The Mold in Dr. Florey's Coat: The Story of the Penicillin Miracle
http://www.100md.com
《新英格兰医药杂志》
Alexander Fleming may be one of only two Nobel laureates in medicine (the other being Ivan Pavlov) whose name is well known to the general public. In contrast, his co-laureates Howard Florey and Ernst Chain and their vital contributions to the translation of Fleming's 1928 observation of the antibiotic qualities of a penicillium mold into the lifesaving drug penicillin are little remembered. The discovery has been both lauded by hagiographers and dissected by revisionists, foremost among the latter being Gwyn Macfarlane, whose biographies, first of Florey and then of Fleming, did much to broaden the story. It is the reflective, analytic tone of Macfarlane's books that Eric Lax adopts. He not only affirms the roles of all three Nobel Prize winners but also brings into the foreground the "fourth man" of penicillin, Norman Heatley, who was a major source for this book before his death early this year.
(Figure)
A Scanning Electron Micrograph of Penicillium Mold Producing Chains of Spores.
By permission of David Gregory and Debbie Marshall/Wellcome Photo Library.
Although Fleming recognized the possibilities of penicillium, his kitchen chemistry experiments produced gallons of "mold juice" that had inconclusive effects. Poor experimental design combined with weak presentation skills and a literary style that Lax describes as "miserly" did little to stimulate others' interest. It was not until 1939 that Florey, Chain, and Heatley took up the work of chemical extraction in Oxford, England. The technical problems were immense; the relationship between Florey, a brash Australian, and Chain, a temperamental German-Jewish refugee, was difficult; and in the wartime conditions, equipment and supplies became increasingly scarce. On May 25, 1940, one of the most famous animal experiments in medical history took place. Eight mice were inoculated with a fatal dose of streptococcus. Four were also injected with a crude penicillin extract. Within hours, the untreated mice were dead and the penicillin-treated mice were still alive. Penicillin's spectacular possibilities were obvious. Weeks later, France fell to Germany, and Britain was left to fight alone in the war. The Oxford group of scientists realized that if the city were invaded, they would have to destroy their work to prevent it from falling into enemy hands. At Heatley's suggestion, they rubbed their jackets with the penicillium spores so that if they had to flee, they could carry the secret with them.
A year later, with the help of the Rockefeller Foundation, Florey and Heatley carried the secret to the United States to persuade scientists and companies to undertake the production work that had been so crippled by shortages in the United Kingdom. The entry of the United States into the war in December 1941 altered the course of history in regard to penicillin, and by the end of 1943 its production was the second-highest priority of the U.S. War Department. New climates and traditions of research then clearly emerged — for instance, the British Medical Research Council believed that patenting medicines was unethical. They rejected Chain's urgent requests that the work be protected — a refusal that bore, Lax suggests, more than a hint of anti-Semitism. American companies patented their production techniques, and Chain's prophecy that he would have to pay royalties to use his own invention proved correct, although whether the Oxford scientists could have patented their preliminary work remains debatable.
The powerful personalities and the extraordinary circumstances in which they struggled on both sides of the Atlantic richly embellish this fresh and hugely enjoyable account of an important episode in medical history.
Tilli Tansey, Ph.D.
Wellcome Trust Centre for the History of Medicine at University College, London
London NW1 1AD, United Kingdom
t.tansey@ucl.ac.uk(By Eric Lax. 307 pp., ill)
(Figure)
A Scanning Electron Micrograph of Penicillium Mold Producing Chains of Spores.
By permission of David Gregory and Debbie Marshall/Wellcome Photo Library.
Although Fleming recognized the possibilities of penicillium, his kitchen chemistry experiments produced gallons of "mold juice" that had inconclusive effects. Poor experimental design combined with weak presentation skills and a literary style that Lax describes as "miserly" did little to stimulate others' interest. It was not until 1939 that Florey, Chain, and Heatley took up the work of chemical extraction in Oxford, England. The technical problems were immense; the relationship between Florey, a brash Australian, and Chain, a temperamental German-Jewish refugee, was difficult; and in the wartime conditions, equipment and supplies became increasingly scarce. On May 25, 1940, one of the most famous animal experiments in medical history took place. Eight mice were inoculated with a fatal dose of streptococcus. Four were also injected with a crude penicillin extract. Within hours, the untreated mice were dead and the penicillin-treated mice were still alive. Penicillin's spectacular possibilities were obvious. Weeks later, France fell to Germany, and Britain was left to fight alone in the war. The Oxford group of scientists realized that if the city were invaded, they would have to destroy their work to prevent it from falling into enemy hands. At Heatley's suggestion, they rubbed their jackets with the penicillium spores so that if they had to flee, they could carry the secret with them.
A year later, with the help of the Rockefeller Foundation, Florey and Heatley carried the secret to the United States to persuade scientists and companies to undertake the production work that had been so crippled by shortages in the United Kingdom. The entry of the United States into the war in December 1941 altered the course of history in regard to penicillin, and by the end of 1943 its production was the second-highest priority of the U.S. War Department. New climates and traditions of research then clearly emerged — for instance, the British Medical Research Council believed that patenting medicines was unethical. They rejected Chain's urgent requests that the work be protected — a refusal that bore, Lax suggests, more than a hint of anti-Semitism. American companies patented their production techniques, and Chain's prophecy that he would have to pay royalties to use his own invention proved correct, although whether the Oxford scientists could have patented their preliminary work remains debatable.
The powerful personalities and the extraordinary circumstances in which they struggled on both sides of the Atlantic richly embellish this fresh and hugely enjoyable account of an important episode in medical history.
Tilli Tansey, Ph.D.
Wellcome Trust Centre for the History of Medicine at University College, London
London NW1 1AD, United Kingdom
t.tansey@ucl.ac.uk(By Eric Lax. 307 pp., ill)