The Mold in Dr. Florey's Coat: The Story of the Penicillin Miracle

The Mold in Dr. Florey's Coat. The Story of the Penicillin MiracleEric Lax, Henry Holt, 2005 This is a book that seeks to redress a balance and reshape a myth. The myth is that Alexander Fleming at St. Mary's Hospital in London was the prime mover behind the discovery and development of penicillin into the first really effective antibiotic. However, the actual development of penicillin into a usable substance was largely done by a group at the William Dunn Institute of Pathology in Oxford led by Howard Florey, Ernest Chain, and Norman Heatley. All were rewarded by the scientific community with prizes and honors, but they remain largely unknown outside the scientific community. Eric Lax has chosen to tell the story of Florey, Chain, and Heatley. His background is as a biographer, historian, and belle lettriste. He is obviously a very intelligent man, he has done his research quite thoroughly, writes well, and handles some of the science quite well. He does particularly well in explaining Heatley's contribution, with Heatley having been very cooperative in the writing of the book.The book is a very good and rewarding read. The writing is clear and uncomplicated and he does do a very good job of placing the effort in the wider context of what had been an unequal battle with infection, and a looming and highly dangerous war. There is also the continuous battle between continuity and change. The British medical establishment had concluded, not unreasonably for the time, that vaccines were the best approach to dealing with infectious disease. There had been a significant investment of time and money in their development, this was how Fleming earned his daily bread, and the possibility that the development of chemical therapies might sweep this away was not welcomed. There was therefore a continual struggle to obtain funds to support the research at Oxford. This was the time when Heatley was in his element and making his most significant contribution when he developed the countercurrent extraction apparatus that greatly increased the yield of penicillin from the cultures. It was also arguably a highly romantic endeavor with the apparatus made up of borrowed and and otherwise obtained items, with many of them being used in ways that were never intended after being subjected to his great personal skill and held together with string, wire and sealing wax. One could reflect that it was the success of this approach that swept that era away to replace it with an ever more industrialized and commoditized set of technologies. Lax does not have a scientific background and leads to some interesting gaps and omissions. For example, when he examines the story of Fleming seeing the zone of clearing around the mycelium in a contaminated plate, there is something that needs to be explained to anybody under 65. There are very few people today who have ever had to what Fleming and his contemporaries had to do. That is, clean out glass Petri dishes and reuse them. Most people have now grown up with disposable plastic dishes that are bagged, autoclaved, and discarded. Nobody would have a plate that old sitting around unless they wanted to be written up for a safety violation. Similarly, he skips the importance of the highly unusual structure of penicillin. It is actually very important for its lack of stability and action and the book would have benefitted from a little more than the paragraph he gives it. There is genuine excitement in the way that improvised equipment and experiments with mere traces of an impure drug reshaped medicine. This was a time when a man could die from an infection obtained from a scratch from a rose thorn, and many infected patients were left to die in separate hospital wards. Even the first experiments on protection of mice against Staphylococcus were done on a minimal scale with just enough mice being used to get much better results than they could have hoped for. It is interesting to reflect that it would have been all but impossible to do these experiments today with the legislative and administrative burdens placed on scientists. All of this was done against the background of imminent, and then present, war with only a few people realizing how important penicillin could be for the war effort. I would have liked to have seen some more on the possible role of disease in affecting the course of World War II and the possible benefits seen for penicillin. For example, a mention of the destruction of Napoleon's campaign in Haiti by yellow fever and the destruction of the Serbian army by typhus in World War I could have been instructive. Purification and characterization were what they did at Oxford, manufacture could not be done there, and the only place it could be done was in the US. It was hard sell, even in wartime, with drug companies not wanting to take resources away from lucrative products. Eventually, some companies were persuaded and technical problems were overcome and penicillin was produced on a scale sufficient to have an impact on the outcome of the war, and to begin the antibiotic era. The Oxford scientists decided that penicillin should be a gift to the world (except the Axis powers) and refused to patent it. There is some discussion of whether or not the different forms (apparently three different chemical structures) could be patented. This strikes me as a little disingenuous because all the companies involved knew that they could have been covered by a generic (Markush) structure. It may be that viewed from a time when the 50-page Markush definition covering millions of possible structures is a commonplace that the criticism is unfair, but I think warranted. The real problem is that even in his earliest publications Fleming had discussed the therapeutic use of penicillin and anyone wanting to patent the antibiotic use probably would have had problems arguing that the antibiotic use was "not obvious to one of ordinary skill in the art." In some respects, Lax has given in to the idea that there is a need to prove that scientists are human. It's unnecessary because you can tell that by looking at them. Being a scientist adds a dimension to the individual, rather than closing off parts of the human experience, but it does place their activities in a different context because they can bring a certain knowledge, discipline, and understanding to their activities. However, the same is true for accountants, bakers, and anybody else who has had to develop special skills. Scientists are no smarter about their lives than anybody else. They can drive too fast, drink too much, betray commitments and affections, go bankrupt, and do all the stupid things that everybody else does. Worse, some try to parlay their scientific standing into some sort of inherent superiority when they should not be trusted with the departmental tea fund. At times, this turns the story into something of a soap opera. It is when the story turns to the awarding of recognition that the story becomes unseemly, even tawdry. Fleming was quite happy to take, and make use of, a lot more credit for the penicillin story than was really his, and even given almost limitless quantities of credit available, Heatley came up short. Florey and Chain shared the Nobel Prize with Fleming for their work, while Heatley did not. A Nobel Prize may not split between more than three people. It may be that his technical contribution and engineering placed him in the category of "rude mechanical" and left him at the back of the line for credit. In many ways he did extremely well, but in comparison with others in the story, he did not. I do have my differences with Lax on some points, but as with any good book on a topic as significant as this, that is to be expected. It is a rewarding read.

