It has been fashionable lately to discount the excessive credit given to Sir Alexander Fleming for bringing us penicillin, particularly in the period between 1944 and 1972.
The counter tendency is now to try to give too much credit to Sir Howard Florey, Fleming's supposed rival for penicillin glory.
Actually, these supposed rivals worked closely quite closely together on British government penicillin committees between 1942 and 1946, sharing a common - if perverted - vision to keep wartime penicillin 'secret, scarce and synthetic'.
But nevertheless it is now general to credit Florey's snap decision to go to America in mid 1941 to try and secure a kilo (40 Mega units of low purity) penicillin from any or all American drug firms for his clinical research, as leading to these same American firms mass producing abundant penicillin a scant (sic) three years later.
The truth is much the reverse, for Florey's trip actually put Allied penicillin efforts in the hands of the OSRD's Abominable No-Man : A.N. Richards, PhD.
If Florey had stayed home and simply let the Free Enterprise that his conservative/Conservative values supposedly espoused work, lots of firms in Britain and America would have produced abundant wartime penicillin as soon as frontline surgeons and doctors had convinced their rear echelon superiors to issue contracts for the same.
It is usually felt that an interview between a newly fired up Fleming (suddenly realizing that systemic penicillin could actually save lives after 14 years of denying the possibility) and his friend from the same small part of Scotland (who just happened to be the current Minister for the extremely powerful Ministry of Supply) that spurred the British government into taking action on penicillin.
This isn't totally true or false as the MOS had been active in a low key way for almost a year but Fleming's intervention did lead to a hastily called penicillin conference in late September 1942 that greatly upped penicillin in MOS and Army priorities.
This quickly came to be communicated, in a general way, even to the British army representatives in America.
As a very indirect result of Fleming's low key political intervention months earlier, by late December 1942 it suddenly became embarrassingly clear to the OSRD-CMR & NAS-COC that a major political crisis was about to explode all around them at any time.
For the British Army medical liaison officer for America, RAMC Colonel Frank S Gillespie, had been visiting the biggest American penicillin-producing firms and they told Richards that they were tired of making all their penicillin for free and giving it to the CMR to pass onto the COC.
Could they please sell some to others ?
(Others : the British !)
If the drug companies did sell their life-saving penicillin to the British Army for use in North Africa while not being allowed to do so for the American Army also taking heavy casualties there and the story got into Drew Pearson's Washington Merry Go Round, soon Congressmen would be getting lots of very irate letters.
From mothers of wounded American servicemen, languishing for months with untreatable chronic severe osteomeylitis, denied penicillin despite repeated pleas from frontline doctors, all because of the opposition of Army Surgeon General James Magee, CMR czar Newton Richards and COC boss Chester Keefer.
Magee, already a big disappointment to his Army superiors, hardly needed this new attack.
And the COC & CMR , lacking actual legislative authority to push doctors and firms around had relied on a general air of mystery about their actual powers, to do the same.
Sweating under the Krieg Lights at some Congressional hearing was going to change all that.
So Richards and Keefer began casting about for a way to appear to give penicillin to the American army, while actually retaining intellectual control (and the resulting funding and public acclaim kudos) over it.
Their chance came in March 1943, ironically from more bad news.
For one of Richard's most trusted younger colleagues, Frank B Queen, was so frustrated with the lack of CMR penicillin for his osteomyelitis cases in a Utah military hospital, he was even going off the medical reservation by growing and applying his own crude penicillin instead !
Instantly, these Beltway pros pivoted left, sending out one of Keefer's most trusted colleagues, Champ Lyons, to assist Queen with CMR penicillin - all designed to steal back all the credit to civilian investigators for work done in a stateside military hospital.
It was not until May 1943, the war more than half over, that penicillin finally reached the American front lines for the 1A troops.
Ironically, some Army cast off 4Fs back home had access to penicillin since October 1940.
During WWII, the Army had all the penicillin, you say ?
If only that was so ......
Saturday, January 30, 2016
growing hope in the depths of WWII, a handful of doctors defeat the Beltway to bring 'penicillin for all'
In early 1943, firmly under the coercive protocol control of elite doctors & scientists in the Beltway's OSRD-CMR and NAS-COC, wartime penicillin was all set to be added to the postwar list of moral calamities thrown up by the Allied effort.
It would have been right up there too, along with the Allies ignoring contemporary evidence about Katyn Forest massacre and the ongoing Holocaust and with doing little to reduce the famine deaths caused by their siege tactics in Greece, Viet Nam and elsewhere.
Joined here by the British MOS (Ministry of Supply) Penicillin Committee, the Beltway plan was to keep penicillin clinical successes as secret as possible and then to release it on D-Day as a weapon of war.
To wit : both governments' lead agencies agreed to divert only enough of national resources otherwise devoted to weapons to produce enough wartime penicillin to treat lightly wounded frontline Allied troops --- and no more.
None, if possible, to be produced for Allied POWs, for the severely wounded Allied troops and enemy POWs --- or for dying civilian patients in the Allied, Neutral,Occupied and Enemy nations.
This plan totally violated both the letter and the spirit of the existing Geneva Convention that wartime medical care was to go to all in need, foe or friend, civilian or soldier, alike.
And one shudders to think how many more cold, hungry and ill throughout the war-torn lands would have died in the first years after the war, if penicillin hadn't been available when and where needed.
Honor then the handful of humanitarian doctors and scientists around the world who, despite the pressures of total war conformity, refused to go along with this moral charade and hand grew off-the-protocol crude penicillin to save the dying before them.
I will here only mention a few : the teams led by Drs Henry Dawson, Robert Pulvertaft, Frank B Queen, JV Duhig, John F Mahoney, Wallace Herrell, George Marshal Findlay.
Add to them, people like publisher Dr James McKeen Cattell of the journal Science and pharmacist Fred Stock and chemist Larry Elder of the WPB.
Traditionally the WPB, as the biggest and most intrusive wartime agency, is seen by many (particularly by partisans of small government) as the very symbol of the Beltway.
