sales of, 224–25
tuberculosis and, 189, 197, 199–200, 203, 207–13, 245, 301
World War II and, 202–3
strychnine, 220, 242, 261
Subbarao, Yellapragada, 153, 215–16
sulfa drugs, 3, 65, 66, 68, 70–72, 74–78, 84, 96, 100, 102, 111, 121, 130, 165, 166, 194, 209, 225, 244, 257, 263, 299n, 305
Prontosil, 67–71, 76, 111, 141, 150, 178, 217, 225, 244
Sulfanilamide Elixir, 75–76, 213n, 264, 281, 282
sulfones, 196–97
sulfur, 8, 187
Supreme Court, 74n
Swieten, Gerard van, 9
swinging, 10
Sydenham, Thomas, 14
syphilis (T. pallidum), 9, 13–14, 35, 55–59, 63, 68, 86, 164, 184, 224
Tuskegee experiments on, 210n
tabloids, 122n
Takamine, Jokichi, 242
tartaric acid, 20, 164
Taylor, Frederick Winslow, 239
Terramycin, 218–20, 222–25, 228, 229, 233, 236, 237, 240, 254, 271
tetanus, 3, 87, 87n, 198
tetracyclines, 3, 200, 223–37, 240, 247, 252–53, 264n, 268, 271
Achromycin, 226–27
Aureomycin, 216–19, 223–27, 231–34, 236, 237, 254, 272, 274
patent on, 225–27, 233, 277
price of, 227
Terramycin, 218–20, 222–25, 228, 229, 233, 236, 237, 240, 254, 271
Tetracyn, 226–28
Tetracyn, 226–28
thalidomide, 281–84, 288
Thatcher, Margaret, 176n
Theorell, A. H. T., 181
Therapeutic Research Corporation, 173
thimerosal, 56n
Thom, Charles, 133–34, 138n, 153
Thomas, Lewis, 3, 71
Thomas, Patricia, 182, 184–87, 189, 203, 210, 294
Thomson, J. J., 51
Thorn, Charles, 93
Thucydides, 13, 42
Time, 147–48, 167, 204
Times (London), 148–49
timothy grass, 214
Tisdale, Wilber, 108
Tishler, Max, 162–63, 192n, 199–201, 207, 220n
Tocqueville, Alexis de, 16
Toussaint, Jean-Joseph Henri, 26–27
toxins, 44, 45, 47–48
Trading with the Enemy Act, 159
tranquilizers, 278
Trevan, J. W., 155
Trudeau, Edward, 187–88
tsetse fly, 52
trypanosomiasis (sleeping sickness), 52–56, 69
tuberculosis, 2, 13, 14n, 28, 30, 35, 42n, 47, 59, 79–80, 85, 102, 182–89, 191, 194–95, 301
Beijing lineage of, 184
in The Doctor’s Dilemma, 79–81, 85, 86, 189
Hill and, 209
history of, 182–85
latency of, 186–87
sanatoriums for treatment of, 182, 187–89, 210
streptomycin and, 189, 197, 199–200, 203, 207–13, 245, 301
sulfones and, 196–97
Thomas case, 182, 184–87, 189, 203, 210
vaccine for, 189
variable symptomology of, 209–10
virulence of, 184–85
Tugwell, Rexford, 74
Tuinal, 239
tularemia, 197
Tuskegee syphilis experiments, 210n
Tyndall, John, 93
typhoid fever, 13, 81–82, 84, 85, 245n
typhus, 93, 94, 202, 245–46, 264
Chloromycetin and, 245–47
lab test for, 247n
tyrothricin, 114n, 190–91, 297
“Über Coca” (Freud), 241
United States:
agriculture in, 131, 134–36
Constitution of, 154
economy of, 131
German immigrants in, 164
pharmaceutical industry in, 132–33, 156, 163, 171
Upjohn Company, 203, 227, 240, 278
urinary tract infections, 217
USDA (U.S. Department of Agriculture), 134–35, 138, 151, 153, 156, 165
U.S. Public Health Service, 152
vaccines, 30, 36, 57, 215
anthrax, 26–27
BCG, 189n
preservatives in, 56n
rabies, 30–31, 44
smallpox, 13n, 14, 26, 209
tuberculosis, 189
vaccine therapy, 84
Varicella zoster, 11n
Vesalius, Andreas, 9
