Penicillin is not Avastin, but it could have been...

My book - The smallest Manhattan Project  - is about us , all 10 billion of us , here today or years dead, whose lives have been improved by the advent of inexpensive penicillin.

In a sense, this book is a rarity : one written from the patient's eye view of how that drug came to be ; a welcome change after decades of endless books exclusively devoted to how penicillin looked to the people who discovered and developed it.

Penicillin is frequently called the Miracle Drug but few consider that its biggest medical miracle was really in fact its cost, or rather 'lack of cost'.

Because the diseases that penicillin treats are contagious,  patients too poor to afford a cure remains a reservoir of the most virulent strains, waiting to infect the rest of us.

There actually were methods of preventing much of these diseases before the development of penicillin : they included the ready availability of good jobs, good food, cleaner and bigger homes, greater social respect.

Baring that, only the worldwide availability of a drug that would cure those diseases once they started up, at a price that almost all could readily afford , could reduce these diseases from being endemic or epidemic to just names in a dusty medical textbook.

That is why I can say, with absolute assurance, that even those of us who have never had a single treatment of beta-lactam (penicillin family) antibiotics are in better health today because the grandparent of them all, Penicillin G , is water cheap - literally a lifesaver "too cheap to meter" .

But it almost didn't happen , we almost lost "inexpensive penicillin".

We almost got an expensively patented synthetic drug more akin to Avastin and all those other $100,000 a year plus medications.

"The smallest Manhattan Project" is the story of a doctor ( himself slowly dying of another unrelated disease) who sacrificed his own health to see penicillin from the patient's point of view.

His name should be honoured for all time.

This, despite the fact that he did not discover penicillin and then neglect it (Fleming) nor did he start its re-discovery and eventual development, albeit while pursuing a pathway that nearly killed off that development (Florey).

Dr Martin Henry Dawson, for that was his name, merely said penicillin should be made available - now! - for every single patient whose life could be saved by it , even during the height of a Total War .

Nay, he went much, much further.

Dawson in fact said all should have access to life-saving penicillin, particularly in the middle of a Total War.

That was because that war was supposedly being fought against one opponent in particular, solely because that opponent's core philosophy said that 'some lives are more worthy than others'.

How could we continue to conduct that war with any moral vigour when our own medical establishment was 'me-tooing' Hitler's doctors ?

Now the mantra 'Penicillin for all who needed it regardless of their income level or skin colour' in the mid-1940s meant its mass production, given the vast amount of infectious disease endemic in those years.

And mass production has its myriad ways of driving production costs down, down , down --- as happily happened in the case of Penicillin G in almost textbook manner.

'Penicillin for all' quickly became 'inexpensive penicillin for all' and once that happened, penicillin began to work almost like the way a good public health vaccine program should work : the treatment of the many ultimately offering 'herd protection' to all the rest of us, free of charge.

Insulin is another drug frequently called a miracle drug.

But the sad fact is that it is far more common today than it was beforeinsulin was discovered, for a variety of reasons.

By contrast, the names of all those bacterial household scourges that so terrified our mothers and grandmothers are not even known to most of us under the age of 50, and most doctors practising today have never seen a case of them.

And that is just the sort of modern day miracle that Dawson's mantra of 'penicillin for all' can produce.

For the complex truth is that our choice of medical ethics has economic consequences and these in turn feedback and have medical consequences.

The case of what the mantra of 'penicillin for all' ultimately led to should be taught in every health economics and health ethics oriented university department for just those very reasons....

Penicillin in wartime: an alphabet soup of organizations passing the buck then hogging the credit

I am still not fully recovered from the disaster of my first public talk on wartime penicillin before Dalhousie University's  Medical History Society.

I was given a very generous amount of time by the Society's Jock Murray and Allan Marble to state my case but it didn't help : my choice for a title slide in my powerpoint presentation simply covered far too big a subject and left me no 'on the spot' wiggle room.

" Wartime Penicillin : from secret 'war weapon' to widely publicized 'beacon of hope' " is not a topic line easy to compress.

 (Though last night's blog entry on the Janus Month of March 1943 would have been a good attempt at compression.)

Within a minute or two into the talk, I felt like crawling into a hole  and disappearing forever --- I could see by the faces of the audience that I was giving far too much unknown information far too quickly.

Any two or three of my powerpoint slides, from the forty two I had actually come with, could have formed the basis of an interesting talk and a lively amount of discussion afterwards.

Eight and a half years of research has finally made me more or less comfortable with the vast array of sound-alike organizations involved in wartime penicillin,  and their activities are just as important as the individual stories of individuals like  Fleming, Florey and Dawson.

But trying to establish what the OSRD and OPRD were in the first place, even before trying to show how much at odds these two similar sounding government agencies really were on penicillin is a month's work - not a small part of a 40 minute talk.

It is entirely my fault - because the night before the lecture I had noticed that even a well known expert on the history of wartime penicillin (name omitted !) still managed to badly confuse the two in an major article in a digitalized book I found on the internet.

And when a printed work is digitalized and put on the internet, an error is forever and eternity --- and visible to all, worldwide.

That is why my penicillin work  will remain electronically fluid on this blog and in website e-books.

 My errors of fact and interpretation (and I expect and even hope to make many) will be instantly correctable as new information comes to light or savvy readers spot errors and typos.)

And another thing about individuals and institutions when Cinderella unexpectedly turns into the Queen of the Ball.

 After passing the buck for years, they now suddenly tack hard right and start clawing each other to take all the credit .

Sorting who actually did what when, not what they claimed ,after the war ,in expensive official histories, that they did, is  itself a work of many lifetimes...

First person to ever read Fleming's 1929 penicillin article, REALLY READ IT, was Henry Dawson, in October 1940...

Very early in his investigation of  the antibacterial qualities of the liquid beneath a penicillium mold , probably by October 1928, Alexander Fleming came to a truly startling conclusion.

And it is not what you - or he - or any other doctor or scientist might have expected.

Finding unknown substances that kill bacteria was and is a commonplace.

Finding a substance that kills bacteria without also killing the patient is a distinct rarity.

But the chances of finding a unknown substance that kills bacteria  while (a) not killing the patient AND (b) while being a part of about two dozen other unknown compounds in a bath of 97% water ?

Well, sir, that simply is an event that has mathematic odds well beyond the calculating.

Let us label the Alec Fleming of this startling conclusion, "Fleming I" , because six months later he had - confusingly - become both Fleming I and "Fleming II", depending on his mood.

Fleming II consistently insisted, for the next fifteen years, that penicillin would not become a useful medication until chemists had purified it, discovered its chemical structure and recreated it as an artificial synthetic. Even then, it would only be good as an external antiseptic.

