FIVE
The battles over credit for the discovery of penicillin were still a year in the future when Howard Florey left Peoria in the summer of 1941. He left Heatley behind to work with Moyer and the rest of the Northern Lab team, while he transformed himself into North America’s most prominent penicillin evangelist. Florey had already spread the gospel to the National Research Council in New Haven, and to the USDA in both Washington and Peoria. On August 7, he arrived in Philadelphia for what would be his most consequential meeting of all, with Alfred Newton Richards of the University of Pennsylvania. Florey had met and worked with Richards as a junior researcher during his first Rockefeller Foundation–funded trip to the United States in 1925; he now had the most exciting discovery in all of medicine, and A. N. Richards was precisely the man who could translate that excitement into action on a national scale. The previous year, he had become chairman of the Committee on Medical Research for the U.S. government’s newly created Office of Scientific Research and Development. This made him, to Florey, the most important person in the country.
By some measures, in fact, the OSRD would be the most important strategic asset of the United States in the coming war. When Florey and Richards met, it was, technically, only a week old, the creation of President Roosevelt’s Executive Order 8807, which had established it to guarantee “adequate provision for research on scientific and medical problems relating to the national defense,” though it had replaced an earlier version, the National Defense Research Committee, created the previous year. In both incarnations, it was run by an electrical engineer named Vannevar Bush. When Roosevelt tapped him to lead the country’s defense-related research, Bush had already made his name as a successful inventor of some of the basic components of what would become both digital and analog computers, as dean of MIT’s School of Engineering, president of the Carnegie Institution, and the founder of the company that was then known as the American Appliance Company (but would evolve into the electronics giant Raytheon). As the first and only head of the National Defense Research Committee, he was, in effect, the first presidential science advisor; as head of the OSRD, he gave strategic direction to the most consequential wartime research projects in history, most notably, the Manhattan Project, which would usher the world into the atomic age.
It’s a close call, though, whether the long-term consequences of nuclear power would be more significant than those of the antibiotic revolution that was ignited by the OSRD’s Committee on Medical Research in 1941. The committee was explicitly not set up to initiate original research, but rather to oversee existing programs and to set up protocols for funding through its six divisions: medicine, surgery, aviation medicine, physiology, chemistry, and malaria. Nonetheless, Florey emerged from his August 7 meeting with Richards, agreement in hand guaranteeing the CMR would recommend a government grant for the production of penicillin.
Medical research paid for, and managed by, federal agencies wasn’t a completely novel concept, even then. Well before the 1940s, the U.S. government had directly sponsored significant research on disease treatment and prevention; in 1887, Dr. Joseph J. Kinyoun of the Marine Hospital Service established a bacteriological laboratory in the Marine Hospital in Staten Island. In 1891, it was moved to Washington, DC, and renamed the Hygienic Laboratory. In 1902, Congress passed the Biologics Control Act largely to regulate the vaccines sold across state lines, but the same act also authorized the Hygienic Laboratory to test and improve such products as vaccines and sera—and added divisions in chemistry, pharmacology, and zoology. By 1912, the Marine Hospital Service had been transformed into the U.S. Public Health Service; in 1930, the Hygienic Laboratory had been renamed the National Institutes of Health, and seven years later moved to Bethesda, Maryland.
But previous investments in research had funded institutions administered by the federal government: the USDA’s laboratories, or—a very different kind of research—Massachusetts’s Springfield Armory. No governmental-business alliance like the penicillin project had ever been contemplated. On October 8, 1941, Richards and Bush called a conference to be held in Washington. Among the invitees were a number of OSRD department heads: Lewis H. Weed, the vice chairman of Richards’s Committee on Medical Research; William Mansfield Clark, the chairman of the Division of Chemistry; and Charles Thom from the Department of Agriculture. More remarkably, the meeting, at which Bush presided, also included George A. Harrop of Squibb’s Institute for Medical Research, Jasper Kane of Pfizer, Yellapragada Subbarao of Lederle, and Randolph Major, the research director of Merck & Co.*
The ad hoc committee would meet again on December 17, in New York. This time, the drug companies were represented not just by their heads of research, but by their presidents. George Merck, the president of his family company, presciently observed, “If these results could be confirmed . . . it was possible to produce the kilo of material for Florey. . . .” But by that time, ten days after Pearl Harbor, the nation had considerably more ambitious goals. Richards was no longer looking for a kilo of material from a single interested corporation. Now, “every possible means of combating infection in battle casualties [must] be explored.” Robert Coghill of the Northern Lab, who was also present at the meeting, would later confirm: “A new pharmaceutical industry was born.”
With the birth of that new industry came a raft of other issues. Despite the patriotic enthusiasm with which the companies embarked on the first stages of penicillin manufacture, they were still, after all, commercial entities. And, although the commercial potential of penicillin was more than alluring to them, they soon realized that the lasting value of this project was knowledge. At the very least, some mechanism was needed to resolve disputes about the ownership of that knowledge: a patent.
The historian of science Derek de Solla Price is generally credited with the observation that patents are to technology what scholarly papers are to science: the key method of allocating credit and disseminating knowledge. But while a system of patents had been a much-lauded feature of American society virtually since the country’s founding—Article I, Section 8 of the U.S. Constitution explicitly empowered the federal government to provide limited patents “to promote the progress of science and useful arts”—they had never been entirely free from controversy. Thomas Jefferson was, at least initially, hostile to the very notion of patenting ideas, writing, “If nature has made any one thing less susceptible than all others of exclusive property, it is the action of the thinking power called an idea. . . . Inventions cannot, in nature, be a subject of property.” As they were applied to medical innovations, patents were even more controversial. While mechanical inventors were unapologetically commercial in their goals, medicine—in theory, at least—was subject to a higher law, one that required that its work be performed for the greater good. Patenting of medicines, in consequence, had been forbidden in France from the time of Napoleon forward, and in Germany the nation’s first patent law, which was passed shortly after the modern state appeared in the 1880s, prohibited them for decades.
