Monday, September 27, 2010

Dawson,Florey: wildly different colonial Edwardians

Howard Florey and Henry Dawson were both born in the mid 1890s and grew up in roughly similar upper/middle class circumstances in two small outposts of the Edwardian Era British Empire.

But both took wildly variant approaches to almost every major decision affecting people born in the Edwardian Era.

Most famously, these two Edwardian colonials differed wildly over the best way to quickly get penicillin into wide use during World War Two.

We abuse history if we read too much into the generalities of a particular era and not enough into the particularities of the individuals living in the era.

 People, not eras, after all make the choices and do the actions.

If Florey was highly 'typical' of his Era, Dawson definitely was not 'typical' at all : however he still remained, someone from that Era -
a fact we must confront head on.....

50 years separate Leaders at top and Teen riflemen at bottom

In every war, the top national leadership are usually in their sixties.

My definition of national leader goes well beyond prime ministers and generals to include the unseen, semi-retired, powers behind the throne: the newspaper owners, the chief shareholders of the largest corporations, the professors emeritus etc.

By contrast, the men at the pointiest end of the stick, the infantry dogfaces armed only with a rifle and a shovel, are often in their teens.

Fifty years, a very long half century, usually separates the men who run the war from those who merely did as they are told.

So a historical approach which focuses too much on the memories of youngest veterans, the ones who survive the longest on civilian street, can seriously distort the historical record.

Yes they actually fought the battles and this makes for dramatic stories.

But, but, but - a focus on their experience comes at a high price.

Babies may experience history but they certainly didn't form it.

We need always to remember that the men who caused World War I -  and who led it -  had their formative experience of their life in the Pre-Modern Era ( back in 1850s and 1860s).

But their front line teenage soldiers were children of the Modern Era at its most florid - the worldwide Wheat and Rail Boom that led into the Edwardian Era.

So there was a disconnect.

In the Viet Nam War, the leaders were fully from the Modern Era but the teens fighting it were of the Post-Modern Era.

Another disconnect.

However in World War II,our only fully MODERN WAR , both its leaders and its teen soldiers were both fully in the same Modern Era ----albeit up to a point.

After all its leaders grew up in the booming Edwardian Era and the kids fighting in its front lines grew up in the depths of the Great Depression.

Probing further, we can see that the Edwardian Era was one where people were both, at almost the same instant, extremely optimistic and extremely pessimistic.

Progress and Degeneracy were their two bywords.

Most Edwardian Era adults held both views but still leaned consistently more to one side or other side.

I would, for an example, place Howard Florey on the optimistic side and Henry Dawson on the pessimistic side of the Edwardian Era estimation of Man's ability to favourably affect Reality.

My book on the wartime Penicillin Saga will not shortchange the leaders of the various wars it covers.

 I will highlight the fact that for most of us, our definitive values-forming experiences occur in our mid teens.

And I will then focus on the paradox that we
only get full rein to impose those teen age values on those younger than us when we are about 50 years older and our victims are themselves in their own mid-teens !

WW II leaders and their populace generally were
less convinced about the effectiveness of War elan and were more convinced of the effectiveness of War Science, in comparison to Great War populations.

This was partly due to the effect of recent experience - elan hadn't worked too well against machine guns in Flanders' Fields.

But it also reflected the intense belief in the 'Power of Science' held by Edwardian Era teenagers who were now running the Second World War at the very top of the food chain...

Saturday, September 25, 2010

War hospital stays made Dawson bacteriologist not surgeon

Not until February 1919, when the war was over, and Henry Dawson was back in Canada facing discharge, did he say that his civilian occupation was to be a MEDICAL student.

Until then, he was just an Arts student.

With his excellent marks, if in 1915 he had told military recruiters that he was intending to go into med school, he would have been almost 'ordered' to remain in school and become a doctor, as they were so desperately needed .

He spent a year in military hospitals as a buck private orderly, dealing with the severely injured and severely infected wounded coming off the battlefields.

Many other patients ,less dramatically, were
nevertheless dying from diseases they had picked up in other places than from a battlefield wound.

Then he was wounded,once as a infantry officer and then once as an artillery officer, both times fairly severely, and spent long periods in various hospitals.

The only heroes in these wound-oriented hospitals were the surgeons - they saved lives by their skill with a good eye and a steady hand.

The nursing staff might save lives by attention to detail in keeping wounds clean.