Talk about a parent praising their latest offspring with faint dams !

But while Fleming II's team had actually started down the chemists' path  and had produced a much more concentrated (and semi-purified) material, he totally and abruptly abandoned this effort and never wrote it up in his seminal 1929 article.

He never even used this highly concentrated material  (a thousand times more concentrated than original his liquid mixture) in any biological experiment.

It could just be that the businessman-bacteriologist Alexander Fleming, a frugal Scot, had more native arithmetic in him than almost all the doctors and scientists who followed him into penicillin - certainly more native arithmetic ability than almost all the writers I have read on the penicillin saga.

Because the two dozen unknown compounds swirling about together hadn't eliminated the anti-bacterial activity or caused a toxic reaction, removing them by purification was a 50/50 shot at  improving- or reducing - those two valuable qualities.

Remember that : let me repeat it : purification might actually reduce the bacterial activity or increase toxicity. Synergy, working together, does many mysterious things.

In fact, Dawson's co-worker, Gladys Hobby ten long years later was only one of many who were convinced that crude impure penicillin worked better than the equivalent amount of units of pure penicillin did all by itself.

Balancing these unknowns, it wasn't mathematically likely that purifying penicillin 100% was actually going to make it a better medicine.

In fact, since with 1929 levels of original mold juice and the then current state of extraction technology, 100% pure penicillin was probably going to require losing 99% or more of the original anti-bacterial substance, 99 patients would now die so that 1 might receive 100% pure penicillin.


Let me go further, and recall some of the economics lesson professor John Graham taught me too many years ago.

Graham had a way of bringing economic jargon down to ground level, perhaps never more so than in explaining the term  "opportunity cost".

I'd like to think that this is the way he'd explain Fleming I's decision to refute Fleming II's progress :

It is not just that purifying the penicillin juice to 100% results in so little penicillin output that 99 potential patients must die so one patient can be treated with 100% penicillin - that has no more medical efficacy than the original un-purified juice.

Because devoting all of your incredible amounts of labour, stress, time, expense, lab space to this purification effort, means your team can't find the time and space to simply produce more absolute units of the original penicillin, with the production technology they already have.

Nor can they find the time, energy and money to improve the biological yield of that original strain of penicillium mold.

In the real world of limited time and resources, when you open one door, you close many others.

Now Fleming II didn't actually go very far down the path of this (pointless) path of purification.

But his team did find success in the much easier and much more potentially useful concentration of penicillin juice ; aka simply removing most of the harmless water, as we do with concentrated orange juice.

If water is the one compound in the mixture known to be harmless, why bother ?

Fleming's strain of penicillium was actually a very potent producer of penicillin on (not in) water : eventually it produced 200 units of activity per ml of liquid in painstaking experiments in the lab, and routinely got at least 40 units in day to day industrial efforts.

But Fleming didn't know how to grow penicillium right to produce its potential in penicillin - and why should be ?

But he also didn't bother to try to find out, from other fungus farmers, how to grow it better.

He was a medical bacteriologist and he grew it as if it was a medically important bacteria.

The results were a disaster : he was lucky to get one unit of activity per ml of liquid.

But even the most careful technique of safely injecting large amounts of liquid by IV drip wasn't going to find a way to get anti-bacterial activity that diluted into the blood stream to cure really life threatening blood poisoning.

Success by this method, as several bold and brave doctors discovered in 1943-1944, wasn't actually that far off : in those early days, even massive infusions of 10 units per ml of liquid would save lives ,and at 40 units per ml of liquid all but the toughest infections could be beat back then.

So if Fleming II concentrated his original liquid down to a thick syrup, he'd have concentrated it enough to inject into patients --- without losing too much of the original scant penicillin in the process  OR consuming all his team's limited energy, time and money in the process.

But at this point, another set of experiments convinced Fleming II completely (and totally wrongly) that penicillin would not work at all as a systemic - concentrated, purified or not.

If only he had injected his syrup, mixed with a little bit of saline solution, into a dying mouse, the mouse would lived.

 And penicillin would have been in wide clinical use by December 1929, repeating the rapid pattern of Banting's insulin, but this time in spades.

However, Fleming I never put Fleming II's work or conclusions into his 1929 paper - only repeating his conclusions in private conversations , if pushed.

He found, (and so told hundreds of hospital bacteriologists all over the world) , that easy to make, 100% recovery , liquid penicillin worked well as a routine lab clearing agent and for use as an a non-toxic human antiseptic.

Now to October of 1940 , exactly 12 years after Fleming's original startling discovery about 'the non toxicity of impurity'.

 Henry Dawson is waiting impatiently for his co-worker Karl Meyer to purify some of Fleming's penicillin up to what the team imagined was the level of purity acceptable to their famous teaching hospital's quality standards.

And to the level they imagined the deliberately vague but purity-obsessed Howard Florey had claimed he had achieved before safely injecting his penicillin into infected mice in the summer of 1940, saving their lives.

Suddenly, while impatiently waiting and pacing the floor, Dawson was presented with a truly Solomon's Dilemma.

He had expected to treat a single patient with SBE, provided the young man didn't die of the invariably fatal disease before Meyer had purified the penicillin to an acceptable level.

Now he suddenly had two young men dying of SBE.

Re-reading Fleming's original article gave him his solution : if purifying merely lent losing half or more (much more) of the limited material available, without making the resulting medicine any less toxic, why bother ?

Merely quickly concentrate the liquid penicillin, so most of the harmless impurities are left in, while the harmless but burdensome excess of water was left out - and you would be quickly left with enough penicillin to treat two patients - and all this could happen before the two men died.

So the spirit of Fleming I , not Fleming II, was guiding Dawson's hand when he injected the world's very first antibiotics , months ahead of schedule, into BOTH Aaron Alston AND Charles Aronson on October 16th 1940.

Fittingly, in this act of inspired charity, Matthew 20:16 was again fulfilled as the Last became the First to receive this healing balm.

(Alston was almost certainly black and Aronson almost certainly Jewish and in 1940s America both were hardly among the truly favoured peoples.)

After Dawson, a few others others would re-read Fleming's paper as if for the first time, and decided to prefer large amounts - today ! - of highly impure but non toxic penicillin, over small amounts of highly purified but no more non toxic penicillin, maybe, tomorrow.

I suspect their grateful patients, plucked back from the grave, more than agreed with their re-reading of Fleming 1929.

A case of Jam Today , indeed .....

Fleming's seminal 1929 article on penicillin is missing two words : impurities and crude

Fleming, in this extremely famous article, defines his "penicillin" as consisting of  one or more soluble solid active ingredients in a liquid nutritional  broth, no more and no less.

He makes it clear that "penicillin" is merely a useful shorthand for that cumbersome longer phrase.

