"Irish Jimmy" Duhig and his Uisce Beatha : Penicillin as Orange Juice

I woke up the middle of last night to find I had a bad cold and so naturally got to thinking about its prevention and cure.

Its natural and unnatural cure and what all this had to do with the unknown history of wartime's crude penicillin.

It was the smallest of the wartime Manhattan Projects, but it had the biggest impact on making our world a kinder gentler place

Has the Manhattan-based Atomic Bomb and nuclear reactors really made our world a kinder healthier place ?

Was the Manhattan-based Norden bombsight and its delusion of mass bombing of civilians as way to end all future wars really the way to a kinder gentler world ?

Was Manhattan-based Dr Foster Kennedy's wartime project to propose the gassing of all the retarded children ,in emulation of Hitler's Aktion T4 project, really going to make us a better people ?

High tech drugs uphold White Man's Burden (1940)

It is still not often recognized that by the late 1930s, particularly after the huge success of the totally-not-from-nature Sulfa drugs (because they were 100% artificial) , high tech pharmaceuticals had became the key pillar upholding "The White Man's Burden".

" Crude is more than 'good enough' ...

... if it can save lives right now ! "

Lifesaving's perpetual understudy , Penicillin, unexpectedly made her long overdue debut in a medical theatre in uptown Manhattan on October 16th 1940 .

Albeit more than a dozen years after the best lifesaver ever known was first discovered.

Crude Penicillin and Bacterial Transformation : two neologisms of Henry Dawson

Henry Dawson was far from a wordsmith but he did coin two neologisms that have survived in today's scientific and historical lexicon.

One was "bacterial transformation" (a form of HGT, horizontal gene transfer -- basically non-Darwinian inheritance) and the other was "crude penicillin".

To explain this latter term is is best to recognize it is really a term of scientific and political polemics.

Let us imagine a British Empire in the early 1940s, badly hurting a time of war because it had refused to accept a fact known for at least two centuries.

That fact was that the most natural , most versatile and cheapest way to solve the naval and merchant ship scurvy crisis was with a good supply of citrus fruit kept on board.

Marshalled against this fact discovered by James Lind was an array of louder, better educated and greedier voices.

What they were telling the government and the media and future historians was that Britain's dying sailors must simply be patient.

In its own sweet time an expensive synthetic vitamin C was sure to emerge, fully patented, from one of the nation's chemical firms.

One expensively patented , tasteless , pill would solve the human daily needs for vitamin C - as would other patented pills for all our daily food intake.

We needn't waste time away from our desks on meals when a glass of water and a big handful or two of pills would solve the problem.

Against this chemical boasting would be an array of people saying that they looked forward to meals - perhaps even more than sex and certainly far more than they looked forward to work.

Others would point out that citrus fruit and vitamin C rich vegetables are found world wide - are both cheap and abundant - a security of supply issue.

They would further point out that the deadly delay in solving this sea-going crisis for the Empire was simply down to greed and ambition.

The delay was down to some ambitious scientists seeking the glory for having synthesized something Mother Nature already provided and to some greedy chemical companies wanting a profitable patent to exploit.

These claims against patented vitamin C pills are so damning  a master scientific polemist would be called upon to defend Chemistry.

A scientific polemist like Howard Florey because he, too, was a bit of a neologism creator : he was the first person to talk about impure and pure penicillin, for example.

An orange ,he could point out, could potentially be a dangerous source of vitamin C because it was an impure  source of the needed vitamin (in the sense that vitamin C only made up a tiny fraction of one percent of the orange by weight).

In a 1940s culture where the middle class had more education than common sense, this would be effective arguing : everyone wanted cleanliness and purity.

Henry Dawson immediately caught onto this "Only I know how to make pure safe penicillin" line of attack from Florey's very first article on penicillin and quickly mounted a rebuttal.

And he did so in the august pages of the New York Times on May 6th 1941.

In effect, he said an orange can be one of four things, as regards to being an safe source of vitamin C.

It could be unsafe because both the orange and its vitamin C are potentially dangerous.

It could be safe because both the orange and its vitamin C are harmless to consume.

