals does force the Nobel prize selection committees into mindless contortions.

Still - what of earth were the Nordics thinking - or not thinking - when the medicine committee gave the 1945 Nobel prize for penicillin to Fleming and Florey ?

After his 1928 discovery, Alec Fleming's main contribution was to tell everybody within earshot (for 15 wasted years) that penicillin would only work if used as a topical antiseptic (it doesn't work well there) and would NEVER work if taken internally (when in fact it works miraculously well there.)

Moreover he said it would never be useful for patients until artificially synthesized when in fact it never has : all clinical penicillin and the bulk of all of today's antibiotics (yes even today !) are still derived from natural penicillin made by fungus.

In this particularly obtuse claim, he was more than fully supported by chemist manque Howard Florey.

In fact Florey led the Allies' wartime charge to repeatedly try and to repeatedly fail to make penicillin by artificial (patentable) methods, rather than to simply produce enough natural (public domain) penicillin to meet current desperate wartime needs.

And Florey and Fleming, both strong supporters of the Conservative Party, fully backed the Conservative politicians in Britain's wartime coalition government who wanted to limit wartime penicillin production to only lightly wounded front line troops.

None for severely wounded troops or any home front civilians in Allied nations and colonies; none for civilians in Neutral, Occupied or Enemy countries - none for Allied POWs, let alone for enemy POWs !

All this because it had been determined that diverting British resources to set up enough British natural penicillin bottle plants in unused buildings to supply all military and civilian needs for the world (and thus to secure a postwar Pax Britannica based on this wartime humanitarian effort) would cost about ten million pounds.

And that was also enough for at least one or two more additions to Bomber Command's already many heavy bomber squadrons.

Since 1932 and Prime Minister Baldwin's famous speech, it had been become the 40th Article of the Conservative Party faith that 'the bomber always gets through' and that destroying people and not saving them was the Conservative way to the moral high ground and winning any war.

But what really made wartime penicillin the world's best known/best loved medicine is that as the last dying act of the New Deal, a new Pax Americana had suddenly made cheap non-patented (natural) penicillin abundantly available to all - wartime friend and foe alike.

But none of these good guys , none of the Americans (and a Canadian) centred in NYC who were mostly responsible for this boon to humanity, ever received a Nobel Prize or public acclaim for the miracle of cheap-penicillin-for-all : only the bad guys.

Because the good guys' approach couldn't have been more different than the atomic Manhattan project.

They were open about their intentions and pragmatically and morally committed to saving the little guy. They wasted little taxpayer money and resources and instead combined a 'little science' approach with a ruggedly low tech engineering style.

All of this was anathema to academics (including non scientists like historians) who wanted to ballyhoo the supposed wartime triumphs of heavily taxpayer funded basic science-big science as a way to getting the taxpayer to permanently fund their postwar hobbyhorses.

So - in a brazen conflict of interest and in violence to the known facts - academics have tended to give all the penicillin acclaim to the big science advocates (cum penicillin bad guys).

To those who were actually most dedicated to keeping wartime penicillin a much delayed, scarce and patented exclusive drug.

So Drs Florey and Fleming in Britain , along with Drs A N Richards and Chester Keefer in the States , got all the acclaim.

Logrolling is what they call this sort of stuff it in politics - I don't know what they call it inside the ivory tower bunker : false weighting of the scales of evidence maybe ?

1928-1948 : 'normal' scientists and doctors loved penicillin but detested penicillium

What if Fleming's team , in early 1929, HAD easily purified penicillin and then synthesized and patented analogues of it ?

Contrary to myth , there never was any 1928-1948 resistance, at all, by normal doctors and scientists to the injecting of penicillin to save lives - just provided it was the penicillins that we have today.


These penicillins are all made by someone else while someone else will gladly come and deliver them to any doctor's door.

Just as chemists have worked hard to ensure these modern penicillins have a long and profitable shelf life in doctors' offices.

Someone else, actually lots of 'somebody elses', have also worked very hard to ensure that all the safe dosages and bad side effects have been found and are made are clear to everyone - laity and GPs alike.

These modern penicillins cum beta lactams emerge as crystal pure white and are usually at least partially semi-synthesized.

They are made in gleaming porcelain-white factories in high tech stainless steel tanks - operated by men mostly.

Men who almost never even seen the yucky green slime hidden inside those opaque stainless tanks.

Nature and the natural has been removed as far as possible from the scene - Man instead, is everywhere.

It would still be best if Man had synthesized penicillin totally out of basic chemicals off the shelf but that can't be.

So while the slime still does all the actual hard work (actually makes the tasty steak), Man (medical and scientific PR) does its best to sell the sizzle instead.

The green slime is rendered as Man-made as possible before anyone has to see or touch the stuff.

Yes, normal doctors and scientists have always loved modern penicillin - it was just ancient natural penicillium molds that they (largely unconsciously) feared and detested.

Fleming in 1929 , Florey in 1940 and 1941, Dawson in 1941 and 1942 : no one responds to their Good News gospels

All three detailed to the entire world of doctors of the wide anti-bacterial potency, the extremely low toxicity and the ease of production of natural penicillin in any hospital lab .

Yet in the many published books on early penicillin there are almost no clear accounts of any  - let alone many - doctors responding to all those articles with a request for some of the starter penicillium spores.

There were no shortage of patients dying of penicillin-treatable diseases in those days.

Just seemingly a shortage of doctors willing to use elbow grease to make the penicillin to save lives - a job a later doctor admitted could be easily done by 'any' hospital lab technician.

And I just don't buy that.

I remain convinced that in the medical world from 1928 to 1948,  there were many, many hard working doctors willing to practise very heroic medicine and willing devote long hours to saving the dying.

So why the moral holdback in the sole case of penicillin - particularly when it will probably turn out to be the easiest to make, safest lifesaver to deliver that will ever be found ?

Its about the mold - not the medicine

The answer, I suggest, lies back beyond the medicine to the mold itself - our ancient (and ongoing) muddled relationship with yeasts, mushrooms and molds.

Generally we like yeasts and mushrooms but detest molds - though all are but different visible forms of the same basic being - the fungus.

To over-simplify terribly, we should think of mushrooms as the above-ground flowering heads of underground molds with the yeasts very much like the tiny spores those mushroom heads' periodically release.