He never once uses the word impurities or impure or crude: to him his active ingredient is perhaps ALL  of the soluble solids left behind when the water is evaporated .

Fleming says that this (mixture) of soluble solids and nutritional broth is non-toxic to the extent that it can be injected in a mass of one fortieth of body weight without harm.

(That is, this liquid mixture appears to be safely injectable in a mouse and a rabbit to the equivalent of  a single bolus of 1500 to 2000 cc into an average adult human.)

And Fleming isn't the only one never to use impurities or crude in describing penicillin in a scientific report, in the twelve years between 1928 and 1940.

Clutterbuck & Raistrick in 1932 do not use the words impurities or crude, nor does Roger Reid in 1934, or Elizabeth Pickering at Squibb in 1937 or Siegbert Bornstein in 1939.

But Howard Florey, the chemist manque , the anti-clinician, he sure does in 1940.

He might even ask his potential readers, "Purity : how many ways do you want it ?"

Despite being a very short article - almost more of a scientific note  in the style of letters to the journal Nature - Florey manages to inject the words "purify" , "not a pure substance", "impure" and "impurities" and talks constantly of his "penicillin preparations" as if they are something quite different and advanced from Fleming's liquid penicillin.

But, in fact, Florey has merely concentrated all the soluble solids by evaporating away the water, so that 4 tiny units of anti-bacterial activity are no longer in a gram of water and solubles, but in a milligram of solubles.

But two thirds of the scarce anti-bacterial activity has been lost in this totally unnecessary and expensive and complex effort : and in any case, this dry powder has to have water added back into it, to inject it for use !

Dawson, Pulvertaft, Duhig, Yermolieva , Berger (among a mere handful of all the world's doctors ---- maybe just .01% of them  thought this way) seemed to have picked up on Fleming's crucial point.

A point he quickly missed, because he publicly always said that the substance would have to be synthesized pure by chemists before it might be a useful antiseptic .

But his original point was true, nevertheless.

It was this : that regardless of whatever was the compound(s) with that mixture of soluble solids that had the anti-bacterial powers, the water and other solids had no harmful effect and needn't be laboriously purified out - or even concentrated by evaporation - at a tremendous loss of the anti-bacterial matter.

Dawson is at pains to introduce the word "crude" repeatedly in his 1941 article, but with a much different point that Florey's article a few months earlier.

Dawson wants to hammer home that despite the crudity of this mixture of the anti-bacterial activity and the other soluble solids, it was still non-toxic even when injected ( finally) into the human blood stream : life-saving does not have to wait until the chemist's apple has been polished to a 't' .

Dawson is , in a sense , "The James Lind of Penicillin".

Put in another way, James Lind said we don't know which compound (later determined to be vitamin c) it is in limes that prevents scurvy but that shouldn't stop us from using it - NOW ! - to save lives.

Almost two hundred years later, another Scottish (Canadian) doctor (Henry Dawson) said pretty much the same thing.

The lesson might be this : chemists, let the sleeping dogs of chemical perfection lie -----  while we clinicians get on with saving lives.....

Howard Florey sole hero of 1944 American national radio play on Penicillin

Here, Howard Florey rules !

Du Pont's Cavalcade of America  on NBC was a very well financed American national radio and later tv show, popular before and after WWII (1935-1957), that as Marcel Lafollette points out , often featured heroes from medicine and science.

Not surprising then that the series featured an half hour show on "The Story of Penicillin" as soon as the censors would let it : which interestingly enough was April 24th 1944  --- starring Howard Florey as the one-and-only who brought us the miracle of penicillin !

(CALV 440424 380 The Story of Penicillin : episode 380, April 24 1944 is very easy to stream or download from the internet.)

Which is to say this half hour national show aired at a time when the OSRD-AMA-NAS triad was still successfully holding back all press interest in penicillin the miracle (by claiming the triad had legal censorship powers that it actually didn't possess.)

Could it be that even the powerful OSRD had to bow before the enough more powerful chemical giant, in part because it was a prime contractor of the A-Bomb ?

But what I  find so interesting about this show - beyond the fact that I do not recall reading about it from any penicillin historian's writing - is that it clearly announces at its onset that its one and only star is "Howard Florey".

Was the show an attempt to discredit Pfizer's sudden success  with non-chemically produced penicillin ?

(Because of all the months of the six years of war, April 1944 was the one I'd been most inclined to credit Pfizer's John L Smith as the man who finally brought us penicillin.)

Because that months of all months was the very first month that billions of units of the hitherto invisible miracle suddenly started pouring out of his rapidly-improvised Marcy Avenue ice plant cum biological penicillin brewery.)

Perhaps the triad felt a need to suddenly burnish the reputation of the big loser in the race to provide penicillin for D-Day :  that loser being synthetic penicillin and Florey's synthetic efforts at Oxford University.

 And believe me, having listened to as much of this half hour show as I could stand, Florey is indeed portrayed as the one and only star of this miracle of medicine.

Florey has an entire army of fans among present-day historians claiming he was elbowed out the fame-feeding-trove by that big mean bully Alec Fleming.

I have always found this hard to stomach.

Florey, in fact, was seemingly born with at least four sharp elbows of his own.

He also had a strong reputation, as a scientist, of being as ready to use his fists to win scientific arguments as  Fred Banting or Vannevar Bush ever did.

I wonder if his academic defenders will still howl " he wuz robbed" after listening to this old radio show ?

The re-invention of a military-only antiseptic into "bedside penicillin for all" creates a global beacon of hope for a world at war

the tiny stone the builders rejected

Despite the self-centred claims of physicists, the greatest benefits to humanity have generally been ardently pursued (invented), not accidentally stumbled upon (discovered).

DNA was discovered in 1860s by an Swiss doctor, but for most of us, it was really only discovered 125 years later in the late 1980s.

That was when it began to first be successfully used to solve unsolved criminal cases, when British researcher Alec Jeffries re-invented 'DNA' as a means to definitely identify biological evidence left at the scene of a crime.


The great medical pioneer Joseph Lister clearly re-invented carbolic acid, when he took it from just one of many industrial solvents and turning it into a global life-saver.

Paul Gelmo "invented" sulfa as man-made chemical in Vienna in 1908 and it was routinely patented in 1909 by Bayer the chemical giant hoping it might yet be a useful chemical intermediate reagent.

But not until Gerhard Domagk , also of Bayer, who systemically tested every one of his firm's new chemical creations for its medical potential, was its life-saving abilities "discovered".

But I still hold this to be a case of re-invention.

 It took an awful lot of grit and determination during the Great Depression to waste scarce company money by systemically and thoroughly testing every one of the thousands of chemicals Bayer made, on then very remote possibility one might have medical applications.