American medical researchers had a very specific objection to medical patents, dating from 1923, when Harry Steenbock, a professor of biochemistry at the University of Wisconsin, discovered that exposing the sterols in fatty foods like milk to ultraviolet light enriched them with vitamin D, and therefore made milk into a defense against the then-widespread deficiency disease, rickets.* Although Steenbock, who had patented the process in his own name, reportedly turned down a million dollars from the Quaker Oats Company for its use, he did transfer the patent rights to a newly established nonprofit organization, the Wisconsin Alumni Research Foundation (WARF). By 1940, WARF was charging milk manufacturers for the use of the technology, and had pocketed royalties well in excess of $7.5 million (the number today is well in excess of $1 billion).*
To the surprise of exactly no one, this was a source of resentment, followed by reaction. Dozens of research institutions, including Harvard, the University of Pennsylvania, Johns Hopkins University, and the California Institute of Technology, either forbade or severely restricted the ability of researchers to seek patents. By 1937, the American Chemical Society was hosting a conference entitled “Are Patents on Medicinal Discoveries and on Foods in the Public Interest?”
On the other hand—when it comes to intellectual property, there is always at least one other hand—Ernst Chain had proposed patenting the Dunn School compound from the time it had been successfully extracted. By March 1941, he was lobbying Dr. J. W. Trevan, then the director of the Wellcome Research Laboratories, to support a patent application. He had considerable support from his boss; Florey shared Chain’s eagerness to secure a patent, less as a way to enrich the Dunn researchers than to enlist an entity like the Medical Research Council to whom such patents could be assigned.
Unfortunately, though, the Medical Research Council wanted nothing to do with it. Its director, Edward Mellanby, the discoverer of vitamin D, had led the fight to invalidate Steenbock’s patent in Britain, and regarded patents with the sort of distaste that wealthy aristocrats generally hold for parvenu tradesmen. It would be a long-standing point of contention between Mellanby and Chain, who saw the development of antibiotics as “a whole tremendous virgin field [in which] we were the leaders and would remain so if we got enough money” [emphasis added]. He later said that it was unethical “not to take out patents protecting the people in this country against exploitation by foreign commercial organizations. . . .”
In the event, he didn’t persuade Mellanby, who rebuked Chain for his stubbornness about patenting, telling him that if he “persisted in his ‘money grubbing’ he would have no scientific future in Britain.” In this, he was allied with the Rockefeller Foundation, which had a policy that discoveries generated on their dime ought to be free of patent . . . and they had been bankrolling Florey and the Dunn since 1939.
But by the end of 1941, both the Rockefeller Foundation and the Medical Research Council had lost control over the penicillin project, which was now largely controlled by the OSRD, American pharmaceutical companies, and the United States Department of Agriculture, all of whom were enthusiastic about patents, less as a financial incentive than as a way of managing the diffusion of new knowledge in a systematic way. The enthusiasm had a strong historical foundation: Henry Leavitt Ellsworth—the “Father of the USDA”—had established the ancestor of the USDA as the Patent Office’s Agriculture Division in 1839.
Small surprise, then, that in the fall of 1941, all the parties working at the Northern Lab, including Norman Heatley, signed a letter of agreement that assigned any subsequent patents to the United States Secretary of Agriculture. No doubt it seemed noncontroversial at the time.
Heatley stayed at Peoria until June 1942, working with his American counterpart, the mycologist Andrew Moyer. Despite Heatley’s naturally genial disposition (and his practice dealing with the extraordinarily difficult Ernst Chain), the relationship was the opposite of amicable. In Heatley’s recollection, Moyer was a loud and obnoxious isolationist convinced Britain was pulling the United States into a mistaken war, one that would inevitably demand “gutters overrunning with [presumably American] blood.”
Even more troubling in the long term, Moyer applied for and received a patent not only for the deep fermentation methods that he had developed jointly with Heatley—the patent itself reads: “a new and useful method for producing penicillin by the cultivation of molds, whereby the yield of penicillin is substantially increased above that previously obtained”—but for using the corn steep liquor. The names on the patent were Robert Coghill and Andrew Moyer: no mention of anyone from the Dunn School. In fact, though Heatley and Moyer had collaborated on a paper summarizing their joint research at Peoria, Moyer never submitted it for publication. It appears neither in his personal bibliography nor the patent application itself. And, while the underlying patent was assigned to the U.S. Secretary of Agriculture, allowing use without payment by all American users, it said nothing about the ability of the patent holders to sue for compensation in countries that were signatories to patent treaties with the United States. One such country was the United Kingdom, which allowed Moyer to secure British patent rights for his method of production.
The members of the Oxford team were furious. Chain, in particular, spent the rest of his life feeling wronged over the patent issue. He had some justice on his side, but not much. The fact was that patenting penicillin itself was highly problematic, since the original discovery, of course, dated from 1928. The elapsed time meant that a patented process for manufacturing it was far more valuable than the substance itself. Chain’s grievances were emotional, not legal. The true innovations in manufacturing the substance had been developed in Peoria, not Oxford. The key Coghill-Moyer patent, for example, was for adding phenylacetic acid to the penicillin broth, which increased yields by two-thirds. This isn’t to excuse Moyer’s actions, which were duplicitous, at best. But since the patents in question were for the procedures developed in 1941 at the Northern Lab, Heatley was the one with a reason for feeling wronged, not Chain.
If Heatley had any complaints about the loss of credit, he had little time to share them. Even before the patent had been granted, Florey sent Heatley a cable reading, “WHY NOT GO MERCK SIX MONTHS IF THEY WILL PAY YOU. MORE USEFUL THAN COMING BACK HERE.”
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When Norman Heatley left Peoria for Rahway, New Jersey, in 1942, Merck was the oldest continuously operating drug firm in the world; though as we have seen, this may be damning with faint praise. The company had been producing and selling medicinal compounds since 1668, when Friedrich Jacob Merck acquired the Engel-Apotheke, an apothecary in the Landgraviate of Hesse-Darmstadt, one of the dizzying number of German-speaking principalities that made up the seventeenth-century Holy Roman Empire.
The business of selling medicine to consumers and physicians remained for nearly two centuries the Engel-Apotheke’s sole business, though one with limited potential before Pasteur and Koch established the microbial causes of infectious disease. In 1816, one of Friedrich Jacob’s descendants, Heinrich Emanuel, became proprietor of the family business, changed the name to E. Merck, and put the company into a different business altogether. An ambitious and, for his day, scientific druggist, Emanuel Merck sensed that the chemicals known as alkaloids were components of a large number of powerful plant-based extracts—examples include belladonna and caffeine—that could be purified and standardized. The most powerful of these extracts was the one derived from P. somniferum, the opium poppy, and in 1827 Merck bought from a Prussian apothecary named Friedrich Serturner the process by which opium could be transformed into a compound he called morphine, taking the name from the god of dreams in Ovid’s Metamorphoses.
