Dr Martin Henry Dawson and the MORAL INVENTION of 4F penicillin ---- during a 1A war (PART 1)

Thalidomide has had 9 lives...

Is it truly unfair that only Paul Gelmo initially invented Sulfa-the-(useless)-chemical, but is was Gerhard Domagk , 25 years later, who won the Nobel prize for Sulfa?


Not in the eyes of  99.9999999% of contemporary (and very grateful) observers.  Because what Domagk invented was something called Sulfa-the-lifesaving-miracle.

Though you'd never notice from our "initial discovery" obsessed journalists, many, many important things were invented several times over.

Thalidomide is a particularly spectacular example : it had already had several medical applications ( with good successes but also very severe side effects that were kept secret) before it was promoted to cure morning sickness.

We all know the results that that particular application caused.

But, believe it or not, it is still in use - for forms of leprosy in particular, - and still being investigated for its ability to inhibit some tumours: new uses still being invented for an old "initial invention" .

AZT and carbolic acid were both much later "re-invented" when they were dragged out of the medical gutter and first used for the uses we best know them for today.

We don't - but we should - most highly honor those people who first put a product to its highest use, rather than merely honoring those who first invent or discover it as a mere substance.

Those who only honor  those who initially discover or invent something are unconscious devote disciples of Auguste Comte and his dogma of Positivism.

That school of thought, if it can be called that, sometimes assumes that the mere act of discovering or inventing something will also instantly inform that inventor/discoverer as to its many self-evident uses and to its self-evident highest possible use.

Anyone else who later does put it to such uses, in this view, was merely taking advantage of information that is open to all that gaze up the substance---- and hence not worthy of any honor.

Put like that, Positivism use in this case does seem childishly ridiculous - as many unstated assumptions often are - when they are more closely examined.

Most re-inventions are of a technological nature : something long thought capable of merely reducing the pain of leprosy turns out to actually - and unexpectedly - reduce the advance of the disease. ( In this case, the drug in question is thalidomide.)

But probably the most famous medicine and science story of all time also saw a substance re-evaluated for a new use , but for moral reasons.

A doctor's moral anger drove him to break a whole bunch of rules and norms to stick the first ever needle of (dirty) penicillin in a dying patient's arm : and the patient lived.

There had never been any technological barriers to putting Alexander Fleming's penicillium juice in a needle and sticking it in a patient's arm to save their life.

Not even to sticking penicillin into someone's arm to save them from invariably fatal Subacute Bacterial Endocarditis (the dreaded SBE).

Doctors and Scientists' objections to natural (impure) systemic penicillin were only ones of an aesthetic nature

The objections had only been quasi-aesthetic : in a modern scientific age, was it worth the risk to the dignity of the medical profession, to be seen sticking something seen as mostly dirt into the human bloodstream, even if it was in a worthy attempt to save the life of someone otherwise facing immediate death?

Many doctors, faced with lots of patients dying of an invariably fatal disease, will indeed throw a kitchen sink of oddball medical treatments at them, in the hope one will stick. SBE saw many such attempts.

But from September 1928 till October 1940, no doctor in the world ever stuck penicillin in someone's arm, to see if it might save their life --- for any disease. Amazing but true.

Since 2004, I have lived and breathed and dreamt why this might be so - and why the unlikely doctor who finally did so , Martin Henry Dawson, chose to break that mental barrier.

It matters because it is only his Penicillin (Penicillin-the-natural-systemic) that the world has used since 1940 - not Alexander Fleming's Penicillin-the-synthetic-antispetic or Howard Florey's Penicillin-the-synthetic-systemic.

It is his penicillin - and his penicillin only - that we use, but it was those two who got the Nobel Prizes for penicillin.

Dawson probably backed his way into penicillin - driven by his anger over the way that the "4F" in society were so quickly abandoned at the first opportunity --- in this case, in preparing to fight a war using the best "1As" in society.

His special area of interest - Rheumatic Fever (RF) - was mostly a disease of the poor, so the well-off donors to the cause of RF were largely motivated by pure altruism.

But it had been recently replaced (by the Fall of 1940) by Polio as the number one child health "Cause" for America's well off .

Polio deaths were far ,far outnumbered by RF deaths, but polio was a disease of the well off mainly, and this was the first evidence of a now common organization : the patients (families) self-help group : mothers going to door to door to find a cure for a disease that might hit their own children.

