Churchill's bombers burn babies while FDR's bombers deliver penicillin to babies

I have tried awfully hard to find stories of Churchill's bombers delivering bottles of penicillin, rather than bombs of napalm, to the world's babies.

No luck so far.

But newspapers in 1943-1944 were rife with stories of FDR's bombers delivering various tiny bottles of penicillin half way around the world to save babies.

It is usual to emphasis how well the left-leaning FDR government got along with the right-leaning Churchill government but it is also possible to overdo all the censor-approved bonhomie.

Wartime penicillin is a clear example where the two differed wildly, with dire permanent consequences for Britain and the British Tories.

The Tory-dominated Ministry of Supply ,egged on by the likes of Alexander Fleming and Howard Florey, successfully kept the miracles of penicillin out of the popular British press, so that it might remain below the radar of the German chemists.

The hope was secret penicillin could be a medical-military weapon, a nasty surprise to drop on the Jerries on D-Day when Allied troop casualties quickly returning to the front while Axis wounded festered and died with only the outdated sulfa drugs to heal them.

The cost of the beginnings of an adequate supply of penicillin for British civilian and soldier alike was only one or two of Butcher Harris's endless bomber squadrons, but the MOS successfully throttled back penicillin production expenditures so that only British troop needs could be ( just barely) met.

In America, FDR's new Deal was dying, a victim of the war.

But in its last hurrah, the very New Dealish WPB (War Production Board) set the USA supply requests at a level a thousand times higher than the British levels, despite a population only three times bigger !

Thanks to Henry Dawson and Dante Colitti and Citizen Hearst, an outraged American public, led by Doctor Mom, demanded to know why the American drug companies were not cashing in on those massive 'firm orders' from Uncle Sam.

Henry Dawson's early supporter from the drug industry, John L Smith of Pfizer, took up the public's challenge and soon was producing penicillin at rates many dozens of times higher than the rest of the world combined.

Flush with excess penicillin, America could easily afford to divert some of its bombers off the killing work and towards delivering tiny vials of penicillin to dying children world wide.

Widely reported in the world press, this penicillin diplomacy from America quietly replaced the Pax Britanica with Pax Americana despite the fact that the Brits had held an exclusive on the life-saving balm for more than a dozen years.

Back home in the UK, things got worse for Churchill.

He had been widely expected to win the 1945 election - not the least by his lackluster opponents in the Labour Party , for his efforts in winning the war.

But doubts over Tory fairness in the quality of medical care for rich and for poor, highlighted in a famous Daily Mirror cartoon of a wounded British soldier, silently moved many voters (in an era before 'public' public polling) over to their opponents.

Unfairness of who got or did not get scarce British penicillin ( versus news stories of obvious American abundance), highlighted by newspaper stories of dying British children with SBE being denied the life-saving mold , was an important part of that emerging move away from the Tory-led government.

Penicillin was British-born, damn it all, and Churchill's government had fumbled the ball, giving it away to the Americans and yet denying it to British civilians.

Who gave a hoot - now - about how many European babies Butcher Harris's bombers had burned while flying above a war won on the ground by millions of Ivans ?

Wartime penicillin never cured Churchill's pneumonia - that is a myth.

But its British failure surely killed his electoral prospects, just as its American success helped pull Harry Truman back out of his expected electoral defeat.....

Fred J Stock : righteous among the nations ? (Part I)

Part I : the Era of Sulfa has run out of steam...

In May 1943, almost 15 years after the world's best lifesaver - Penicillin G - was first discovered , the whole world was making about a 100 million units of it a month.

That sounds like a lot but it is not at all - that amount of Penicillin G today would be only sufficient to treat one ordinarily sick patient requiring it !

A severely ill patient today requiring penicillin G might need a whole year's worth (1200 million units) at May 1943 production rates.

But May 1943 was hardly ordinary times with ordinary patients - it was the height of WWII , the biggest deadliest war ever seen : a seven ring circus of sickness and injury where the box office never closed.

The only other lifesaver around at that time - the wonderful sulfa drugs - had had a great five year run of success (cheap and easy to make in huge amounts, easy to give to patients) but had now run out of steam and were in grave danger of collapse.