Some yeast/spores are good - bread, beer - others spoil food and ruin whole crops.

Some mushrooms are among the tastiest of foods - while other ours are among our fastest fatal poisons.

Moreover by 1900 ,most of us olny saw yeast and mushrooms as divorced from nature - bought packaged in stores.

By contrast, we didn't really consciously buy mold - all by itself - in stores : though we did buy mold-infected cheeses instead.

Instead, in those largely pre-plastic polymer days - we did see mold in nature and in our homes almost daily ---- and hated doing so.

Mold spreading and spoiling our foods , ruining any clothing made of natural products stored in dark damp warm places, rotting wet wood fixtures, growing vigorously up dank dark basement walls.

Mold seemed associated with death and decay - who hadn't come across an animal body dug up by a dog and seen the mold threads running all through the shrunken corpse ?

It even smelt bad ( actually we simply associated its smell with negative situations !)

The fact that it was slimy, slippery, and jelly like was the worst.

Though we often like like materials and even food that is slippery and jelly-like.

But mold only grew by decaying something else : a black spot quickly became a furry and slimy jelly only by visibly dissolving what was once seemingly dry and solid with fixed boundaries  into a watery gell with fluid boundaries.

Now humanity isn't that upset by violent death - not by the way we love war, murders and the slaughter of animals.

And the molds rarely kill what they consume - they usually feed on the those who have died naturally or at others' hands.

So it it isn't the deadness of death they evoke - only the decay of death - the breaching of definite boundaries between the fixedness of solid substances and the fluid state of liquids.

A  mold (gell) is neither solid or liquid - or rather, worse, it is both.

The ever changing slimy mold is the very symbol of modernization or globalization - the mixing and intermingling of everything and anything in ever new unexpected ways.

By contrast, the 100% pure rationally-made chemical synthetic, built from the bottom up by chemists out of known consistent pure atoms, with consistent known repeatable results, is the very symbol of Modernity.

I buy Roger Griffin's thesis - even if he doesn't - that all Modernity (not just Fascist Modernity) was a reaction against Late Victorian modernization and globalization that progressive moderns both sought and feared.

So I see this twenty year battle (between using slime mold to save lives or waiting until it has a chemical synthetic before doing so) as a key battle between Modernity and modernization.

Perhaps even the key battle : the result being the end of Modernity and the birth of a post-Modernity far more willing to seek power-with-nature rather than only wanting power-over-nature....

Int'l competition spurs penicillin production as American Pfizer/Dawson goes against British ICI/Florey for most production

Wartime penicillin production was greatly hurt , not helped , when Florey came to America.

Because then an Anglo-American cartel emerged that focused on restricting what firms could produce penicillin - rather than increasing competition to produce more penicillin.

Already in September 1941, fermentation experts Pfizer and their advisor Dr Dawson were already producing commercially-oriented penicillin in the USA - without government inference or 'help' .

As was Florey's team and chemical giant ICI in the UK, again without government 'help'.

This was before Florey's across the ocean visit to his good American friend Dr A N Richards.

That led to Richard's decision to abuse the extraordinary wartime powers of American's main military research agency (the OSRD) to create an international penicillin cartel.

Only when Dawson's former patient and friend Floyd Odlum induced the equally powerful (but New Dealer oriented) WPB agency to open up penicillin production to more firms, did the spur of competition finally produce massive amounts of penicillin.

But what if Florey had stayed home instead of coming to America to mark his claim to penicillin fame over that of Dawson ?

The normally cautious Pfizer had been very bold once before - risking all on a new method of producing citric acid and ending up very wealthy.

If it decided to go all out for penicillin in 1941-1942 as it did in 1943-1944 , there would have been no wartime penicillin shortage crisis....

Penicillin fame , September 1941 : when cat Florey is out of town, mouse Fleming begins to play ...

Alexander Fleming never asserted his quite spurious claim that he had long advocated a lifesaving role for penicillin until the beginning of September 1941.

That was exactly the time when the person most likely to be able and willing to accurately dispute that claim, his friend and fellow penicillin pioneer Howard Florey, was (in) conveniently out of the country and unable to respond because of war restrictions on communications.

When one of the UK's biggest newspapers - the Daily Herald - took up Fleming's claim from his letter to the editor in the British Medical Journal (BMJ) , the infamous "Fleming Myth" was fully made.

Because , quite quickly, both popular and learned journalists took up and repeated the myth on and on throughout the next month.

Nobody from Florey's team at Oxford University refuted the the myth before it grew.

None there dared speak up for the boss , for like present day Canadian Prime Minister Stephen Harper, Florey was a controlling individual who particularly hated the popular media.

Florey had done nothing to diminish Fleming and had been the picture of kindness to him - which itself  was rather unusual for Florey.

He would continue to bend over backwards towards Fleming for at least another year .

For example, by personally delivering some of his own precious penicillin to Fleming to help him save a life - the only injection of penicillin Fleming ever gave in the 14 years since he first discovered the substance.

I feel that Alexander Fleming was sneaky in the way he operated this end run around his friend when that friend's back was turned.

 I have a feeling that Leonard Colebrook could provide other examples of when  his friend Alexander Fleming also was sneaky in how he had gradually replaced Colebrook in the affections of their joint boss, Sir Almroth Wright.

In person, Florey was instantly hard to like and Fleming was instantly easy to like - but superficial surface impressions did not convey the true nature of either man ..

Synthetic Howard Florey vs Natural Martin Henry Dawson

The untold scandal of the Anglo-American pharmaceuticals "CODE SLOWING" natural penicillin production in the crucial months before D-Day

Howard Florey seems to have contacted every major pharmaceutical firm and governmental scientific organization in the UK , Canada and America but clicked with only a very few.

Martin Henry Dawson's project was known by most of the same organizations - but he clicked with even fewer.

But both men eventually found institutional supporters of the same like mind as themselves - so it probably didn't matter how many rejected them.

Both men were relatively inflexible as to their ultimate objectives.

 Florey sought a perfect chemical synthetic solution, no matter how long it took and was unwilling to settle for anything less .

By contrast, Dawson wanted any sort of solution to the penicillin supply issue - as long as it happened now ! - and that it provided an abundance of inexpensive wartime penicillin.

