Would penicillin have been available for patients in 1930, if Fleming had produced his '29 paper - and then died ?

If only pneumonia had killed Alec, not John....

Imagine - if you will - that you're at a medical meeting - one of hundreds and hundreds that Alexander Fleming routinely attended between the Fall of 1928 and the Fall of 1942 and you happen to overhear Fleming regaling a small audience in the corridor about his 'wonderful' penicillin.


It is, he says (translated into today's medical terminology) a wide spectrum totally non-toxic anti-bacterial agent , the only one he as ever seen that doesn't harm the natural healing powers of the body's blood.

It is, Fleming says with great force , simply a great lab clearing agent for vaccine studies and potentially a useful antiseptic...

....And ? AND ?!  You wait for the other shoe to drop, somewhat impatiently : how is it as a systemic, for saving those dying from bacterial infections ?

Oh that, says Fleming indifferently , its useless for that.

And, he adds brutally honestly , as an antiseptic it is slow acting and is so unstable that it will only be useful if the chemists can synthesize it - but they haven't so far.

For fourteen years , I believe only one man stood between penicillin the potential life-saver for millions and penicillin the actual life saver for millions and that man was - unfortunately - Alexander Fleming.

The history of penicillin might have been quite different if only he and not his brother John had died of the pneumonia that Fleming's 1928 imperfect penicillin would have cured.

I can not believe that Fleming could offer such frequent public build-ups of his wonderful penicillin without someone in the audience venturing : well how do you rate its life-saving systemic qualities then ?

Fleming in his honest (but incorrect) way , would have had to say in public what he deliberately omitted from his published articles : 'as a systemic, I believe that penicillin is useless'.

This - more than anything someone else did or didn't do - dammed penicillin to wander useless in the desert for 15 years : its own discoverer damning it with the very faintest of praise ....

On the May & Baker factory floor, the magic bullet of M&B 693 was decidedly low tech

Science journalism and Chemistry Industry advertising (often hard to tell apart in the 1930s) saw the new Sulfa Drugs as the latest and most glamorous product to roll out of the cornucopia of the synthetic arcadia.

But as John Lesch describes in his account of how the British drug firm May & Baker developed its famous M&B693 (the sulfa drug that saved Churchill's life at the height of World War II) the view from the factory floor was distinctly low tech.

A dusty bottle of a rarely used chemical compound, made up for an ex-employee who never used it, but retained by the research lab of a large drug firm because, well, its the Great Depression and money is too tight to lightly throw anything out.

Experimental Chemistry Theory insisted there is absolutely no point in wasting effort in trying the contents of that old

chemical bottle in synthesising a potentially useful analogue from the original German sulfa compound.

Fortunately, an older tradition (in medicine they call this the 'hands on' or clinical approach) said "try everything" .

Unexpectedly ,and thankfully, the unusual new compound showed some promise in the chemical lab.

But the next stage would be to try it on deliberately-infected mice in another type of lab.

But this lab had none of the usual mice (infected with strep bacteria) -- money was tight in the Depression remember ?---

so a harried assistant, trying to fill in for his boss while he was away, tested the compound instead on mice inflected with the bacteria that gives us the worst kinds of pneumonia.

Nothing had ever killed these bacteria reliably and almost everything possible had been tried on them since 1919 and the pandemic of Spanish Flu.

(Most of the Spanish Flu's 50 million deaths worldwide were actually caused by pneumonia -- reason enough to research it more thoroughly than any other virulent agent had been to date.)

Once again, trying the unexpected and the unscientific paid off - this new sulfa killed the most dangerous of the pneumonia types.

This would, if confirmed, be headline news worldwide and would push May & Baker into the front rank of world drug firms.

But for now, back to Depression realities.

A number of intermediate chemicals had to be made in quantity on the way to making the actual sulfa.

Various stratagems were employed as the factory hands struggled to break up recalcitrant chunks of an important intermediate into a coarse powder, without blowing up themselves and their building.

Their delicate lab-grade tools of high precision?

A hammer and chisel !

Then a lot of ordinary mortars and pestles were filled with the crude powder and it was slowly,painfully, hand-ground down to a sufficiently fineness.

May and Baker, despite being a large, diversified , long standing British drug house , had no vacuum still and so its first sulfa 693 had to be made up in one or two litre flasks, so to make that first batch of one kilogram took two months of hard unrelenting effort on behalf of the entire team.

Still,a little of that very first batch in early February 1938, saved the life of a Norfolk farm labourer who was given up for dead because of his seemingly non-responsive lobar pneumonia.

A decidedly better result that the much better known first British effort, in early February 1941, to use penicillin to save the life of a policeman !

Pneumonia - the dreaded 'Captain of the Forces of Death' - had a cure !

But Lesch's detailed account of the development of M&B693 bears only the most fleeting acquaintance with the usual starry-eyed account provided to the public by Thirties media accounts...