I am not sure this was the case ever and especially so in the example of penicillin...
It would have been right up there too, along with the Allies ignoring contemporary evidence about Katyn Forest massacre and the ongoing Holocaust and with doing little to reduce the famine deaths caused by their siege tactics in Greece, Viet Nam and elsewhere.
Joined here by the British MOS (Ministry of Supply) Penicillin Committee, the Beltway plan was to keep penicillin clinical successes as secret as possible and then to release it on D-Day as a weapon of war.
To wit : both governments' lead agencies agreed to divert only enough of national resources otherwise devoted to weapons to produce enough wartime penicillin to treat lightly wounded frontline Allied troops --- and no more.
None, if possible, to be produced for Allied POWs, for the severely wounded Allied troops and enemy POWs --- or for dying civilian patients in the Allied, Neutral,Occupied and Enemy nations.
This plan totally violated both the letter and the spirit of the existing Geneva Convention that wartime medical care was to go to all in need, foe or friend, civilian or soldier, alike.
And one shudders to think how many more cold, hungry and ill throughout the war-torn lands would have died in the first years after the war, if penicillin hadn't been available when and where needed.
Honor then the handful of humanitarian doctors and scientists around the world who, despite the pressures of total war conformity, refused to go along with this moral charade and hand grew off-the-protocol crude penicillin to save the dying before them.
I will here only mention a few : the teams led by Drs Henry Dawson, Robert Pulvertaft, Frank B Queen, JV Duhig, John F Mahoney, Wallace Herrell, George Marshal Findlay.
Add to them, people like publisher Dr James McKeen Cattell of the journal Science and pharmacist Fred Stock and chemist Larry Elder of the WPB.
Traditionally the WPB, as the biggest and most intrusive wartime agency, is seen by many (particularly by partisans of small government) as the very symbol of the Beltway.
I am not sure this was the case ever and especially so in the example of penicillin...
Friday, January 29, 2016
Mahoney uses penicillin 'which had been released to him for other purposes' to cure syphilis
Personally, I believe both published accounts of where exactly Dr John F Mahoney's team got the non-protocol-authorized penicillin to test his off the wall/ highly successful theory that penicillin could kill syphilis germs inside the body.
One account says he liberated/stole some the CMR/COC penicillin granted to him with his assent that he would follow strict protocol and only study penicillin's cure rate against sulfa-fast gonorrhea.
Another account says says he grew his own crude penicillin (in my view, probably with help from Dr Gladys Hobby) to further his successful effort.
I think Mahoney's team started with (A) and later moved onto (B).
Now Dr Henry Dawson was sharply criticised - during the war and by academics after the war - when he did so similarly, while seeking the successful cure for SBE, a disease that hitherto was quickly and invariably fatal.
Syphilis is also deadly but hardly kills one in a few months like SBE.
Syphilis patients could wait a year or two for more abundant penicillin - while denying penicillin to SBEs was to sentence them to death as surely as with a gas chamber.
But keeping out recruits likely to get SBE is what draft board medical examinations are for, so the fact that many young civilians were needlessly dying from it was judged by these civilian elite doctors to be hardly a medical priority.
But they saw gonorrhea (and later syphilis) as a big big military problem.
Particularly as VD was often deliberately acquired by America's too-few-already frontline combat troops, hoping a couple of months of old style VD treatment might keep them from an early combat death.
The civilian elites in the rear echelon figured that if penicillin could cure them in a day or two, it would stop all that sort of nonsense.
I believe that Mahoney's early - verbal only - Spring 1943 report to the military about the efficacy of penicillin against the increasing number of sulfa-resistant cases of VD was the real catalyst to the mass production of penicillin by the WPB.
But since he later broke all the 'cooperative (read coercive) investigation' protocols, Mahoney's early VD efforts were ignored and COC favourite Champ Lyons' work at Bushnell Hospital got all the OSRD-NAS public praise.
Academics have followed the OSRD-NAS cue ever since.
Ironically, the Bushnell work also actually began when some doctors there went outside the COC-controlled protocols and grew their own crude penicillin to try and treat some combat-acquired cases of severe chronic osteomyelitis.
In a panic, the OSRD-NAS stepped in to quickly bring their work within their protocols and thus save their own reputations.
So too these Bushnell crude penicillin heroes were ignored in the later OSRD-NAS orgy of bureaucratically self congratulation.
Interestingly, while Dawson and Mahoney both broke protocol and both 'stole' government-controlled wartime penicillin, only Dawson (dealing with a 'militarily unimportant disease') got flak from postwar academics --- while Mahoney, dealing with militarily important VD, got only praise.
This highly utilitarian approach to ethics probably says as much about the real moral values of post-Nuremberg academics, as it does about the moral centres of wartime Beltway bureaucrats...
One account says he liberated/stole some the CMR/COC penicillin granted to him with his assent that he would follow strict protocol and only study penicillin's cure rate against sulfa-fast gonorrhea.
Another account says says he grew his own crude penicillin (in my view, probably with help from Dr Gladys Hobby) to further his successful effort.
I think Mahoney's team started with (A) and later moved onto (B).
Now Dr Henry Dawson was sharply criticised - during the war and by academics after the war - when he did so similarly, while seeking the successful cure for SBE, a disease that hitherto was quickly and invariably fatal.
Syphilis is also deadly but hardly kills one in a few months like SBE.
Syphilis patients could wait a year or two for more abundant penicillin - while denying penicillin to SBEs was to sentence them to death as surely as with a gas chamber.
But keeping out recruits likely to get SBE is what draft board medical examinations are for, so the fact that many young civilians were needlessly dying from it was judged by these civilian elite doctors to be hardly a medical priority.
But they saw gonorrhea (and later syphilis) as a big big military problem.
Particularly as VD was often deliberately acquired by America's too-few-already frontline combat troops, hoping a couple of months of old style VD treatment might keep them from an early combat death.
The civilian elites in the rear echelon figured that if penicillin could cure them in a day or two, it would stop all that sort of nonsense.
