Wednesday, June 30, 2010

Dawson had been set to be the "invisible man", the Charles Fletcher of The Manhattan Pilot

I believe that for two critical weeks at the very beginning of the The Manhattan Project, Martin Henry Dawson was not set to be the team leader/senior investigator - in fact he was not expected to be involved at all.

The team was supposed to be led by the biochemist Karl Meyer, with someone (anyone) acting as the microbiologist to test the 'in vitro' activity of the penicillin produced , again with some doctor (anyone) from Columbia Presbyterian's eye clinic in the clinician's job  (the nominal job of Dawson on the final Pilot team) .

The penicillin pilot's aim, at that point, was simply (!) to purify and then synthesize penicillin - most of the small amounts of crude penicillin produced would have to be destroyed in crystallization (purification) experiments.

Only tiny, tiny amounts could be spared to show the resulting penicillin still retained the needed biological activity against bacteria on a glass slide or against bacteria on/in a human.

These were expected to be merely subordinate activities to the main show - "making penicillin".

Now any drug, not just penicillin, needs to be first proven safe for humans when taking internally and be available in huge amounts, before it can be injected into the body as a 'systemic' --- versus simply being dropping a bit of it into the restricted/external area around the eyeball as an 'antiseptic'.

Penicillin, in particular, quickly slips out of the body and so needs even larger amounts than most drugs to work successfully as a systemic.

This is why penicillin's first successes in Britain during the 1930 (but tragically for humanity never published), were in removing deadly bacteria from the area around the eyes.

Meyer ,working in an eye clinic ,knew these truths better than most. In fact, he did involve two doctors from his clinic to use some of his penicillin with their patients but both doctors (Von Sallmann and Thygeson) seemed dubious about its usefulness around and in the eyes (as well they should have been).

 The results were not spectacular and were published a few years later.

Eyes were saved in the early 1930s from a lifetime of blindness with treatments of diluted crude penicillin that in total must have consisted of only 1.6 Oxford units of biological activity (that is equal to one millionth of a gram of pure penicillin).
By contrast, Dawson's disease of choice to test penicillin upon, SBE, subacute bacterial endocarditis, may today require 1.6 billion units of penicillin to cure.

That is one kilogram of pure penicillin - one billion times as much penicillin.

It was known in 1940 that SBE would need an extraordinary large amount of whatever drug that could kill the bacteria in its vegetations because of the unique location of the lesions and the poor blood supply of the heart valves they rested upon- that is the problem in fact that still makes SBE the 'gold standard' of intractable infections.

All drugs to date, as of 1940, had to be used in such large amounts to kill the bacteria that they killed the patient first - because even a relatively "non-toxic" drug is deadly if used by the shovelful !

It was Dawson's genius to see that penicillin's strength was not what the popular books on it still proclaim - its ability to kill bacteria - but rather its ability not to kill the patients, even when used in extraordinarily high amounts for months at a time.

And SBE proved to be just the disease to demonstrate that fact....


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