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

Henry Holt and Company, 2005

Alexander Fleming’s discovery of penicillin in his London laboratory in 1928 and its eventual development as the first antibiotic by a team at Oxford University headed by Howard Florey and Ernst Chain in 1942 led to the introduction of the most important family of drugs of the twentieth century. Yet credit for penicillin is largely misplaced. Neither Fleming nor Florey and his associates ever made real money from their achievements; instead it was the American labs that won patents on penicillin’s manufacture and drew royalties from its sale. Why this happened, why it took fourteen years to develop penicillin, and how it was finally done is a fascinating story of quirky individuals, missed opportunities, medical prejudice, brilliant science, shoestring research, wartime pressures, misplaced modesty, conflicts between mentors and their protégés, and the passage of medicine from one era to the next.Alexander Fleming’s discovery of penicillin in his London laboratory in 1928 and its eventual development as the first antibiotic by a team at Oxford University headed by Howard Florey and Ernst Chain in 1942 led to the introduction of the most important family of drugs of the twentieth century. 


Reviews

From The New York Times

Reviewed by Simon Winchester

These are good times for the forgotten heroes of science, for the also-rans, for the runners-up. In the last couple of years there have been big and well-received books about Rosalind Franklin, who should have been given more ample credit for her work on the discovery of DNA, and Alfred Russel Wallace, whose work on evolutionary theory matches that of Darwin and who coined the phrase ”survival of the fittest.” There have been laudatory articles about the work of Fred Hoyle, who figured out where all the atoms in the human body came from, but whose colleague Willy Fowler won the kudos for saying so, and Jocelyn Bell, who discovered pulsars but is all but forgotten beyond astronomy and remains unhonored.

Now in his admirable, superbly researched (and alluringly titled) new book, the Los Angeles-based biographer Eric Lax — rather better known for tackling more obvious subjects like Woody Allen and Humphrey Bogart — has turned his attention to the unsung heroes of the penicillin saga. That saga, perhaps the most exciting tale of science since the apple dropped on Newton’s head, is dominated in the public mind by the severe and patrician figure of the Scotsman who first noticed the antibiotic properties of the mold Penicillium notatum, Alexander Fleming.

By reminding us of the stellar contributions to that same story that were made by the Oxford University team of Howard Florey, Ernest Chain and a hitherto utterly anonymous chemist named Norman Heatley, Mr. Lax has performed a service to science of which he should be proud and all must be grateful.

He was prompted to do so in 1999, after reading an obituary of Anne Miller, the first American to have been given the newly-minted wonder drug. She had been injected with it in New Haven in March 1942, after coming down with a furious infection in the aftermath of a miscarriage. She recovered almost immediately, prompting the drug companies that had been toying with the notion of manufacturing penicillin to swing into full-scale production.

Within months all the scourges of war and poverty and dirt — gonorrhea, meningitis, anthrax, diphtheria, gas gangrene, tetanus and a foul complaint of the soldiery called lumpy abscesses — had at last met their match, via a needle and a tincture of mold extract; and until the dread modern concerns of drug-resistance raised their head, so penicillin stood in the vanguard of anti-bacterial drugs, the greatest medical advance of all time.

But what Mr. Lax has done at long last is to hand out the properly deserved degrees of merit to all who were involved in the making of this extraordinary and fugitive piece of magical chemistry. If his prompt came in the form of that brief obituary (and its expansion by Alistair Cooke into a particularly memorable ”Letter from America”), it was his adroit realization that there was a mystery to solve, and so probably another story to be told, that led to this book.

The mystery is one that can be readily seen by looking at the index entry for ”Fleming, Alexander” in Gwyn Macfarlane’s supposedly definitive biography of penicillin’s discoverer, published in 1984. The index entry is 87 lines long. A third of these are devoted to Fleming’s list of honors and honorary degrees. But between the entry about the discovery of penicillin and one noting the first systemic use of penicillin there are only 14 lines, and one of those is a reference to Fleming’s doubt that the drug might ever be useful.

Yet fully 13 years separated the two events: Fleming discovered the mold’s effect in 1928, and the first human guinea pig (guinea pigs themselves react badly to the drug; mice were used instead) was injected in 1941. So just what was happening in those 13 intervening years? Why did it take so long to turn an interesting chemical conceit into a life-saving piece of pharmaceutical weaponry? And during those years what contribution exactly did Fleming himself make? What was it that permitted him, primus inter pares, eventually to be buried in St. Paul’s Cathedral as one of the most honored and revered Britons of all time?

Mr. Lax sets the record straight. He tells us just what took place following that fate-directed moment in 1938 when an Einstein look-alike from Berlin, Ernest Chain, stumbled across Fleming’s 1929 paper announcing the interesting properties of the mold (which he had found in old tennis shoes, among other places). Chain and Florey, then working in Oxford, decided to investigate further. They enlisted the brilliant and modest chemist Norman Heatley to join their team, and then slowly and painstakingly they produced enough pure crystalline penicillin to test on sick mammals.