Mahoney,Dawson and Queen deserve far more credit - Camp Lyons far less so
I believe that Mahoney's early - verbal only - Spring 1943 report to the military about the efficacy of penicillin against the increasing number of sulfa-resistant cases of VD was the real catalyst to the mass production of penicillin by the WPB.
But since he later broke all the 'cooperative (read coercive) investigation' protocols, Mahoney's early VD efforts were ignored and COC favourite Champ Lyons' work at Bushnell Hospital got all the OSRD-NAS public praise.
Academics have followed the OSRD-NAS cue ever since.
Ironically, the Bushnell work also actually began when some doctors there went outside the COC-controlled protocols and grew their own crude penicillin to try and treat some combat-acquired cases of severe chronic osteomyelitis.
In a panic, the OSRD-NAS stepped in to quickly bring their work within their protocols and thus save their own reputations.
So too these Bushnell crude penicillin heroes were ignored in the later OSRD-NAS orgy of bureaucratically self congratulation.
Interestingly, while Dawson and Mahoney both broke protocol and both 'stole' government-controlled wartime penicillin, only Dawson (dealing with a 'militarily unimportant disease') got flak from postwar academics --- while Mahoney, dealing with militarily important VD, got only praise.
This highly utilitarian approach to ethics probably says as much about the real moral values of post-Nuremberg academics, as it does about the moral centres of wartime Beltway bureaucrats...
Wednesday, January 27, 2016
If Future is knowable, simple, controllable - then we don't need immigrants and troublemakers
But if it is not -- if we face a potential global disaster in the near future with no sure way yet to resolve it -- then maybe we need the biggest possible of all 'Big Tents' : we need everyone's ideas and everyone's critique.
Particularly those of immigrants - for their often strikingly different take on a crisis (instead of our conventional same old same old) might be just what Dr Mother Nature ordered.
For do we really still believe that the Anglo Saxon scientific establishment (all on its own) could have won the last war, without the help of the foreign born, their children and native-born troublemakers ?
Is to dream !
Particularly those of immigrants - for their often strikingly different take on a crisis (instead of our conventional same old same old) might be just what Dr Mother Nature ordered.
For do we really still believe that the Anglo Saxon scientific establishment (all on its own) could have won the last war, without the help of the foreign born, their children and native-born troublemakers ?
Is to dream !
Tuesday, January 26, 2016
WWII penicillin : independent or institutional ?
On May 20th 1944, Dr Gladys Hobby writes to OSRD medical chief Dr A.N. Richards (wartime penicillin's real Penicillin Tsar), in effect to protest the largely successful efforts by his fellow institutionally oriented medical elite to use the excuse of wartime necessity to crush all remaining independent medical efforts.
In the early 1940s, it was still not unusual, as Dr Ronald Hare recounts in his book "The Birth of Penicillin", for ordinary doctors to prepare and purify a drug with their own hands, personally test on some of their own patients (all that is entailed when we say drugs are 'compounded') and then to personally dispense the medicine directly to any willing customers.
A different, lost, age.
Yes, individual doctors in direct competition with the pharmaceutical firms, albeit drug firms that were invariably set up not that long before, by ordinary doctors just like themselves.
Hobby explains/complains that she and her co-worker Dr Henry Dawson are particularly anxious that their paper on 'the cultural factors influencing the production of (hospital-lab-made crude) penicillin' be allowed to be published.
This because such publication was the only way 'independent laboratories' (her words) such as that of Dawson & Hobby, individuals not contractually ensnared inside the net of secret government contracts controlled by Richards, can make their findings known to all groups working on hastening wartime penicillin production to save the dying.
In particular, make their findings known to other independent penicillin teams who are all denied access to the taxpayer funded research controlled by Richards.
Hobby & Dawson's thinking on encouraging individual independent efforts was precisely what Richards and others in the wartime medical elite were most intent on destroying (and after them, the Nazis perhaps).
So, in a sense, Hobby already had answered the question she raised in this letter : why was their paper censored while others so similar in content where easily published ?
It wasn't a question of their content, per say, but of their intentions : work within the grid of institutional protocols and get published, work freelance and be repressed.
The big, big problem - which academic historians haven't yet been willing to confront in their hagiographies to the institutional-oriented elites inside the MRC, COC &CMR - is that all the biggest successes for wartime penicillin came from independently-minded individuals, not from the massive institutional group efforts.
These outlier successes were unfunded by the institutional elites,tested new treatment proposals rejected by their institutional protocols and were fuelled by unapproved home-brew crude penicillin rather than by institutionally controlled commercial penicillin.
Let us rehearse them one more time for the slow learners : Queen at Bushnell using home-brew crude to successfully test upon military cases of severe chronic osteomyelitis ; Mahoney on Staten Island using home-brew crude to prove penicillin could cure syphilis ; Dawson at Columbia-Presbyterian curing the hitherto invariably fatal SBE with his home-brew crude.
The problem was that everyone in the institutional-oriented elite were extremely highly competent plodders : middle-aged men who had all come to realize they were better as administrators than as individual researchers ; finally and sadly recognizing that they lacked the courage and the flashes of genius required to pursue long shots to their paradigm-shaking, Nobel-winning conclusions.
Their only chance at eternal fame as scientists were to be the titular heads of massive, highly conventional, group efforts using brute-force science.
They feared individual unbridled unfettered genius far more than they feared Hitler.
Yes, penicillin was very much involved in a fierce war during the early 1940s, but Mr H, Mussolini and Tojo played no part in it.
For much of that war, the main objective of the penicillin cum institutionalized medical elite was to keep this potentially Nobel prize winning new drug as far away from the Allied military as possible ---- away from the military doctors and also away from independently minded doctors and pharmaceutical firms.
Until the fact of this hidden intercine war is openly admitted no account of wartime penicillin will be true to the primary sources, only true to the postwar self justifications by penicillin's guilty losing elites....