The Nobel committee obviously agreed with me - giving Domagk the inventor and not Gelmo the discoverer the Nobel Prize for sulfa.

Alexander Fleming accidentally discovered penicillin in1928 and "discovered" it was only useful as a military-style antiseptic.

In 1940, Florey and Chain accidentally discovered that penicillin also might work as a systemic.

But like Fleming (by 1940) ,they still choose to emphasize its rather limited application against combat wounds infected by staph bacteria : a tiny, tiny, TINY proportion of all the deaths caused by WWII.

They were hardly alone : I was amazed to discover in my research that I could find no penicillin-making researcher between 1928 and 1945 who first put their penicillin to work as a human systemic life-saver, before they also tried it on localized wounds.

With one crucial exception: Henry Dawson.

In October 1940, months ahead of the schedule that he and his three fellow researchers had already worked out, he choose to inject systemic penicillin into two young men suffering from invariably fatal endocarditis.

At least one of the men - unexpectedly - lived.

It wasn't because of Dawson's penicillin : at an estimated 8 units per mg, it was about .56% pure.

Useless Junk ? Or Love, Hope and Charity ?

The rest (99.44%) was junk - or as I like to emphasis : "99 and 44 100ths percent pure love....hope... and charity" -- bedside penicillin.

A good bedside manner has probably saved more lives throughout history than all but a tiny handful of medications.

I contend that Dawson deliberately used his tiny amounts of home-made penicillin as part of his traditional clinician's bedside manner, to rally his patients' own body defences against their disease.

As prove, I offer up Gladys Hobby, a fellow member of his tiny team, who said she daily walked through Henry Dawson's wards, showing the patients the growing penicillium in flasks, hoping their rising interests in their treatment might rally their psychic resources.

Dawson was not content to reserve his invention of "bedside penicillin" to the handful of endocarditis patients that his small home-made supply could hope to treat.

So Dawson quickly told a convention of his colleagues (the world's top clinical researchers) that natural penicillin had "unlimited possibilities", thousands times stronger than the then acclaimed synthetic sulfas, but without their toxic side effects and inability to work well in blood and pus.

These researchers took his claims home to their labs all over the world.

Meanwhile popular media, like the New York Times , Newsweek and the wire services, spread his gospel throughout North America.

He tried to get the American government - in 1941 -(and by extension all Allied governments) to take over the production of penicillin form Big Pharma and mass produce it themselves in quantity.

Instead, wartime government bureaucrats, who were themselves paid consultants to Big Pharma , censored Dawson's conventional scientific methods to spread his good news - by restricting his access to scientific journals and restricting what he could say at scientific conferences.

But in wartime, person-to-person gossip becomes the new telegraph.

So Dawson was able to keep on spreading the word until most all of the doctors in metropolitan New York and beyond had heard of his unexpected successes with systemic natural penicillin, curing incurable endocarditis , the "Gold Standard" of infectious diseases.

Penicillin , he said, didn't have only a limited wartime role, limited to just being applied to local staph infections in combat wounds or to cure self-inflicted military VD cases.

He said it  had unlimited possibilities and could cure many of the diseases that plague a peacetime nation or a multi-million man wartime military --- if only government bureaucrats opened their eyes, their hearts and their pockets and gave it a "fair go" .

When the world's general populace, after the story of Baby Patricia broke worldwide, catch Dawson's "vision thing" , governments were forced to play catch up in the production of actual penicillin.

Meanwhile, they too caught Dawson's "vision thing" and governments all over the world turned their propaganda machine full blast to tout penicillin as a beacon of future health and hope for all , if only the Allies win this war.

The key change in the Allied governments' approach was that "for all" as it became clear that the voters did not agree with an Allied war effort that deliberately limited the supply of life-saving medicine and then triaged the world into the people worth saving and those not worth saving.

That - they said - sounded awfully familiar : wasn't that also Hitler's line ?

Well it was certainly Modernity's line : the  methods of instrumental rationality ruled all the modern nations from America to Germany.

By contrast, Dawson's general systemic was 'general' in the widest sense of that word.

 He thought it was particularly important in a Total War against Absolute Evil to give - and be seen giving - life-saving health care and food & shelter to all : it  was the best single reason why people should be willing to fight and die for the Allies' cause.

And seventy five odd years later, was he not right ?

Penicillin has a powerful mystique that tens of thousands of other useful medications ,combined, can't hope to match.

Dawson's crusade to make his inexpensive, abundant, safe "bedside penicillin" a commonplace at hospital beds the world over , in war and in peace , is the major reason we grant penicillin that mystique....

ROP on this penicillin milch cow is beyond astounding : and it is all down to lactose intolerance !

Ironic isn't it ? Hundreds of millions of people have enjoyed longer lives thanks to the lactose intolerance of some slimy little mold.


That mold makes penicillin : in the beginning, very little,  only converting about one millionth of the war-rationed sugar that was so lovingly fed into penicillin.

Turns out that was the biggest part of our problem : we were feeding it far too well, on easy-to-digest sugars and so it failed to produce any penicillin.

But as soon as we learned to starve it slowly, by giving it milk sugar, (lactose) a sugar it didn't exactly live to eat , it started into giving us tons of penicillin.

Lactose stresses the diets of molds something wicked and when they get food-stressed, but not to the point of actual starvation, they play defence .

The penicillin they start making kills and keeps at bay possible bacteria competitors for what little suitable food the mold can lay its threads upon.

But actually starve a mold (and early researchers often accidentally did that), and they started to rapidly self-suicide themselves in despair.

But feed it lousy lactose, just at the right time, just after its had a day or two of easy living on some nice sugar and protein, and it will produce tons of penicillin.

Literally : annual penicillin product induced by human industry is now at least 20,000 metric tonnes a year.

In 1928, it was about one micro-gram. That's about what Fleming saw in the bottom of his petri dish and it was about as much penicillin as was used in its first cure : curing a newborn baby of a lifetime of blindness , in 1930.

A micro gram is 1 millionth of a gram , so there are a billion of these tiny micro grams in a kilogram of penicillin ( ie about 2 pounds of penicillin). And a trillion of them in a metric tonne of penicillin ( ie about 2000 pounds of penicillin if you are old school.)

So we now produce 20,000 thousand trillion times as much penicillin today as we did 85 years ago.

Fleming's particular penicillium mold was actually very good producer - seemingly the best in the world for 15 years, but only produced one micro gram of penicillin in every gram of liquid medium.

That is a million parts junk to one part money ratio, unbelievably dismal in comparison to every other fermentation process in commercial use at the time.

Today, we get 50 milligrams of penicillin per gram of medium : that is 50,000 times better.

That is a 5,000,000 percent improvement in about 50 years.