We generally think this is a good thing, but it is also another example of a society of individuals increasingly looking out for Number One.

In 1940,mighty  America collectively looked out for itself as Number One and did not come to the aid of about a dozen of Europe's small weak nations : Czechs, Poles, Danes , Belgians etc etc.

Dawson who had gone to war to help the people of little Belgium in 1915, was in agony - too old to fight, but also too principled to just sit back.

When he arrived in the Fall of 1940 back at his employer (Columbia University Medical School), he found that the research and teaching efforts were to be dialled back in social medicine (medicine to help the poor) and put into war medicine (making the armed forces better fighters).

By sheer coincidence, his fellow researcher, German Jewish refuge (and potential internment camp alien) Dr Karl Meyer, wanted to revenge himself upon another biochemist who he felt had downplayed Meyer's successes. This biochemist was also a German Jewish refuge and potential alien in an internment camp), Ernst Chain.

Both men were not evil or naive : they simply knew the best way to be kept out of a miserable internment camp in the event of war, was to be judged very useful by their anti-semitic hosts. So they were holding nothing back to avoid an internment camp for themselves and their families.

Meyer thought he was a far better biochemist than Chain (very true !) and could more quickly and easily synthesize penicillin  than Chain (very untrue !)

Would his friend, Dawson the bacteriologist and clinician, help out by testing the resulting product ?

Dawson read up on what little there was on penicillin and noticed its unique combination of extreme non-toxicity and extreme diffusiveness could possibly be the best shot in a long time to cure SBE.

Now SBE was usually a matter for the heart specialists (an elite in every hospital) and Dawson's main job was in an arthritis out-patient clinic (at the low end of  any hospital's pecking order).

Moreover, some people had made SBE their primary lifelong research and clinical interest and Dawson had never - as far as I can tell - written or spoken on SBE.

To barge into their area of expertise would be a disaster.

I can only presume that Dawson first suggested his idea to SBE and heart experts and then to his contacts at the big Drug Companies.

Only when none responded positively and he had two dying SBE patients in front of him, did he act.

Because he felt that penicillin might save their lives, he pulled out all stops and broke all the rules and norms, to try and save their lives --- with this urgency additionally fueled by his anger at how the 4Fs of society were now being treated.

SBEs, in a month of the first ever peacetime Draft registration ( an entire nation trying to find all the 1As in society), were everyone's 4Fs of the 4Fs : about the most useless to the war effort young males imaginable.

Many medical staff felt they'd only consume precious medical attention for months and then invariably die anyway.

So, when Dawson stuck that first ever penicillin needle into an SBE's arm on that first ever peacetime Draft Registration Day, I feel sure his first finger was cocked in the air while the other four were wrapped around the needle.

"Down goes the needle - and 'up yours' !!!!! " .....

DRUGS and Romney's 47% : AZT, Penicillin and Sulfa once didn't pay federal income tax either

AZT once part of the 47%

In a dynamic - Democratic - world, one minute you're down, not paying any federal tax, the next minute you're paying millions. But in a static - Republican - world : when you are down, you're out - for all time.

Roughly 47% of all of our most famous, best-loved, life-saving drugs were written off as "useless" when first discovered.

In the lexicon of Ryan, Romney and Republicans everywhere : they were part of the "unfit" 47% - well past caring about.

So Sulfa, penicillin and AZT were labelled as "useless" for 30 , 15 and 20 years respectively.

But then some kindly souls picked them up out of the medical gutter and gave them second chance, a second chance to do good and save lives.

AZT, Penicillin, Sulfa later saved the lives of those who earlier wrote them off as "useless" : poetic justice

But revealing once again that God has an infinite sense of irony, He - in his spirit of forgiveness - later permitted those "unfit" miracle-inducing medications to be used to save the lives of Romney, Ryan and all the rest of those church-going Republicans.

 All the people who had earlier failed so demonstratively to obey God's command to show mercy to the "unfit" : there is a lesson here - maybe even a sermon (!) : something about how the weak and the useless are sent to humble the mighty and the wise, maybe ...

AZT, Penicillin,Sulfa : Mr Romney, 47% of life-saving drugs were once written off as "useless"

Romney "latinoing-up" for votes

Asking who invented AZT, like asking who invented Penicillin or Sulfa drugs, is entirely missing the really important point : which is "who exactly first discovered their life saving qualities?"