But regular (clinician) doctors contributed little towards a cure - they could diagnose but didn't have any medicine to save a patient if severe blood poisoning set in.

Bacteria were more dangerous than German bullets.

Interesting, there is no evidence Dawson decided to try and become a surgeon like all the surgeon-heroes he had met in the hospitals, once he was at McGill's Med School.

Instead Dawson quickly became a bacteriologist-pathologist and remained so all his life.

I think he felt that too many of the healthy young boys around him in his stays in hospital had survived their battlefield wound and had survived the surgery , only to die of bacterial infection.

This, he felt, was medicine's weakest link.

He wasn't seeking to emulate his medical heroes, but rather seeking to reform medicine from within.

 I believe he set out with a critical attitude to the existing medical practise - he felt it didn't give enough attention to the successful bacteria's secrets.

I think he saw too many young boys needlessly die who had never danced or ever been kissed...

Florey family and PATENTS :ducks and water

In the reverential biographies of  Howard Florey ( he has never had a critical biography - I hope to inspire one of them though), he is always played as the anti-patent guy on penicillin.

By contrast, Ernst Chain is always played as the greedy pro-patent guy.

Well, he is Jewish after all - he would be the greedy  money-grubbing one, won't he ?

Edward Abraham, who was there at the time, says that both were pro-patent to a degree - seeking Oxford University to control it ,(as the University of Toronto did insulin).

I agree.

The assumption was made that because Chain's father was in some sort of chemistry business in Germany Chain the PhD chemist would know all about the importance of patents.

(But we don't actually know if his father was involved in patents.)

But Florey ,the MD, would not anything about patents - against MD ethics in the UK at the time. Etc.

Bull dung !

Florey-the-son had wanted to be a chemist and was only nominally a MD in reality anyway.

His father had made his fortune by being the first into a new cutting edge technology, the first into high tech chemistry and trade marks, and by being the first in his state to obtain exclusive geographic rights to new processes.

Joseph Florey even tried to obtain at least one patent himself - for improvements in pneumatic tyres - applied for in Western Australia on May 16 1996, according to the local daily paper.

Leather making technology hadn't changed in around 10,000 years - so when it did, many in the industry refused to take the first leap.

Beyond how technically challenging the new ways of tanning leather were, was the fact that they were not public domain and free, as the tannin way of leather-making had been for centuries.

Florey took both risks and fell into a hot area of patents and licenses and paying high fees - or ignoring patents and fees and focussing on trade marks instead.

His many ads never claimed he had a patent for his chromella leather or even a patent license with a registered number - merely that he was the exclusive South Australia agent for it and held control of it as a trademark.

I haven't been able to find the original owner of chromella leather, but I believe very much they existed.

Here is why:

Florey's very first time he is mentioned in any newspaper seems to have been the month (October 1894) - even the day - he got that exclusive agency for chromella and he took out ads proclaiming that fact.

The word chromella almost never left the Australian papers, in some form or other, until well after his death.

His wealth seemed to have started around 1894 as well.

Having that chromella agency really seemed to have mattered.

But Joseph Florey having interests in tyres and patents of his own was news to me.

Patent talk would have been mother's milk to his son, Howard.

And I think we all owe Chain a heartfelt apology....

CHEMISTRY made Joseph Florey family rich and famous

Tanning leather is an ancient and highly skilled activity involving many chemical processes --- a process humans have been doing world wide for tens of thousands of years.

But tanning leather by use of formal chemistry (man-made rather than naturally found chemicals) is only about 150 years old and was brand new to the Southern Hemisphere when Joseph Florey set out to make his fame and fortune in the backward colony of South Australia.

This new method was called "chrome leather"  and consisted of tanning leather by means of various compounds of the metal chromium.

 The traditional, natural way, was via using tannin from the bark of various hardwoods, together with urine,dung and brains of animals and humans, as well as involving a lot of expensive, capricious hand labour.

 And a lot of time.

Joseph Florey was also a part owner of a new wattle plantation near Mount Cone in the interior of South Australia.

Wattles make an important variant of leather, suitable where chrome leather was too soft.

Till then,  virtually treeless South Australia had to import its tannin at great cost.

Chrome leather, by contrast, was modern, fast, machine-oriented, capital oriented.

It was made without the use of foul-smelling human urine and excrement collected by little poor children on the street corners of the poor neighbourhoods .