It could be unsafe because vitamin C is potentially dangerous, perhaps in larger quantities.

It could be unsafe because the orange itself was potentially toxic.

The only thing to do , as always , was less talk and more experiments.

He tested impure penicillin (penicillium juice) upon himself and upon some human patients and found it perfectly safe.

He boldly called his successful medicine "crude penicillin" --- naturally made penicillin happily bathing its its naturally produced impure bath.

it was a medicine made by microbes and offered up to all, free in the Public Domain : thus meeting Florey's subtle corporate agenda head-on.

Ironically, years later, it was revealed that pure penicillin itself  was potentially unsafe (unlike the rest of the harmless penicillium juice) because when pure it can be given in large enough amounts to result in sudden penicillin allergy deaths !

Pure members of the aryan races might still believe they can only survive on pure penicillin and pure vitamin C but the rest of this polyglot world still likes to take its daily nourishment 'crude' , dining around the table with family and friends.

It hasn't seemed to harm the seven billions of us so far....

Majority of Americans remain silent as Woodrow Wilson's legacy is brutally destroyed : 1938-1941

Thank God Almighty that Adolf Hitler declared war on America, because without it, would America have ever gone to war against the greatest evil the world has ever known ?

The fact remains that between September 1938 and December 1941, the majority of Americans had stood silent as the legacy of their own president Woodrow Wilson was brutally dismembered by the twin 'evil empires' of Hitler and Stalin.

Czechoslovakia, Poland, Estonia, Latvia, Lithuania, Finland, Yugoslavia were all creations of Wilson's direct efforts at Versailles.

The larger spirit of Wilson's efforts : that small nations should be allowed to live without being swallowing up by their larger neighbour's brutal might  had , until 1938-1941, kept countries like Belgium, Luxembourg, Denmark, Albania, Norway, Holland and Greece independent.

Now that too was all gone.

Still the majority of Americans kept silent and indifferent ; they wanted to keep out of the "conflict between the nations" of Europe.

Conflict between nations ???!!!

When I learn that a high school senior and football star has walloped the hell out of a primary toddler his girlfriend was supposed to be minding, I do not call it a "conflict between school students" though that is technically and legalistically correct.

I call it child abuse and deadly assault : the 5 year old didn't start this "conflict" , the 17 year old went to war on it.

So it was when Russia invaded Estonia or Germany invaded Denmark , without any cause besides sheer evil greed.

Morally the excuses most Americans gave then for not going to the defence of the weak against the strong would not stand up in a court today, if they were accused of just standing by while a 17 year old football star beat the crap out of a 5 year old child.

And in a higher - moral - court , they did not stand up then.

This was the sort of moral cesspool that Henry Dawson was swimming against when he defiantly decided to introduce the Age of Antibiotics by treating the "weakest of the weak", the "4Fs of the 4Fs" with his crude penicillin, on the very day America choose to celebrate its "1As of the 1As" : Draft Registration day, October 16th 1940...

The Cure for Auschwitz Disease : "Dawson's Crude" : .56% penicillin ...and 99 and 44/100ths pure love

Pray there comes a day when most premature deaths really are 'Acts of God', when even the best of money and the best of medical care could not result in a happy ending.

But until that happier day, most premature deaths in the world - in peace as in war - are 'Acts of Humanity' , or rather 'Acts of Lack of Humanity'.

Sins of Omission : premature death caused because the people dying are not judged (by others more fortunate) as worthy of devoting much money or effort towards saving.

In war, comparatively few people die as soldiers dying of mortal wounds gained in combat.

The Nazis' behavior provides a particularly clear example of this.

They fed and cared for  the captured POWs and enemy civilians of some nations (the Dutch for example) but for other (Russians and Poles for example) many or most of these people were shot after battle or left to starve and die of disease from lack of food, medical care and shelter.

The food and fuel saved as a result meant that no German citizen went hungry or cold.

The right kind of German civilian anyway.

Using the war as excuse, the Nazis killed many German civilians, those judged 'life unworthy of life' , to free up food and hospitals for other Germans.