Florey found similarly chemically minded executives at Merck, ICI and in A. N. Richards the head of the medical division of the American OSRD (where the ultimate boss, Vannevar Bush was notorious for never ever hiring biologists.)

Dawson found a kindred soul in John L Smith of Pfizer (albeit prodded by his wife Mae) who decided to risk all by going the all-natural route when the industry consensus was to "Code Slow" natural penicillin production until perfect synthetic penicillin was invented.

And like Dawson, Smith's vision was for lots and lots and lots of penicillin - now !

Suddenly - a crucial month before D-Day - the race between the two competing visions was all over.

Not a drop of synth pen in the pipeline to Kansas City Kansas and then onto the waiting military hospital units in the south of England - instead tens of billions of units of natural penicillin were in that pipeline , almost all from Pfizer.

Florey stormed and the dying Dawson permitted himself a rare - wall-to-wall - grin .....

Memo to RAMZI YOUSEF : Wartime Manhattan gave the world's first penicillin shots --- as well as the world's first A-bomb

Manhattan's first ever penicillin shots (75 years ago next  October 16th 2015) were a deliberate act of provocation by Dr Martin Henry Dawson.

Penicillin shots across the bow against the Allied medical establishment for using the excuse of war medicine preparation to dismiss efforts of social medicine directed at the poor and minorities.

He felt that penicillin should be deliberately given a high enough wartime production priority to be able to give penicillin to all those in wartime dying from lack of it .

This would serve as a very public rebuttal to the Axis who felt only the 'fit' from the 'fittest' nations deserved medicine, food and indeed life itself.

Wartime penicillin for all the Allied armed forces and civilians , as well as for Allied and enemy POWs, and the people in Neutral lands ,  even via the Red Cross into the occupied lands and eventually used to save the lives of former enemies.

The aftershock from Manhattan's first penicillin shots radiated out in ever-widening circles.

The then modest biological firm of Pfizer , from Brooklyn , was quickly recruited by news of those historical first shots and began helping out Dawson.

But first Dawson had to demonstrate success against a hitherto invariable fatal disease (SBE) to really suggest what penicillin might do if it was mass produced.

 He did so, starting in November 1942, by 'going off the reservation' and used some OSRD controlled penicillin to save a group of women dying of SBE - something the OSRD strictly forbade - which meant abandoning them to a certain death.

But the astounding success he had with SBE was enough evidence for Dawson's former patient , industrialist Floyd Odlum , to suggest to his boss at the powerful (the New Deal-oriented) War Production Board (WPB) that it greatly up the original production proposed by its rival Vannevar Bush's OSRD .

But Big Pharma sat on its hands, convinced it could make much more money for a much smaller investment (and without a need to learn new skills) when it had synthetic (aka patentable) penicillin instead of this dangerous natural penicillin - which could be made by any competitor.

Such as Dawson - whose modest hospital pilot plant was for several months , the world's "biggest" penicillin producer !

Dawson had certainly convinced a fellow colleague and fellow WWI vet, Dr Rudolph (Rudy) N Schullinger in the Surgical Service of his hospital.

Rudy went overseas in mid 1942 with the CUMC's wartime Second General Hospital unit to Oxford England. Dawson had full-blown Myasthenia Gravis (MG) by that date or he would have been the Lab Chief for that military hospital.

Rudy Schullinger tried very hard to get some of the OSRD's penicillin sent into the European Theatre of War so he could both treat wounded American troops in wartime and contribute the results to the ongoing research pool.

Despite repeated entreaties the OSRD would have done of it !

Thankfully Schullinger's protests finally did pull some some penicillin out of the hands of stay-at-home civilian researchers and into the frontlines (before the war ended).

Though it was only to be used to treat american troops , he broke Regulations and used a good deal of it to save the life of a British soldier dying of the same disease Dawson was trying to cure - endocarditis !

(Dawson's "Acting Up" was infectious .)

Then another former patient , med resident Dr Dante Colitti , threw an emotional spanner in the works - suggesting to the parents of a dying two year old girl from Queens called Patty Malone that they call up Citizen Hearst's biggest paper and beg them to get penicillin the OSRD was denying her.

The Hearst media empire's emotional accounts of rushing the penicillin to the little girl with "just seven hours to spare" gripped first a nation and then a world.

It gripped - in particular - the hearts of Mr and Mrs John L Smith . They had lost a young girl to meningitis that mass produced penicillin - as Dr Dawson always insisted - could easily have cured.

The normally hyper-cautious Smith - the boss of Pfizer - now threw all caution to the wind - ordering his firm to build the world's first really big penicillin plant in as few months as a 24/7 schedule could produce.

Bolder yet - he decided to use the penicillin allocated to his firm to do synthetic studies (to secure a share of the future patents) to save the lives of people in New York  with SBE that his government was refusing to save.

A mysterious woman (probably the otherwise very upright Gladys Hobby) would arriving offering bottles of penicillin without labels to doctors like Ward J MacNeal and Leo Loewe with the oblique suggestion it might just help their SBE patients - and then disappear.

At the time it seemed clear to people inside Big Pharma that Smith had recklessly threw away a certainty of big future profits for Pfizer, just to help save the lives of a few worthless nobodies.

But his - and our - salvation lay in the most unlikeliest of all places : the former eugenic laboratories at Cold Spring Harbour in Long Island , once one of the intellectual godfathers to the Nazi holocausts agains Jews, Slavs and the 'unfit'.

For several years, its new (non-eugenically oriented) director Milislav Demerec had pleaded in vain with Vannevar Bush's OSRD to let him help develop more productive natural strains of penicillin-producing penicillium.

But the OSRD - like Florey and Fleming in England - had its heart set on a man-made synthetic triumph with penicillin - they had no intention to share the glory with anyone small and weak  - let alone microbes.

Once again , the WPB saved the day. Its Office for Production Research and Development (OPRD) had about one hundredth the budget and influence of Vannevar Bush's better known Office for Scientific Research and Development (OSRD).

But the OPRD had street smarts in spades and it wisely gave a tiny amount of money and a lot of morale-boosting support to Demerec's and the spectacular results has repaid that debt a million fold and more ever since.

Demerec gave the penicillium spores a nasty sunburn under an ordinary tanning lamp - most died from the radiation.