The chemically active ingredients of those natural products had been learned and synthetically made equivalents were used instead.

This was Victorian Progress and Joseph Florey never let anyone forget it - it was the focus of his firm's static displays at the Exhibitions of Industry and Progress so beloved by the Victorian and Edwardian middle class.

It was encompassed in his trade mark,Chromella, which he had secured throughout all of Australasia (sic). He repeatedly defended that trademark in expensive court cases.

Joseph Florey hadn't invented chrome leather but he acted as he had.

He successfully won via the courts , at least locally, the right to prevent any other competitor from using any trade name that hinted that their leather was produced by the 'chrome' method - though the patents on the original process had gone by then.

Chemistry - and a very competitive and ligatious nature - made the Florey fortune.

These were lessons learned well by Howard Florey and why he wanted to become a chemist - and why he was so highly competitive.

Ironically, chromium, a heavy metal, in those days and today gives many  customers contact dermitious or worse -- it is banned in very young children's shoes.

And its waste products are far worse for the environment than urine and dung ever were.

So today a new progressive modified organic, natural, method called 'wet white' is replacing the Old School chrome, wet blue, method......

Wednesday, September 22, 2010

Pity poor, poor pitiful Florey, surrounded by leftie subordinates

 Howard Florey got some very useful advice the day he arrived in America to protect Oxford University's Chromella Brand Penicillin from what he imagined were attacks on his left flank from Henry Dawson and his cohorts in deepest Brooklyn.

"Whatever you do, stay away from taking sides between the advocates of continuing social medicine (people like the US Surgeon General Thomas Parran) and those using the war as an excuse to roll back New Deal medical gains for the poor ( people like AMA godfather Morris Fishbein and the NAS's Lewis Weed.)"

(Dr Weed, upon whom the Hippocratic Oath lay lightly, saw medicines like penicillin and projects like germ warfare as highly useful weapons in a total war - and to test them the poor and the weak would be unwittingly conscripted into the war effort.)

This useful advice from Dr Gregg at the Rockefeller Foundation was wasted on Florey, the son of a hard-nosed industrialist and someone who loathed Blacks, Italians, Jews and trade unionists. (Just for a start.)

In fact, most of the problems that Florey had had with his subordinate Ernst Chain and his co-workers  Epstein and Duthie ,had come from of their left-wing social medicine-oriented politics.

Florey rather more preferred men like John Randal Baker, author of the controversial book RACE, if he had a choice as to who he wanted in his Institution.

Leslie Epstein (later Leslie Falk), from the Parran side of the debate, exacted his revenge on Florey by telling all on Florey's secret penicillin work to fellow Jew, Karl Meyer, working with Henry Dawson.

He thus setting into motion the wartime across ocean race to see whether Man or Nature would provide the lifesaving penicillin for the Allied wounded on the beaches of the upcoming Second Front.

And Thomas Parran got his revenge on A N Richards and C S Keffer from the Weed side of the debate, by releasing the penicillin to Baby Patricia which blow the lid off the whole secret effort to keep penicillin hidden until a chemical synthesis had been worked out.

After the war Parran and Falk joined up in Pittsburgh, still pushing a social medicine agency during a time in Cold War America the act of providing health care for all was regarded as the work of the Devil, in his human guise as Stalin.

America never did get decent medical care for its poorer citizens.

But hey, "We'll always have Penicillin. "

Won't we America ...?

Tuesday, September 21, 2010

WWII : German tanks mauling Polish horses to Polish horses hauling German tanks...

In September 1939, as reports emerged from neutral American and Italian journalists of 'fast-moving German panzer tanks destroying charges by the lumbering Polish horse calvary', the world's thumb-suckers all agreed: this war would see the Triumph of the Mobile Will over Stolid Matter.

A war of active chemical synthesis over passive biology and agriculture.

Of physics and active weather modification projects over the passive observations and avoidances of meteorology.

A war of fast tanks over slow horses; of high tech bombers and highly trained bomber crews over low tech shovels and the unskilled troops than employ them.

The weight of the Draft and Conscription would lay lightly on the population.

The mostly highly educated wouldn't even be drafted because scientists were too valuable to heft shovels overseas in some trench.

The highly skilled would either received deferments to remain in their home jobs or if drafted, would carry on their skills in the rear echelons of the war zone or would engage in combat from inside a high tech tank, plane or ship.