For a century, morphine would be the most profitable and popular medicinal product produced by Merck, but its real importance was giving the still-small company expertise in chemical manufacturing. The same techniques used for making consistent doses of morphine out of decidedly impure opium allowed Merck entrée into the business of manufacturing so-called fine chemicals: small-batch, high-value, and very pure compounds. His timing was excellent, as the giant chemical companies that emerged after William Henry Perkin’s discovery of the first aniline dyes became Merck’s largest customers, and a valuable source of knowledge about the most advanced nineteenth-century industrial chemistry. In 1889, the company’s first publishing venture, Merck’s Index, became the ultimate source of chemical information for a generation of scientists and engineers.
Merck remained a maker of medicines as well. In 1887, the company opened its first office in the United States, as a marketing and sales department for the German parent, still known primarily for morphine; and, in 1891, as a subsidiary: Merck & Co., run by Georg Merck. The following year, Georg anglicized his name by adding an e to it, and welcomed his first child: George W. Merck.
For the next twenty-five years, the company prospered. In 1900, it acquired 120 acres of swampland in Rahway, New Jersey, where it built a factory to produce bismuth—the active ingredient in Pepto-Bismol, invented as an antidiarrheal in 1901—cocaine, and morphine. Next door, another Merck subsidiary known as Rahway Coal Tar Products manufactured, among other things, carbolic acid, the antiseptic discovered by Joseph Lister four decades before. By 1917, Merck & Co. was recording sales of $8 million annually—roughly $96 million today—solid, but not earthshaking, considering that same year General Electric sales were nearly $200 million, and U.S. Steel $400 million.
Of course, 1917 is the year that marked the entry of the United States into the First World War, with serious consequences for U.S. subsidiaries of German companies. Because Germany, particularly the I. G. Farben cartel, dominated manufacture of virtually all medicinal chemicals, supplies of critical compounds were at risk. The world’s entire supply of atropine, for example, an extract of belladonna that was one of the key medications in treating heart problems, was in the control of Germany and her allies. On April 17, 1917, the Medical Section of the Advisory Commission of the U.S. Council of National Defense convened a meeting attended by representatives of more than 250 companies, including Merck, to find alternatives.
Meanwhile, anti-German hysteria led to a dozen new laws intended to limit the activity of “enemy agents,” such as German-owned corporations. The Trading with the Enemy Act, which went into effect in October 1917, was the most significant. One of its clauses provided for the selection of an Alien Property Custodian, a federal judge named A. Mitchell Palmer who immediately required that the German-owned chemical companies be “Americanized.” True to his word, he confiscated 80 percent of Merck, the eight thousand shares owned by the parent company in Hesse-Darmstadt—and only held them in trust after a plea from George W. Merck, Sr., who owned the other two thousand shares himself, and didn’t want his company sold out from under him.*
At the moment the roof fell in, twenty-nine new researchers—chemists, pharmacists, and chemical engineers—had just been hired. They were just in time to help the company grow dramatically during the war years, which saw the Rahway plant triple in size—and to see George Merck outbid Monsanto and American Aniline to repurchase his company at auction, in 1919, for $3.75 million. Some of those researchers were still there in 1925, when George W. Merck, Jr., took over the firm.
Biographers looking for a successful business leader with a virtually unblemished record for honorable behavior would probably stop searching immediately after coming across George Merck, Jr. Born in New York, he was raised in the comfortable New Jersey suburb of Llewellyn Park where, at least in family legend, he was so friendly with Thomas A. Edison’s two sons that he was permitted to haunt the great inventor’s lab and workshop. Supposedly, Edison called the Merck heir “Shorty,” though he was probably the last to do so. George, as an adult, was an imposing six foot five inches tall, athletic, and charismatic. When he graduated from Harvard as part of the class of 1915—a year early—the war in Europe prevented him from pursuing his earlier plan to attain a graduate degree in chemistry in Germany, and he instead joined the family firm, becoming a vice president by 1918, and, when his father fell ill in 1925, president.
Although it would be reasonable to assume that his rapid promotions were a function of his name rather than his talent, from the start he did his best to correct any misapprehension about his abilities. In 1927, still in serious debt from the purchase from the Alien Property Custodian, George engineered a merger with another fine chemical manufacturer, the Powers-Weightman-Rosengarten Company of Philadelphia (Adolph Rosengarten, Merck’s largest nonfamily stockholder, was ready to retire), and in 1929 made the far more momentous decision to build, on the Rahway property, a research laboratory. At its dedication on April 25, 1933, more than five hundred spectators heard Sir Henry Dale, the future president of England’s Royal Society (and the same man who would try and fail to interest British pharmaceutical companies in the penicillin innovations under way at the Dunn School a decade later), give a speech on “Academic and Industrial Research in the Field of Therapeutics.” And they heard George Merck assert, “We have faith that in this new laboratory . . . science will be advanced, knowledge increased, and human life will win a greater freedom from suffering and disease.”
This corporate gamble on the future of scientific medicine wasn’t unique to Merck. The onetime Abbott Alkaloidal Company, renamed Abbott Laboratories in 1914, opened a 53,000-square-foot Chicago research facility in 1938 (interiors by the design genius Raymond Loewy). That same year, in October, the Squibb Institute for Medical Research was dedicated in New Brunswick. In Indianapolis, Eli Lilly opened Lilly Research Laboratories in 1934. A year later, DuPont opened the Haskell Lab of Industrial Toxicology in Newark, Delaware.
But the Merck Institute for Therapeutic Research was the first, and by most measures, the most innovative. In conscious imitation of the academic-industrial conveyor belt that had served the German chemical companies so brilliantly, Merck hired the Viennese pharmacologist Hans Molitor as the institute’s first director, and recruited Randolph Major from Princeton to join Alfred Newton Richards—Howard Florey’s erstwhile mentor from the University of Pennsylvania—in Rahway.* He invested in more than just personnel; the institute’s annual research budget increased from $146,000 in 1933 to nearly $1 million by the beginning of the 1940s.
If George Merck’s goal was that “science will be advanced, knowledge increased,” he could scarcely have been disappointed. In 1937, Major persuaded the brilliant Max Tishler—in the words of a colleague, “Max was born with an energy level that was like an avalanche and a brain that was incandescent”—to leave Harvard for Rahway. During the institute’s first five years, its researchers published thirty papers in peer-reviewed journals; from 1939 to 1941, the number was closer to fifty. Not included in that number is a nonetheless revealing article that the president himself published in 1935, in the journal Industrial and Engineering Chemistry. Entitled “The Chemical Industry and Medicine,” it contains the lines, “to do research worthy of the name, to do research which will bring to industry true recognition of its contribution to the advance of knowledge, industry must have at its disposal genuinely creative minds so placed and so protected that the mental powers of thought, study, and imagination can concentrate on problems of great difficulty. For even to see the problems clearly is of itself a major task.”
