1940s medical reformers' views on Indie PEN ("crude" penicillin) : 'about as safe as mother's milk ---- and equally unfashionable'

The aesthetic objections to live-saving Indie PEN

The medical reformers controlling the (glacial) pace of the mass introduction of penicillin (from 1928 to 1944) viewed the idea of saving the lives of dying patients with crude (Indie PEN) penicillin with the same sort of distaste they held towards mothers who still breastfed.

They all wanted penicillin that was first of all was pure and stable.

Some further wanted to wait until it was chemically synthesized (patentable) and many others wanted to keep it secret and limit it only for Allied wounded soldiers while the war raged.

And if countless patients died needlessly while they polished the turd - so be it .

The medical phobia against fresh bread

It was an age when all the best educated (with urban medical researchers often in the vanguard) sincerely believed that mothers who made biscuits on the kitchen stove right before her waiting children and then immediately fed it to them were endangering their health.

Much better to feed them factory made biscuits made two thousand miles away and stored for weeks in a warehouse, smothered in chemical preservatives.

For only the old fashioned rural poor still made 'fresh from the oven' home made bread and biscuits.

And all the best educated used baby formula - only country yokels would be so gauche as to breastfed a baby in public.

The less you needed to buy artificial vitamins , the more you bought of them

The best fed and best educated  - who could actually easily afford fresh oranges even when they were most expensive - prided themselves on not getting their daily vitamin C from impure fruit.

For mixed in with the pure vitamin C (that they preferred to get from synthetic pills) natural fruits contained all sorts of impurities.

(Impurities such as tasty juicy fruit sugar water, fibre and  traces of minerals and other vitamins.)

We today who are well educated - we who pride ourselves on our 'advanced thinking' - should view this all as a cautionary tale against the hubris of the well educated who don't realize the sharp limits to their very expensive educations.

But it does help explain the irrational phobias held by well educated doctors had so hampered the mass production of wartime's 'safe enough' penicillin .

Because even in 1944 and the introduction of mass penicillin - high quality commercial penicillin was still at best 85% dross and 15% pure penicillin.

Vincent Duhig, unsung hero of Indie PEN movement

Again, as late as 1944, Vincent Duhig , one of the least known heroes of the Indie PEN movement, was still saving lives with injections of penicillin that were 99.99% dross and one part in a ten thousand pure penicillin.

That is food grade medicine - some cooked fruits and vegetables deliver vitamin C in those same (extraordinarily low) ratios.

But we don't inject those foods directly into a patient's bloodstream via an IV drip.

But that is what Duhig dared to do - plucking a dozen lives back from the grave - patients considered so far gone that all the other doctors permitted Duhig's 'mad' scheme , as a sort of a patient's faint hope clause.

"Heroic medicine" they call it.

But heroic or merely canny ?

Because while Duhig used techniques more primitive than those that Alexander Fleming had rejected 15 years earlier in 1928, he judged them safe enough to use to save the dying who had no other hope and he was proved right, over and over.

Like Martin Henry Dawson, Robert Pulvertaft and some pioneering Russian penicillin doctors, Duhig was near enough to the hospital ward floor and far enough away from the ivory towers of basic research labs to recognize some obvious medical facts of life.

He knew penicillin itself was the most non toxic lifesaver even seen (still true today) and that by great good luck, the impurities in crude natural penicillin juice (like the impurities in crude orange juice) were 'safe enough'.

By contrast, the conventional treatment for most deadly bacterial infections were the all new , all dancing , all synthetic sulfa drugs - the darlings of that era's chemistry-mad medical reformers.

They were cheap, plentiful and often worked without incident.

But for a growing percentage of patients - a figure that rose rapidly as bacterial resistance grew to the sulfas and doses had to get dangerously high to remain effective - sulfas could make the patient painfully sick or damage their kidneys permanently - sometimes even kill them.

Doctors used them because the alternative often was an equally painful death.

The crude compromises of the busy hospital ward

Life on the busy ward floor - unlike inside the lab's pristine porcelain white walls - is always full of tricky compromises.

After all , ultimately doctors gets paid the big bucks above all for their skill in juggling between a drug's dosage being too safe to be effective and a drug's dosage being so high as to kill patient as well as germ.

As it happened, the crude penicillin of Duhig - being totally untreated by any chemical solvents etc - was probably less toxic to patients than the so called purified penicillins were .

That is because all the chemicals used in the purification process often added new impurities in the mix !

Yes ,wartime indie PEN , like wartime breast milk, was crude and impure - but unlike most wartime medical researchers, it was never brain-dead stupid....

Wartime Penicillin, told as sharp clash of vivid personalities and philosophies -- not as a dry scientific treatise or as cheerleading fantasy of selfless wartime cooperation

If you have never read a book about the exciting saga of wartime penicillin that is hardly because of a lack of choice.

Dozens and dozens of authors have written well researched (and well regarded) renderings of the dramatic story, even if we discount the mass of uniformly dreadful books directed at children.

But despite a potential reading audience  that since 1944 that must number in the billions, none of these books can be said to be a national - let alone international - best seller.

Even more unexpectedly, there has never been any Hollywood movie about the wartime penicillin saga, let alone any successful one.

All these penicillin books to date suffer from one honest, sincere but erroneous assumption.

All their authors are united in seeing a single reason for the 15 years of delay between fleming's discovery of penicillin and when we in the rest of the world first heard about.

The same explanation is also used to account for the 25 year delay between the 1928 discovery and when it became readily available to almost all of the world's dying (regardless of income or location) during the 1950s.

Technical Flaws ?

They believe that all the delays in bringing penicillin to a world that badly needed it can  blamed on technical flaws in our sincere efforts to purify and preserve penicillin.