In the early 1940s, it was still not unusual, as Dr Ronald Hare recounts in his book "The Birth of Penicillin", for ordinary doctors to prepare and purify a drug with their own hands, personally test on some of their own patients (all that is entailed when we say drugs are 'compounded') and then to personally dispense the medicine directly to any willing customers.
A different, lost, age.
Yes, individual doctors in direct competition with the pharmaceutical firms, albeit drug firms that were invariably set up not that long before, by ordinary doctors just like themselves.
Hobby explains/complains that she and her co-worker Dr Henry Dawson are particularly anxious that their paper on 'the cultural factors influencing the production of (hospital-lab-made crude) penicillin' be allowed to be published.
This because such publication was the only way 'independent laboratories' (her words) such as that of Dawson & Hobby, individuals not contractually ensnared inside the net of secret government contracts controlled by Richards, can make their findings known to all groups working on hastening wartime penicillin production to save the dying.
In particular, make their findings known to other independent penicillin teams who are all denied access to the taxpayer funded research controlled by Richards.
1940s penicillin's intercine war
Hobby & Dawson's thinking on encouraging individual independent efforts was precisely what Richards and others in the wartime medical elite were most intent on destroying (and after them, the Nazis perhaps).
So, in a sense, Hobby already had answered the question she raised in this letter : why was their paper censored while others so similar in content where easily published ?
It wasn't a question of their content, per say, but of their intentions : work within the grid of institutional protocols and get published, work freelance and be repressed.
Penicillin's biggest successes were all independent outliers - go on, say it, even if saying so destroys your tenure prospects at the biggest institutions
The big, big problem - which academic historians haven't yet been willing to confront in their hagiographies to the institutional-oriented elites inside the MRC, COC &CMR - is that all the biggest successes for wartime penicillin came from independently-minded individuals, not from the massive institutional group efforts.
These outlier successes were unfunded by the institutional elites,tested new treatment proposals rejected by their institutional protocols and were fuelled by unapproved home-brew crude penicillin rather than by institutionally controlled commercial penicillin.
Let us rehearse them one more time for the slow learners : Queen at Bushnell using home-brew crude to successfully test upon military cases of severe chronic osteomyelitis ; Mahoney on Staten Island using home-brew crude to prove penicillin could cure syphilis ; Dawson at Columbia-Presbyterian curing the hitherto invariably fatal SBE with his home-brew crude.
The problem was that everyone in the institutional-oriented elite were extremely highly competent plodders : middle-aged men who had all come to realize they were better as administrators than as individual researchers ; finally and sadly recognizing that they lacked the courage and the flashes of genius required to pursue long shots to their paradigm-shaking, Nobel-winning conclusions.
Their only chance at eternal fame as scientists were to be the titular heads of massive, highly conventional, group efforts using brute-force science.
They feared individual unbridled unfettered genius far more than they feared Hitler.
Yes, penicillin was very much involved in a fierce war during the early 1940s, but Mr H, Mussolini and Tojo played no part in it.
For much of that war, the main objective of the penicillin cum institutionalized medical elite was to keep this potentially Nobel prize winning new drug as far away from the Allied military as possible ---- away from the military doctors and also away from independently minded doctors and pharmaceutical firms.
Until the fact of this hidden intercine war is openly admitted no account of wartime penicillin will be true to the primary sources, only true to the postwar self justifications by penicillin's guilty losing elites....
Monday, January 25, 2016
"Off the Grid" Penicillin
The bad things that happen when academics prefer easily obtainable secondary sources over hard-to-get primary accounts
A prolonged troll through the day to day, year by year, archival records of Washington's National Academy "Committee on Chemotherapeutic Agents" (COC) and Vannevar Bush's Office of Scientific Research & Development's "Committee for Medical Research" (CMR) is profoundly depressing.
And it leads one to sharply question the underlying - shared - thesis beneath nearly everything written on wartime penicillin to date.
It can only lead one to the conclusion that these two lead agencies did not work to speed the pace of wartime penicillin - far from it.
Instead the pair far acted more like classical peacetime 'blocking institutions' than like inspired and badly frightened wartime agencies driving strategic innovation before the enemy gets to it first.
These are only two out of three agencies controlling the worldwide fortunes of wartime penicillin - but when I examine the daily records of the third, the British Medical Research Council (MRC), I expect it to have played a much lesser role overall.
Supposedly totally oriented in wartime to military needs, the three actually worked tirelessly and deftly to keep the vast military body of expertise from getting its hands anywhere near this potentially Nobel winning new substance from November 1939 till April 1943.
If you are doing the math, that is more than half of the entire six year long course of WWII !
Equally, freelance clinical, biological and chemical researchers who sought to do anything not yet in the prescribed and rigid protocol were censored and harassed.
Yet too often their radical ideas were the true road ahead, not the blandly conventional approaches of 'science by committee' at its worst.
Dawson & SBE, Queen and military cases of Osteomylitis,Mahoney and Syphillis are all huge successes for penicillin - in fact its biggest successes.
Yet all three approaches were originally rejected by these blocking organizations and only after our three rebels 'home brewed' their own crude penicillin to prove up their cases, did the blockers step in...... and then dare to steal the credit !
If only the OSRD & Dr AN Richards had listened to (and not lied to) Milislav Demerec in 1942, the dramatic story of wartime penicillin would have lost most of its drama --- for it was Demerec's discounted innovation that largely gave us our multi-trillion dollar biotech industry that we have today.
And as for freelance industrial firms with new approaches and greater eagerness to push the production envelope, they too were discouraged at every turn - particularly, once again, by wartime penicillin's Abominable No Man (OSRD CMR chief Dr AN Richards).
And beyond discouraging individual efforts from the military aimed at using penicillin to save lives on the battlefield, these agencies also tried to ward off any other government agencies from gaining too much political credit for their own freelance efforts to advance the success of wartime penicillin.
The Royal Navy quietly and efficiently made its own homebrew penicillin in 'off the grid' remote Somerset and then had to fend off snide comments from the unhappy unholy triad of Oxford-British Army-Ministry of Supply.