Only a relatively small number, the unskilled and the uneducated, the small and the thin, would end up assigned as riflemen.

They ,only, would be the ones to see an old fashioned war and to carry a backpack, a shovel and a rifle and to charge up and down hills at a trot and sleep in foxholes in the rain.

The highly scientifically educated A1s were each nation's most valuable asset - their least valuable asset was their chronically ill, medical-resource-consuming, too-sick-to-work, 4Fs.

Resources would be assigned to each, accordingly.

This would be the first fully Modern, first full Modernity, War : that would be the fundamental unity binding together the various combatant nations, despite the surface appearance of deep ideological differences.

Modernity united all combatant nations in this agreement: "There is nothing in Nature that Organized Man can not improve".

Natural Philosophy and active alternation would triumph completely , at long last, over passive Natural History and observation/ avoidance.

It was a time for Big Military Budgets , but relatively small military forces.

A time for Big Governments, Big Foundations, Big Businesses, Big Science.

The God of Modernity, all the thumb-suckers agreed, was on the side of the Big Battalions.

The stage was set so let the drama begin !

But entering Stage Left ,as unobserved as any airborne spore , came :


 'the Little Guy from Chrysogenum' ...

Monday, September 20, 2010

"Howard Florey stole the true story of wartime penicillin - we're here to steal it back !"

People ask what is the purpose of this blog/book "MO goes PO".

Here it is:

America - and Britain - and a whole lot of other countries made wartime penicillin.

No one stole penicillin (a natural product and hence already in the Public Domain) from anyone else - this was thanks to the pre-war legacy of Alexander Fleming freely spreading his unique strain of penicillium spores world wide.

It is true some  - in America - tried to control penicillin by sharing publicly-funded highly productive strains with only themselves and their pals - thankfully that scheme failed to do more than needlessly delay wartime penicillin's wide introduction.

On the other hand, Howard Florey and his post war supporters (many of whom are American) successfully and seemingly permanently 'stole' the true story of wartime penicillin away from America.

There was about nothing as petty as fighting over mere billions in dollars of profits.

This was the world's best known and best loved - and simply 'the best' - medical cure ever.

So it mattered muchly, which individuals, institutions and nations got the bulk of the glory for bringing it forth for All Humanity to enjoy.

This is was a battle over who controlled the Narrative and the Brand of the world's greatest Miracle.

Britain may have lost an Empire and its position as a World Power - but it clung onto penicillin-the-narrative.

All that America got was credit for the Manhattan Project and giving us the terror of Atomic Death to All Humanity.

Hardly a fair exchange.

I merely wish to suggest that the tiny "Manhattan Pilot" project had a very much bigger impact in the popular discovery of - and hence the immediate mass development of - wartime penicillin then it has been given credit for in the Florey-dominated story of wartime penicillin.

So  - and to recall Bono's memorable phrase in Rattle and Hum -
"we're here to steal it back !"

"Trust only CHROMELLA Brand Penicillin, manufactured in his Oxfordshire factory by Joseph Florey, Junior"

Howard Florey is famous for dismissing outright any idea that he might patent penicillin, or at least patent his extraction process.

Of course he dismissed the idea - he was Joseph Florey's son, and his family were no idiots in matters concerning Trade Patents, Trade Secrets and Trade Marks ---- far, far, far from it.

It had been the entire basis of the considerable Florey family fortune.

And when his father Joseph's industrial empire all came down around the Florey family, it was because the value of the father's most important asset, the reputation for quality engendered in customers' minds when they saw or heard the term Chromella Brand Leather, had been allowed to be be destroyed by Mr Florey, senior.

It was a lesson, Mr Florey, junior never forgot.

The well spring of the entire wartime penicillin saga lies in the murky business practises of the Anglo Saxon businessman in the Edwardian era , when firms were merged holus-bolus by wily operators and their stocks watered as frequently as one's own garden.

Jospeh Florey got very rich very quickly, probably by using the exact same unsavory practises that Max Aitken (Lord Beaverbrook) used to get very rich very quickly at exactly the same time in Halifax and Montreal Canada.

Henry Dawson also knew, at fairly first hand , about fluffed up industrial empires that grew quickly and collapsed like a house of cards.

His mother's cousin - and possibly her own banker-brother - had rapidly created a far flung lumber empire, based on borrowing a lot of a bank's money without normal collateral.