Nice price.

Like most other students in medicine of any kind, especially those of us with a predeliction for books and information about viruses, bacteria, and our 'failing' fight against them, I was under the impression that Fleming discovered penicillin. I guess you could still say that, but he sat on it for over 10 years and never did have much to do with its development as an antibiotic. Typical. Our textbooks are inaccurate because in the rush to make money off of textbooks, publishers don't bother to actually use people who know the history of medicine, to research and read what is known now about such situations as the development of penicillin. Like the exclusion of Rosalind Franklin from recognition of her very valuable part in the understanding of the DNA molecule (thanks a lot to Watson), in most medical histories or books that med students read, Franklin's name never comes up.Same thing with Florey, and the many other young men such as Chain and Heatley...these guys never received credit for the immense work they did in developing penicillin. It is not enough to find something. Many people discover things everyday, things that could be useable, things that are important...but the 'prepared mind' must be accompanied by plain old work ethics, even grubby work, repetitious work.I was interested to see how much the pharmaceutical industry has changed, and medical universities along with it. Everyone is out for the money now. The thought of doing the right thing, and sharing information, sharing technology in order to save lives, rather than merely to make a profit seems to have gone the way of the dodo bird.A very interesting book. I hope that others will read and use Lax's book, especially in setting the textbooks right, and getting these men and women the credit they are due. I also think it may be time to possibly set up another committee, such as the one that awards the Nobel prize, only this time, make it so that even those who are dead are recognized for their enormous contribution to medicine. The prize money can go to their families or institutions or charities. That's the least important part of all this...to encourage other young people to spend years working on possible solutions to current plagues like AIDS and Alzheimer's, they need to see that other researchers are recognized, and that mentorship has rewards outside and beyond monetary awards.Karen Sadler,Science Education,University of Pittsburgh

The book is informative but painfully difficult to read. Way too many compound and ambiguous sentences. The author uses commas, quotations, hyphens, and parentheses with reckless abandon. Unusual wording such as "rather like" instead of "like" or "studying trying to find" instead of either "studying" or "trying to find" throughout every page. Lots of anecdotes are inserted without needed transition words. I kept having to re-read paragraphs or whole pages to try to follow the text.

Well written history of Fluency, Heatley and others who did the hard work to make penicillin widely available as a miracle drug.

This is an easily readable account of the development of penicillin during World War II. While everyone has heard of Fleming, this book details the efforts of a separate Oxford group led by Howard Florey to develop the antibiotic after Fleming had considered it too labile and of little value.

This is a very well written history of the not-so-famous group of scientists at Oxford who developed Penicillin 10 years after Fleming discovered it and gave up trying to make it useful. Fleming got all the glory, even though if the group at Oxford headed by Dr. Florey had not done their work, Penicillin would never have become the wonder drug of the century.

Α most interesting biography of all the major participants in the discovery and development of penicillin. This book outlines all the factors that influenced this most astonishing medical revolution. It is a concise study that does not include many biological details, and it is more useful rather as a historical/biographical source. Definitely recommended

Very engaging book sharing light on what must have been doing research during the Second World War. A must to understand the development of antibiotics.

This book is well worth reading. It is both interesting and compelling from beginning to end. So often a new idea, concept or invention is ignored by people who should know better. Then once the ball gets rolling everyone wants to get involved. Finally those who worked the hardest on the project are forgotten. Good book and worth reading.

Si well writen. So great. I fully recommend. How much struggle it was to develop Penicillin. Happy that the drug was made available

Excelente relato del desarrollo de la penicilina como herramienta terapéutica, de las dificultades técnicas, humanas y materiales para su desarrollo, así como una descripción detallada de las personalidades que lo hicieron posible