But a few survived and were soon producing ten - then one hundred and today 50,000 times as much penicillin from the same amount of feedstock as Fleming's original strain (and Fleming's was an extraordinarily good natural producer !)

Yet Demerec remains the most unsung among all the unsung true heroes of the wartime penicillin story : a case once again where the moral scum - not the moral cream - rises to the top of the fame charts.

Now Dawson's team wasn't the only team in New York thumbing their nose at Big Pharma and Big Medicine by starting a penicillin grow-op.

A doubting doctor John Mahoney out on Staten Island Marine Hospital questioned the OSRD's claim that penicillin couldn't cure syphilis .

With unofficial help from Dawson's team they started growing their own and tested their theory on "Easter" Bunnies (as they told their innocent children) that they kept in their home garages over the Easter holidays !

The public clamour from Doctor Mom for "more penicillin now !" that had started with the story of Patty Malone really took off with the thought that with penicillin families need no longer be threatened with VD from errant husbands.

We can't negate the atomic Manhattan Project and Hiroshima.

But Manhattan Penicillin ,the other Manhattan Project , can point with pride to the fact that 80% of the penicillin landed on D-Day (in its first ever mass clinical trial) came from Pfizer's Marcy Avenue Brooklyn plant and that plant went on to supply the biggest chunk of the world's penicillin for the rest of the war.

So much penicillin that America - not the Britain of Nobel prize winners Florey and Fleming ( who were still chasing the decade old chimera of synthetic penicillin and only then mass production) - supplying most of the penicillin for the Allied, Neutral, occupied and Enemy lands.

And that in turn ushered in a Pax Americana based on diplomatic gifting of abundant New York penicillin.

Dawson's dream of abundant - non-patented - penicillin cheap enough to help all has come true - it is life-saving too cheap to meter, lifesaving far cheaper than bottled water.

It has beaten back age old diseases kept endemic by residing among remote and poor people not reached by clean water, adequate food and proper health care.

As a result a sort of herd immunity has occurred as ten billion of us since 1940 have indirectly had better health from seeing diseases like Rheumatic Fever fade from sight.

No, the 250,000 lives lost at Hiroshima and Nagasaki can never be re-gained by actions in other areas - but I think I have offered up evidence to terrorists like Ramzi Yousef and others that wartime Manhattan was at least as much from Venus as it was from Mars.

And if Manhattan citizens are too modest to blow their own horn about its decisive role in making cheap abundant penicillin available to ALL in a world tired, huddled and wretched - then the rest of us should do it for them.

We can't continue to let a terrorist like Ramzi Yousef be the last word on Manhattan's wartime role ....

Ramzi Yousef - and the British - mustn't be allowed to forge the last word on Manhattan's wartime role

Yes, a thousand times yes, many of the events that birthed the Atomic Bomb that killed 250,000 did in fact occur on Manhattan and in the surrounding Greater New York City area.

But there was another wartime Manhattan project which has saved far far far more lives than the A-Bomb ever took : a wartime project a lot more from Venus than from Mars, a project more Emma Lazarus than Gordon Gekko.

Manhattan began by birthing the first ever use of antibiotics on October 16th 1940.

Columbia University Medical Centre associate professor and medical doctor Martin Henry Dawson aimed to see the wartime development of "Penicillin-for-All" : for friend, enemy and neutral alike.

Yes, even in -- especially in -- a Total War against an opponent who thought only the 'fit' of the 'fittest races' deserved medicine , food and life.

The Anglo American scientific-medical establishment hotly opposed Dawson but his tiny team of misfits and unfits persisted.

Dawson told the world of his first ever use of penicillin as an antibiotic in February 1941 and again in May of that year.

The second one caught the attention of the American media and through a big story in the New York Times , the eye of a then small citric acid producer in Brooklyn called Pfizer who soon began a prolonged engagement with Dawson's project.

Then thanks to Dawson's former patient (and Manhattan resident) Floyd Odlum , one agency (the War Production Board (WPB) -- out of many for the Allies -- caught his vision too.

They ordered that enough American wartime penicillin to be be produced to save all those dying in the Allied civilian and military worlds , with enough left over to save many of those dying in the rest of the world as well.

But Big Pharma sat on its hands, hoping public domain natural penicillin might soon be replaced by high profit patented synthetic penicillin.

But when another former patient of Dr Dawson,  Dr Dante Colitti from the Bronx , broke the embargo on going to the popular press to plead for government penicillin for dying baby Patty Malone of Queens.

Soon a local Manhattan news story broke big - first going stateside (thanks to the newspaper chain of Citizen Hearst) and then going international , despite the war censorship.

(Good News travels fast --- never faster than in the middle of a Bad News War.)

Pfizer boss John L Smith was moved because the plight of the little Patty because it reminded him so much of the unhappy circumstances surrounding the un-necessary meningitis death of his daughter Mary Louise. (Penicillin usually quickly cures cases of frequently fatal meningitis.)

She had died basically because the (healthy) Alexander Fleming couldn't get off his fanny in the early 1930s to make penicillin in the same way that the (terminally ill) Dawson had done in the 1940s.

John L and his wife must have had a serious heart to heart pillow talk about this one night because soon the normally extremely cautious Smith had thrown off all traces.

'Damn the rest of Big Pharma, and damn petty government regulations forbidding Pfizer and Smith from giving away secret penicillin to keep people alive.'

He ordered in Klieg Lights and put the firm on a 24/7 mad rush to complete the world's first really big penicillin plant.

He was moved as well by all the successes Dawson was having in curing endless kinds of diseases with penicillin - and by the unexpected discovery made in a Staten Island hospital that penicillin quickly and safely cured the age old scourge of syphilis.

John L was big Dodgers fan - he owned part of the club - and in the early summer of 1944 the baseball team stiffed.

Despite this , Brooklyn still scored big on an extended road trip : Omaha, Utah, Juno , Gold and Silver.

For 80% of the penicillin that landed on D-Day came from Pfizer's converted ice-cube plant on Marcy Avenue in "The-Borough-That-Builds" -- and for the rest of the war Pfizer supplied by far the biggest portion of the world's penicillin.

Obviously more than just a tree grew green in Brooklyn that summer.

Britain had discovered penicillin and done almost all the work on it until Dawson's first ever injections of penicillin-the-antibiotic on October 16th 1940.