You rarely learn of the Royal Navy success in any academic histories of wartime penicillin.
Equally, Vannevar Bush and the OSRD successfully got away with claiming credit for work done by other competing agencies.
For example, the USDA spent far more money on penicillin research at its NRRL Peoria site than did the OSRD - but you'd never know this if you simply trusted academic accounts about the NRRL.
And claiming credit for the truly vital work that the similiar-sounding OPRD of the WPB (War Product Board) advanced was routine for the OSRD.
I think the reason why the OSRD et al got away with their Big Lie among the academics is because there is confusion over what is a primary source, in historians' terms.
(Here the voices of my teachers, David Sutherland and Judy Fingard hover on each of my shoulders, whispering "trust only the primary primary documents".)
I learned long ago that an institutional account of itself - be it a footnoted multi-volume book or a brief informal talk before a chicken a la king service club - is only in one sense, a primary source.
It is indeed a primary source as to the deceitful PR and bumpf and propaganda that an institution puts out about itself - an untrustworthy autobiography/memoir of an institution.
It is selective, usually derives from indirect second hand experience and it is colored and controlled by strong myths that evolved after the fact.
But trolling the vast depths of an institution's archival records, gives a much better feel for the day to day reality at the time - the dross being perhaps even more valuable than the 'gotcha' nuggets.
(I say this despite being aware that often the most vital (cum later embarrassing) decisions were never recorded on paper or if they were, were removed and 'lost' after the war.)
How you can tell when a historian is lying : the lips of his missing footnote aren't moving
I didn't expect to say these sort of mean things when I started researching a small aspect of the overall wartime penicillin story (or so I thought initially.)
But too often I came upon a really big development in wartime penicillin without any footnote to its primary source (or a footnote only to an informal post-event account, again with out footnotes).
When even well known and minor events are well-footnoted to a primary source, this absence of footnoting was bound to make me suspicious.
Case in point : Major Frank B Queen.
Supposedly - as all histories of penicillin explain - a single letter from him sparked the most decisive change of all for wartime penicillin - the move to heavy American military involvement and American mass production.
Once having been and army reservist and with my extended family having about two dozen members who had careers in the regular forces, navy, air force and army from bottom ER to high level Navy Captain, I was extremely suspicious from the get go.
The COC & CMR, who had smoothly fended off requests for penicillin from well connected colonels connected to various general Staffs, were now instantly responding with full support to a civilian doctor made a temp wartime major and working in the then ultimate wilderness of Utah ?
That isn't the way any ten million strong chain of command structure ever works - in peace or in war.
And the letter from Queen to Keefer, head of the COC, was never directly quoted or footnoted.
I was unable to find it in my trolls through the archives of COC & CMR & WPB in Washington DC.
Dross a plenty was preserved but not this epoch-changing letter.
But I was fairly sure that I knew what it was about - for David Rothman's book "Strangers at the Bedside" had said, in mere passing (for his book was not part of the penicillin history industry) that Queen had written for advice in making his homebrew crude penicillin grow better.
Queen was trying to save the lives and limbs of Pacific War GIs languishing between life and death foe years, due to severe chronic osteomylitis (hard to reach infections deep inside major bones.)
The MRC, COC and CMR were all prepared - as committee science is wont to do -to refight the medical battles of WWI : gas gangrene.
But thanks to blood transfusions and sulfa, that wasn't happening and the formerly mortally wounded were now surviving, just barely, for years in expensive hospital beds, with chronic severe deep osteomylitis that sulfa and blood transfusions could only hold off but never cure.
Queen recognized this and figured easily made crude liquid penicillin could be poured into these deep wounds to bring relief.
I suspected all this from Rothman's casual remark but couldn't prove it from Halifax.
Once in Washington, I had no luck (no surprise !) finding Queen's original letter to Dr Keffer of the COC.
But Queen was a former postgrad of the CMR's Richards and crucially he was present at the very apex of Richard's long gone glory days as a world class academic researcher.
So his letter to Richards, written not long after his first letter to Dr Keffer, is very informally friendly and chatty.
In it, he indicates that yes he did apply crude penicillin to his osteomylitis cases, crude made by Dr Robert E Hoyt, PhD, from the pathology department at U of Utah.
It was the fact that Hoyt was leaving to go to make penicillin at an industrial level at Harrower Labs in far off Glendale California that prompted Queen to cry out for help in making crude penicillin himself inside the Army's big Bushnell hospital at Brigham City Utah.
Now imagine the headline this could have thrown up in the 1943 (or 2013) Hearst newspaper and magazine chain if it had gotten out.
"Army hospital doctor forced to make crude homemade penicillin in a tub because Washington (beltway) bureaucrats refuse pharmaceutical company penicillin to save lives & limbs of brave Marine and Army heroes of Guadalcanal languishing, uncured, in great pain for years"
Simply put, Keefer and Richards panicked at the mere thought of the sort of headlines if the story of Queen's crude got out and went to Army Surgeon General James Magee (who up to then had fully supported their refusal to give any penicillin to the military).
Magee too was in a panic, albeit for another reason.
He was about to be forcibly retired, because the Army top brass had disliked him for years and now with the possibility of a 1943 invasion of Western Europe suddenly removed at the Casablanca's Conference, were willing to fire him and make some drastic changes regarding both the fast-fading sulfa and its possible replacement penicillin.
Magee suddenly decided to switch sides and get on the side of history - get ahead of history in fact - for Queen, if only he kept his mouth shut about the crude, could become a good thing, not a bad thing.
But Queen casually mentioning Robert E Hoyt's name in one preserved letter was enough, because it eventually allowed me to find the extremely obscure wartime article from Queen, detailing Hoyt's work with crude penicillin.
So I still don't have that vital letter - but I now do have all its vital details in the form of an abstract from this article, soon winging its way to me :
God, I love my job !
Sunday, January 24, 2016
Helen Elliot, Vassar '41, Dawson's H.E. ?
A Vassar graduate of the class of 1941, Helen Elliott, unfortunately died in the medical crossfire of late 1943, as the American therapeutic reforming elite struggled to regain control of their own personal take on the course of WWII.