These steps were judged essential before it could be safely injected into the dying and cast as not really not surprising delays ---- once the reader is shown the complex nature of the penicillin molecule .

 These  authors consider briefly and then quickly dismiss the idea that the delays were really the result of character cum intellectual flaws ... in the complex natures of those we initially allowed to lead the penicillin effort.

These authors can hardly be accused of sugarcoating the personality clashes among the best known of the penicillin leaders or of denying differences between the various international organizations involved .

But neither do they portray these clashes as lying at the very heart of the causes for the years of delays.

Big Pharma - Big Science - Big Government vs Indie PEN

Powerful individuals and organizations holding widely popular views lay behind the delay to bring penicillin to the whole world.

In the beginning only a handful of individuals with few resources refused to accept the validity of these excuses for the delay in penicillin's mass introduction.

I call them , collectively, the Indie PEN movement.

Against overwhelming odds, this handful took on Big Pharma, Big Science , Big Government at the height of a Total War - and then, quite unexpectedly, totally triumphed at the very end.

A classic tortoise and hare story.

These personality (cum intellectual) flaws were not merely of a petty pattern or whimsically inconsistent .

Character/Intellectual Flaws ?

They are seriously held, consistently represented and strongly sustained .

The conflicting intellectual arguments and those who made them were internally consistent.

That is , the differing intellectual positions were held by individuals whose personalities were of those people who generally held those particular intellectual viewpoints.

This is why I say it is hard to separate out character flaws from intellectual flaws.

Those differences ran deep - deep as can be.

They reflected deeply held personal or institutional philosophies ("Weltanschauung") that differed in almost every way possible.

Some of those philosophies that lay behind the delays to bring penicillin to the masses would be regarded as deeply repugnant today.

 I certain think that way about them - I am not shy in saying that I see more than a whiff of the clash between absolute good and absolute evil buried deep inside the wartime penicillin saga.

 And I also see those ignoble philosophies as the main reason for all the delays.

 They lay behind the secret drive to weaponize penicillin and to deny it to most of the wartime world.

So we have before us a number of vivid , strongly etched characters (with strongly held and violently different worldviews ) clashing repeatedly .

I  don't think I am wrong in thinking that this will all make for a truly propulsive page turner --- one that also happens to better represent the reality of the war years.

Seventy five years on, its finally time that we dropped all remnants of the wartime Pollyanna rah rah cheerleading.

Let's let the story of wartime penicillin finally unfold as it truly happened , ignoble warts and selfless heroics and all ....

Indie Pen versus Trolling for Grants

Trolling for Grants

Would Nobel Prize winner Sir Howard Florey have ever even gotten involved with penicillin if he hadn't first won grants to do so from the UK's  MRC and America's Rockefeller Foundation along with a book contract on the subject from Oxford University Press ?

It wasn't just their promise of money either - Florey was the type that never ventured forth unless he was assured of the stamp of approval from the powerful - and grants and book contracts from such as these were definitely that.

He was made the chaired professor (director) of a large institution within Oxford University (with a main building about the size of his rival Martin Henry Dawson 's entire alma mater -Dalhousie University - circa 1914).

But no operating budget to speak of to run it.

To keep the lights on , he needed many make work projects to operate within it - what subject areas they covered it didn't really matter to Florey- just as long as they brought in many grants for many years to many busy researchers.

Not too small a project - that gave no certainty that any grant agency would be interested. Too big and too popular  meant too many potential rivals worldwide.

He sought a medium sized but worthy project that someone should really have looked into years before - but no one had.

If he got in early enough and got in big enough, he'd have a head start in so many aspects of the subject that no serious rival would find enough virgin territory to want to stake a rival claim  --- he'd rule that entire important albeit medium sized research area forever.

The study of microbe to microbe offensive and defensive tactics (antibiosis) seemed just such an untapped area - and Florey had indeed guessed right and he was given grants to secure his institution for years to come.

But he himself had no real interest in that area - he was a Sherrington styled old fashioned physiologist , one who experimented on healthy animals to learn about the normal functions of healthy human beings.

He was in no way a microbiologist , clinician or pathologist - he had no interest in curing human disease caused by external microbes.

Only upon the Fall of France did Florey realize that Ernst Chain's project - penicillin - might yield useful materials to heal war wound infection caused by the one big family of bacteria the existing sulfas could not attack - the staph bacteria.

This basic science project of Chain's might yet make Florey a wartime medical hero - and win him anything and everything - even a much desired baronetcy .

His main rival (at least as Florey saw it) was in fact content with his lot in life but burned with the ardour of a medical crusader - he sought to make life better for the weak and the small.

Indie Pen

Dawson sought no grants , sought no prior approval from the powerful.

He was quiet, modest , diffident.

And in his quiet way, also extremely stubborn and brave.

Throughout the race, Dawson was always so far behind as to be almost out of the race.

He was also dying.

It therefore becomes a very exciting story then for me to unfold.

How on earth did this (dying) tortoise managed in the last minutes before D-Day  to suddenly pulled far ahead of his British hare rival  ?

Tortoise and Hare : the race between indies and suits for wartime penicillin

Indie Pen

The Tortoise was 'indie' penicillin , New York City penicillin , Emma Lazarus penicillin - humanized and naturalized. It had none of the innings for nine tenths of the game but pulled way ahead at the end.

The Hare was 'suits' penicillin : weaponized , synthesized , eugenicized , profitably-patentable, 'I am a Republican in a Democratic administration and I am here to help you 'penicillin.

It was supported by  the Anglo-American scientific-medical establishment ,  by Big Pharma and by the British Conservative-dominated government and some all-powerful agencies of the wartime American government.