But the attitude of the leading British researcher, Oxford's Dr Howard Florey , was directly opposed to Dawson's humanitarian values.

He wanted penicillin kept secret and used only as a weaponized medicine , something that would give Allied troops a surprise advantage over the Germans.

Allied civilians and POWs , along with the dying in the occupied countries, the neutrals and the enemy would just have to wait at the back of the bus.

In addition, Florey (and Fleming) banked all his hopes on the chimera of cheap synthetic penicillin - something still not achieved - or ever likely to be!

So as American natural penicillin (and not British synthetic penicillin) flew by plane all over the the world, very highly publicized in the global media, to save dying children in Allied and Neutral countries (some like Australia a former close ally of Britain and ironically , the home of Florey !) , something very important for our post-war world happened.

Pax Britannica , sustained up to now by collective memories the British bravery under the Blitz, faded and was replaced by the new Pax Americana.

Or perhaps Pax Penicillia ? Pax Manhattana ? Pax New York ?

When Dawson died of his terminal disease in the spring of 1945 , just after the death of FDR and just before those of Mussolini and Hitler, his passing got a moment of respectful recognition for all he wrought.

But Dawson safely dead, Fleming and Florey got all the credit ever since though they had signally failed to produce any synthetic penicillin for either the war effort or for the world's dying.

The were aided by Britons , all of them - from top to bottom , unconsciously determined to recover something from a costly war they supposedly won.

Ever since then, the British have rivalled the Russians in the number of important wartime inventions and discoveries that only they supposed did the fundamental work in --- even though the hard evidence says many people in many nations made important contributions over many decades.

Penicillin , along with radar and the jet , occupies the very Parthenon of this false-memory syndrome.

If left to British science - and left to Churchill's Conservative British government - the war or the postwar would never have seen cheap abundant penicillin produced all over the planet.

Endless endemic diseases would not have been knocked back - millions would have died - with billions suffering ill health.

Come on up Manhattan and New York - on October 16th 2015 take a deep bow for your role in wartime's humanitarian "Penicillin-for-All" - you fully deserve it !

And Ramzi Yousef and all your terrorist ilk - Manhattan penicillin has saved far more of your kinfolk than your bombs will ever kill - at least try and show a hint of respect.

Don't be like the ungrateful British....

Specialist - in depth - beat reporters - or just cheerleaders, captured by their sources ?

In August 1941, Howard Florey published a gripping human interest drama in the pages of the world's leading medical journal, THE LANCET, complete with dramatic before and after photos of little kiddies rescued from certain death.

Yet no reporter in Great Britain's highly competitive newspaper world ever published a single word about it !

Why not ?

I think it is because the general reporters who would have published such a gripping human interest story in a shot never heard of it from their "filtering" colleagues, the beat specialists.

Otherwise, general reporters only write such stories if they had had a personal approach - say by the parents of one of the boys in question.

But general reporters do not generally scan endless numbers of highly specialist publications like THE LANCET looking for likely stories and exclusives - that "filtering" job is the role of their papers' specialist or beat reporters.

These beat specialists cover only Parliament, or only The City.

 (Or perhaps only the labour scene, or medicine and science , or the police courts, sports etc.)

During WWII , effective if informal censorship existed for all the Allies' scientific and technical publications.

A word to the wise to a few key technical-scientific editors about subjects to be low-balled generally worked better than a legal (and hence highly public) censorship notice detailing all the subjects these publications could not talk about.

For that method had the paradoxical effect that it only alerted everybody on the specific scientific areas the military was most concerned about !

I think that almost* all the beat reporters covering medicine and science for the general media during WWII got too close to their sources and too far away from the readers who paid their wages .

They thus failed - for but one example - to ask why such a good news story - already published globally, during a world war, in THE LANCET - couldn't also be read by the millions of downmarket readers of the UK's DAILY MIRROR ?

William L Laurence - the New York Times  science reporter who shilled under the table for the Manhattan Project - is the best known example of this process of being morally captured by the sources you are supposed to cover objectively for readers outside that field.

But surely , he can't be the only one....

* One key exception : James McKeen Cattell , publisher of the giant scientific journal SCIENCE, who went to bat with great courage in the darkest days of early 1942 , against censoring Dawson and his Penicillin-for-All proposal.

Moral Courage --- this doctor tested on himself first - not on some helpless dying woman ...

First to receive penicillin needle : Henry Dawson, October 15 1940, Columbia Presbyterian medical center, New York

Despite this, Canadian-born (Martin) Henry Dawson wasn't actually a patient.

He was instead the lead investigator of this particular American penicillin research team.

He was merely following an old tradition that says a truly caring doctor doesn't first test a potentially dangerous new therapy upon his patients , but rather upon himself.

It is a tradition that Dawson's main penicillin rival, Australian Howard Florey - entirely in character with his self-serving nature - declined to follow.

Just one of many reasons why Hollywood producers find the idea of a penicillin drama featuring Florey as the lead to be box office poison for the women viewers who form the bulk of the audiences for medical dramas.

Dawson's other penicillin rival, Britain's Alex Fleming , like Florey was consistently unwilling to do anything that might risk his own neck - like fight in the Boer War - and he too never gave himself a needle of his own penicillin to test its safety.

Dawson, by contrast, was a decorated front line war hero and equally heroic in the front lines of peacetime medical laboratories.

The first patient to receive a penicillin needle in an effort to save their life was Charles Aronson, at the same hospital, one day after Dawson survived that very first needle of antibiotics....

Finally ---- a penicillin movie with a genuine hero - a North American hero to boot !

My book series will be the first books - ever - about the dramatic events of wartime penicillin that will feature a North American, Canadian-American Martin Henry Dawson, as its chief protagonist.

And it will thus be the first ever to feature a genuine hero as its chief protagonist.

Give credit to your typical cigar-chomping Hollywood producer - they have consistently seen what 75 years of academics have failed to see : that the proposed 'heroes' of an wartime penicillin film, Alec Fleming and Howard Florey, are in fact pure box office poison to the women who form the bulk of the audience for any medical drama.

By contrast, Henry Dawson looks like the self-less medical hero from classic Hollywood central casting -  but on steroids : this truth being stranger and stronger than any possible fiction....

Penicillin is not Avastin, but it could have been...