This elite had recently come under attack from a handful of courageous doctors and industrialists questioning the moral compass of wartime penicillin as these therapeutic reformers had self-defined it.
Simply put the issue was this : was wartime penicillin to go on being distributed as the Nazis might have distributed it, or was it to now be distributed as the Atlantic Charter suggested it should be distributed ?
Now this blog has had many posts (mostly from 2015) where I definitively identify (and offer a brief biography of) the three men who were History's first patients to treated with an life-saving antibiotic.
All who received Dawson's homebrew injected penicillin before the better known (but later) Oxford policeman patient of Nobel winner Howard Florey.
They were in Dr Henry Dawson's first group of five SBE and one ABE male patients, all that he treated prior to being ensnared in the all-controlling web of the medical 'therapeutic reformers' running the wartime OSRD/CMR & NAS/COC.
Their names : Aaron (Leroy) Alston, Charles Aronson and George M. Conant.
Dawson's closest associate, Dr Gladys Hobby, in the 1980s met with three patients from the last and quite large group of SBE patients of both genders that he and Dr Thomas Hunter treated before Dawson's tragically early death in April 1945 .
These were all patients Dawson had treated without Dr Hobby by his side, as she by then worked at Pfizer ---- while remaining close to Dawson and Columbia-Presbyterian Hospital in her spare hours.
I will call them by their first names and last name initial (Miriam L, Penny M and Otto M) because unexpectedly, I have had no luck at all finding any trace of them by the last names that she had given them in her 1985 book, "Penicillin : Meeting the Challenge".
But until my recent trip to the NAS and NARA II archives in Washington, I had no luck putting a name to any of the five young women (The Five) that Dawson treated in his heroic middle period.
In that period, between November 1942 and January 1944, Dawson basically had to "steal" (re-allocate) scarce government controlled penicillin to demonstrate, at last, that modestly large amounts of penicillin could indeed finally cure the invariably fatal SBE.
The five women were known only by their age, gender and medical history - and their first and last name initials.
But in July 1943, OSRD/CMR staff choose to break ordinary protocol and refer in writing to one of Dawson's patients by her actual name (Helen Elliot) and connect that name with a letter from Dr Dawson in association with Dr L W Gorham of Albany NY.
And with their desperate plea for additional penicillin after the July 16th WPB 1943 cutoff of penicillin distribution outside official channels.
Together that means Helen Elliot simply must be patient H.E. - everything matches her highly unique medical history.
Helen is probably from Colonie NY, a big suburb of Albany - but that is only a maybe for now.
However, Dawson's published article on The Five also gives H.E.'s date of death precisely as September 4th 1943.
A Vassar website says that a Vassar graduate of 1941 (likely making her 23 in 1943, as was H.E.) named Helen Elliot died on September 4th 1943.
H. E. had been denied extra penicillin by the CMR & COC and after being put on sulfa to no avail, died of the effects of her continuing blood poisoning, though her SBE itself seemed cured according to the autopsy results.
I'd bet everything that this unfortunate Vassar graduate is our H.E. ....
This elite had recently come under attack from a handful of courageous doctors and industrialists questioning the moral compass of wartime penicillin as these therapeutic reformers had self-defined it.
Simply put the issue was this : was wartime penicillin to go on being distributed as the Nazis might have distributed it, or was it to now be distributed as the Atlantic Charter suggested it should be distributed ?
I would like to rescue Helen's story from its present obscurity for what it tells us about medicine at war
Now this blog has had many posts (mostly from 2015) where I definitively identify (and offer a brief biography of) the three men who were History's first patients to treated with an life-saving antibiotic.
All who received Dawson's homebrew injected penicillin before the better known (but later) Oxford policeman patient of Nobel winner Howard Florey.
They were in Dr Henry Dawson's first group of five SBE and one ABE male patients, all that he treated prior to being ensnared in the all-controlling web of the medical 'therapeutic reformers' running the wartime OSRD/CMR & NAS/COC.
Their names : Aaron (Leroy) Alston, Charles Aronson and George M. Conant.
Dawson's closest associate, Dr Gladys Hobby, in the 1980s met with three patients from the last and quite large group of SBE patients of both genders that he and Dr Thomas Hunter treated before Dawson's tragically early death in April 1945 .
These were all patients Dawson had treated without Dr Hobby by his side, as she by then worked at Pfizer ---- while remaining close to Dawson and Columbia-Presbyterian Hospital in her spare hours.
I will call them by their first names and last name initial (Miriam L, Penny M and Otto M) because unexpectedly, I have had no luck at all finding any trace of them by the last names that she had given them in her 1985 book, "Penicillin : Meeting the Challenge".
But until my recent trip to the NAS and NARA II archives in Washington, I had no luck putting a name to any of the five young women (The Five) that Dawson treated in his heroic middle period.
In that period, between November 1942 and January 1944, Dawson basically had to "steal" (re-allocate) scarce government controlled penicillin to demonstrate, at last, that modestly large amounts of penicillin could indeed finally cure the invariably fatal SBE.
The five women were known only by their age, gender and medical history - and their first and last name initials.
Perhaps the animus because L W Gorham was "that man's" (FDR) personal physician ?
But in July 1943, OSRD/CMR staff choose to break ordinary protocol and refer in writing to one of Dawson's patients by her actual name (Helen Elliot) and connect that name with a letter from Dr Dawson in association with Dr L W Gorham of Albany NY.
And with their desperate plea for additional penicillin after the July 16th WPB 1943 cutoff of penicillin distribution outside official channels.
Together that means Helen Elliot simply must be patient H.E. - everything matches her highly unique medical history.
Helen is probably from Colonie NY, a big suburb of Albany - but that is only a maybe for now.
However, Dawson's published article on The Five also gives H.E.'s date of death precisely as September 4th 1943.
A Vassar website says that a Vassar graduate of 1941 (likely making her 23 in 1943, as was H.E.) named Helen Elliot died on September 4th 1943.