The failure never went public, though all the family knew, and the cousin lived a fraudulent life , very publicly pretending to still own and run the biggest lumber empire in Atlantic Canada, while actually the bank was quietly selling it all off in pieces, trying to recover its losses.

The discovery of anything pre-existing and natural like penicillin or of water or air or sunshine can't be patented - it is inherently PD - in the Public Domain for all to enjoy.

Patenting processes to extract or purify it are possible and were frequently employed.

But the true basis of the economic value (if any) of these patents would not lie in what was written on the patent documents.

No, if you paid the patent royalties faithfully and seemed (a) to be trustworthy and (b) a distantly located competitor, then their real value to someone with a license, was the Trade Secrets the patent-holder would tell you directly by sending over highly skilled employees to train your staff.

Pfizer was not alone in dismissing the worth of costly and hard-to-defend, short-lived Trade patents, preferring keep their complicated and subtle production methods top secret -Trade Secrets - for ever and ever.

There was a third route - the route the two Florey's ultimately took :
Trade Marks, "Branding".

Joseph Florey in his advertising said, in effect, "Everyone knows that the shoes I make are very well made and that they are called Chromella - to be sure the shoes you buy really are well made by seeking out that mark of my work."

He then threw the full weight of the law on anyone who dared to use his mark.

When Howard Florey was only one year old, for example, Joseph Florey brought a competitor ,The Hunter Boot Company, before the Supreme Court in Adelaide,seeking an injunction and 1000 pounds in damages, for inserting Chromella in one of their newspaper ads.

The judge dismissed the case - with all costs to be paid by Florey, finding the insertion an accidental error.

He still probably counted the case a victory though - it had put the Hunter Company to considerable bother defending themselves and no doubt many still felt that the insertion hadn't been a 'accident' in reality - so its reputation never did totally recover.

Any future competitor who was tempted to use the Chromella brand on their boots no doubt noted that Florey would be onto them like an attack dog.

The price wasn't worth the pain.

This is the style of doing business Howard Florey grew up with and this is how he made his fame and fortune when Ernst Chain dropped penicillin in his lap in March 1940.

Florey liked money very well, thank you very much - as did his wive, they obsessed about it in fact.

But it was not vast fortunes they sought,  for they could be here today and gone tomorrow, but the lifetime security of a upper middle class professional's salary and pension.

Scientific fame for Howard would bring those kind of professional positions - and it would restore the lost reputation of the Florey family - destroyed throughout Australia by media reports of angry shareholder meetings alleging something was fishy with Joseph Florey's shoe empire.

So first he went the Trade secret route, keeping all information about his extraction methods secret for a year and half, (March 1940-August 1941) despite Britain desperately needing all the
medical help it could get, in those terrible days of the Battle of Britain.

Entirely typical of Florey though - he had avoided WWI's trenches and he wasn't about to do anything extraordinary or risky in WWII either.

He was trying to get one of the drug companies in Britain to commit contractually to his extraction process, not for money directly of course (after all it was Heatley who had actually fine-tuned it, not Florey, by using well known standard chemical techniques suggested to Heatley by others.)

No, Florey would settle for a consultant's role - at a hefty consulting fee of course - that was the honorable way professionals got very rich without violating professional codes of ethics.

Chemically, there was no doubt that his extraction system worked.

But economically - always the weak spot in academic Oxford (see Ivory, Towers, and 'out of it') - it was a bomb, a disaster.

No firm could see it paying, but most - because it was wartime - still offered to voluntarily help improve the process enough to try and get enough penicillin for definitive human clinical trials.

Florey was resigned to this until March 1941 - after all his team had shifted to all out efforts to synthesize penicillin rather than do anymore than the two human cases he had attempted so far.

Then in that March of 1941, he got his own bombshell (Oxford itself was NEVER bombed , not even once) - word of the work of Dawson in New York.

Dawson too had his own penicillin factory - even bigger than Florey's and Dawson had won the race to be the first to put penicillin into a patient by needle - and he had gone public about it, in a public lecture, in February 1941.

He also had treated more patients while focusing on a very well known and very well feared disease - Juvenis Interruptus (Rheumatic Heart Disease) - something that was very media-worthy.

Dawson too had a German Jewish biochemist with a lot bigger
reputation than Chain - in fact this man, Karl Meyer, had long standing contractual links with the American branch of a very famous international drug firm from Germany - Schering Corporation.