The results were stunning. Lives were saved in their tens of thousands. American drug companies caught on to the profitability of the drug and made millions. And in a monstrous piece of injustice Fleming’s old boss, Almroth Wright, wrote a letter to The Times of London saying that the laurel wreath for the making of the miracle belonged to Fleming.

For years the supporters of the Oxford team tried in vain to have the world honor them as well. And true, Florey and Chain did join Fleming in winning the 1945 Nobel Prize; but the headline in The New York Times said it all: ”Fleming and Two Co-Workers Get Nobel for Penicillin Boon.” They were regarded merely as the hired help. And these days they are all but forgotten.

As is Heatley, the modest chemist who did all the hardest laboratory work, both in Oxford and in Peoria, Ill., where penicillin was first made commercially. He died in January, in his old Oxford cottage, having in the weeks before spoken at length to Mr. Lax, perhaps the first writer ever to have taken him seriously, as he does in this valuable and eminently readable book.

Correction: May 27, 2004, Thursday The Books of The Times review yesterday, about ”The Mold in Dr. Florey’s Coat” by Eric Lax, which tells of the effort to turn penicillin mold into a medicine, misstated the given name of a researcher at Oxford who worked on the project. He was Ernst Chain, not Ernest. Correction: June 19, 2004, Saturday The Books of The Times review on May 26, about a history of penicillin called ”The Mold in Dr. Florey’s Coat,” by Eric Lax, attributed a distinction incorrectly to Anne Miller, a patient injected with that antibiotic in 1942. She was not the first American to receive it; others were treated in 1940 and 1941.

From Publishers Weekly

This book sets out to correct the misapprehension that Alexander Fleming, the first scientist to discover the antibacterial properties of the mold Penicillium notatum, was also responsible for developing the wonder drug that saved countless lives and ushered in the era of modern medicine. Although Fleming coined the term “penicillin,” his tentative research on the mold produced few valuable results and was prematurely abandoned. More than a decade later, in 1940, a pathology team at Oxford University-headed by Howard Florey, Ernst Chain and the now almost forgotten Norman Heatley-resumed Fleming’s preliminary work and eventually developed the world’s first viable antibiotic. 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 2004 Reed Business Information. 

From Library Journal

Lax, whose previous Life and Death on 10 West and Woody Allen: A Biography drew favorable reviews, turns his attention to the fascinating story surrounding the development of penicillin during World War II. Many people believe that Alexander Fleming was solely responsible for penicillin, yet he was only one of the players. Though Fleming initially reported the discovery of penicillin, several Oxford scientists, led by Howard Florey, worked on isolating, purifying, producing, and testing the antibiotic on humans. Eventually, Florey and his colleague Ernst Chain shared the Nobel prize with Fleming. Relying heavily on interviews and personal papers, Lax consistently illustrates the major impact of the war on their research-the antibiotic was desperately needed, yet they were stymied by a constant lack of funding and the threat of enemy soldiers destroying their work. Unlike previous Florey biographies or historical accounts of penicillin, Lax focuses on the early stages of research as seen through the eyes of the Oxford scientists. This fast-paced book is recommended for all public libraries and history of medicine collections.
Tina Neville, Univ. of South Florida at St. Petersburg Lib. Copyright 2004 Reed Business Information. 

From Kirkus Reviews

Veteran journalist and author Lax (Woody Allen, 1991, etc.) takes a revealing look back at the time when world-altering science was done on a shoestring, bringing to brilliant life the story of the first great antibiotic. While Alexander Fleming is the name most often associated with penicillin, it was the Oxford team of Howard Florey, Ernst Chain, and Norman Heatley, the author reminds us, that turned Fleming’s 1928 discovery of the potent mold into a life-saving miracle drug while working under Spartan and dangerous conditions. Responding to the threat of an imminent Nazi invasion, Heatley proposed that in case they were forced to abandon their work and flee, they preserve the mold spores by rubbing some into the fabric of their clothing. (Hence the title.) Lax first captures the personalities of each of these four men and then moves on to Florey’s efforts to scrounge together the funds for his team’s work. An initial grant from the Medical Research Council for materials was £25, the equivalent then of about $100. Funds from the Rockefeller Foundation were more generous, but ingenuity and improvisation remained essential. Heatley cobbled together an apparatus to extract penicillin from mold juice using glass tubing, assorted pumps, copper coils, colored warning lights, and even an old doorbell. The meager amounts of penicillin the team was able to produce showed therapeutic potential, but larger quantities were needed to run the necessary clinical trials. Unable to interest British pharmaceutical companies, they turned to the US, offering to share all their knowledge of how to produce penicillin in return for a supply. Florey and Heatley’s dog-and-pony show in the US, the American rolein the penicillin story, Fleming’s public behavior when the news of penicillin’s clinical value became known, the Nobel Prize expectations of those involved all make for fascinating reading. Even sex rears its intriguing head, with both Florey’s wife and mistress getting into the act. Informative and thoroughly enjoyable science history.