No hope without penicillin…

I didn’t manage the full day of research I intended today up at Waddesdon. That will have to wait for another day. Instead I had a couple of hours in the depths of the staff reading room at Kew. I came across this record only a year or so ago, and thanks are due to my indominatable colleague Trish for pointing me to it. 

Today I was looking at the letters contained in MH 76/184 Distribution of Penicillin – general correspondence and I read and listed the first 60 items which cover 1943 and the early part of 1944. 

The Ministry of Health knows that Penicillin is almost within their grasp. The letters are fairly mainstream, sometimes repetitive but there’s a sense throughout that they know they are on the verge of something astonishing. Penicillin is being used in the treatment of wounds in Africa and Asia, and it is a game changer. 

The officials, medics most of them, who were dealing with the arrangements to bring penicillin into the UK, distribute it, train the staff in its use and monitor its use in a way we might nowadays recognise as medical trials, were still unsure about this new drug. They knew it had potential to make many illness none lifethreatening, but it wasn’t yet clear to what extent it would work. And this was just for the use of military personnel, those wounded in battle. There was little thought given to the point at which it would become available for civilian use.

The Americans were a little ahead of the UK in terms of use and distribution, and Prof. Francis Fraser cited a U.S. Report which summarised the number of requests they had had for this new wonder drug. 

“The Chairman… reported on the method of handling applications for penicillin for civilians. The office in Boston has handled 8,500 applications in five months. Most of these applications involve several letters, telegrams and phone calls. There is a staff of six and the Company has installed a Teletype machine and a separate telephone switchboard. They receive about 50 telegrams, 50 long distance calls and 75 letters a day, and those numbers are increasing.” 

The demand for this drug speaks for itself. 1700 applications a month In America alone, and steadily increasing. Being on the brink must have been so frustrating for the medics who knew this was coming and I think this is summed up by this telegram,  hoping (I suspect Dr. Hood knew against hope) that there might be penicillin available for this sick child.

As Hood was involved in the arrangements for the distribution of penicillin, he must have known that this request was at the very best, a shot in the dark. I’m no medic, but I know that peritonitis and septicaemia are nasty illnesses and in the age before antibiotics, the outlook for this child was poor. We’ll never know whether penicillin would have saved this child – possibly, if not probably – but this request arrived three months before penicillin even arrived from the USA, much less became available to civilians. On the 26th January 1944, Sir Francis Fraser wrote “apparently it is still difficult to define the usefulness of pencillin and its contraindications”, and this is certainly evident from subsequent papers in this file. Finally, for now, the particulars of the different diseases for which requests for penicillin had come in. 70 years on, we know that it wouldn’t have worked for some of these listed below but I can’t help but feel for these doctors, who were practising knowing there might just be something out there which might save a life, but which was presently unobtainable, just beyond their reach.

On the 7th December 1943, Sir Edward Mellanby (of the Medical Research Council) wrote:

“No substance can be more easily wasted, especially if it is poured into patients by systematic treatment”

It is clear from this file that the medics who ensured that penicillin became available to you and I were keen for it not to be used to a point where it became useless. These letters are only seventy years old. They are by no means ancient history. Yet, antibiotic resistance is now a major concern in the practice of medicine. In less than a century we have swung from one extreme to another. Deaths from infections are once again a very real threat. No new antibiotic has become available in over a decade. Seventy years on, the usefulness of penicillin is up for discussion once again. Only this time it is tinged with fear, not hope. 


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