Dawson's team might well have beaten him on both patents and trade secrets already.

Florey panicked - ditched his erstwhile British drug company supporters - speeding off to battle Dawson on the grounds his family was most comfortable with - Trade Marks.

His ace in the hole was the unnatural respect every democratic American had for anything British and aristocratic - like the Oxford University Brand.

This brand was a winner world wide, in many areas of education - Oxford textbooks taught one the best way, the only way, to speak English or play music.

Only the Oxford  strain of penicillium, combined with the Oxford standard sample of purified penicillin and the Oxford method assay, was real penicillin , said Florey over and over, all through America.

This was total scientific hogwash but the Floreys hadn't climbed to the top of the Spencerian world of Survival of the Fittest by being concerned with niceties.

Off to battle !

Juvenis Interruptus more accurate for RHD ?

Someone ,who admits they are not a Latin scholar, wondered about my use of Juvenis Rumpo to describe RHD (Rheumatic Heart Disease.)

They thought Juvenis Interruptus seemed a more likely term, based on the much better known phrase coitus interruptus.

They may be right.

About four years ago,I had been reading an account of  some
notable early Rheumatic heart Disease (RHD) cases of a doctor who had specialized in that very serious and widespread disease.

He had mentioned RHD was also sometimes called "-------" (a New Latin medical term) which could be translated as Youth Interrupted in English.

I remembered his explanation why this little known term was so appropriate , but not his name or the actual Latin phrase.

I merely tried to translate the English term back into Latin, using a half dozen translation engines to get a consensus.

All used Rumpo ---- but I was concerned that when I back-translated the term back yet again into English - it came out  a youth torn into two (!)

Technically accurate, I suppose, to describe the break in youthful activities engendered when your loving parents learned you have had permanent damage to your heart caused by a bout of acute Rheumatic Fever, (RF) and that you must not tax your heart.

My brother, for example, had RF when he was four
and years later,when he was 20, a doctor examining him before he ran in a race, noticed he had a heart murmur.

 This was something his parents had not known, so he had not been overly-protected : his youth was not interrupted.

But in English, Rumpo is an unknown Latin term, while Interruptus is in fact a very frequently used term to create cod-latin phrases.

In any case, I will be glad to hear comments from people more familiar with Medical New Latin than me...

Saturday, September 18, 2010

"JUVENIS RUMPO" : curing RHD, Rheumatic Heart Disease

Another name for Rheumatic Heart Disease, which until the 1950s was our biggest single heart disease, is JUVENIS RUMPO , which can be loosely translated as "Youth ,Interrupted" .

Every mother ,between the 1910s to the 1960s, had to worry about about whether her children would have to endure the consequences of a severe case of acute rheumatic fever.

Some kids got lots of bouts of strep throat but never got rheumatic fever (RF) - others got it so gently that after the fever, sore joints or jumbled nervous system had gone, they had no reminders - and the disease never came back.

Other children got the disease - once - and  quickly died . End of story, almost.

Because if one child got it bad enough to die of it, it certainly meant your remaining children might also have the slight but definite genetic affinity for RF.

Similarly, even moms who had one child with a gentle case knew this didn't mean others in the family couldn't get the worse case possible.

And the fact that 4 kids of five didn't get RF ever, didn't mean number five child won't get it bad.

It was the uncertainty as to who and when , and how badly, and how frequently, someone in your family could get RF that made it a Sword of Damocles to all moms in that era.

Stage two worries were almost as bad.

Your child or children did get acute RF and didn't die.

Unfortunately, surviving one attack did not give immunity as it does in most diseases - in fact it means you are likely to get it again but even more intensely.

Get it again and again, each worse than before and you are certain to die.

That's death by acute RF.

More likely by the 1930s, was that you would survive even repeated bouts of acute RF.

But the permanent scars left on your heart muscle and heart valves meant that your mom would fret that if you played sports or did anything too vigorously - including romantic engagements.

It was felt that sexual intercourse might--- and pregnancy and child birth definitely would --- tax your heart murmur and bring on SBE (endocarditis) and death.

So ironically, Mom would take all the joys of youth out of your life in a loving attempt to bring you to adulthood alive.

But why bother if everything a young person liked to do, wanted to do, needed to do, was forbidden ?