Think your grandfather's prize milk cow had an outstanding ROP improvement ?

Try this rapid a percentage improvement on for size !

The main reason why we didn't see this sort of improvement for almost 20 years after Fleming found his mold is because we let chemistry guide our thinking ; trying hard to extract ever more of the penicillin we did manage to produce.

But as I used to say to the CUPE picketeers whenever the Gerry Regan government boasted of the size of its final, final, contract offer : " ten percent of nothing is .... still nothing" .

Only by learning to starve penicillium molds, which we had done by late 1944, did we begin to see enough penicillin to make the stuff a paying proposition , not a charity case, for Big Pharma.

But you can read all the best known books on war time penicillin - and I believe I have - and yet never read one word said about starvation of the molds.

The same goes for present day articles from historians and social scientist about wartime penicillin.

Only articles and books from physical scientists actually working in the fermentation industries routinely mention starvation stress in regards to being essential to penicillin production but even they seem to quote articles from the early 1950s as being the first to signal this fact.

But what then to make of little gem from July 26th 1941 from a letter from Norman Heatley to Howard Florey, just three weeks into Florey's effort to get American Big Pharma to make penicillin on at least a pilot plant scale?

Heatley is at a spanking brand new research facility in Peoria, set up by the US Department of Agriculture to find new uses for farm surpluses - particularly surpluses of low value farm wastes.

He is working with Andrew Moyer : one part mold genius to two parts paranoid nutter.

Already, just ten days after looking at penicillin for the first time, Moyer hazards a guess that penicillin production might be dependent on a starvation metabolism.

If Moyer had only been listened to - and there is no sign that any scientist or bureaucrat then - or historian since - ever did, we might have had commercial penicillin flowing by the Fall of 1941 not the Fall of 1944.....

Between Wartime Penicillin's initial failure ( Chemistry) and its final success (Biology) stood a third party : the humanitarians

When I call Henry Dawson "Penicillin's Third Man", I am being more than ordinarily facetious.

Penicilin's problem was chemistry-besotted biologists, the solution was  biologically-pragmatic chemists and the connecting threat were a tiny group of humanitarian-minded clinicians.


I mean that penicillin's main problem was - dating from September 1928 - was that its initial (biological) investigators  -names like Fleming,Florey and Richards spring to mind - tacitly accepted penicillium production levels of one microgram of penicillin per gram of medium as a given.

 As a result, they sought - blinker-eyed - only one possible solution : the total chemical synthesis of penicillin.

By contrast, it was chemist Larry Elder who finally pushed mycologists into doing their jobs like people on a mission, not people politely going through the motions.

And it was Larry who sought out "farmer-minded" scientists from any and all fields to up penicillium yields the old-fashioned way, the way farmers had successfully done so with other species for thousands of years : trial and error selective breeding.

But before people like Larry could be called in on the file, the public in September 1943 had to be outraged, ("its been 15 years since penicillin was discovered and  its still in desperately short supply !") and demanding that the authorities put new people on the job to finally start making this stuff - now - and in bulk.

Elder, Colitti, Queen, Hearst never get the credit they deserve

The humanitarians like Henry Dawson, Robert Pulvertaft, Rudy Schulinger , Frank Queen and Dante Colitti all pushed the civil and military powers to be to make penicillin available for all who are dying - now !

And when the purple-toned slash yellow press of Citizen Hearst picked up on their efforts, all the pieces fell into place.

In less than six months, the government of America was pulling a little bit of its money out from making nuclear bombs and germ warfare and towards saving lives and the job was done.

 America - and soon the world - would be awash with cheap naturally-breed penicillium-made penicillin....

Penicillin : both its mold and its morals seem to hang out in basements and sewers

Rollo Martins the Canadian naif to Harry Lime's evil...

When I started looking into wartime penicillin, back in late 2004, I quickly felt like that other Canadian , Rollo Martins, learning far more about the immoral underbelly of  the official - and sunny - penicillin story than either of us wanted to know.


About all I originally knew about wartime penicillin was from recalling a CBC TV production (originally from Britain ?) that involved a policeman dying of a cut from a rose bush and a doctor named Fleming .

(I had seen it in the late 1950s, back when I was about eight years old.)

That and the fact that the peacetime penicillin clan was a firm family friend - having saved my family many times from serious illness.

I had no idea of penicillin's Canadian connection - like virtually everyone I wasn't aware there even was one.

I gradually and dimly recalled penicillin coming up in a great British film called The Third Man.

I looked at a video of it again and then, on a visit to my brother in Britain, read a great book on how the film and novella came to be.

From both video and the book about the film and novella, I got a strong sense of the extraordinary moral over (and under) tones that penicillin has and that the other three hundred or so existing commercial antibiotics completely lack.

I am only guessing why The Third Man is rated , not near the top of the all time best British films (a dead cert that), but at the very toppermost of the very top : but for me it is the penicillin sub-text.

Britain, unlike Japan and Germany, had really and truly lost the war and so its wartime scientific discoveries like penicillin, jets and radar were seen as absolutely essential to retaining the British sense of collective self esteem.

And so for Harry Lime to muddy penicillin's (and Britain's) good name by , in effect, using it to murder helpless kids , was for them a worse crime against humanity than anything short of Auschwitz.

Sewers as a metaphor for both good - and evil 

Dark ,cool ,dank, concrete sewers and basements is where penicillin the green and gold agent of life actually originally came from - but it was also the true home of that agent of death, Harry Lime .

This was a masterstroke from Greene and Reed ,the one Ying and Yang symbol that puts this film over the top.....

Was Alexander Fleming a coward ?

FLEMING avoided this ....

Hard to say --  but he definitely didn't have a chivalrous bone in his body.  And twice - while still a young man - when given a chance to be brave,  he fearlessly declined.


Fleming joined an infantry unit when he was 19 and the Boer War was a year old and despite being a crack shot , he never volunteered to go and fight.

He remained with that infantry regiment, the Scottish London Rifles, enjoying laying at war until 1914 when a real war broke out.

He quit the regiment in 1914 (April, apparently) and thus avoided going into battle with them on October 1914 at Messines Ridge.

His regiment is forever remembered for being the first  ever Territorial Army unit to go into general war action : but Fleming wasn't among them.

Aged 33 when war broke out, Fleming was young enough to be conscripted but unexpectedly got married - shocking his friends.

(Marriage among lifelong bachelors is always very popular in wartime.)

As a married man ,he needn't fear conscription -- at least until after December 1916, when the marriage exemption was ended. Later the upper limit for conscription was raised from 41 to 51 , but in any case he was well under those limits and healthy as an ox.)

In any case, Fleming was already in military uniform, working at a desk job in a medical lab, well behind the front line.