By the Fall of 1942 , the chemists had a convincing scientific explanation for why they had run out of places on the basic sulfa ring to insert new additional  "side chain" molecules, to provide additionalanti-bacterial action via new variants of  sulfa.

So : no new sulfa drugs for germ-killing ---- ever .

The existing ones were now meeting unexpectedly rapid bacterial resistance - the normal solution : up the dosage amount and duration of treatment to overcome that resistance - had revealed just how dangerously toxic the safe sulfa drugs could be at high and prolonged dosages.

A repeat of WWI's deadly combo pandemic of Spanish (viral) Flu and (bacterial) Pneumonia and maybe this time more than a 100 million people (one in twenty) might die.

A huge potential disaster loomed, just offstage.

The problem , as always , was that scientists were in charge of public policy on penicillin - not politicians.

The academic scientists - on penicillin - had made common cause with their normally mortal enemies : Big Pharma.

Penicillin had long been ready to report for war duty - but only as a public domain natural substance made up in medieval brews by rural peasant midwives from mold slime ( I am paraphrasing the scientists' and CEOs' mutual objections here.)

The CEOs were chemically-minded as only executives matured during the chemistry-made interwar years could be and really wanted a synthetic penicillin.

Synthetic means man-made means patents : patents to raise prices and secure world markets free from profit-cutting competitors.

The scientists claimed to abhor profit-making but loved reputation making instead.

And for scientists still unsure if their new found high social status was really secure , it would be a retrograde step for the world's best ever lifesaver to be seen as something a housewife could brew up in their kitchen and apply directly.

Because that meant all its lifesaving prestige would bypass both the male academic basic scientist and the male applied scientists in medical labs and hospital wards.

(For the Gender War raged on , military war or not.)

The OSRD/NAS in America and the MRC in the UK ,dominated by Republican/Conservative Party scientists (for virtually all tenured academics in those years voted Republican or Conservative), controlled the production of penicillin until May 1943.

Their conservative views even continued to dominate the Conservative Ministry of Supply in the UK.

But in America they were soon to be defeated - in great part because they were now to deal with the very New Deal and Democratic Party-oriented War Production Board (WPB) and the formidable head of its Drugs and Cosmetics Branch, Fred J Stock.....

"Pax Penicillia" : how Churchill's Britain won the war and lost the peace

The decision by Winston Churchill's (Tory) Minister of Supply (MoS) not to divert the money for one additional Lancaster squadron, used to bomb civilians in Europe, towards providing enough penicillin for British (and European) civilians resulted in Churchill's Tories winning the war for Britain --- but at the cost of losing the peace.

By contrast, when the (left-leaning) War Production Board (WPB) decided to greatly up the production level of American penicillin from the miserably niggardly amounts proposed by the (right-leaning) OSRD , the resulting surplus provided State Department diplomats with the amazing opportunity to wrestle Victory's moral  authority from Britain (which claimed - somewhat incorrectly - to have stood alone against Hitler) to the tardy latecomers Americans.

Forget Chewing Gum and Coca Cola, or even the A-Bomb , the single best means for American diplomats to win friends for America was by providing the gift of life to people dying of sulfa-resistant infections all over the world.

And thus, American "Pax Penicillia" replaced the "Pax Britannica"...

Penicillin's "Bengali Famine Years" : 1943-1944

It was not America and Britain, it was not even the British and American governments ,that made the momentous decision, between late 1942 and early 1943, not to divert tax money just a little away from bombs and towards penicillin production instead.

This decision led, over the period of 1943-1944,  to a Bengali Famine-like situation among the Allies over shortages of live-saving drugs for civilians.

It was only one government agency in each country that made that decision ; albeit all-powerful agencies in the middle of a war.

But I do not believe they acted contrary to the informally expressed sentiments of their country's war cabinets.

Let the record note their names : Vannevar Bush's weapon-developing agency known as the OSRD in America and the Ministry of (Army) Supply (MoS) in Britain, with the common link urging them into this course being Sir Howard Florey.

By contrast, diverting even a tiny tiny amount of the government's war resources to the issuing of firm standing orders for penicillin purchases could have provided adequate semi-purified natural penicillin to treat all cases (civilian and military) of patients dying from blood poisoning that were resistant to the only life-saving alternative, the sulpha drugs.