In another well known example of  WWII's Sins of Omission, Winston Churchill ignored the pleas of his top British officials in India and let four million poor Bengali civilians needlessly starve to death in 1943-1944 ,rather than divert some food and some shipping from  Allied peoples he judged more worthy of receiving them.

Even the different death rates from wounds gained in combat  , among the so called "modern" nations engaged in World War Two is revealing.

The Americans and British generally devoted more resources to saving their wounded compared to the Germans, Japanese, Russians and Italians.

 As a result,more western Allied troops survived the same severity of wound as experienced by troops of these other nations.

'Of course', I hear you say, 'they were richer nations, it was easy for them !'

But no : they had a choice, because the extra money devoted to this extraordinary care of the wounded could have been allocated elsewhere: to more and better anti-tank artillery, for example.

An extraordinary effort to produce the best anti-tank artillery ever made was , in fact, probably the cheapest way for the Western Allies to have ended the war against Germany at least a year earlier than it did, saving millions of lives all around.

I raise the genuine issue of better earlier anti-tank artillery versus the best possible military health care to remind us that even total war still leaves us with genuine moral choices.

More Lancaster bombers versus more 17 pounder anti-tank guns versus raising everyone's morale by generously providing penicillin enough for all people were some of the choices - part political, part moral, part economical - that leaders had to make in WWII.

Making the wrong ones meant the war dragged on longer than it had to, costing more lives lost.

It is not enough to say Churchill won the war in 1945 ; better to ask, could he have won the war in 1943 ?

In 1940, Henry Dawson was battling a near universal mindset among the world's research-oriented doctors of that time : that a medical researcher's only task was to determine that disease A was caused by bug B and that bug B was killed by compound C.

Then, like sleeping under a bridge, the researchers considered that the cure for disease A was open to rich and poor alike : pay for three weeks of needles at $10 a shot: together with doctors fees, say $250 in total.

When the annual wages of the working poor, if they found work, was very lucky to be $750 in 1940, that was a cure well beyond their reach.

Besides the fact that their disease might be far harder to cure than that of someone well off, due to the cumulative affect of their lack of good nutritious food for years and years.

Or that fact that living, as they did, in poor and crowded housing, disease A was more likely to come back again, even after an impossibly expensive cure.

Now what if disease A is something one gets from having open wounds - such as the open wounds all civilian mothers have after childbirth, or the open wounds that soldiers get after exposure to shell fire in battle.

How do we judge western Allied governments unwilling to provide the only life saver for disease A , either to any civilian moms (except those personally known to lead disease A researchers) or to any soldiers with wounds so severe they will be discharged and pensioned off, if they live ?

And how do we judge these governments when at the same time, they are gladly willing to provide live-saving compound C  (totally free !) to men who had either very high and very low peacetime incomes, just as long as their war wounds (by sheer luck) are only moderately severe and they can be expected to return soon to combat duty ?

Is this attitude not different in kind from that of the Nazis, but merely different in degree ?

Dawson had no realistic expectations that a few small injections of a very crude penicillin powder, hastily made in a few weeks, would cure such an incurable invariably fatal disease as subacute bacterial endocarditis, (SBE), then as now the acid test of all infectious diseases.

His powder had only about 8 to 9 units of penicillin per mg in it ; ie it was only about .56% pure.

The rest (the remaining 99 and 44/100ths worth),was in many researchers' minds, "junk".

Rather as they later described most of our DNA : "junk".

I believe Dawson considered his little bit of brown powder to be .56% penicillin and 99.44% pure love.

99.44% pure care, concern, caring.

For Dawson was judging his attempt to save Aaron Alston and Charlie Aronson by a much different - and much more moral - acid test.

To Dawson, SBE in the Fall of 1940 was not the acid test of infectious disease, but rather the acid test of pernicious morality.

These SBE patients were be judged to be 1940 America's "4Fs of the 4Fs", suffering from the militarily most useless disease on earth and not worthy of wasting any precious medical resources upon.

Now a doctor named Francis Peabody that Dawson had hoped to train with (but who died of cancer before that could occur) had earlier and famously said that the care of the patient begins (only begins in fact ) if the doctor first cares about the patient.

