MEDICINE

20th Century Seer

Medical news last week vied with news of the days before an invasion. Under the aspect of eternity, the medical news might even be more important than the military. The War Production Board announced that the wonder drug penicillin, for three years practically a monopoly of the Army & Navy, was now being manufactured in such quantity that it can be issued to civilians. Some 1,000 hospitals will be allowed to buy generous monthly quotas for distribution to patients and other hospitals.*

For impatient sufferers (many of them dying), the good news came none too soon. Penicillin (sometimes rhymes with villain, sometimes with whistle in) is the best treatment for all staphylococcic infections, all hemolytic streptococcic infections, pneumococcic infections (of the lining of skull, spinal cord, lung and heart surfaces), pneumococcic pneumonia that sulfa drugs will not cure, all gonococcic infections (including all gonorrhea that sulfa drugs will not cure). Diseases against which penicillin is effective but not fully tested: syphilis, actinomycosis, bacterial endocarditis.

The man who made possible this incalculable alleviation of human suffering is Dr. Alexander Fleming, discoverer of the antibacterial effect of the mold from which penicillin is made. He is a short (5 ft. 7 in.), gentle, retiring Scot with somewhat dreamy blue eyes, fierce white hair and a mulling mind, which, when it moves, moves with the thrust of a cobra. Until time's solvent has dissolved the human slag, it will be hard to say who the great men of the 20th Century are. But Dr. Alexander Fleming is almost certainly one of them.

For he belongs in the tradition of the scientific seers, which includes Galileo watching the swing of a lamp in the Cathedral of Pisa and deducing from it the law of the pendulum, and Isaac Newton watching the fall of an apple and deducing from it the law of gravity. For thousands of years men looked at the cryptogamic mold called Penicillium notatum, but Dr. Fleming was the first to see its meaning. His discernment, restoring to science the creative vision which it has sometimes been held to lack, restored health to millions of men living and unborn.

The story of his discovery is legendary. Back in 1928 Alexander Fleming taught bacteriology at St. Mary's Hospital Medical School, University of London. In his small, old-fashioned laboratory, he grew staphylococci in petri plates (flat glass culture dishes). One day he found that mold had spoiled one of his cultures. Staphylococci grew on only half of the plate. A blue-green mold spotted, but did not cover, the other half. He noticed that the mold had cleared a wide, bacteria-free area between itself and the staphylococci--perhaps had killed them.

Next year what Dr. Fleming knew about the mold's bacteria-baiting byproduct appeared in the British Journal of Experimental Pathology. He had found out that the mold was some kind of Penicillium (from the Latin for pencil--the shape of the magnified mold). He named its by-product penicillin. Having made his great discovery, Dr. Fleming went on to other work. He was engaged in many other experiments--no scientist knows just which of his bottles contains the Nobel Prize.

By 1938 when World War II loomed, a good internal and external antiseptic was still to seek. But at Oxford's Sir William Dunn School of Pathology, the man who was to make Dr. Fleming's discovery save human lives was already at work on the problem. He was Dr. Howard Walter Florey, 45, an Australian-born professor of pathology.

At first, Dr. Florey's researchers got only about a gram of reddish-brown powder (the sodium salt of penicillin) from 100 liters of the mold liquid. But at last, after heroic chemical cookery, they accumulated enough penicillin to test the drug on living creatures.

Eight mice were inoculated with a deadly strain of streptococci. Says Dr. Florey: "We sat up through the night injecting penicillin every three hours into the treated group [four mice]. I must confess that it was one of the more exciting moments when we found in the morning that all the untreated mice were dead and all the penicillin-treated ones alive." The first human guinea pig was a policeman dying of staphylococcus septicemia (blood infection). After five days on penicillin, he "felt much improved."

Last year penicillin patients were still rare enough to be front-page news. First such case was two-year-old Patricia Malone of Jackson Heights, Queens. The New York Journal-American, which begged enough penicillin to save her life from staphylococcic septicemia, last week won the Pulitzer Prize for the story. After that, the nation watched one "hopeless" case after another get well.

Penicillin is already big business, yet Dr. Fleming (who discovered it) and Dr. Florey (who made it tick) have got nothing out of it but praise--doctors generally do not patent drugs. To Dr. Fleming, whose pioneer mind has reverted to watching and waiting, penicillin is not an end, but a beginning. There are at least 100,000 molds and fungi, any one of which may one day yield a drug with which to cure the many plagues penicillin leaves untouched. "It would be strange indeed," says Dr. Fleming, who is hard at work on other antibiotics, "if the first one described remained the best."

* They will get the drug from 21 manufacturers (two Canadian, the rest U.S.) now or soon to be in production. Manufacturers will make about 100 billion units in May, about 200 billion units by the end of the year. Prices now vary from $2.85 to $10 for 100,000 units (last year's price: $20). This file is automatically generated by a robot program, so viewer discretion is required.