Let me make it perfectly, morally, clear : the fundamental issue was not that penicillin was in short supply : it was that any method of saving those dying of sulpha-resistant blood poisoning was in desperately short supply.

These diverted resources , expressed as firm government orders for penicillin at currently profitably prices ,would have stimulated private capital to make good use of current technology and of idle rural factories that had closed because of the war , as well as unskilled rural labour also left idle because of the war.

As models that this could have and in fact did work in practise, one only needs, in the case of Britain, to point to Glaxo's first low tech but efficient penicillin factories cobbled out of bits of unused space in other people's factories.

And in the American case, to point to an enterprising rural mushroom farmer called Raymond Rettew who briefly became the world's biggest penicillin producer, in the late spring of 1943.

FDR's party did not lose the 1944 election over this issue , because another part of his American government (the WPB, War Production Board) chose to totally reversed this decision, and in spades.

But Churchill's party did ultimately pay the full price for this decision made by the MoS (led by his fellow Tory, Sir Andrew Duncan) not to push for enough penicillin production resources to help civilian as well as soldier, later in the war.

That was when his party overwhelmingly lost the general election it was supposed to romp home in, July 2nd 1945 .

Churchill's equally callous decision not to stop the wartime Bengali Famine in which four million people died ( "If there really is a famine, why hasn't Gandhi died?" he sneered) probably also sealed the chances of Churchill's Britain holding onto the Indian Empire.

If Florey had been even moderately left wing rather than very right wing, he might have gone to other more left wing oriented agencies of the British and American governments and the wartime penicillin story could have been very different .

If the wartime history of Civil War Era America was written as historians write the Pollyanna story of wartime penicillin, there would be only one America and one government ,with no sense at all of conflict between different parts of America.

My work on wartime penicillin will make it very clear that two agencies of the American government, the OSRD and the WPB were not in agreement on penicillin production levels and methods but in conflict.

 Just as in the UK,  Howard Florey/MoS and Harry Jephcott/Glaxo were not in agreement on these same issues but in conflict.

And I will make it clear that there were no technical reasons why civilians could not have penicillin in 1943-1944 , rather it was the result of a political and moral decision not to produce one less bomber squadron if that was the cost of bring penicillin to dying civilians.

For these were penicillin famines by government fiat : Bengal-on-the-Potomac and Bengal-on-the-Thames.....

Patient ONE of the Antibiotics Era : how the saving of Charlie Aronson changed our world

During his lifetime, Dr Henry Dawson only gave penicillin to several dozen endocarditis patients, Charlie Aronson first among them ; only saved several dozen lives, Charlie among them.

Dawson's pioneering effort to inject Charlie with penicillin on October 16th and 17th 1940 (Dies Miribilis) certainly didn't directly save many lives.

But the moral fact that Dawson cared enough in the first place about Charlie-the-person, to pioneer in making and to giving him penicillin, has certainly saved tens and tens of millions of lives ever since Dawson's premature death in 1945.

If  only the greater cultural milieu surrounding Dawson and Charlie had been as willing - nay as eager - to save Charlie 'the 4F of the 4Fs' as Dawson was, it might also have been as willing - nay eager - to save the Jews of Europe as well.

Immaterial that Charlie was almost certainly Jewish as well : the point to Dawson was that Charlie was a fellow human being, end of story.

Social medicine, Dawson's domain, says that medicine is not just the narrow manipulating of bio-chemical activities to save lives.

It holds instead the view that most people die prematurely, not because their bodies failed or because medicines failed, but because the world around them see them as not worth much, so not worthy of much effort, time and expense to try to save them.

Doctors who challenge these utilitarian views by their voices and their actions indirectly save far more lives than do their equally competent colleagues who may directly save more lives, but who are content to only save the lives their culture deems worthy of saving.

The Allies (rather like the Axis, differing only in degree not in kind) divided the world of World War Two into three parts, like Gaul.

There were the enemy-oriented people and the allies-oriented people : themselves further divided into 1A allies and 4F allies.

Until June 1943, only enough American resources were going to be devoted to penicillin to ensure that the needs of the 1A allies would be met.