Fleming and Florey : what a pair !

Howard Florey was equally (not) brave : a first rate, highly competitive athelete, he claimed health reasons for why he didn't join his fellow students in the Australian Army in WWI.

Like Fleming, in WWII now that he was safely too old for combat, Florey was a real chicken hawk on conducting an aggressive war policy when it came to rationing penicillin away from dying civilians and towards unfaithful soldier husbands with a dose of the clap...

Florey vs Dawson : penicillin to be perfect & a war medicine OR an imperfect but universal medicine ?

Baby Patty Malone helped the whole world discover penicillin 

As should be well known, penicillin-the-molecule and penicillin-the-lifesaver were discovered September 1943 by the whole world, (not in September 1928 by Alexander Fleming) while natural-penicillin-the-universal-livesaver was invented on October 16th 1940 by Henry Dawson.


Penicillin-the-molecule was ignored in June 1929, firstly by Alexander Fleming himself and secondly by the world.

This was because Fleming on that date indirectly denied any possibility of penicillin ever becoming a lifesaver, ie a systemic ( spread through the blood system) medication.

As a result, Fleming - and the world - yawned.

Contrast this with Banting team's excited, animated, passionate announcement --- at a Boxing Day medical conference just a few years earlier  -- that it was  just two weeks away from injecting insulin-the-lifesaver into a dying patient.

(What a Boxing Day present for millions of diabetics and their familes !)

You can just bet that insulin-the-lifesaver and insulin-the-molecule were discovered together, by the entire world, at that moment.

What about Howard Florey then ? Didn't he play some role in penicillin ?

Yes, some role.

But Florey ,along with Fleming, and along with the British and American governments together with the leading firms in the pharmaceutical world, was convinced that penicillin first must be perfected (100% pure, industry-made, probably synthetic, tested-onto-death) before being used on humans .

 And even then 'humans'  really meant 1A military personnel only, at least during the war.

In addition, they all only saw penicillin as an useful supplement to the existing sulfa drugs - mostly for use in sulfa-resistant staph infections.

Truly a perfectionist and limited vision of wartime penicillin.

One can only begin to imagine the high prices that would be charged governments and patients for such perfect material.

Chain deserved less credit for his chemistry and more for his pushiness , in forwarding the penicillin story to a happy conclusion...

By way of total contrast, only five weeks after learning of penicillin's lifesaving potential (and here Florey and above all Chain deserve the credit) , Dawson was injecting life-saving penicillin into 4F civilians ( Negroes ! Jews !) dying from a strep infection (SBE) , using imperfect , impure, hospital-made, natural, penicillin made by slimey molds.

Yes, like Banting's first insulin injections, Dawson's first penicillin injections 'stung like a bee', from natural impurities still in it. The stings, in both cases, did no permanent (or even temporary) harm.

To Dawson (and to Banting, his model) saving dying patients today with imperfect, impure medication was preferable to letting them die so we can maybe save dying patients, years from now, with a perfected pure medication.

These clashing visions of penicillin ran throughout the war with Florey's vision overwhelming dominant until Dawson's success with -stolen - government issue penicillin on SBE patients inspired another local doctor (Dante Colitti) to jump over the traces for his dying patient as well.

The resulting  heart-stirring story of baby Patty Malone ( late August - early September 1943) broke the media floodgates and the entire civilian world began to "ACT UP" and demand Dawson-style penicillin - now !

By 1944, the Allied governments, dragging the still reluctant Big Pharma firms along with them, had caved.

Semi-purifed, semi-perfect - CHEAP- natural penicillin was being mass produced and being made available for all, as fast as that was humanly possible.

And not just Allied civilians as well as Allied military personnel , but for Axis POWs , Neutral nation civilians and ultimately even Axis civilians.

Canadians Banting and Dawson and Canadian Medicare : there is a pattern here :  a strong belief in medical care that is universal in theory as to who is permitted to receive it (everyone, anywhere) and universal in practise (as a result of being very inexpensive).

But it wasn't something simply discovered and instantly received with acclaim by everyone - as science historians want you to believe how science works : as a totally bloodless affair.

 Instead, it was invented by some humans and contested fiercely by some other humans until finally most humans accepted it.

Invented by people like Banting, Dawson and Douglas ...

Sulfa's Alexander Fleming : Paul Gelmo, winner of 1939 medical Nobel for discovery of Sulfa

Sulfa the MIRACLE drug

Alas Paul Gelmo , discoverer of Sulfa, is not likely to ever be as famous as Alexander Fleming, the discoverer of Penicillin and it is a mystery worth investigating to ask why not.

(And in truth Paul Gelmo did not win the 1939 Nobel in Medicine for his discovery. Gerhard Domagk, the actual winner, deserved his Nobel for sulfa about as much as Ernst Chain did his Nobel for penicillin --- which is to say "still in doubt".)

Gelmo invented cum discovered  sulfanilamide in 1908 as part of his PhD in organic chemistry, doing what Germans of his generation did best : churn out endless synthetic variants of dyes.

It had no known uses, although 11 years later it was found to have some anti-bacterial quantities by American biochemist Michael Heidelberger.

Voices off, unheard  : the cries of the dying

But Heidelberger didn't feel any moral urgency to push to have it tested clinically, to see it it might actually save lives.

(Heidelberger, a later colleague of Martin Henry Dawson , similarly declined to assist Dawson in the development of penicillin - thus missing on the ground floor action of the century's two biggest lifesavers.

Cry not for Michael - he outlived Gelmo and Dawson and died showered in laurels, apparently for never uttering an unconventional thought over his long, long life : an all around, don't-rock-the-boat, team player.)

Domagk did two things with Gelmo's sulfa , one good one bad.

The good thing is that he did what Ernst Chain did ,but which Fleming refused to do : he tested the substance at hand "in living creatures ("in vivo") despite it have failed earlier test tube tests ( "in vitro tests").

Once inside animals, surprise, surprise, it did work and it did fight off the deadliest of infections.

The bad thing he did is that he went along with his employer, I G Farben, when it delayed telling the world about this life-saving drug (the only one available at the time, mark you) for years, while it sought to invent a patentable analog of it.

Neither I G Faben or Domagk felt any moral urgency to put the drug they did have at hand on the market at once, profitably-patentable or not.

The actual dye that Domagk was originally charged with testing consisted of two separate molecules ( one of them sulfa) loosely bonded together to form a beautiful ruby-red dye---- a totally new dye and hence very patentable.

Ie potentially very profitable as a dye - but not as a drug.

This was because "in vitro", bonded together inside a test tube, the two molecule "patentable" ensemble did nothing medically.