My book - The smallest Manhattan Project  - is about us , all 10 billion of us , here today or years dead, whose lives have been improved by the advent of inexpensive penicillin.

In a sense, this book is a rarity : one written from the patient's eye view of how that drug came to be ; a welcome change after decades of endless books exclusively devoted to how penicillin looked to the people who discovered and developed it.

Penicillin is frequently called the Miracle Drug but few consider that its biggest medical miracle was really in fact its cost, or rather 'lack of cost'.

Because the diseases that penicillin treats are contagious,  patients too poor to afford a cure remains a reservoir of the most virulent strains, waiting to infect the rest of us.

There actually were methods of preventing much of these diseases before the development of penicillin : they included the ready availability of good jobs, good food, cleaner and bigger homes, greater social respect.

Baring that, only the worldwide availability of a drug that would cure those diseases once they started up, at a price that almost all could readily afford , could reduce these diseases from being endemic or epidemic to just names in a dusty medical textbook.

That is why I can say, with absolute assurance, that even those of us who have never had a single treatment of beta-lactam (penicillin family) antibiotics are in better health today because the grandparent of them all, Penicillin G , is water cheap - literally a lifesaver "too cheap to meter" .

But it almost didn't happen , we almost lost "inexpensive penicillin".

We almost got an expensively patented synthetic drug more akin to Avastin and all those other $100,000 a year plus medications.

"The smallest Manhattan Project" is the story of a doctor ( himself slowly dying of another unrelated disease) who sacrificed his own health to see penicillin from the patient's point of view.

His name should be honoured for all time.

This, despite the fact that he did not discover penicillin and then neglect it (Fleming) nor did he start its re-discovery and eventual development, albeit while pursuing a pathway that nearly killed off that development (Florey).

Dr Martin Henry Dawson, for that was his name, merely said penicillin should be made available - now! - for every single patient whose life could be saved by it , even during the height of a Total War .

Nay, he went much, much further.

Dawson in fact said all should have access to life-saving penicillin, particularly in the middle of a Total War.

That was because that war was supposedly being fought against one opponent in particular, solely because that opponent's core philosophy said that 'some lives are more worthy than others'.

How could we continue to conduct that war with any moral vigour when our own medical establishment was 'me-tooing' Hitler's doctors ?

Now the mantra 'Penicillin for all who needed it regardless of their income level or skin colour' in the mid-1940s meant its mass production, given the vast amount of infectious disease endemic in those years.

And mass production has its myriad ways of driving production costs down, down , down --- as happily happened in the case of Penicillin G in almost textbook manner.

'Penicillin for all' quickly became 'inexpensive penicillin for all' and once that happened, penicillin began to work almost like the way a good public health vaccine program should work : the treatment of the many ultimately offering 'herd protection' to all the rest of us, free of charge.

Insulin is another drug frequently called a miracle drug.

But the sad fact is that it is far more common today than it was beforeinsulin was discovered, for a variety of reasons.

By contrast, the names of all those bacterial household scourges that so terrified our mothers and grandmothers are not even known to most of us under the age of 50, and most doctors practising today have never seen a case of them.

And that is just the sort of modern day miracle that Dawson's mantra of 'penicillin for all' can produce.

For the complex truth is that our choice of medical ethics has economic consequences and these in turn feedback and have medical consequences.

The case of what the mantra of 'penicillin for all' ultimately led to should be taught in every health economics and health ethics oriented university department for just those very reasons....

Penicillin in wartime: an alphabet soup of organizations passing the buck then hogging the credit

I am still not fully recovered from the disaster of my first public talk on wartime penicillin before Dalhousie University's  Medical History Society.

I was given a very generous amount of time by the Society's Jock Murray and Allan Marble to state my case but it didn't help : my choice for a title slide in my powerpoint presentation simply covered far too big a subject and left me no 'on the spot' wiggle room.

" Wartime Penicillin : from secret 'war weapon' to widely publicized 'beacon of hope' " is not a topic line easy to compress.

 (Though last night's blog entry on the Janus Month of March 1943 would have been a good attempt at compression.)

Within a minute or two into the talk, I felt like crawling into a hole  and disappearing forever --- I could see by the faces of the audience that I was giving far too much unknown information far too quickly.

Any two or three of my powerpoint slides, from the forty two I had actually come with, could have formed the basis of an interesting talk and a lively amount of discussion afterwards.

Eight and a half years of research has finally made me more or less comfortable with the vast array of sound-alike organizations involved in wartime penicillin,  and their activities are just as important as the individual stories of individuals like  Fleming, Florey and Dawson.

But trying to establish what the OSRD and OPRD were in the first place, even before trying to show how much at odds these two similar sounding government agencies really were on penicillin is a month's work - not a small part of a 40 minute talk.

It is entirely my fault - because the night before the lecture I had noticed that even a well known expert on the history of wartime penicillin (name omitted !) still managed to badly confuse the two in an major article in a digitalized book I found on the internet.

And when a printed work is digitalized and put on the internet, an error is forever and eternity --- and visible to all, worldwide.

That is why my penicillin work  will remain electronically fluid on this blog and in website e-books.

 My errors of fact and interpretation (and I expect and even hope to make many) will be instantly correctable as new information comes to light or savvy readers spot errors and typos.)

And another thing about individuals and institutions when Cinderella unexpectedly turns into the Queen of the Ball.

 After passing the buck for years, they now suddenly tack hard right and start clawing each other to take all the credit .

Sorting who actually did what when, not what they claimed ,after the war ,in expensive official histories, that they did, is  itself a work of many lifetimes...

First person to ever read Fleming's 1929 penicillin article, REALLY READ IT, was Henry Dawson, in October 1940...

Very early in his investigation of  the antibacterial qualities of the liquid beneath a penicillium mold , probably by October 1928, Alexander Fleming came to a truly startling conclusion.

And it is not what you - or he - or any other doctor or scientist might have expected.

Finding unknown substances that kill bacteria was and is a commonplace.

Finding a substance that kills bacteria without also killing the patient is a distinct rarity.

But the chances of finding a unknown substance that kills bacteria  while (a) not killing the patient AND (b) while being a part of about two dozen other unknown compounds in a bath of 97% water ?

Well, sir, that simply is an event that has mathematic odds well beyond the calculating.

