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Although Fleming, Florey and Chain shared a Nobel Prize in 1945 for their revolutionary
work, accolades and media attention were disproportionately bestowed on Fleming, and in
the popular imagination he was transformed into the sole creator of penicillin. Lax (Woody
Allen; Life and Death on 10 West) has written a commendable account of this historical
oversight, conveying the thrill of discovery during the upheaval of WWII and skillfully
translating the abstruse technicalities of lab work and medical jargon into enjoyable
prose. Yet this book also shows that monumental discoveries are not always born of
monumental stories, and the narrative contains trivial details and petty grievances that
made up these scientists' circumscribed lives. Lax's treatment is disciplined and focused,
but it would have been improved by a broader historical sweep and more involved
discussions of penicillin's impact on the pharmaceutical industry. 18-page b&w photo
insert not seen by PW.
Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights
reserved. --This text was written about the Hardcover
From The New England Journal of Medicine
Alexander Fleming may be one of only two Nobel laureates in medicine (the other being Ivan
Pavlov) whose name is well known to the general public. In contrast, his co-laureates
Howard Florey and Ernst Chain and their vital contributions to the translation of
Fleming's 1928 observation of the antibiotic qualities of a penicillium mold into the
lifesaving drug penicillin are little remembered. The discovery has been both lauded by
hagiographers and dissected by revisionists, foremost among the latter being Gwyn
Macfarlane, whose biographies, first of Florey and then of Fleming, did much to broaden
the story. It is the reflective, analytic tone of Macfarlane's books that Eric Lax adopts.
He not only affirms the roles of all three Nobel Prize winners but also brings into the
foreground the "fourth man" of penicillin, Norman Heatley, who was a major
source for this book before his death early this year. (Figure) Although Fleming
recognized the possibilities of penicillium, his kitchen chemistry experiments produced
gallons of "mold juice" that had inconclusive effects. Poor experimental design
combined with weak presentation skills and a literary style that Lax describes as
"miserly" did little to stimulate others' interest. It was not until 1939 that
Florey, Chain, and Heatley took up the work of chemical extraction in Oxford, England. The
technical problems were immense; the relationship between Florey, a brash Australian, and
Chain, a temperamental German-Jewish refugee, was difficult; and in the wartime
conditions, equipment and supplies became increasingly scarce. On May 25, 1940, one of the
most famous animal experiments in medical history took place. Eight mice were inoculated
with a fatal dose of streptococcus. Four were also injected with a crude penicillin
extract. Within hours, the untreated mice were dead and the penicillin-treated mice were
still alive. Penicillin's spectacular possibilities were obvious. Weeks later, France fell
to Germany, and Britain was left to fight alone in the war. The Oxford group of scientists
realized that if the city were invaded, they would have to destroy their work to prevent
it from falling into enemy hands. At Heatley's suggestion, they rubbed their jackets with
the penicillium spores so that if they had to flee, they could carry the secret with them.
A year later, with the help of the Rockefeller Foundation, Florey and Heatley carried the
secret to the United States to persuade scientists and companies to undertake the
production work that had been so crippled by shortages in the United Kingdom. The entry of
the United States into the war in December 1941 altered the course of history in regard to
penicillin, and by the end of 1943 its production was the second-highest priority of the
U.S. War Department. New climates and traditions of research then clearly emerged -- for
instance, the British Medical Research Council believed that patenting medicines was
unethical. They rejected Chain's urgent requests that the work be protected -- a refusal
that bore, Lax suggests, more than a hint of anti-Semitism. American companies patented
their production techniques, and Chain's prophecy that he would have to pay royalties to
use his own invention proved correct, although whether the Oxford scientists could have
patented their preliminary work remains debatable. The powerful personalities and the
extraordinary circumstances in which they struggled on both sides of the Atlantic richly
embellish this fresh and hugely enjoyable account of an important episode in medical
history. Tilli Tansey, Ph.D.
Copyright © 2004 Massachusetts Medical Society. All rights reserved. The New England
Journal of Medicine is a registered trademark of the MMS. --This text was written
about the Hardcover
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