A single doctor can't hope to directly save everyone dying in a big war.

But by setting a very public example about caring for the least of these, those judged "unworthy of life", even in the midst of a war , they can hope to begin to still the trigger fingers of those all too willing to kill prisoners  just because 'it is too much bother to bring them back to our own lines'.

Only when the world is willing to care about "useless" others, even in the midst of wars, can we expect to begin to see war deaths reduced to combat mortal wounds, and then to ultimately see lesser and shorter and less brutal wars.

Only in a world where ordinary people care about others judged "useless", can we expect to still the hand that dropped the pellets at Auschwitz .

Which is why I earnestly claim that Dawson's Crude was the best and only cure for the Auschwitz Disease ....

OSRD /1942: did Manhattan Project type thinking bleed over and obstruct the Penicillin Project as well ?

It is crystal clear that Merck's top scientific advisor A N Richards was never a strong advocate for fast-paced penicillin development within Merck, as that drug company casually messed about with penicillin, from November 1939 till August 1941.

That is, Merck had 18 months of some sort of commercial and scientific activity around penicillin , before Howard Florey actually arrived on the scene.

But Florey eventually made Richards a strong convert to the idea of having Richards' military medical weapon oriented agency , the famous OSRD , use penicillin for secret military advantage over the Axis.

It is not clear that this would have extended - in practise - to denying penicillin to dying Axis POWs.

 But keeping penicillin a secret from the Axis definitely would have denied penicillin to dying Allied POWs behind Axis lines : something that all of Florey's, Richards' and Fleming's present day defenders universally ignore.

Very much to his credit then that WWI vet and WWII military officer and doctor Robert Pulvertaft did dis-obey orders and shared the secrets of penicillin production with Axis-friendly Turkish doctors.

But imagining a Canadian dying of sulfa-resistant blood poisoning in a German POW camp and the Canadian POWs being told by the German doctor, 'we could save him , if only we had a bit of this Allied-invented penicillin that we've been hearing rumours of'.

When the Canadians ask why doesn't the doctor get some, the doctor says that if the Allies won't even share penicillin with their own dying civilians, how can they be expected to share it with the enemy ?

But could penicillin have really ever have been a potentially secret and successful medical weapon ?

Here I , following closely on Henry Dawson's thinking,  definitely part company with Florey and his friend Richards.

Henry Dawson demonstrated - in just five weeks - and under conditions as fully primitive as Fleming's, that one could quickly make a lot of crude penicillin that was non-toxic when injected into humans.

If Fleming and Dawson could do so, (quickly, easily and cheaply, ) so too could the fired up Nazi war machine.

Not so, said Florey -and his side kick Richards.

The scientific characteristics of penicillin haven't changed at all since September 1928, but now , thanks to Florey, the scientific rhetoric totally had.

Florey tells his readers and listeners, to ignore completely what Fleming-the-author says is "penicillin".

To wit, 'a mixture of about two dozen unknown compounds in a slurry of water that is non-toxic even if injected in very large volumes internally, and yet has marked anti-bacterial affects'.

In my revision of the facts, says Florey in his first August 1940 article, "penicillin" is now actually just one of those compounds.

All the rest and all that water are just dirty, dank and dangerous.

Only if penicillin is first pure, dry and stable is it any good.

Because where it is really good , is in the front lines as a local antiseptic for open war wounds (here I do still agree with Fleming) ---- and that idea won't work if crude liquid penicillin must kept viable in portable electric refrigerators.

Who ever has heard of such things ?

But as Florey tells Richards how complex and difficult the purification process is, Richards grows despondent again, but never the less this information does go into the back of Richards brain.

Only to re-emerge in early 1942, when the forces of war censorship and secrecy can be employed in full bloom.

Because complex and expensive separation and purification processes had become very much a two-edged sword for American military science and industry.

Artificial rubber was vital to the war effort - it was easy to make but a real bugger to separate the good rubber from the bad.

Dried blood products held real promise at the front lines - but only if their separation wasn't so complex.

And the Atomic Bomb - a piece of cake to make it work - if only we could get enough pure U-235 separated.