Then the American WPB (Wartime Production Board) made its most surprising decision ever : that a considerable portion of America's bomb and bullet making potential would be diverted instead to making lifesavers - penicillin lifesavers enough to save soldier and civilian alike.

This was not a decision followed by Britain , Canada and Australia.

They decided to divert only enough of their country's resources to penicillin-making to fill the needs of their armed forces at a minimal level.

Winston Churchill and his Tory-dominant government took the lead on this decision, by their broad hints and inaction (if nothing else), and the other Commonwealth nations chose to follow his lead rather than that of the WPB.

A single additional Lancaster bomber squadron is about three million pounds in 1943 money,(about a million pounds in planes , plus two million pound  more for the 500 members of the squadron , hangers, armaments, fuel etc).

This amount would have paid for enough new penicillin production facilities such that by early 1944 , Britain's could have supplied its civilians as well as its soldiers.

Ie, match the Americans' penicillin output, despite using a lower level of technology.

We know well enough the costs of a Lancaster squadron and  the costs of Glaxo's low tech but highly efficiently run bottle-penicillin factories , to be able to make this claim with a great deal of certainty.

Churchill, however, chose 'LANCs over PEN' and paid for it in the surprising election results of June 1945 ; the inequalities of  wartime health care provision being the number one reason most people chose the egalitarian Labour Party over the war-winning Tories.

America's super abundance of wartime penicillin allowed it to use penicillin as a tool of diplomacy , replacing British influence with that of the Americans at every turn : replacing Pax Britannica with Pax Americana,  again causing Churchill to "win the war but lose the world".

Dawson did not force the WPB to make the decision it did, though certainly his uniquely civilian oriented approach to penicillin treatment, starting way back in September 1940, must have played a part.

But the WPB pledge was just that : a pledge - it was up to industry to carry it out.

Industry was willing - even eager - to build high tech buildings out of extremely scarce materials now suddenly obtainable thanks to top-of-the-drawer allocation quotas for would-be penicillin producers.

Postwar, those buildings would give them an early lead on their competitors.

But they weren't so willing to make biological penicillin in those shiny new buildings, not with rumours than synthetic penicillin was just months away.

Dante Colitti forced their hand.

In August 1943, the junior staffer, a surgical resident at a small hospital a mile from Henry Dawson's hospital,  was about to get married and go on a honeymoon. He didn't have to go poke his nose into the affairs of a patient in the non-surgical part of the hospital.

But he did.

He was moved by what he had heard about the dying Henry Dawson a mile away being willing to steal government penicillin to save the weak and the small.

 And perhaps because Colitti himself was a lifelong "cripple", suffering from TB of the spine.

Dante decided to risk his own career by intervening over the other more senior doctors' heads on a patient that wasn't even his --- urging the patient's parents to call the Hearst newspaper chain directly, to ask them to help obtain the tightly rationed penicillin needed to save the baby's life.

The resulting day by day heart-rendering accounts and photos of the life-saving efforts for little Patty Malone finally - albeit 15 years late - put a human face on penicillin.

Suddenly the population woke up to the fact that they wanted/  needed  penicillin -right now ! - and what was their Congressman doing to see that it happened ?

Doctor Mom, in high dudgeon , can provoke fear even in generals, industrialists and Presidents and soon John L Smith, boss of the biggest potential penicillin producer (Pfizer) got the moral message as well.

The chain reaction : Dawson + Charlie : Dante Colitti and Patty Malone:  John L and Mae Smith and memories of their own dead daughter  + Pfizer : tons of and tons of penicillin by April 1944,  is clear enough .

Also clear enough is an ageless message : one person, even if they are dying, can indeed make a world-quaking difference .....

Roy S Koch "shows me the money" on wartime penicillin

In December 1944, a very youthful looking economist named Roy S Koch was heading up The Biologicals and Parenteral Solutions Unit, hitherto an unimportant sub-section of a sub-section of a sub-section, buried deep somewhere in the bowels of the powerful War Production Board in wartime Washington.

Then , overnight in August 1943, penicillin became one of those parenterally delivered biologicals and nothing was ever quite the same.