When Heatley arrived in Rahway in 1942, the lab, under Major, was still primarily doing research on vitamins, which then accounted for more than 10 percent of the company’s sales. In 1936, Joseph Cline of Merck and Robert Williams of Bell Labs had succeeded in synthesizing vitamin B1 for the first time, and by 1940 Karl Folkers, late of Yale, had isolated and synthesized both vitamin B6 and pantothenic acid. Max Tishler had been explicitly recruited to work on vitamins by Randolph Major himself, who told him, “We made up our minds that we’re going to specialize in research in the field of vitamins. We’re going to isolate every vitamin; we’re going to determine their structures . . . synthesize them, and make them available.” Tishler didn’t waste any time; by 1938 he had discovered a new way to synthesize vitamin B2 in order to perform an end run around patents owned by I. G. Farben and Hoffmann-La Roche, neither of which would license them to Merck.
All that was about to change, not just at Merck, but at other American pharmaceutical firms that had invested millions in research laboratories they were eager to employ on products with more commercial potential than vitamins and antiseptics. In February 1942, Merck signed a research-sharing agreement with E. R. Squibb, the company founded in 1858 by a former U.S. Navy surgeon, Dr. Edward R. Squibb, largely to produce surgical anesthetics. His timing was, in its way, impeccable; the Civil War broke out only two years later, and so increased the nation’s annual quota of amputations and other surgical procedures by at least an order of magnitude. Union surgeons carried thousands of the fully stocked wooden medicine chests known as Squibb Panniers from Antietam to Appomattox: a kit of medicinal compounds including anesthetics like ether (which would remain the company’s signature product for more than forty years), quinine for malaria, and, of course, whiskey.
By the beginning of 1942, the company had been owned and managed by a former Merck executive, Theodore Weicker,* for more than thirty years; and if there had been any bad blood over his leaving the firm—Weicker had sold his share of Merck’s U.S. division in 1903, and, backed by his wealthy industrialist father-in-law, Lowell Palmer, transformed himself from a colleague into a competitor—it had long since been diluted by time, and the national emergency. The Merck-Squibb agreement contemplated joint ownership of any inventions that might appear, not just between the two companies, but including “other firms who have made definite contributions to the solution of the problem.”
For most of 1942, the “other firm” that mattered the most was Chas. Pfizer & Co., Inc., of Brooklyn, New York.
Like Merck, Pfizer was a German transplant, though one with a longer history in America. Beginning in the 1840s, a huge wave of German immigrants arrived in the New World, some of them politically motivated—the failed 1848 revolution made thousands into political refugees—but mostly for economic reasons. More than 1.4 million German-speaking immigrants arrived in the United States between 1840 and 1860, and with them came an enormous amount of technical knowledge that its carriers were ready to commercialize. Two of them, Charles Pfizer, an apprentice apothecary, and his cousin Charles Erhart, a confectioner, left the town of Ludwigsburg in the still-independent Kingdom of Württemberg sometime in the 1840s. In 1849, they opened a business office, and later, with a $2,500 loan from Pfizer’s father, their first chemical factory, at the corner of Bartlett and Tompkins in the Williamsburg section of Brooklyn.
The cousins’ first product combined their chemical training with their skills in candy making, packaging the bitter compound known as santonin—an antiparasitic, or, more precisely, an anthelminthic: a drug used for killing, or at least discouraging, intestinal roundworms—in a toffee-flavored sugar cone. But while flavored santonin remained its most important medical product for more than sixty years, and the company produced disinfectants like iodine, chloroform, and calomel—the highly dubious mercuric compound used to treat both constipation and syphilis—its real business was, like Merck decades later, fine chemicals: tartaric acid (used as the leavening agent in baking powder, and as a flavoring), camphor, and especially citric acid.
It was citric acid that made the company both profitable and perhaps the world’s most experienced at the process of deep fermentation. This, in turn, made them ideal to expand on the innovations that Moyer, Heatley, and Coghill had developed in Peoria. Late in 1941, the company had borrowed the same aerated flasks used at its SUCIAC plant to manufacture citric acid and put them to work making penicillin. Yields were still highly variable—from 20 penicillin units per cc to none at all—and tiny, but enough to provide testable quantities to the same team at Columbia University that had requested samples from Ernst Chain back in 1940: Henry Dawson, Karl Meyer, a chemist, and Gladys Hobby, a microbiologist, all part of a group of scientists studying hemolytic streptococci. Others were investigating as well. Alexander Hollaender, a researcher at the National Institutes of Health and one of the founders of the field of radiation biology, assembled a team at Cold Spring Harbor lab to find a mutated version of the Penicillium mold using radiation. Researchers at the University of Minnesota and the University of Wisconsin were enlisted to bombard them with X-rays; the team at Madison had a pilot plant for deep fermentation, and had been researching irradiation in milk to improve vitamin D content since the 1920s. They were so successful that they ended up developing a new variety of the mold, known as Q-176, which produced more than 2,000 units of penicillin per cc. This improved on Pfizer’s yields dramatically, and matched the best number produced by Moyer and Heatley in Peoria. (The original Oxford number, lest we forget, was barely 2 units per cc.)
In less than a year, the seemingly inexhaustible resources of the United States—Department of Agriculture laboratories, university biology departments, and especially the research facilities built by American drug companies in the 1930s—had increased the pace of innovation in penicillin research by an almost unimaginable amount.
All this progress in the manufacture of the drug was well known to the brilliant but underfunded scientists at the Dunn School (to say nothing of St. Mary’s), who could only look on in amazement as the United States invested millions in exploiting their discoveries. But except for the occasional “wonder drug” article here or there, general awareness of penicillin’s potential for fighting infectious disease was very low in both the United Kingdom and the United States. Through 1942, the OSRD’s various subdivisions had authorized only twenty-two specialists in the entire United States to receive the drug at all, and even they were permitted to test it only on a very short list of infections—basically staph, strep, and pneumococci infections that didn’t respond to the sulfa drugs.
In November 1942, the public’s obliviousness about penicillin came to an abrupt halt, in a gruesome fashion.