H. E. had been denied extra penicillin by the CMR & COC and after being put on sulfa to no avail, died of the effects of her continuing blood poisoning, though her SBE itself seemed cured according to the autopsy results.
I'd bet everything that this unfortunate Vassar graduate is our H.E. ....
Saturday, January 23, 2016
when Science appeared to give definite answers, conservatives became scientists
Until the mid 1960s, the most reliable Republican Party or Conservative Party districts were university towns. Today they are the least.
What changed ?
Back in the early sixties, the soon-to-be-retiring elite of Modernity science , both physical and social, still gave forth the definite answers that social conservatives crave and in fact need, in order to remain sane.
So no wonder then that science was one of the preferred occupations for social conservatives.
But, in fact, even as these scientific elites had begun their educational careers, way back around 1900, science's cutting edge was revealing a very uncertain world and universe.
It all began with the discovery of totally unpredictable natural radioactivity - all atoms will self destruct, given enough time, whenever they feel like it.
Effect without apparent cause --- randomness gone wild.
I could here add the new quantum physics, new insights into the inherent blurriness and unpredictability of real world chemical bonding and the new biological discovery of unpredictable HGT-generated genetic mutations across species.
But these scientific elites had all been educated, at the high school and undergraduate level, in the old comforting WASP triad of Newton, Dalton & Darwin.
Kids still are, more than 100 years after these three had all been proven to not offer the best explanations of reality.
But because the three offer the comforting soothing pap that the world is knowable by Man and controllable by Man - and offering up that comfortable big lie is precisely what high school and undergraduate teachers are hired to teach.
Modernity Science can even be seen as a last ditch effort by social conservative scientists to teach against the new evidence emerging from ordinary modern science practises that uncertainty was the norm of reality.
In the conflict between textbook science and scientific practise, all science students began to divide on a social conservative, social liberal fault line.
Those students who found the new science norms of widespread uncertainty of reality too hard on their social conservative mindset bailed out ---- stopped at the BSc or maybe MSc level at non-research universities and went into industry and did production science.
Those more comfortable with uncertainty, (social liberals generally), stuck with the new science, got PhDs and became post docs at the big research universities, all bound for academic careers.
By the late 1960s and early 1970s, they got a toehold on the tenure ladder and began to climb up as the older generation retired and died.
They focussed on process science - auditing the unpredictable and generally unwelcome results of what happened when simple production science hit a complex environment.
(Hint : pollution, health risks.)
And they taught their grad students the same.
We see the results today as 'scientists' debate climate change ---- those with just a BSc and working in industry tend to be deniers while the PhD academics believe in it....
What changed ?
Back in the early sixties, the soon-to-be-retiring elite of Modernity science , both physical and social, still gave forth the definite answers that social conservatives crave and in fact need, in order to remain sane.
So no wonder then that science was one of the preferred occupations for social conservatives.
But, in fact, even as these scientific elites had begun their educational careers, way back around 1900, science's cutting edge was revealing a very uncertain world and universe.
It all began with the discovery of totally unpredictable natural radioactivity - all atoms will self destruct, given enough time, whenever they feel like it.
Effect without apparent cause --- randomness gone wild.
I could here add the new quantum physics, new insights into the inherent blurriness and unpredictability of real world chemical bonding and the new biological discovery of unpredictable HGT-generated genetic mutations across species.
But these scientific elites had all been educated, at the high school and undergraduate level, in the old comforting WASP triad of Newton, Dalton & Darwin.
Kids still are, more than 100 years after these three had all been proven to not offer the best explanations of reality.
But because the three offer the comforting soothing pap that the world is knowable by Man and controllable by Man - and offering up that comfortable big lie is precisely what high school and undergraduate teachers are hired to teach.
Modernity Science can even be seen as a last ditch effort by social conservative scientists to teach against the new evidence emerging from ordinary modern science practises that uncertainty was the norm of reality.
In the conflict between textbook science and scientific practise, all science students began to divide on a social conservative, social liberal fault line.
Those students who found the new science norms of widespread uncertainty of reality too hard on their social conservative mindset bailed out ---- stopped at the BSc or maybe MSc level at non-research universities and went into industry and did production science.
Those more comfortable with uncertainty, (social liberals generally), stuck with the new science, got PhDs and became post docs at the big research universities, all bound for academic careers.
By the late 1960s and early 1970s, they got a toehold on the tenure ladder and began to climb up as the older generation retired and died.
They focussed on process science - auditing the unpredictable and generally unwelcome results of what happened when simple production science hit a complex environment.
(Hint : pollution, health risks.)
And they taught their grad students the same.
We see the results today as 'scientists' debate climate change ---- those with just a BSc and working in industry tend to be deniers while the PhD academics believe in it....
MLK Day and Jonas bookmarked my Washington Archival trip
I got away from Washington DC and superstorm Jonas just in time ----all thanks to the kindness of many strangers!
For days, american-run airlines were offering waivers of normal travel change fees for people in the path of superstorm Jonas, particularly in the epicentre of southern Maryland, where I was staying while conducting research on wartime penicillin at the nearby NARA II archives.
But my airline on my return trip home was Air Canada and it was not so kind ---- despite my departure time being 4pm Friday, well into the time that snow would start coming down real hard.
I had already lost one vital day of archival research at NARA II from a short five day trip.
I hadn't realized until I had booked flights and hotel rooms that the federal holiday honoring the memory of MLK was on Monday January 18th.
Now Jonas was effectively closing up NARA II for researchers at the week's end as well.
However, the unexpected ability to use my ipad mini to freely photograph interesting archival texts had greatly speeded up the researching process - being both more detailed and far more accurate than whatever handwritten notes I could normally quickly scrawl.
So on Friday I got up real early and walked the half hour over to the Greenbelt metro subway, terminus of Washington's Green Line.
This subway terminus is metro Washington's closest subway stop to Baltimore-Washington International (BWI) metro Washington's third and best-run international airport.