One of Koch's jobs was tallying the actual amounts, month by month, firm by firm, of medical grade penicillin that passed from the FDA's approval into the military or civilian supply chain.

In those excited anxious days with American families's sons, brothers and fathers dying left (Pacific) and right (Atlantic) in record numbers, all eyes and ears were on the progress reports on penicillin production.

Everyone, in their own way, was pitching in to help American industry finally deliver the goods, 15 years later but better late than never.

Above all the American taxpayer was working overtime to pay for that promise of expanded production.

 Paying for the government building of private-firm-run buildings, paying through extra personal taxes for the shortfall caused by the writing off of excess corporate taxes, paying for military and civilian expeditors, paying to aid to university researchers who were in turn aiding corporate coffers - on  and on and on.

 So a corporate failure to make good on a public promise to deliver a lot of penicillin, with the help of lots of taxpayers' money, was going to seem tantamount to committing an act of treason.

Hence Koch's carefully collected figures had to remain a closely guarded secret : American corporations may fail to deliver all the time, but the American public is never ever to know.

But in 1958, about 55 years ago and almost 15 years after the figures were first collected, a muckraking US government inquiry into price-fixing in the antibiotic business did reveal the figures --- even put it in a public domain documents so all the world could quote them freely.

But I have never seen anyone do so and I have read an awful lot on wartime penicillin : so if I am wrong, please email me at my email on this blog.

Anyway, the figures are posted above and you can access the report  ("Economic Report on Antibiotics Manufacture" )  online --- this chart is from the appendix, page 331.

In January 1944, the Hare side of the race to make - and define - wartime penicillin was feeling pretty good : Merck had produced some actual therapeutically-effective penicillin by human synthesis (take that you nasty mold !), a result soon confirmed by the Oxford Hares and by other American Hares.

Yields were much lower than the mold-made penicillin and the impurities both more abundant and much more lethal than in the naturally-made penicillin , but the chemists (hundreds of the best chemists in the world) were working on it.

Soon the pesky Tortoises of  wartime penicillin, mostly obscure johnnies come lately, could be kissed off - their brand new plants just so yesterday, so very obsolete : growing mold like some rural farmer and then making things by fermentation.

 In this Modern Age !

Really, the nerve !

Still, in January 1944, some of the leaders in the secret effort to make penicillin by synthesis are still putting up a good front in aiding the build-up of penicillin supplies for the widely expected opening of the Second Front (D-day) in the late spring or early summer.

Their production of natural penicillin was quite good - compared to even a few months earlier.

The all-mighty Merck (leader, along with Howard Florey in Oxford England, of the penicillin Hares) delivered 3.1 billion units that month, about as much as some obscure mushroom farmer (Reichel) did , buried somewhere out in the backwoods of rural Pennsylvania.

Merck wasn't going to really go all out to produce a lot of natural penicillin for the boys overseas, not when they were about to blow the world away with their very own "technically sweet" synthetic penicillin.

But the boss, George W Merck, was still determined to be patriotic none the less, "do his bit".

Pfizer, another part of the New York area Hare triad, led the production, just barely, with 3.98 billion units.

Squibb ,the third of that triad, was not pulling its weight - even the War Production Board could barely contain their anger , as the folks at Squibb laying back on the oars --- producing just .61 billion units.

The Mid-West group of Hares hadn't done as well, but they hadn't been at it as long : Abbott did .71 billion, Lilly .43 , Upjohn .07 , Parke Davis .03.

Let us jump to April 1944.

Synthetic penicillin yields are still so low that they were a joke - making even Fleming's small amounts that he produced in 1928 look enormous in comparison.

But almost everyone's natural penicillin output has improved --- it was getting close, after all, to make the deadline to get into the pipeline to Kansas City's big depot and then out again to Southern England for the D-Day medical supply loadings.

Every drug CEO wanted to boast later in ads that it was his firm's penicillin that had won the day in the invasion of Nazi Europe.

Reichel had fallen way back below its January output and Merck hadn't even doubled its output.

But Squibb had increased its supply by 10 times , albeit from a low base and Abbott had done almost as well.

(Commercial Solvents had increased its output by 300 times, from a very low base - but it was a real newcomer.)

Pfizer switches sides and kills Modernity ...