The Cocoanut Grove, on Piedmont Street in Boston’s Back Bay neighborhood, had been a speakeasy through the years of Prohibition, and, after the repeal of the Volstead Act, the city’s most popular nightclub. On November 28—the Saturday of the Thanksgiving holiday weekend—more than a thousand partiers crowded into the club, which the Boston Fire Department had authorized for fewer than five hundred. Sometime after 10:00 P.M., one of the artificial palm trees used to decorate the club caught fire, and flames quickly spread to the club’s wall and ceiling decorations. In five minutes, the nightclub was an inferno of superheated air and toxic smoke. Panicked people were crushed at exit doors. Four hundred ninety-two people died.
Hundreds more were victims of smoke inhalation and second- and third-degree burns. More than a hundred were brought to Massachusetts General Hospital, whose emergency physicians decided against debriding the burns—picking off particles of clothing or other foreign material; they were convinced that debriding would be more likely to remove what was left of the skin’s protection against invading bacteria. Instead, they hoped to fight infection using “chemotherapeutic agents administered internally.” Sulfa drugs were available, but only effective against a limited range of infections. It was an emergency, and it demanded an emergency response. Only days after the fire, Merck’s Rahway facility packaged a quantity of penicillin—not Anne Miller’s powder, but thirty-two liters of highly diluted broth—and transported it, complete with police escort, to Mass General.
It’s hard to know whether the miracle medicine performed miraculously. The emergency room physicians at Mass General and the other Boston hospitals used a variety of techniques in treating burn patients, and while dozens survived staph infections that would have been fatal only a few years before, there is no way of knowing for sure whether the broth from Merck was the reason. Victims were treated with protective dressings and given antibacterial treatments—including sulfa drugs—internally. That didn’t stop the December 2 issue of the Boston Globe from proclaiming penicillin “priceless,” and if anyone was disposed to argue the point, no record of it survives. What did survive was the belief that a wonder drug was, at most, only weeks away from widespread use. Before the Cocoanut Grove, the number of human beings that had been treated with penicillin was measured in the dozens. Alfred Newton Richards, chairman of the CMR had, as a matter of policy, restricted the amount of publicly available information on the new drug, offering updates only in vaguely worded press releases. His logic was obvious enough; given that the national priority was manufacturing enough penicillin for battlefield use, raising hopes about its availability to the nonuniformed public would be both cruel and a public relations nightmare. Chester Keefer of Boston University, the chairman of the Committee on Chemotherapeutics and Other Agents, was actively hostile to journalists, whom he believed would inevitably create expectations that could not be met. For months, all communiqués about the penicillin project had been run exclusively through the CMR press office. A single night in Boston and the secret was out. Time magazine’s February 8, 1943, issue said it all: “The wonder drug of 1943 may prove to be penicillin, obscured since its discovery in Britain in 1929, only now getting its thorough sickroom trial.”
Keefer and Richards did their best to keep the lid on, but a sampling of newspaper headlines that followed Cocoanut Grove will give the flavor:
7 HOURS TO LIVE—SCARCEST DRUG RUSHED TO BABY
GIRL, 20, DEAD AFTER REFUSAL OF PENICILLIN
PENICILLIN . . . DEW OF MERCY*
A woman in Oklahoma City wrote to President Roosevelt because “I do not know who else has the authority to help me, or if you can possibly tell me where my son can get the medicine penicillin. . . .” Another mother wrote the president a letter in which she allowed that “I know you are busy with the war, but . . . I am in great need of your help. My husband is in great need of the new drug penicillin. . . .” In the face of such demand, the New York Herald-Tribune actually provided hopelessly optimistic instructions for making penicillin in a home kitchen.
The result was that demand and supply were seriously out of balance. During the first five months of 1943, American production of penicillin was only 400 million units; and, since more than 2 million units were needed to treat simple staph infections, the total supply was sufficient to treat fewer than a hundred patients. For skin infections like the acute streptococcal skin disease known as erysipelas, a single treatment could require 9 million units or even more: 200,000 to 400,000 units three times daily for ten days.
Penicillin manufacturing had to be industrialized.
In June 1943, Richards and Keefer attended a meeting in Washington hosted by Elihu Root of the National Academy of Sciences. In attendance were Robert Coghill from the Northern Lab, and members of the War Production Board, which had unprecedented authority over all allocations of resources—private and public—for the duration of the conflict. Three months later, a slightly larger version of the same group met again, this time as the WPB’s Penicillin Producers Industry Advisory Committee. Two key items were on the agenda. The first was the appointment of a “penicillin czar,” formally the coordinator of the penicillin program: Albert Elder, a chemical engineer from the U.S. Patent Office’s Chemical Division. The second was to recruit a sufficient number of qualified American corporations to ramp up penicillin production.
The new agenda demanded a wider ambit. At the meetings called by Richards in October and December 1941, only four pharmaceutical companies had been represented: Merck, Pfizer, Squibb, and Lederle . . . and only the first three agreed to commit any resources to the project. By 1943, matters had changed dramatically. The penicillin project was now a national priority, and virtually every company that had anything to do with medicinal compounds, or even fermentation, was invited to apply for consideration, most of them given only the vaguest knowledge of the nature of the project.
From the 175 companies that applied, Richards, Elder, Keefer, and Coghill selected seventeen. Some were obvious, like the first three: Merck, Squibb, and Pfizer. The others included drug companies like Lederle, Eli Lilly, Sharp & Dohme, Abbott Laboratories, Parke-Davis, Winthrop, Upjohn, Cutter Laboratories, Roche Nutley (the American subsidiary of the Swiss drug company Hoffmann-La Roche, located in Nutley, New Jersey), and Bristol-Myers’s Cheplin Laboratories; but also companies with experience in fermentation for other uses, such as Allied Molasses, Schenley Distillers, the Heyden Chemical Corporation (like Merck, a once-upon-a-time German-owned firm, seized by the Office of the Alien Property Custodian during the First World War), and the Commercial Solvents Corporation.* Each was promised free access to all publicly available information about penicillin fermentation, pluspatentable ownership of any techniques they developed while part of the program.
By any standard, this was a dramatic change. As later recalled by Sir Robert Robinson:
Richards . . . recognized the simple truth that the commercial interests would not develop penicillin unless they were guaranteed some enjoyment of the fruits of their labors and investment. Somehow the companies that participated in the development of penicillin had to be permitted exclusive rights to their discoveries. Once the research and development of penicillin were completed, no one would be allowed to jump on the penicillin bandwagon for a free ride. The CMR thus found itself in the awkward position of needing to devise a system by which private companies would gain patent rights to processes and products developed, at least in part, with public money.