Victoria, Queen, 34
viral diseases, antibiotics and, 266–67, 302
vitalism, 19
vitamins, 162, 230–31
antibiotics and, 271
B, 162–63, 176, 194, 199, 220, 230–33
C, 231
D, 102, 121, 154–55, 165, 230
Volta, Alessandro, 11
Wainwright, Milton, 190
Waksman, Selman Abraham, 132, 189–95, 193, 197, 198, 200–206, 209, 213, 215n, 216, 218, 231, 236, 238, 243, 244n, 269, 274, 291, 294
Walter Reed Army Hospital, 246–47
Warner-Lambert, 296
War Production Board (WPB), 168, 170, 178, 220
War Research Service, 202
Washington, George, 5–6, 9, 25, 38, 63, 298, 303
Washington, Martha, 5
Washington Post, 75, 284
Wassermann, Paul von, 86
Watkins, Albe, 249–50, 254, 260, 268
Watkins, Harold, 75, 75n
Watkins, James, 249
Watt, James, 11
Weaver, Warren, 115, 131–32, 144–45
Weed, Lewis H., 153
Wehmer, Carl, 137
Weicker, Theodore, 163
Weinstein, Haskell, 280
Weinstein, Louis, 254
Weizmann, Chaim, 169n
Welch, Henry, 250, 254, 268–71, 273, 274, 279
Wellcome, Henry S., 122
Wellcome Foundation, 173
whooping cough, 35–36
Wiley, Harvey Washington, 73, 74
Williams, Robert, 162
Wilms’ tumor, 192n
Winthrop Chemical Company, 71, 169, 268, 296, 299n
Wisconsin Alumni Research Foundation (WARF), 155
Witts, L. J., 128–29
Wöhler, Friedrich, 50
Woods, Donald, 77
Woodward, Robert Burns, 175, 220–22, 221, 225, 240, 274
World Health Organization, 264n
World War I, 59–60, 62, 71, 77, 85–86, 87, 159–60, 169
World War II, 77, 115, 118–19, 120, 125, 128, 131, 133, 148, 151, 153, 156, 173, 177, 178, 220, 239
antibiotics and, 177
streptomycin and, 202–3
Wright, Almroth Edward, 81–87, 83, 97n, 132–33, 149, 150
Wright, Louis Tompkins, 217
Wylie, Francis, 98
X-ray crystallography, 144–47, 174–76, 221, 235n, 293
X-rays, 143, 144, 146, 147, 165
yeasts, 19, 20, 24
yellow fever, 82, 99, 202
Yersin, Alexandre, 44
zoonoses, 184
* Like thousands of others in the late eighteenth and early nineteenth centuries, the “Father of His Country” faced death with equanimity, but not the prospect of being buried alive. Hundreds of designs for so-called “safety coffins,” fitted with bells or other signaling devices, were patented from 1780 on.
* Neither phrase appears in that precise language in either the Hippocratic Oath or other works of Hippocrates—the original oath is usually translated as “. . . never do harm to anyone”—but there’s little doubt that Hippocrates subscribe
d to the sentiments they describe.
* In fact, the level of virulence of any disease is a fairly good proxy for the time during which humans have been exposed to it; members of societies that have lived with Varicella zoster—the virus that causes chicken pox—for millennia get sick for a few weeks, both because the host’s defenses grow more skilled with time and because the pathogens grow less dangerous, while populations encountering it for the first time die in large numbers.
* His practice was eventually debunked by an all-star commission appointed by King Louis XVI that included Antoine Lavoisier and Benjamin Franklin.