This is why RHD was so frequently called Juvenis Rumpo .

 Not because RHD killed outright all the young people it effected - it never did kill more than a relatively small number - but because of the huge pall it hung over  the 'best years of their lives' for tens of millions of North American teenagers between 1910 and 1960 .

Fear of the Sword of Damocles was more damaging than the actual possibility it would really fall on a vital spot.

Dawson never did get to enjoy his youth times because he
volunteered to serve in the trenches of WWI.

His life mission was to see that as many other young people as possible did not see their youth be interrupted.....

Saturday, September 11, 2010

the moldS in Dr Fleming's letterS

A jab - I admit - at Eric Lax's famous book title, "The Mold in Dr Florey's Coat".

Florey and his team are usually applauded for their
"selflessness" in rubbing brown penicillin liquid/powder/spores (accounts vary in the endless re-tellings) into the seams of their clothing in May 1940.

 Their supposed intention was to ensure that precious penicillin could go out into the world to grow anew and save lives everywhere, even if the beastly Nazis did succeed in conquering Britain and the spires of Oxford.

"There will always be an England ...and England's precious gift, to Humanity, Penicillin". Etc.

But what if a single bomb had destroyed their Dunn Pathology Building, killing all the entire team and all their moldy coats?

Or if the Germans invaded Britain as fast as they had overrun the rest of Europe, so that no one from the Florey team got away to what remained of the Free World?

Was there an alternative to these theatrics?

Yes there was.

Three in fact.

(1) Do what Fleming had already done for 12 years and would continue to do - sprinkle a few of his spores into a folded paper as part of an ordinary unremarked-upon letter and mail it to anyone in the world, without charge, upon request.

But because there was an invasion coming, don't just wait for requests - mail out your version of Fleming's spores to all your friends and acquaintances ----- and ask them to store them and hide those precious spores.

 Or better yet, mail them Fleming's spores, together with what you have learned so far as how to extract , semi-purify and store dry penicillin and urge them to start their own research efforts based around that work.

(2) A bit late now, but if Florey did really think that Fleming missed the boat back in 1928 by not doing the "animal protection test" why didn't Florey do it in himself in 1929, when he received the manuscript of Fleming's first paper, as an editor of the journal that paper was submitted to?

Or in 1931, when one of his subordinates at Sheffield , Dr Cecil Paine, told him of his success in external applications of liquid penicillin in curing real diseases of human patients.

Why did Florey not immediately follow this up, by seeing if liquid penicillin would work as well in curing artificial internal  diseases in lab mice by way of a needle (ie internal application), aka "the animal protection test" ?

Or why did Florey not 'do the mouse' back in 1938, when he first began his research on penicillin  -- if it was that apparent that the vital "animal protection test" had been overlooked?

Any of these times would have revealed the power of penicillin as a internal, systemic, cure - ie as the first,best, modern antibiotic, rather than just another also-ran in the overcrowded and ineffective external antiseptic market.

But in 1929,1931 or in 1938, Britain and the world would have had the peacetime resources to quickly bring penicillin to market.

But waiting two years, till the Fall of France, to 'do the mouse' and only doing it because your subordinate, Chain, jumped the gun in a fit of pique hardly shows you were concerned about the fate of a unique life-saving drug.

(3) While retelling the tale of the spores rubbed into your clothing, admit it happened because only you were (inaccurately) convinced that your team were the only scientists in the world with (a) access to these unique penicillin-producing penicillium spores and (b) had found a method of extracting and preserving dry penicillin.

This is why you kept your new penicillin success a secret, even from your prime funder, the MRC, and why you also didn't tell the scientific world of your extraction method in your August 1940 paper in Lancet.

And why as late as March-April 1941, you weren't telling any outsiders the details about your extraction methods --- not even to your many friends and colleagues overseas.

And why you only revealed your extraction methods in August 1941, after it appeared that a competitor in America had already released his own methods of extraction back in February 1941.

If Britain was About to Fall and All  Civilization About to Totter, these hardly sound like the actions of a selfless individual.

But they do sound  exactly like the lifelong characteristics of one Howard Florey - from ruthless 'take-no-prisoner' teenage tennis competitor to adult scientific 'bushwhacker'.

This is why the lazy, laidback Fleming almost got the only Nobel prize to be awarded for penicillin, instead of it going to the hardworking, ambitious, Florey and his hard-driving team.