There is a special Metrobus express, the B30, that runs from Greenbelt to BWI: very fast, very cheap and stopping at all of the big airport's far flung concourses.
It is a vital part of the best and cheapest way to fly in and out of metro Washington.
I needed to get the earliest B30, if I could hope to get a standby on the early 10am AC flight home from BWI.
Waited and waited and waited, along with a fellow B30 potential customer named Jason, wondering why it was so overdo.
Then Jason checked the very fine print on his wmta.com app - yes the top news story on the Metro bus and subway system was that subway trains would run from 5am to 11pm on Friday, snowstorm or not but far less well reported was that the fact that the only buses running would be on 'major' arteries.
The vital B30 bus link for people hoping to get outa the storm's path was not considered to run on a major artery.
No B30 and now I am really stuck.
A taxi - if one could get one, would be at least $100 American - and while there was a cheap fast MARC rail link from Greenbelt to Baltimore, it didn't stop anywhere near BWI.
But Jason had used Uber before and got lucky - a woman named Frieda had just turned on her Uber readiness and was very very near by.
He offered to share his Uber ride with me.
Thanks to Freida, we got there fast and smooth, right up to the AC desk even, and only cost me $17 !
Thank you Jason and Freida so very much !
The ladies at BWI Air Canada were equally nice and got me a standby on the 10am flight to Toronto and even overlooked me ignoring my callout (I had never gone standby before and didn't understand the process.)
In Toronto, more AC ladies guided me through the process, urging me to run run run, to get onto a very lucky second early flight, this time to Halifax.
Lucky for me and many other standbys from the storm belt at least - because this plane was one hour late coming in from Halifax, allowing us to make the connection.
Strong headwinds generated from far off Jonas was the explanation, because with those winds now behind us, we flew to Halifax in record time - literally, according to various flight trackers apps !
Finally, at Halifax Stanfield airport, I lacked the additional Canadian loonie coin needed to make up the fare for the airport bus to downtown Halifax.
My paper US one dollar bills won't work in the machine, but the driver kindly overlooked the extra dollar and gave me a ride and a nice familiar blue transfer.
I made it home about the same time I should still be on the tarmac in BWI's ever-deepening snow....
__________________________
Postscript : the Nor'Easter left NYC Saturday night and soon headed north east, just brushing the Atlantic coastal communities of my native Nova Scotia.
In central Halifax I saw very little new snow - but my dad is very exposed to the direct Atlantic winds in his part of Seaforth NS and got much more of Jonas's remnants....
For days, american-run airlines were offering waivers of normal travel change fees for people in the path of superstorm Jonas, particularly in the epicentre of southern Maryland, where I was staying while conducting research on wartime penicillin at the nearby NARA II archives.
But my airline on my return trip home was Air Canada and it was not so kind ---- despite my departure time being 4pm Friday, well into the time that snow would start coming down real hard.
I had already lost one vital day of archival research at NARA II from a short five day trip.
I hadn't realized until I had booked flights and hotel rooms that the federal holiday honoring the memory of MLK was on Monday January 18th.
Now Jonas was effectively closing up NARA II for researchers at the week's end as well.
However, the unexpected ability to use my ipad mini to freely photograph interesting archival texts had greatly speeded up the researching process - being both more detailed and far more accurate than whatever handwritten notes I could normally quickly scrawl.
So on Friday I got up real early and walked the half hour over to the Greenbelt metro subway, terminus of Washington's Green Line.
This subway terminus is metro Washington's closest subway stop to Baltimore-Washington International (BWI) metro Washington's third and best-run international airport.
There is a special Metrobus express, the B30, that runs from Greenbelt to BWI: very fast, very cheap and stopping at all of the big airport's far flung concourses.
It is a vital part of the best and cheapest way to fly in and out of metro Washington.
I needed to get the earliest B30, if I could hope to get a standby on the early 10am AC flight home from BWI.
Waited and waited and waited, along with a fellow B30 potential customer named Jason, wondering why it was so overdo.
Then Jason checked the very fine print on his wmta.com app - yes the top news story on the Metro bus and subway system was that subway trains would run from 5am to 11pm on Friday, snowstorm or not but far less well reported was that the fact that the only buses running would be on 'major' arteries.
The vital B30 bus link for people hoping to get outa the storm's path was not considered to run on a major artery.
No B30 and now I am really stuck.
A taxi - if one could get one, would be at least $100 American - and while there was a cheap fast MARC rail link from Greenbelt to Baltimore, it didn't stop anywhere near BWI.
But Jason had used Uber before and got lucky - a woman named Frieda had just turned on her Uber readiness and was very very near by.
He offered to share his Uber ride with me.
Thanks to Freida, we got there fast and smooth, right up to the AC desk even, and only cost me $17 !
Thank you Jason and Freida so very much !
The ladies at BWI Air Canada were equally nice and got me a standby on the 10am flight to Toronto and even overlooked me ignoring my callout (I had never gone standby before and didn't understand the process.)
In Toronto, more AC ladies guided me through the process, urging me to run run run, to get onto a very lucky second early flight, this time to Halifax.
Lucky for me and many other standbys from the storm belt at least - because this plane was one hour late coming in from Halifax, allowing us to make the connection.
Strong headwinds generated from far off Jonas was the explanation, because with those winds now behind us, we flew to Halifax in record time - literally, according to various flight trackers apps !
Finally, at Halifax Stanfield airport, I lacked the additional Canadian loonie coin needed to make up the fare for the airport bus to downtown Halifax.
My paper US one dollar bills won't work in the machine, but the driver kindly overlooked the extra dollar and gave me a ride and a nice familiar blue transfer.
I made it home about the same time I should still be on the tarmac in BWI's ever-deepening snow....
__________________________
Postscript : the Nor'Easter left NYC Saturday night and soon headed north east, just brushing the Atlantic coastal communities of my native Nova Scotia.
In central Halifax I saw very little new snow - but my dad is very exposed to the direct Atlantic winds in his part of Seaforth NS and got much more of Jonas's remnants....
Subscribe to:
Posts (Atom)