* It is no coincidence that the Latin root for “patient” is patior: “I am suffering.”
* Also, that exposure conferred lifetime immunity, which is why vaccination against smallpox was being practiced in Asia centuries before Edward Jenner’s 1796 inoculation of an eight-year-old boy named James Phipps (with lesions containing cowpox—vaccinia—rather than the variola virus that caused smallpox).
* Mortality tables aren’t always as accurate as they are precise. A table showing the reasons for 942 recorded deaths by “Diseases and Casualties” in the city of Boston during the year 1811 lists such causes as “drinking cold water” (2 deaths), “sudden death” (25), “white swelling,” and “decay.” To be sure, the most common was “consumption”—tuberculosis, which was tagged with 221 of the total, or 23 percent of all deaths. Even as late as 1900, tuberculosis was responsible for 194 out of every 1,000 deaths in the United States. See Chapter Six.
* Another reason is that yeasts, which are multicellular fungi, are much larger than single-celled bacteria, which had not yet been reliably identified.
* When Schwann published his results, Liebig responded in what might seem, in retrospect, a slightly juvenile manner. In 1839, he wrote—anonymously—a paper in which “the riddle of alcoholic fermentation [is] solved” by a tiny animal shaped like a still, which swallowed sugar at one end and excreted alcohol from its anus and carbonic acid from its penis.
* One of the three components of anthrax toxin—somewhat strangely, none of the three are toxic in themselves, but only in combination—is actually called “lethal factor endopeptidase.”
* As of this writing, the most widely accepted tree of life has two domains: prokarya, which includes both the kingdoms of the bacteria, and microoganisms that live in extreme environments that resemble that of the young and oxygen-free earth, known as archaea; and the eukarya, with four kingdoms: plantae, animalia, fungi (single-celled organisms, like the yeasts), and protista (many algae, also single-celled microbes).
* It wasn’t until Pasteur’s death in 1895 that Eduard Buchner announced the key discovery that proved both Bernard and Pasteur correct: Enzymes—products and components of the metabolic activity of microorganisms—were what caused fermentation.
* For more about tuberculosis, see Chapter Six.
* Plausible, but wrong. Many pathogens can be found in otherwise healthy carriers, which violates postulate number one, and even when they can be grown in a Petri dish (and not all disease-causing agents can be cultured) don’t cause disease in every new host, which made Koch’s tool an exercise in both diagnostic reductionism and the contingent nature of knowledge, since they were upended even during their creator’s own life.
* This is the basis of the modern TB skin test.
* In any case, rabies was scarcely a large public health hazard. In 1885 France, fewer than thirty people died of it annually.
* He did not, of course, know how. Phenol causes cell membranes to degrade and eventually rupture, with a resulting—and devastating—leakage of the cell’s internal constituents.
* It should be noted that many other factors were simultaneously contributing to a drop in surgical complications, including simple hygiene. Moreover, Lister’s view of the causes of infection evolved considerably from 1867, when he still held to the belief that at least some diseases were the result of miasmata, or bad air, and seemed to favor the Liebig view that putrefaction was a cause of microbial action, rather than a result of it.
* The term used by most historians of the phenomenon is actually “therapeutic nihilism.” In fact, the modern version of the Hippocratic Oath includes the phrase, “I will apply for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism.”
* The word also appears in the great German dictionary assembled by the folklorists Wilhelm and Jakob Grimm, referring to a technique used by the Lapps to poison their targets at a distance.
* Six weeks after Koch announced the discovery of the tubercle bacillus, Ehrlich had written a paper on staining it, using a dye known as fuchsine, and then leaching the color out with an acid. Shortly thereafter, he used the “acid-fast” staining method to find the bacillus in his own sputum, and spent two years in southern Europe and Egypt recovering from the disease.
* The leatherlike pseudomembrane gave the disease and the bacterium their name; the Greek word for “leather” is diphtheria.