But Pfizer wasn't playing fair, for it had turned from being a Hare into a Tortoise : it had increased its natural penicillin output by 10 times, from a very high base and doubled it again in May : producing more than the entire world's penicillin plants combined.

By July, Merck was almost producing less than it had in January, while Pfizer was producing 25 times as much as it had in January.

Still no early sign of synthetic penicillin production and Pfizer was on its way to producing enough penicillin for the entire world,naturally, with or without Merck's 'technically sweet" synthetic stuff .

Modernity had just taken a fatal shot to the base of the neck and deep down, everyone knew it....

OPRD and Dawson vs OSRD and Florey : social or war penicillin ?

If America was to win the war for the Allies by being becoming a ponderous and relentlessly-slow grinding mill of the gods ( a veritable "Arsenal of Democracy" as President Roosevelt proclaimed) than sometimes Vannevar Bush's OSRD (Office of Scientific Research and Development) worked hard against that objective, never more so than with Penicillin (and DDT).

In Total War, attrition (greater weight of arms and men) rather than generalship (the better use of the elements of secrecy and surprise) is felt to be - in the long run - the truly dominant factor.

The OSRD obviously disagreed, as did Hitler's High Command and the Japanese War Cabinet.

These three agreed amongst themselves that it didn't really matter that both sides shared the same 105mm howitzer and that so the side with the best rate of production of that artillery piece and its ammunition would win in the long run.

That was so old-school, so World War One style thinking.

No, the OSRD would win a quick clean war, by speed and secrecy of new weapon invention and by taking the offensive role at every turn in the war of new weapon invention : as the British would say, WWII was to be a war between sciences : a Boffin's war, not a foot soldier's war like WWI.

But you could also see this as classic "chicken hawk" style thinking  : stoutly favouring bold offensive operations, albeit from the cosy safety of an comfy armchair.

Because seemingly the only requirement for rising in the OSRD hierarchy was that you had successfully avoided combat when you were young and fit enough to do so, but now that you were now old and fat and balding and safely beyond the age of conscription your bellicosity had returned full on.

The German, Japanese and British military agreed with the OSRD - preferring to invent more truly new and superior - secret- weapons even when they knew this meant that fewer units of existing conventional weapons would be produced.

(By contrast, the Russians tended to want to produce greater numbers of a far fewer and far less technically sophisticated range of weapons - working in some minor incremental improvements over long, long production runs.)

So if the OSRD "took up" the development of Penicillin and DDT it would come with some heavy and hidden costs : for these two would now be developed strictly be for use as  secret and new "instruments of war" (weapons).

How we "almost lost penicillin" : it got captured by the OSRD

Penicillin being "captured" by the OSRD in the summer of 1941 when Howard Florey took it to his old pal ( OSRD heavyweight Dr A N Richards) wasn't as bad as being captured by the Gestapo , but it was a close run thing.

By contrast, the War Production Board (WPB) and its OPRD (Office of Production Research and Development) took a more sophisticated view of war work in a Total War situation : understanding completely that if civilians don't eat or are home sick, both old-fashioned howitzers and new-fashioned atomic bombs don't get built.

So if the epidemic of lung infections in America in the winter of 1944 among war workers had become a pandemic and shell production had been cut in half, just when the Battle of the Bulge needed more 105 mmm shells not less, the OPRD would have been ready, with massive amounts of civilian penicillin for ailing war plant workers.

But the OSRD would be left touting its claim that fewer of our wounded men in the Ardennes were languishing in hospital beds than in the case of the Germans, thanks to our Allied frontline military hospitals having most of the world's scarce supply of natural penicillin.

Artificially scarce , by government fiat, only because the OSRD and its British counterpart were STILL working on trying to make top secret synthetic penicillin and didn't want to warn the Germans of penicillin's potential by letting civilian doctors use it and then talk up miracle cures.

Dawson's unexpected SBE cures with stolen government penicillin leading to dying Baby Patricia Malone's widely publicized 'stealing' of penicillin beyond the OSRD's direct jurisdiction, brought the public and the OPRD into the picture and finally got us wartime penicillin en masse : for frontline Ardennes soldier and home front civilian alike .....