Let us label the Alec Fleming of this startling conclusion, "Fleming I" , because six months later he had - confusingly - become both Fleming I and "Fleming II", depending on his mood.

Fleming II consistently insisted, for the next fifteen years, that penicillin would not become a useful medication until chemists had purified it, discovered its chemical structure and recreated it as an artificial synthetic. Even then, it would only be good as an external antiseptic.

Talk about a parent praising their latest offspring with faint dams !

But while Fleming II's team had actually started down the chemists' path  and had produced a much more concentrated (and semi-purified) material, he totally and abruptly abandoned this effort and never wrote it up in his seminal 1929 article.

He never even used this highly concentrated material  (a thousand times more concentrated than original his liquid mixture) in any biological experiment.

It could just be that the businessman-bacteriologist Alexander Fleming, a frugal Scot, had more native arithmetic in him than almost all the doctors and scientists who followed him into penicillin - certainly more native arithmetic ability than almost all the writers I have read on the penicillin saga.

Because the two dozen unknown compounds swirling about together hadn't eliminated the anti-bacterial activity or caused a toxic reaction, removing them by purification was a 50/50 shot at  improving- or reducing - those two valuable qualities.

Remember that : let me repeat it : purification might actually reduce the bacterial activity or increase toxicity. Synergy, working together, does many mysterious things.

In fact, Dawson's co-worker, Gladys Hobby ten long years later was only one of many who were convinced that crude impure penicillin worked better than the equivalent amount of units of pure penicillin did all by itself.

Balancing these unknowns, it wasn't mathematically likely that purifying penicillin 100% was actually going to make it a better medicine.

In fact, since with 1929 levels of original mold juice and the then current state of extraction technology, 100% pure penicillin was probably going to require losing 99% or more of the original anti-bacterial substance, 99 patients would now die so that 1 might receive 100% pure penicillin.


Let me go further, and recall some of the economics lesson professor John Graham taught me too many years ago.

Graham had a way of bringing economic jargon down to ground level, perhaps never more so than in explaining the term  "opportunity cost".

I'd like to think that this is the way he'd explain Fleming I's decision to refute Fleming II's progress :

It is not just that purifying the penicillin juice to 100% results in so little penicillin output that 99 potential patients must die so one patient can be treated with 100% penicillin - that has no more medical efficacy than the original un-purified juice.

Because devoting all of your incredible amounts of labour, stress, time, expense, lab space to this purification effort, means your team can't find the time and space to simply produce more absolute units of the original penicillin, with the production technology they already have.

Nor can they find the time, energy and money to improve the biological yield of that original strain of penicillium mold.

In the real world of limited time and resources, when you open one door, you close many others.

Now Fleming II didn't actually go very far down the path of this (pointless) path of purification.

But his team did find success in the much easier and much more potentially useful concentration of penicillin juice ; aka simply removing most of the harmless water, as we do with concentrated orange juice.

If water is the one compound in the mixture known to be harmless, why bother ?

Fleming's strain of penicillium was actually a very potent producer of penicillin on (not in) water : eventually it produced 200 units of activity per ml of liquid in painstaking experiments in the lab, and routinely got at least 40 units in day to day industrial efforts.

But Fleming didn't know how to grow penicillium right to produce its potential in penicillin - and why should be ?

But he also didn't bother to try to find out, from other fungus farmers, how to grow it better.

He was a medical bacteriologist and he grew it as if it was a medically important bacteria.

The results were a disaster : he was lucky to get one unit of activity per ml of liquid.

But even the most careful technique of safely injecting large amounts of liquid by IV drip wasn't going to find a way to get anti-bacterial activity that diluted into the blood stream to cure really life threatening blood poisoning.

Success by this method, as several bold and brave doctors discovered in 1943-1944, wasn't actually that far off : in those early days, even massive infusions of 10 units per ml of liquid would save lives ,and at 40 units per ml of liquid all but the toughest infections could be beat back then.

So if Fleming II concentrated his original liquid down to a thick syrup, he'd have concentrated it enough to inject into patients --- without losing too much of the original scant penicillin in the process  OR consuming all his team's limited energy, time and money in the process.

But at this point, another set of experiments convinced Fleming II completely (and totally wrongly) that penicillin would not work at all as a systemic - concentrated, purified or not.

If only he had injected his syrup, mixed with a little bit of saline solution, into a dying mouse, the mouse would lived.

 And penicillin would have been in wide clinical use by December 1929, repeating the rapid pattern of Banting's insulin, but this time in spades.

However, Fleming I never put Fleming II's work or conclusions into his 1929 paper - only repeating his conclusions in private conversations , if pushed.

He found, (and so told hundreds of hospital bacteriologists all over the world) , that easy to make, 100% recovery , liquid penicillin worked well as a routine lab clearing agent and for use as an a non-toxic human antiseptic.

Now to October of 1940 , exactly 12 years after Fleming's original startling discovery about 'the non toxicity of impurity'.

 Henry Dawson is waiting impatiently for his co-worker Karl Meyer to purify some of Fleming's penicillin up to what the team imagined was the level of purity acceptable to their famous teaching hospital's quality standards.

And to the level they imagined the deliberately vague but purity-obsessed Howard Florey had claimed he had achieved before safely injecting his penicillin into infected mice in the summer of 1940, saving their lives.

Suddenly, while impatiently waiting and pacing the floor, Dawson was presented with a truly Solomon's Dilemma.

He had expected to treat a single patient with SBE, provided the young man didn't die of the invariably fatal disease before Meyer had purified the penicillin to an acceptable level.

Now he suddenly had two young men dying of SBE.

Re-reading Fleming's original article gave him his solution : if purifying merely lent losing half or more (much more) of the limited material available, without making the resulting medicine any less toxic, why bother ?

Merely quickly concentrate the liquid penicillin, so most of the harmless impurities are left in, while the harmless but burdensome excess of water was left out - and you would be quickly left with enough penicillin to treat two patients - and all this could happen before the two men died.

So the spirit of Fleming I , not Fleming II, was guiding Dawson's hand when he injected the world's very first antibiotics , months ahead of schedule, into BOTH Aaron Alston AND Charles Aronson on October 16th 1940.

Fittingly, in this act of inspired charity, Matthew 20:16 was again fulfilled as the Last became the First to receive this healing balm.