* For readers who remember high school chemistry fondly: Anilines are compounds in which a phenyl group, a ring made up of six carbon and five hydrogen atoms, is joined to an amine group, or a nitrogen atom is connected to three other atoms of either carbon or hydrogen.
* However, it has subsequently been expanded and replaced by a number of new and more finely detailed theories of immunity and immunoregulation.
* Not for quite a while, anyway. The 2014 Nobel Prize in Chemistry was awarded for the “development of super-resolved fluorescence microscopy,” a technique for getting around what seemed a fundamental limitation of optical microscopes, which was that they could not, even in theory, produce pictures with a resolution greater than half the wavelength of visible light, about 200 nanometers, or 1/20,000 of a millimeter. This is fine for many biological investigations—most bacteria are about 1,000 nanometers in diameter—but not all. Viruses, for example, can be as small as 20 nanometers in cross-section. Even fluorescence microscopy is too blunt an instrument for molecular investigation. A water molecule is only 1/10 of a nanometer in diameter. For that kind of picture, an electron microscope, which diffracts beams of electrons instead of waves of light, and can resolve at the (wait for it . . .) picometer scale: 1/1,000 of a nanometer.
* Azo is an abbreviation of azobenzene, a blanket term for compounds made up of two rings comprising six carbon and five hydrogen atoms—phenyl rings—connected by two nitrogen atoms sharing a double bond of two electrons.
* Methylene blue, which is still used today for the treatment of urinary tract infections, would have a darker future. It was one of the drugs tested on human subjects at Auschwitz.
* Technically, arsenic oxide. Redox (reduction-oxidation) reactions occur when atoms transfer electrons; reduction is the gain of an electron, oxidation the loss. Trivalent arsenic is reduced; pentavalent is oxidized.
* From whence the phrase, “A night with Venus, a lifetime with mercury.” It’s not that mercury isn’t a powerful bactericide. In fact, it is more than fifty times as deadly to bacteria as Lister’s carbolic acid, which is why it was used, beginning in the 1930s, as a vaccine preservative in the form known as Merthiolate or thimerosal. Worth noting: In order to soothe public anxieties, and despite no evidence that thimerosal was harmful in the amounts used, it was removed from most vaccines beginning in 1999.
* Reducing phenylarsonic acid with dithionite. Because dithionite is an anion, or charged compound, of sulfur and oxygen, it was very difficult to work with.
* These cells are known as “Kupffer cells,” for the German physician, Karl Wilhelm von Kupffer, who first observed (and misidentified) them in 1876. They are part of the family of white blood cells that patrol for, and destroy, invading foreign substances.
* Gross would, in his way, become as notab
le as Domagk, though for a far blacker achievement. A raging anti-Semite and early member of the Nazi Party, he created and ran the party’s Office of Racial Policy from 1933 until his suicide in 1945.
* By the end of the twentieth century, investigators working at what came to be known as “combinatorial chemistry” realized the limits of such an approach, which is that there are far more ways to combine atoms than there are atoms in the universe. As a result, even if some imaginary supercomputer had started testing a new combination every second since the Big Bang some fourteen billion years ago, it would barely have scratched the surface of all possible molecules.
* The economist Kenneth Romer calls it nonrivalrous property, as distinguished from rivalrous.
* The new name was actually an old one: The dye at the center of KL-730 had originally been developed as a rapid-working dye for leather, when it was called “Prontosil Rubrum” or “fast red.”
* In 1843, Dr. Oliver Wendell Holmes, Sr.—the same one who sneered at the entire nineteenth-century pharmacopoeia—quoted another doctor as saying, “I had rather that those I esteemed the most should be delivered unaided, in a stable, by the mangerside, than that they should receive the best help, in the fairest apartment, but exposed to the vapors of this pitiless disease. Gossiping friends, wet-nurses, monthly nurses, the practitioner himself, these are the channels by which . . . the infection is principally conveyed.” Holmes was quoting James Blundell’s Lecture on Midwifery.
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