By the end of 1943, the CMR was spending public money like water. The scope of the effort was really stunning in retrospect: The office had recruited thirty-six universities and hospitals, twenty-two separate companies, and four federal, state, local, and national organizations. Some were multimillion-dollar corporations, like Squibb, but not all; the first company to make a real contribution to the effort was the relatively tiny Chester County Mushroom Laboratories of West Chester, Pennsylvania, which was processing forty-two thousand surface cultures a day. In 1943 alone, the CMR approved fifty-four contracts totaling more than $2.7 million for research on penicillin, and agreed to pay penicillin producers $200 for each million units (Chester Keefer was allocated $1.9 million to buy the stuff needed for his clinical trials). In addition, the War Production Board approved sixteen new penicillin-manufacturing plants, on which the pharmaceutical companies spent nearly $23 million. They also sweetened the deal by offering, as a wartime priority, so-called certificates of necessity, along with tax breaks that allowed companies like Merck and Pfizer to depreciate their investments in only five years. The WPB also spent nearly $8 million of federal money on six penicillin-manufacturing plants, all of which were sold to private companies after the war ended, as designated “scrambled facilities,” a term of art for assets in which the private and public investments were almost impossible to disentangle—a metaphor for the entire penicillin project.*
It was, to free-market purists, either the greatest of heresies or—more likely—the source of much cognitive dissonance. At the end of the 1920s, pharmaceutical development and manufacturing was the sixteenth most profitable industry in America. By 1944, it was, by far, the most profitable. It would remain so for nearly twenty years.
Moreover, the industry, which had been made up of hundreds of firms, none possessing more than 3 percent of the national market, had consolidated into twenty or so companies that held, in the aggregate, 80 percent of the market for all drugs, and that market had grown tenfold. What separated the twenty winners from everyone else was possession of a penicillin contract: Each firm that got an OSRD manufacturing contract quickly outstripped its peers; one contract, in economic terms, was the equivalent of finding three hundred additional researchers or $10 million in profit (the entire profit for a company the size of Squibb in a good year prior to the project). It is almost impossible to overstate the importance of this. A mediocre company—measured by profitability or growth—without an OSRD contract was transformed into one of the most profitable simply by winning the CMR sweepstakes. It was equivalent to giving the winners a two-decade head start on the rest of an entire industry. The only comparable events in American economic history were the deals that built the transcontinental railroad and allocated the radio broadcast spectrum.
The penicillin project would prove a game changer for companies like Merck and especially Pfizer, which staked its future on penicillin. When Jasper Kane, who had represented Pfizer at the October 1941 meeting of the OSRD, brought his plan for fermenting penicillin in the same sort of deep tanks the company used for producing citric acid to his boss, Pfizer president John L. Smith, he was asked, “Is it worth it?” Smith explained, “The mould is as temperamental as an opera singer, the yields are low, the isolation is difficult, the extraction is murder, the purification invites disaster and the assay is unsatisfactory. Think of the risks and then think of the expensive investment in big tanks—think of what it means if you lose a 2,000-gallon tank against what you lose if a flask goes bad.”
Kane’s reaction is unrecorded, but it must have been persuasive. Smith had a friend whose daughter had been cured of erysipelas by a series of penicillin injections, and Smith hadn’t forgotten. In early 1943, he charged his chief engineer, John McKeen, with building a pilot penicillin plant in an old ice factory and, once the plant had been fitted with fourteen 7,500-gallon fermenting tanks, “followed every tank, every potency and everything on a day to day basis.”
He had to. Separating high-grade penicillin from all the other components in the fermentation soup was hard enough in the Northern Lab’s washing machine–sized tanks. To scale up production by several orders of magnitude, McKeen hired a process-engineering firm that was experienced with another separation challenge: turning crude oil into petroleum, kerosene, and aviation fuel. Within months, Pfizer’s subcontractor, the chemical engineering company E. B. Badger & Sons (“Process Engineers and Constructors for the Petroleum, Chemical, and Petro-Chemical Industries”; their lead engineer, Margaret Hutchinson Rousseau, had been the first woman to receive a doctorate in chemical engineering from MIT) had solved the problem of distributing sterile air throughout the fermenting liquid evenly, by introducing pressurized sterile air at the tank’s bottom, while agitators mixed it evenly into the broth. By June 1944, penicillin production exceeded 100 billion units a month, and the dramatic increase in supply had a predictable impact on price. The United States government had, the year before, guaranteed the members of the penicillin consortium that the price for the drug would be set at $200 per million units. When the price supports were removed, the market was able to find a price where supply met demand: $20 for a million units of penicillin . . . on its way to $6.*
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For a time, Britain was able to keep pace with American developments, though the spigot through which research money flowed remained astonishingly narrow. Research funds continued to depend on patrons with titles. In March 1943, Florey persuaded Lord Nuffield (the former William Morris) to donate £35,000, but only over seven years. Government funds matched this, once Prime Minister Churchill concluded that the Allies might be short of the drug on D-day (or worse, that the entire supply would be reserved for American and Canadian troops), but it is scarcely surprising that British production was severely challenged by the need to keep pace with the Americans.
Two consortia had been selected by the British government to lead the way in penicillin manufacture. The first was the giant Imperial Chemical Industries, which had been able to produce only a few dozen doses of penicillin a week as late as 1942, but had agreed to invest £300,000 in a new state-of-the-art facility (apparently after touring Pennsylvania’s Chester County Mushroom Laboratories). The other was the Therapeutic Research Corporation, which had been formed in 1941 as a joint venture composed of the Boots Pure Drug Company,* British Drug Houses, Glaxo Laboratories, British Drug Company, May & Baker, and the Wellcome Foundation.
Because of the support of the prime minister, and heroic efforts on the part of British pharmaceutical firms, British production of penicillin managed to match American output through 1943, though, as noted, the total quantity produced by each country was barely enough for clinical trials.