At some point early in 1942, these problems suddenly became military and commercial opportunities in the minds of the OSRD's highest officers.

If only rich, un-bombed America could solve these complex purification problems - and then keep the details secret - this would give them a big military advantage over their poorer enemy opponents.

And give America a post-war commercial advantage as well over its smaller poorer Allied friends like Britain.

So just as we see an abrupt turn around , in mid 1942 , from the OSRD re sharing much atomic information with the British, we start to see the British also get less information from the OSRD about penicillin research as well.

Like synthetic rubber, synthetic quinine, dried blood products and U-235, the very expensive complexity of pure penicillin suddenly made it more, not less ,of an attraction to the military weapon-oriented OSRD.

The key was to keep secret from the American voters and taxpayers just how many miracle cures were happening with the current - relatively impure -penicillin.

Because if they knew that, the newspapers would be filled with it and the Germans and Japanese would hear about it via Neutral nation reporting.

They they too would also start curing their base hospital wounded with crude semi-purified penicillin ,largely negating the military advantage of fully dry stable pure penicillin.

But was there really ever an absolute need for dry stable penicillin to use it in the front lines ?

Poppycock !

Because it turned out that good old crude liquid blood was actually much better than the complex dried stuff at saving soldiers' lives and could just as easily be used even in combat : good old fashioned low tech American ingenuity (not from the OSRD high tech boys of course) came to the rescue.

Cheap, rugged, disposable,  parachute-portable plywood ice boxes kept blood and penicillin cold, with refills of ice every couple of days........

Aside from VEGEMITE, what did Aussies Gray & Duhig have that Alexander Fleming totally lacked ? (Moral Fervour)

6 million might have lived

In the Fall of 1943, fifteen years after Nobel Prize winner Alexander Fleming proved that penicillin - at least his method of making penicillin - could NOT save lives, two intrepid Aussies using his very same penicillin strain and his very same methods (right down to the use of Seitz asbestos filter pads) plucked a half dozen patients from the jaws of certain death.
  Aussie "Men at Work" , under tough wartime conditions

"They came from a land down under" - working in fact in then remote Brisbane Australia , under severe wartime shortage of staff and materials, their methods displayed NO technical improvements over what Fleming and his two young assistants had managed 15 years earlier.

Unfortunately, Altruism was never Alexander Fleming's long suit...

The key difference was that they had the moral fervour ( that Fleming totally lacked) to try almost anything to save people who were certain to die in days if not hours , by pumping extraordinary amounts of impure ("crude") penicillin water into their bodies.

Even at that late stage in penicillin's development, when the whole middle class world was talking up the miracle of penicillin, most doctors would rather see a patient die, than publicly admit that they injected an impure natural substance into a human being's bloodstream.

(It, after all, was an age of eugenics, and pure breeds, families of good blood and evil half bloods , pure-blooded Indians, when 1/32 or even one drop of black blood made you legally black and when the American Red Cross would not allow the mixing of black and white blood in transfusions : pureness and blood had a quasi-scientific, almost mystical , quality in those years .)

 Nothing impure went into such a symbol of purity as human blood.

So even in late 1943, only a few doctors let the two pioneers, Duhig and Gray, inject raw penicillin juice into their patients - and even they, only when their patient seemed at death's door.

So these were not average very sick patients - they were gravely weakened patients given up for dead - so their recovery was all the more remarkable.

Penicillin's Holocaust

If Fleming had displayed any of their moral fervour in the 12 peacetime years when he had penicillin virtually to himself, an estimated six millions lives might have been saved.

Including - tragically - his own favourite brother  John in 1937 - whose pneumonia case was easily curable by even modest amounts of crude penicillin water - if only Alexander Fleming  had tried.

Instead it was left to the moral fervour of another Scot, Nova Scotian born  Martin Henry Dawson, to first put impure penicillin into a patient's bloodstream, in 1940.

Fewer doctors than you can count on your hands followed Dawson's moral fervour when it came to fighting for the right of impure - natural - penicillin's  to save lives,  in those all important  years between October 1940 and May 1944....

* They used Vegemite in the making of their penicillin juice , as a growth stimulant