(Alston was almost certainly black and Aronson almost certainly Jewish and in 1940s America both were hardly among the truly favoured peoples.)

After Dawson, a few others others would re-read Fleming's paper as if for the first time, and decided to prefer large amounts - today ! - of highly impure but non toxic penicillin, over small amounts of highly purified but no more non toxic penicillin, maybe, tomorrow.

I suspect their grateful patients, plucked back from the grave, more than agreed with their re-reading of Fleming 1929.

A case of Jam Today , indeed .....

Wartime penicillin was "A Genie of Universal Healing", trapped by Florey in a military bottle...

... a Genie intended to remain secret, military and patented for the duration of the war, until others --- led by Henry Dawson --- fought to set it free to benefit all humanity.

Like the war itself, wartime penicillin was not a single event, as we tend to treat it today, but a six year long, world-wide process - a conflict in fact.

A conflict between the much more powerful and much more numerous Hares, led by Florey, who sought to seal off penicillin in many different senses of that phrase.

The small band of Tortoises , led by Dawson, sought to make penicillin free to mix , again in many different senses of that phrase.

The Hares had all the early running from 1939 till 1944, when the Tortoises suddenly appeared out of the dust , like the US Seventh Cavalry, to save the medical establishment's bacon just moments before the D-Day beaches became red with blood .....

Fleming's seminal 1929 article on penicillin is missing two words : impurities and crude

Fleming, in this extremely famous article, defines his "penicillin" as consisting of  one or more soluble solid active ingredients in a liquid nutritional  broth, no more and no less.

He makes it clear that "penicillin" is merely a useful shorthand for that cumbersome longer phrase.

He never once uses the word impurities or impure or crude: to him his active ingredient is perhaps ALL  of the soluble solids left behind when the water is evaporated .

Fleming says that this (mixture) of soluble solids and nutritional broth is non-toxic to the extent that it can be injected in a mass of one fortieth of body weight without harm.

(That is, this liquid mixture appears to be safely injectable in a mouse and a rabbit to the equivalent of  a single bolus of 1500 to 2000 cc into an average adult human.)

And Fleming isn't the only one never to use impurities or crude in describing penicillin in a scientific report, in the twelve years between 1928 and 1940.

Clutterbuck & Raistrick in 1932 do not use the words impurities or crude, nor does Roger Reid in 1934, or Elizabeth Pickering at Squibb in 1937 or Siegbert Bornstein in 1939.

But Howard Florey, the chemist manque , the anti-clinician, he sure does in 1940.

He might even ask his potential readers, "Purity : how many ways do you want it ?"

Despite being a very short article - almost more of a scientific note  in the style of letters to the journal Nature - Florey manages to inject the words "purify" , "not a pure substance", "impure" and "impurities" and talks constantly of his "penicillin preparations" as if they are something quite different and advanced from Fleming's liquid penicillin.

But, in fact, Florey has merely concentrated all the soluble solids by evaporating away the water, so that 4 tiny units of anti-bacterial activity are no longer in a gram of water and solubles, but in a milligram of solubles.

But two thirds of the scarce anti-bacterial activity has been lost in this totally unnecessary and expensive and complex effort : and in any case, this dry powder has to have water added back into it, to inject it for use !

Dawson, Pulvertaft, Duhig, Yermolieva , Berger (among a mere handful of all the world's doctors ---- maybe just .01% of them  thought this way) seemed to have picked up on Fleming's crucial point.

A point he quickly missed, because he publicly always said that the substance would have to be synthesized pure by chemists before it might be a useful antiseptic .

But his original point was true, nevertheless.

It was this : that regardless of whatever was the compound(s) with that mixture of soluble solids that had the anti-bacterial powers, the water and other solids had no harmful effect and needn't be laboriously purified out - or even concentrated by evaporation - at a tremendous loss of the anti-bacterial matter.

Dawson is at pains to introduce the word "crude" repeatedly in his 1941 article, but with a much different point that Florey's article a few months earlier.

Dawson wants to hammer home that despite the crudity of this mixture of the anti-bacterial activity and the other soluble solids, it was still non-toxic even when injected ( finally) into the human blood stream : life-saving does not have to wait until the chemist's apple has been polished to a 't' .

Dawson is , in a sense , "The James Lind of Penicillin".

Put in another way, James Lind said we don't know which compound (later determined to be vitamin c) it is in limes that prevents scurvy but that shouldn't stop us from using it - NOW ! - to save lives.

Almost two hundred years later, another Scottish (Canadian) doctor (Henry Dawson) said pretty much the same thing.

The lesson might be this : chemists, let the sleeping dogs of chemical perfection lie -----  while we clinicians get on with saving lives.....

Merck has credible excuses for being beaten on D-Day penicillin by Pfizer - but none whatsoever for being crushed by Commercial Solvent

Merck, the OSRD, Florey's Oxford team (all part of the synthetic penicillin obsession) continue to have many defenders among academia.

Yes, one academic excuse goes, yes Merck failed to deliver much penicillin to the D-Day beaches - that was left to Pfizer, which had been a major partner of Merck and Squibb in the three year long effort to produce commercial amounts of penicillin.

But, the excuse went, Pfizer had 20 years of highly successful fermentation experience before late 1941and the commercial penicillin project's beginnings.

But how then to explain the huge success of Commercial Solvents  in producing medical grade penicillin from a cold start in January 1944 to levels twice that of Merck in just four months and then levels six or seven times higher than Merck in just three more months after that?

True, Commercial Solvent had 30 years of success in industrial grade fermentation in making bulk acetone but had never done anything even remote to pharmaceutical levels of purity and cleanliness.

But there it was - passing an increasingly demanding FDA testing requirements with its tens of billions of units of injectable penicillin.

Clearly, the supposedly-arcane craft could be learned fairly quickly, if a corporate culture demanded it.

Even Squibb redeemed itself by well beating Merck's output, by late 1944 .

Merck lost the race for one reason only : hubris.

It thought that since it had synthesized a few 300 molecular weight molecules that all 300 weight biological molecules were a piece of cake.

Tell that to  penicillin with a weight of 334 and still not commercially synthesized.

Or tell it to quinine , molecular weight 324, and 200 years after Man-The-Almighty first started to synthesize it, still without a commercially viable synthesis technique at hand....