The people who first discovered Penicillin and AZT and Sulfa (and Carbolic Acid et al) did not in fact discover and prove-up their uniquely tremendous life-saving qualities : that credit belongs to other people.

Many famous drugs once part of Romney's "unfit" 47%

And there is a current lesson here : not a medical one - but a political one - because this ties in very closely indeed to the 2012 American Presidential election.

Many famous drugs, as well as many unfortunate American citizens, can fit---temporarily --- into Mitt Romney's 47%.

One minute a drug is down and not paying any federal income tax (and so is written off for all time by Romney and Ryan) ---- the next minute it is up --- up in the lineup to get a Nobel from the King of Sweden and wondering how it is going to tax-shelter all the billions it is making.

Some very famous drugs were discovered twice : once as a useless chemical and only later as a marvellous life saver.

Fairness demands (even if  if the black and white simplicity of contemporary journalism does not) that the credit for them be shared.

Shared between those who discovered or invented the original substance and with those who (much) later decided to try it out to save lives in unexpected applications - often against the opposition of their more cautious colleagues.

Pause from thinking of Romney's strange new Latino tan - please - to honor the memory of Jerome Horwitz who died, unnoticed and unhonored, on September 6th of this year.

In 1964, Horwitz came up with a promising theory of drug therapy that he thought might help conquer cancer. He and his colleagues synthesized "almost but not quite perfect" analogues of a common building block used by life in creating DNA.

Horwitz hoped these drugs (AZT being by far the best known) would act as a Trojan horse and confuse cancer cells into using it to try and build new DNA.

The effort would falter and then the cancer cells would cease to multiply - effectively halting the cancer growth in its tracks.

Unfortunately AZT failed to work - in cancer cells - and Horwitz put it on the shelves - unpatented.

But not before publishing his FAILURE in the open public literature.

In the success-oriented world of Science (rather like the stock market) it takes courage for a scientist to admit failure and for a journal editor to publish that admission of failure : kudos to both for doing so.

Cut to 20 years later, AIDS is in full blown attack and every smart pharma company is in hot pursuit of finding a cure.

A traditional and time tested method is "brute force science" : mindlessly try every known chemical against the HIV virus, on the off chance that one will work, despite roomfuls of Nobel Prize winners standing around whining "that it won't work /don't bother".

Ten thousand (relatively un-expensive, very unimaginative) experiments later, sometimes something totally unexpected and totally wonderful happens.

As it did for Burroughs Wellcome . They patented AZT when the results showed it slowed HIV , AIDS was seemingly repelled - at least among those who could afford their patented marvel - and they made billions in profits.

Horwitz got none of that money and little of the acclaim that AZT garnered.

But he will get someday get wide acclaim - sadly only now that he is dead - because his line of research is indeed working on a broad front against many viruses, not just against HIV.

And successes against viruses (outside of vaccines and Mom's advice of lots of bed rest and lots of fluids)  are rare enough to cheer to the rafters.

So why is Horwitz ,the discoverer that AZT doesn't cure cancer, ignored and why is Michael Heidelberger, the discoverer that Sulfa don't save lives, also ignored? When Fleming ,the discoverer that penicillin won't save lives, is among the best known, best loved scientists of all time.

Why mostly because popular journalism is not in fact Rocket Science or Brain Surgery. It is not particularly rational or scientific or sophisticated: its priority is to tell uncomplicated - simple - compelling stories while remaining willing to use the facts ----- but only if they fit that simple narrative.

Alexander Fleming, Paul Gelmo, Jerome Horwitz do all deserve some fame for penicillin, Sulfa drugs and AZT : but so do Martin Henry Dawson, Gerhard Domagk and the nameless boffins at Burroughs Wellcome ---- the guys who first used those useless inventions to save useful lives.

Naturally, as a patient and not a chemist, I am profoundly biased : I honor much more those who save lives then those who merely invent or discover chemicals.

Don't you wish your average journalist started thinking more like a patient and less like a chemist when they appropriate honor ?

After all their readers are almost certainly likely to be patients sometimes in their lives but very few will ever be chemists.

And don't you wish Mitt Romney and Paul Ryan would ponder the "down and then up" life stories of Sulfa, penicillin and AZT before they write off the human 47% for all time ?