Thursday, July 1, 2010

Personal animosities at Columbia Eye Institute pushed Meyer into Dawson's arms on penicillin?

Blepharitis , a chronic inflammation of the eyelids, remains one of the world's most common eye problems.

Much of the time it is caused by staph bacteria and at the start of world war two, staph was one of the few common pathogen bacteria not killed by the various sulfa drugs - the 'antibiotics' of the day.

This was a big problem for the military of all the combatant nations of that war.

They regarded aviation as the alpha and the omega of modern warfare and so gave inordinate attention to the brand new field of "aviation medicine".

One only has to recall the moral panic the Allies fell into on mere rumours that the Germans had discovered the Viagra of aviation - a cortisone that let their pilots fly higher faster longer, well you get the picture.

Meyer had a consultancy with Schering Corp America - an German-owned company - involving ,among other things, attempts to create stable esters of penicillin.

Fears that Schering's work on cortisone was at the behest of the Nazis, ( it was not) rendered Schering totally suspect in the eyes of British and American intelligence circles.

Anyone connected with Schering - like Karl Meyer and his penicillin efforts - went into a little black book of "no-nos".

Aircrews and Blepharitis

An existing, generally intractable, case of blepharitis kept a lot of potential air crews out of the various air forces right at the recruiting office - that was problem A.

Problem B was that a lot of crews seemed to get blepharitis,  either after they had been through training or while out on active service .

This was perhaps due to the strain of operating in the air of five miles up, behind an oxygen mask for hours.

It doesn't directly worsen your vision but it gives you blurry eyes which comes much to the same thing.

It also needlessly worried aircrews, who feared it meant worse things than it did.

Not just pilots or gunners are hit by its effects - engineers, navigation officers and bomb setters all had to look at lots of crucial numbers on lots of dials in very dim light - one pair of blurred eyes at the wrong moment could be terminal for the entire plane and crew.

Karl Meyer ,as a German Jewish emigre, had an easier relationship with Dr Ludwig Von Sallmann, who also was in exile --- from his native Austria because his wive was Jewish.

But even Sallmann only seemed to want to put Meyer's semi-purified penicillin into animals and then didn't publish anything on the results till a few years later (in 1943 - at least 2 years after the first experiments).

Typically of many,many doctors, he published freely on his early work with penicillin only after Baby Patty Malone made penicillin world famous, safe and respectable.

At least Dr Phillips Thygeson did put the crude penicillin into the eyes of 8 patients with chronic blepharitis caused by (sulfa-resistant) staph bacteria, between the late Fall of 1940 and the early Spring of 1941, with some very good results.

But he refused to publish on this success (adding his name to Fleming and Paine et al in England who also refused to publish their spectacular early successes with crude penicillin and eye diseases.)

The history of penicillin might have been much different if these doctors had crowed just a little.

Thygeson finally published on bleparitis and penicillin - in 1945 - noting its key military importance !

I think an oral history interview with Thygeson late in life suggests what happened:
I don't think he could stand Meyer much.

He accused him of being a constant paranoid about his work--- and having a gutteral accent that no student could understand.He said nothing about Sallmann's accent - though Sallmann had arrived in America about 8 years after Meyer.

Now a young student had heard all of these stories, feared dealing with Meyer but found him soft spoken and kind and stuck with him throughout his career long enough to write his  affectionate obit - so opinions clearly differed on Meyer's manner and personality.

Dawson hung in with him for almost 10 years, so he couldn't have been impossible to work with.

In fact, Meyer gradually transferred himself from the eye clinic to the internal medicine department where Dawson worked.

Thygeson chose not to help out Meyer, Dawson or the fate of penicillin by publishing in an area sure to advance penicillin's importance in the eyes of the military-oriented OSRD of Vannevar Bush.

Instead he stuck to publishing on his results with sulfa drugs - these were totally pure, came via the highly conventional route of a commercial drug company - and didn't work and had potential toxic side effects.

But they didn't come from the home brew lab of Karl Meyer and that might have been a big point in their favour...


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