Britain’s contribution to basic research, however, remained critical—Dorothy Crowfoot Hodgkin’s in particular. Somehow, Hodgkin had gotten access to the most powerful computing machinery then available, the punch-card calculators that were used by the Royal Navy to assemble the most efficient convoys for transatlantic duty, and by the RAF for bombing tables. The computational work wasn’t easy or cheap—the Medical Research Council questioned her bill for computing, convinced it was a mistake; she assured them it was not. But by May 1943, she reported, “Our analysis reached a stage at which we felt reasonably confident that we had found the atomic positions within the crystal structure of . . . penicillin.” The dispassionate prose of scientific writing underplays both the scale and importance of Hodgkin’s achievement. Without a clear picture of the molecule, attempts to synthesize it—that is, build it from a simpler set of component parts rather than cultivate it in fermentation tanks—were doomed. Improving the antibacterial properties of the compound, however it was produced, was hostage to a clear picture of its structure in three dimensions; if penicillin fought Gram-positive bacteria by disrupting cell walls (it did), some of its molecular components had to be able to latch onto the surface of a pathogen, which required an understanding of where exactly those components were located.
Even more impressive, Hodgkin had used a remarkable technique for elucidating the structure of penicillin; not by taking a picture of it, but by calculating its atomic positions from empirical knowledge of its activity viewed through the lens of very sophisticated mathematics . . . the biological equivalent of finding an otherwise invisible planet by measuring the effects of its mass on other, visible, objects.
However, even with the results of the Fourier analysis of the X-ray crystallography, the molecular structure of penicillin remained controversial.* Robert Robinson, Hodgkin’s onetime tutor and now at the Dyson Perrins lab, proposed a structure based on the chemical compound oxazolone. Hodgkin, knowing how difficult it had been for Chain and Abraham to work with the compound, thought oxazolone too stable, and proposed that it was more something else, one that Abraham and Chain had already suspected, and that they therefore “immediately accepted.”
The “something else” was a beta-lactam ring.
A beta-lactam ring is a fairly simple chemical feature: a square formed by three atoms of carbon, one of them connected to a doubly bound atom of oxygen; and one of nitrogen, connected directly to the oxygenated carbon atom. Because two of the carbon atoms and the oxygen are bonded together at one angle, and the third carbon is attached to the square at a different angle, the square it forms is constantly under tension—imagine trying to build a square out of struts that are bending away from one another. This gives the ring both its instability—which had frustrated everyone from Fleming to Chain—but also its effectiveness. As early as 1940, researchers from Florey’s team at the Dunn had been observing penicillin’s activity against pathogenic bacteria, and reported that it didn’t kill them or dissolve them immediately; rather that the microbes exposed to penicillin went through the same first stage of mitotic division as other bacteria—elongation—but instead of dividing, they just kept elongating (sometimes ten or twenty times their normal length) until they exploded.
Now, they knew why. All that strain from the different attachment angles made the beta-lactam ring vulnerable to breakage, and the bond that typically broke first—between the oxygenated carbon and the nitrogen atom—ended up adhering the oxygenated carbon to the enzyme needed to create the substance used to make the cell walls of Gram-positive bacteria, the ones that are unprotected by the lipopolysaccharide outer membrane. When the enzyme was locked up by the now-open beta-lactam ring, it couldn’t produce a sufficient quantity of the key component of cell walls, so when the cells divided, the new walls were, metaphorically, missing a lot of bricks, and even more mortar.
Unsurprisingly, such walls eventually collapse. Though the debate over penicillin’s structure would continue until 1945, when both Hodgkin and the American chemist Robert Burns Woodward were able to produce incontrovertible X-ray crystallographic proof of the beta-lactam ring, the puzzle had, for all intents and purposes, been solved. As a commemorative gift, Hodgkin later presented Chain with a model decorated with pushpins stuck in place to represent the molecule’s structure.
Hodgkin’s discoveries were exemplary science, just as she was an exemplary scientist. In addition to the Nobel Prize, she was awarded the Order of Merit, the Copley Medal, the annual medal of the Royal Society, and has appeared not once, but twice, on British stamps.* She derived the structure of some of the most medically significant compounds in the history of medicine, including insulin, vitamin B12, and not merely penicillin, but the entire family of antibiotics. At her memorial service in 1994, the molecular biologist Max Perutz, a colleague at both Oxford and Cambridge, said, “She radiated love: for chemistry, her family, her friends, her students, her crystals, and her college. . . . There was magic about her person. She had no enemies, not even amongst those whose scientific theories she demolished or whose political views she opposed.”
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Applying Fourier analysis to X-ray crystallography—to help to synthesize penicillin—was to prove both elusive and an expensive lure for the American and British penicillin efforts. For academics like Dorothy Hodgkin and corporations like ICI and Pfizer, the manufacture of penicillin by fermenting mold exudate seemed slightly disreputable; a temporary stopgap at best, something like treating malaria by boiling cinchona bark to get quinine rather than taking Atabrine tablets. It wasn’t merely that growing medicines, at that moment in history, seemed a bit medieval. It was also far more difficult to standardize dosages, or even, as researchers at the Northern Lab had learned, to find a reliable “pure” strain of Penicillium. Out of a combination of practicality and pride, Merck alone invested nearly $800,000 in synthesis experiments through 1944, and even promised Vannevar Bush at the OSRD—which had provided American universities grants amounting to an additional $350,000 to investigate penicillin synthesis—a bottle of synthetic penicillin by the beginning of 1945. Chemical synthesis was clearly seen as a superior, modern, way to make medicine.
There was another, more urgent, reason to master the technique. The Allies were in a shooting war with the world’s best chemical synthesists: the Germans, who had first synthesized mepacrine/Atabrine as an antimalarial in 1931. And yet, despite the undeniable fact that the academic and industrial resources of Germany, at least as regarded chemical innovation, were superior to those in the United States or the United Kingdom before the war, they never developed a wartime antibiotics program. The question is, why not?
At first glance, the answer might appear to be the enormous resources commanded by Vannevar Bush, Alfred Newton Richards, and the OSRD. Or, for that matter, the industrial strength that gave the United States, by the end of the Second World War, nearly half of the entire world’s gross domestic product. It was probably inevitable that American infrastructure would eventually dominate the new business of drug production, as indeed it did in every other measurable economic activity.
Even so, that explains American postwar dominance a whole lot better than the achievements that occurred during the war. Germany possessed an enormous head start in the key industries of drug development and production, was preeminent not only in every aspect of chemical manufacturing, but also benefited from hundreds of alliances between commercial enterprises like the I. G. Farben cartel and what were, at the outbreak of the war, still the world’s most prestigious universities. Moreover, once the Oxford group started publishing in 1940, academic papers about penicillin started appearing practically every week in both English and German, which means that however much the OSRD and Britain’s Medical Research Council tried to keep the details secret, by 1942 the Penicillium cat was out of the bag. And yet, even by 1945, Germany was able to produce only about 30 grams of penicillin a month, no more than the quantity required to treat four dozen or so patients. Germany, where both Salvarsan and Prontosil were introduced, had become a dead end in the search for more powerful anti-infective treatments.