You see ,the world had just been through the most brutal war it had ever seen, a war created by a hardworking, ambitious individual.

 So, yes, Fleming might well have been lazy on following up on penicillin - he freely admitted as much.

But lazy Fleming had also never denied anyone his unique spores - or sought any payment or even reminded them that he be mentioned in their scientific publications.

(It is worth recalling that until late 1945, those same 'Fleming Spore, albeit a little subcultured and subselected, were still supplying the world all of its therapeutic penicillin--- the many efforts to find better spores and make them workable had failed up until that date.)

And Fleming had never denied anyone his methods he himself had used to extract and preserve penicillin.

That is why he got - and deserved to get - the Nobel Prize for penicillin.

I,then, am also a partisan of Fleming's worth, like Milton Wainwright and Kevin Brown ---- up to a point.

I'd take his freewill "spores in a letter", in a New York instant, over Florey's secretive "spores in a coat", any day.....

Thursday, September 9, 2010

1941-1950: Friedberg revises SBE deathwatch


In 1950 Dr Charles Friedberg told the readers of JAMA, one of the world's leading medical journals for frontline doctors, not to forget that SBE was now the easiest of the common heart diseases to cure.

They listened.

 Friedberg had quite literally wrote the book on SBE, back in 1941.

The, ahem, old book on SBE.

In that 1941 book, Friedberg and chief co-author Emanuel Libman had carefully surveyed 1200 cases of SBE in detail and said 'no cures' - at least no cures by the efforts of doctors.

 However three percent might expect a spontaneous cure.

Until the next and the next attack -  for SBE was a repeater disease and so really inevitably fatal - over the short medium term period.

Another researcher at the time was even less hopeful - finding  out of 249 of his SBE patients, maybe one had a temporary cure.

But now in 1950,Friedberg's 'invariable fatal SBE' had become Friedberg's 'the most curable common heart disease' !

The reason for this amazing turn about, Dr Martin Henry Dawson, had died a little earlier, back in April 1945.

But these amazing 1950 conclusions were due to his pioneering 1940-1945 efforts to prove up penicillin as an anti-biofilmic agent , able to penetrate SBE vegetations and kill the bacteria without killing the patient.

It was a mission carried on and brought to a spectacular conclusion by his assistant Thomas H Hunter, after the war.

DOCTOR MOM  now had one Sword of Damocles removed from over her head --- thanks to a doctor from Columbia University.

Just in time too.

Because another doctor from Columbia university, Harold Urey, PhD, had just given her a new Sword of Damocles.

During World War II, in one part of Columbia,
the former Lt Dawson,(winner of the Military Cross with Citation),was busy(illegally) curing "4F" SBE patients.

 Meanwhile, in another part of Columbia, Urey-The-Pacifist, with his crew of war-exempt healthy, young "1A" scientists, was busy inventing the Cold War's most fearsome weapon: the gaseous diffusion process for the extraction of uranium for the mass production of nuclear weapons.

As a result, 1950s kids, of which I was one, were the healthiest and the most scared generation of kids ever raised.

Thank you, Columbia.....

Tuesday, September 7, 2010

Why I claim Warren Weaver was 'naive' over penicillin

Some have objected that Warren Weaver,long time chief of the Rockefeller Foundation Natural Sciences Division was one of the most astute men in American science.

I say he was a math teacher, placed in charge of allocating millions in grants devoted to discerning the 'deepest secrets of biology' and what he did not know about the basics of biology and medicine would fill a library.

In particular, can you see the people in the medical side of the Rockefeller Foundation buying the Florey and Chain claim of 1939 that penicillin was an enzyme (ie a foreign protein) and yet, once purified ,it could be safely injected into a vein as a systemic medicine?

Aren't we also always told that Fleming's penicillin was too
unsafe to inject as a systemic medicine?

This because the mold was grown in a foreign protein medium and so was too deadly to inject into humans.

Though Fleming ,in fact, showed that neither penicillin juice or the medium juice seemed to affect mice when injected into them.

Weaver knew next to nothing medical, but he loved a good line.

The line he always loved best was that chemists, physicists and mathematicians  and other hard science types would quickly clear out the soft descriptive clinical types holding up true medical progress.

So he gave Florey and Chain all they asked for.... and more.

A good thing really - because Florey would never have given penicillin a moment's notice, if he hadn't a nice grant to do so.....