 But once in a living body,"in vivo", the body's enzymes quickly cleaved the bonds between the two molecules and the sulfa portion - once on its own, quickly brought bacteria growth to a stop.

Sulfa could and did save tens of millions of lives.

 But as sulfa was now Public Domain (PD) 25 years after its original discovery, it would make no real money (only worldwide gratitude and acclaim) for I G Faben, and so they stalled releasing this life-saving miracle.

But as they never could find an analogue for sulfa , I G Faben finally and reluctantly released the original 2 molecule dye without telling anyone that it cleaved apart in living bodies and the active ingredient was a dirt cheap, abundant (and PD) byproduct of many dyeing operations.

Domagk-the-hero has to be forever tainted for his part in this delay.

Fleming also never tested his penicillin in a living being with a disease - he just did "in vitro" testing that told him that penicillin killed bacteria slower than it was secreted out of the body - thus to the never-one-to-waste-a-motion Fleming it seemed so useless as a systemic that it was not even worth testing "in vivo".

He felt no moral urgency in "just double checking" his hunch.

When Howard Florey - pushed hard by Chain - did finally test penicillin almost 12 years after it had been first discovered , he found it did kill artificial infections inside animals - it did work , "in vivo" !

But while he was an editor of the journal that Fleming's original 1929 article appeared in and so could have demanded Fleming do the "in vivo" tests to double check Fleming's hunch, he never did so.

That he did so only 12 years later - and this when pushed hard by Chain - hardly displays any moral urgency on his part to test this potential life-saver.

Sulfa and penicillin - successes "in vivo", failures "in vitro".

Like I G Faben , though not because it could be profitably patentable as a result, Fleming and Florey put all their priorities to see penicillin made synthetically before it was given mass distribution.

Martin Henry Dawson was all alone in believing that natural penicillin was perfectly acceptable to be mass produced and put to work right away, because people all around were dying daily without it.

Dawson thus invented a moral reason why natural penicillin should be mass produced "today - if not sooner".

It was this 'moral urgency' that Dawson alone brought to its invention, that finally led to the development of mass produced life-saving systemic penicillin.

 A moral urgency that Fleming, Florey,Heidelberger and I G Faben all so obviously lacked.....

Nova Scotian-born Dr Henry Dawson and the "Invention" of systemic - natural - penicillin

The "Invention" of systemic - natural - penicillin

Discovery vs Invention

Many substances were "discovered" many years (sometimes centuries) before they were (re) "invented" as having a highly useful medical effect.

It is only since Aug 1945 (and the ascendancy of Physics over Chemistry as the Queen of Science) that we have devoted all our adulation to "discovery" , rather than "invention" in medicine.

Carbolic acid and sulfa's both had early dates of discovery (versus their much later first medical use) .

Alexander Fleming is - wrongly - credited with discovering the penicillin we have used since 1940 - but what did he actually do ?

 Fleming in fact thought his penicillin would be useful as a sort of "Plan B" antiseptic -- and only if pure and synthetic.

Howard Florey - ten years later - thought his penicillin would be a useful "Plan B" back-up systemic to Sulfa -- but again, only if pure and synthetic.

By contrast, right from the start and until his death, Martin Henry Dawson thought that natural (even if impure) systemic penicillin would be the "Plan A" choice to cure the incurable, to save the unsavable --- starting with those dying of invariable fatal SBE.

Only two people in New York worked with penicillin in 1940, despite a war (with millions soon to be dying of infections) raging the world over.

 One doctor published a conventional article in JBC, reminding bacteriologists how useful crude penicillin could be as an agent to clear common throat bacteria from suspected specimens of influenza bacteria.

That was about all that penicillin was in (semi-) common use for, in 1940. Just as carbolic acid had its various non-clinical uses in the days before Lister "re-invented" it as a life-saver.

The other doctor, Dawson,  saw crude penicillin as the most likely cure for SBE.

NOT because it was a super-killer of bacteria, but for some less sexy but rather more "useful" characteristics: it combined nearly-limitless non-toxicity with an extraordinary diffusion ability.

He could thickly saturate the blood stream with penicillin without killing the patient, and hope some would still diffuse in past the thick vegetations (bio-films) of SBE, as that saturated blood rushed past the diseased heart valves at breakneck speed.

Some modern SBE patients have needed as much as a kilo of pure penicillin over many months - that's 1.67 BILLION units of penicillin - but have beaten the disease.

Still while penicillin - and only penicillin - could save an SBE in the 1940s, SBE was a prodigious user of then very scarce penicillin, so Dawson also had to morally kick start ("invent") an entire "natural penicillin" industry into existence, to deliver the amount of penicillin needed for his SBE patients.

(As a by-product, the rest of the world soon got as much penicillin as anyone could need - so much so it was soon feed to cattle as a growth stimulator, partly to absorb some of the production.)

I say his "invention" was by moral argument, because the scientific and commercial consensus then was that only synthetic (patentable) penicillin could do the trick.

But only when Dawson morally convinced the head of Pfizer, John l Smith, to take a very great financial risk and go against the consensus of his industry, did the miracle of penicillin really begin to happen....

the epic triumph of DEMAND SIDE penicillin

All penicillin histories - to date - have been about what I call "SUPPLY SIDE" penicillin.

"Brilliant scientists, working day and night in the 15 years since September 1928, once again totally surprised humble but ever grateful lay people all over the world."

"They did so by dropping the new miracle cure penicillin  upon them, out of the blue, in September 1943."

This version of the saga says penicillin is best told in two competing stories or parts.

 But both parts are united in being all about active scientists --- with no role what so ever for us, the totally passive and inert citizenry, or in our roles as patients and patients' families.

Part One ,(1928-1937), features Dr Fleming - discoverer of penicillin - with far too many pages devoted to the mysteries of that discovery and with too few of the rest devoted to his efforts to bring his penicillin juice forward to the point of actually saving lives -----when used as an antiseptic.

Part Two, (1937-1940), features Dr Florey of Oxford University (all bow) and his years of wartime work on the chemistry of penicillin - all about his troubles extracting and purifying and synthesizing penicillin.

My book will be about Part Three, (1940-1943), the era of "DEMAND SIDE" penicillin. It will be all about the life-saving done by early penicillin doctors (not scientists), on the rare occasions when penicillin was diverted to the ward bedside and away from the synthetic chemists.

 It will focus on Dr Dawson - the patient. Yes, the patient.

Dawson was not unique in deciding to become a doctor after months spent in a hospital - Dr Colitti ( of Patty-Malone-and-penicillin fame) resolved to become a doctor after his own childhood bouts in hospital dealing with his spinal TB that left him a permanent hunchback.

For Dawson, his insights as a doctor dealing with chronically and terminally ill SBE patients could only have deepened when he himself became a chronically and terminally ill MG patient at about the same time.