The reason certainly wasn’t because the Nazi state lacked an urgent need for treating battlefield injuries. In May 1943, when the OSRD and the War Production Board approved an additional sixteen new plants for producing the penicillin needed for D-day, thirty thousand soldiers of the Wehrmacht died on the eastern front alone, a huge number from septic wounds.
So far as can be gleaned from the historical record, the answer is not primarily, “They were manufacturing Zyklon B for the gas chambers instead.” Mass killing on an industrial scale was, indeed, a national priority for the Nazi state; but, for Germany’s great chemical companies, an even higher priority was oil. The Saar region had enough coal to fuel the Industrial Revolution, and more than enough to run German factories. Oil, though, particularly petroleum, was a different matter. Outside of Romania, there wasn’t a decent-sized oil field anywhere from the Atlantic to the Urals. Which was why, even before the Nazis took power in 1933, I. G. Farben was investingenormous resources in the manufacture of synthetic fuels: $100 million and $125 million in current dollars between 1925 and 1932, or at least $1.7 billion today.
It wasn’t, by traditional standards, a profitable investment. The Leuna brand of synthetic gasoline—the name came from the facility where it was produced, in the Saxon city of Leuna, near Leipzig—was an attempt to gasify Germany’s still-abundant reserves of coal, using the chemical process known as hydrogenation. Even with substantial subsidies from the Weimar government, though, it hemorrhaged red ink from 1930 forward, and continued to do so after the Nazis took power in 1933. Carl Bosch, the Nobel Prize–winning head of BASF and, since the 1925 merger, a director of I. G. Farben, instructed his staff to provide documentation for even larger state subsidies, projecting that the German state would consume 50 percent more fuel oil and petroleum by 1937. Bosch’s protégé and successor, Carl Krauch—a Nazi Party member, unlike his anti-Nazi boss—proposed to Hitler’s cabinet that domestic production of fuel oil and petroleum could be increased between 25 and 63 percent, from 500,000 tons to nearly 3 million tons annually. If, that is, the national government could close the German market to “foreign influences” and agree to buy the fuel at a substantial premium over the world market price.
What this meant, in effect, was that the Nazi state would be subsidizing the production of oil to the extent that nearly 40 percent of all industrial investment in Germany before 1939 (except for coal and electricity) went to either synthetic oil or—the other requirement of a mechanized army—synthetic rubber.
It was a success, if that’s the correct word, for I. G. Farben. Revenues soared, at least partly due to a gruesome policy for controlling labor costs: Dozens of Farben’s directors would serve time as war criminals for employing slave labor in its synthetic oil and rubber plants. Scholven AG, a joint venture with a number of German mining companies, produced 125,000 tons of synthetic fuel in 1936; by August 1939, just before the start of the Second World War, I. G. Farben had twelve hydrogenation plants making gasoline and other refined oil products, for which they earned between $65 million and $140 million annually—up to $1.5 billion in current dollars. Another $50 million was earned annually producing synthetic rubber.
This also guaranteed, though, that tens of millions of dollars weren’t being spent subsidizing research into any drugs, much less penicillin. Perversely enough, pharmaceutical companies in the United States and the United Kingdom, fearful of investing in factories that could be made obsolete so quickly, diverted millions of dollars from a technology that actually worked—fermentation—in an attempt to surpass Germany’s perceived mastery in chemical synthesis. And they did so while the Germans were embarked on an entirely different project. The country that had the world’s best chemists in the 1930s directed them to spend the decade—and a ridiculously large percentage of the nation’s investment capital—not in pharmaceutical innovation, but in supplying fuel to the Wehrmacht. The big difference was that the United States was wealthy enough to afford to make expensive mistakes. Germany wasn’t.
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In 1943, British production of penicillin had been approximately equal to that of the United States. In 1944, it was barely one-fortieth as large.
Howard Florey, more responsible than anyone for that extraordinary achievement, spent most of 1943 and 1944 in the field, investigating how best to use penicillin for treating battlefield injuries. On a trip to his native Australia, he gave forty-two lectures on the proper use of the drug, and would eventually train five hundred clinicians and more than two hundred pathologists on penicillin therapy.* He also demonstrated the effectiveness of penicillin in treating gonorrhea, which was believed to be at least as dangerous to Allied troops as German artillery. One of the largest grants from the CMR during the months leading up to D-day had been to research the best ways to use penicillin to help treat gonorrhea—one American administrator noted that “the goal [is] to make penicillin so cheaply that it costs less to cure [VD] than to get it . . .”—thus keeping tens of thousands of troops at least putatively battle ready (though also creating an ethical dilemma about treating civilians in postwar Europe in preference to STD-infected soldiers).
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By December 1945, when Florey, along with Alexander Fleming and Ernst Chain, received the Nobel Prize in Physiology or Medicine, penicillin had already saved tens—perhaps hundreds—of thousands of lives. But it transformed the world in other ways, too. The penicillin project had created an entire industry, and built what would become some of the most profitable companies in history: not merely the American participants in the penicillin project, but also British firms like Glaxo, France’s Rhône-Poulenc, and even Swiss companies like CIBA-Geigy and Sandoz. At the Nobel Banquet, Professor A. H. T. Theorell of the Nobel Institute of Medicine toasted the laureates thus:
To you, Ernst Chain, Howard Florey, and Alexander Fleming, I will relate one of Grimm’s fairy-tales, that I heard as a child. A poor student heard under an oak a wailing voice that begged to be set free. He began to dig at the root, and found there a corked bottle with a little frog in it. It was this frog that wanted so badly to be set at liberty. The student pulled the cork, and out came a mighty spirit, who by way of thanks for the help gave him a wonderful plaster [i.e., bandage]. With the one side, one could heal all sores; with the other one could turn iron into silver. . . .
Florey, Chain, and Fleming, along with a long list of colleagues, hadn’t quite healed all sores with their discovery. Penicillin was widely, but not universally, effective; it had no curative powers against infectious diseases caused either by viruses or by Gram-negative bacteria. But for institutions like Merck, Pfizer, Squibb, and all the others, it had indeed turned iron into huge quantities of silver. The first antibiotic, and its successors, would do so for many decades to come.