Actually I will focus on Dawson, on his first penicillin cure Charlie Aronson, on Baby Patricia Malone's family and on the mother of a dead child he never got to save - Mae Smith, wife of Pfizer chief John L Smith.

In August 1943,Dr  Dante Colitti - inspired by Dawson's illegal SBE successes (an early example of ACTING UP) at another hospital a mile away, got Mr and Mrs Malone to also 'ACT UP' and publicly demand penicillin for their dying child.

Soon hundreds of families were doing the same all over North America and when enough Doctor Moms kicked up a fuss, even the stupidest men in Washington or Brooklyn listened - penicillin production really got moving, after 15 years of male excuses for 'not taking out the trash'.

CHRONICALLY ILL are always 4F

Med Schools in that era - and perhaps even today - hated the chronically ill because they refused to die or get better, within the only school term that could be devoted to that particular form of illness.

The chronically ills' failure to get better 'put paid' to the notion that Science was always successful.

And Society in general packed the chronically ill of low income families away in large impersonal institutions with too many patients and too little money.

It got worse in wartime - a lot worse. A lot of people feel free to unleash their inner evilness in wartime and the helpless are a safe target.

In Hitler's Germany, the chronically ill were actively gassed - particularly those 'useless mouths' type patients like the SBEs (Charlie) and MGs (Dawson) who needed lots of repeated interventions of  high tech medical care without any hope they would eventually recover and start back at productive war work.

In Vichy France or in the US, it was more subtle - the eugenics of benign neglect.

Budgets were cut for the chronically ills day to day living expenses so more money could go to the war, or simply back to the well to do taxpayer when no one was able to complain.

Many chronically ill in institutions died of hunger-induced  infections while the budget-cutters' consciences could remain unsullied.

 Chronic illness research efforts were re-directed away from these useless mouths 4Fs towards the 1As and war medicine.

 Many patients were conscripted,without their informed consent, in some very dangerous experiments for the war - humans being as badly and baldly treated and cast off as laboratory white mice usually are.

Dawson and his supporters rejected the artificial divide between Social Medicine and War medicine, between social penicillin and war penicillin.

They said , against Hitler and Tojo, social medicine was war medicine,in fact the best kind of war medicine.

They said are we fighting Hitler simply because he took raw materials and markets we once regarded as ours or rather because we detest his values with all our hearts?

If it truly was the latter - FDR's Four Freedoms -  we should contrast how we treat our old and weak against how Hitler treated his.

For we will all become old and weak someday.

By 1943-1944, a lot of people saw that Dawson was right - and penicillin's promise was held out to people in the occupied ,enemy, allied and neutral nations as a symbol of the rightness of the Allied Cause.

Until then it had been treated as one of the Allies' best war weapons - a strange term for a life-saver .

 Yes, Dr Dawson probably did 'go a little native' when he got MG and became a perpetually ill patient as well as life-saving doctor -----but Thank God for that !

In January 1945, when AMA boss Morris Fishbein, the American medical censor, finally let Dawson tell American GPs about his five years of successfully curing SBE with penicillin, Dawson could reflect he hadn't done too badly for a chronically ill 4F.

Most histories of penicillin - to date - act like Dawson withdrew to a shadow world of chronic illness and inactivity after he got his MG diagnosis around May 1941, so the authors can return to focus on his rival Florey.

But in the Spring of 1945, Dawson could say, like a lot of chronically ill people who kept on being highly productive despite the pain, "*I'm Still Here - and so is my penicillin !"

Partially because of Dawson and Colitti's ACTING UP, patients today are much more likely to demand quick relief rather than simply waiting for the desultory scientists to get it all perfect and pure before dropping it into our grateful little hands - and Thank God for that, too....

* "I'm Still Here !" is a copyrighted expression and used with the kind permission of the late copyright holder, Margo Takacs Marshall, 1928-2010

The Mystery of Penicillin's 18 missing years

I believe that all of the penicillin books up to now - and there have been hundreds of them - have basically been a series of 100,000 word excuses - "the dog ate my penicillin homework".

Excuses to us - the lay public - on behalf of Science in general or on behalf of one or other early penicillin researchers in particular.

But eighty years later, we lay people still want to know why it was that the best life saving medicine this world will ever see took an eighteen year vacation (from September 1928 till about September 1946) before local doctors around the world could routinely prescribe it to save a life.

Whether they are from the pen of a medical historian  seeking to defend all of Science/a particular team effort or the effort of a lay author defending an individual scientist they particularly admire, all those apologies basically come down to this:

The 18 year delay was due to technical difficulties, not moral failings - at least not the moral failings of my hero.

My book, by contrast, is not going to be a technical book - at least in its intentions.

(It will actually highly technical and highly accurate at times---- but only when needed to refute technical excuses and bromides.)

THE FIRST MORAL HISTORY OF PENICILLIN

Mine will be a Moral History of penicillin - it will lay out a thesis that it was moral failings, not technical difficulties, that delayed penicillin becoming popularly know and commonly prescribed during all those years of death and suffering that we now call The Great Depression and World War Two.

The two events caused an excess of 100 million premature deaths over what might have been expected in that 16 year period.

Even if we content to 'merely' reduce those excessive deaths and not seek to prevent many of the so-called normal infectious deaths, how millions might penicillin have saved if it was readily available by 1929-1930?

Or consider this: despite the new global threat from nuclear weapons, the Cold War period from 1945 till 1985 was actually an incredibly optimist period in world human history.

The promise of 1945's penicillin was sufficient, all by itself, to overcome the fear induced by 1945's A-Bomb.

For a generation, penicillin kept most of us buoyed up about ourselves and the world around us.

Could those good vibes - induced in 1928-1929 instead of twenty years later - have been enough, by themselves, to prevent the worst of the Great Depression and World War Two from even happening ?

We will never know.

 But I believe these questions are still big enough,eighty years on, for it to be worthwhile to re-examine the early penicillin saga to see if there is another explanation for the delay. One that will finally convince most lay people - and hopefully - even convince a few of the scientists.

DUHIG IS PROSECUTION'S KEY WITNESS 

In the Fall of 1943, in Brisbane Australia, 15 years after Fleming discovered penicillin, Dr J V Duhig saved the lives of a dozen seriously ill people using a form of penicillin juice no more sophisticated than what Fleming had on hand in November 1928.

This the single hard, hard, hard, hard ,hard, historical stone against which I am going to grind every author and every account that claims that there were 'technical complications' why the world had to wait 15 or more years to put the life-saving effects of penicillin to work.

Until and unless they can explain to everyone's satisfaction why Duhig could do this - but why Fleming/Florey and Dawson et all couldn't - I will not relent.....