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The Rise and Fall of Modern Medicine by M. D. James le Fanu M. D.
Barry Marshall: ulcers, clean water, cuban missile crisis, discovery of penicillin, double helix, experimental subject, Gary Taubes, Isaac Newton, meta analysis, meta-analysis, rising living standards, stem cell, telerobotics, The Design of Experiments, the scientific method, V2 rocket
I found it informative and intriguing’ THOMAS STUTTAFORD in the Literary Review ‘The skill [of medical journalism] is to write with humanity and objectivity, a dual responsibility brilliantly fulfilled by the author . . . This book is well worth reading just for the brilliant pen portraits of Le Fanu’s twelve definitive moments of medical advance. Some, like the discovery of penicillin, are well known, but even here the author has a way of encapsulation that is full of insights and unusual detail . . . It would be possible to close the book here, just over halfway through, and still feel you had had your money’s worth. But the challenge is in the second half, where three much hyped hopes for the future are brought down to earth . . .
There were, however, three ‘new’ diseases that had recently emerged to become major causes of untimely death in middle age: peptic ulcers, heart attacks and cancer of the lung. Their cause was not known and, as ever, there were no effective treatments. The purpose of this book is to describe what happened next, starting with an account of the ‘twelve definitive moments’ – the ‘canon’ – of modern medicine. 1 1941: PENICILLIN The discovery of penicillin is, predictably, both the first of the twelve definitive moments of the modern therapeutic revolution and the most important. Penicillin and the other antibiotics that followed rapidly in its wake cured not only the acute lethal infections such as septicaemia, meningitis and pneumonia, but also the chronic and disabling ones such as chronic infections of the sinuses, joints and bones.
If a naturally occurring non-toxic chemical compound produced by a species of fungus such as penicillin could make the difference between whether a child with meningitis should live or die, it was only natural to wonder whether other ghastly and baffling illnesses might not yield to similar simple solutions. Perhaps cancer might be curable, or schizophrenia might be treatable? In the public imagination antibiotics came to symbolise the almost limitless beneficent possibilities of science. Yet this is not entirely merited, for, as will be seen, the discovery of penicillin was not the product of scientific reasoning but rather an accident – much more improbable than is commonly appreciated. Further, at the core of antibiotics lies an unresolved mystery: why should just a few species of micro-organisms produce these complex chemical compounds with the capacity to destroy the full range of bacteria that cause infectious disease in humans?
3D printing, 4chan, A Declaration of the Independence of Cyberspace, augmented reality, barriers to entry, Benjamin Mako Hill, butterfly effect, citizen journalism, Claude Shannon: information theory, conceptual framework, corporate governance, crowdsourcing, Deng Xiaoping, discovery of penicillin, Douglas Engelbart, Edward Glaeser, en.wikipedia.org, experimental subject, Filter Bubble, Freestyle chess, Galaxy Zoo, Google Earth, Google Glasses, Henri Poincaré, hindsight bias, hive mind, Howard Rheingold, information retrieval, iterative process, jimmy wales, Kevin Kelly, Khan Academy, knowledge worker, Mark Zuckerberg, Marshall McLuhan, Menlo Park, Netflix Prize, Nicholas Carr, patent troll, pattern recognition, pre–internet, Richard Feynman, Richard Feynman, Ronald Coase, Ronald Reagan, sentiment analysis, Silicon Valley, Skype, Snapchat, Socratic dialogue, spaced repetition, telepresence, telepresence robot, The Nature of the Firm, the scientific method, The Wisdom of Crowds, theory of mind, transaction costs, Vannevar Bush, Watson beat the top human players on Jeopardy!, WikiLeaks, X Prize, éminence grise
Because they want the fame of discovery, once they learn someone else is working on a similar problem, they’re as liable to compete as to collaborate—and they’ll bicker for decades over who gets credit. The story of penicillin illustrates this as well. Three decades after Duchesne made his discovery of penicillin, Alexander Fleming in 1928 stumbled on it again, when some mold accidentally fell into a petri dish and killed off the bacteria within. But Fleming didn’t seem to believe his discovery could be turned into a lifesaving medicine, so, remarkably, he never did any animal experiments and soon after dropped his research entirely.
Merton, “Singletons and Multiples in Scientific Discovery: A Chapter in the Sociology of Science,” Proceedings of the American Philosophical Society 105, no. 5 (October 13, 1961): 470–86. Merton discusses the mathematicians on page 479. the tragic story of Ernest Duchesne: My account of Duchesne’s discovery of penicillin comes from Serge Duckett, “Ernest Duchesne and the Concept of Fungal Antibiotic Therapy,” The Lancet 354 (December 11, 1999): 2068–71; Kurt Link, Understanding New, Resurgent, and Resistant Diseases: How Man and Globalization Create and Spread Illness (Westport, CT: Greenwood Publishing Group, 2007), 13–14; Paul André, M.
consider what happened next to Ory Okolloh: My account of the origins of Ushahidi draws from Ory Okolloh, “Update Jan 3 11:00 pm,” Kenyan Pundit, January 3, 2008, accessed March 22, 2013, www.kenyanpundit.com/2008/01/03/update-jan-3-445-1100-pm/; Erik Hersman, “It’s Not about Us, It’s about Them,” WhiteAfrican, January 4, 2008, accessed March 22, 2013, whiteafrican.com/2008/01/04/its-not-about-us-its-about-them/; Ted Greenwald, “David Kobia, 32,” MIT Technology Review, September 2010, www2.technologyreview.com/tr35/profile.aspx?trid=947; and an e-mail communication with Hersman. Three decades after Duchesne made his discovery of penicillin, Alexander Fleming in 1928: Alexander Kohn, Fortune or Failure: Missed Opportunities and Chance Discoveries (Cambridge, MA: Blackwell, 1989), 76–96. “most of the smartest people work for someone else”: Lewis DVorkin, “Forbes Contributors Talk About Our Model for Entrepreneurial Journalism,” Forbes, December 1, 2011, accessed March 22, 2013, www.forbes.com/sites/lewisdvorkin/2011/12/01/forbes-contributors-talk-about-our-model-for-entrepreneurial-journalism/.
Albert Einstein, Black-Scholes formula, Bretton Woods, Brownian motion, capital asset pricing model, collateralized debt obligation, correlation coefficient, Credit Default Swap, credit default swaps / collateralized debt obligations, David Ricardo: comparative advantage, discovery of penicillin, discrete time, Emanuel Derman, en.wikipedia.org, Eugene Fama: efficient market hypothesis, financial innovation, fixed income, floating exchange rates, full employment, Henri Poincaré, implied volatility, index fund, Isaac Newton, John von Neumann, Joseph Schumpeter, Long Term Capital Management, Louis Bachelier, margin call, market clearing, martingale, means of production, moral hazard, naked short selling, price stability, principal–agent problem, quantitative trading / quantitative ﬁnance, RAND corporation, random walk, risk tolerance, risk/return, Ronald Reagan, shareholder value, Sharpe ratio, short selling, stochastic process, The Chicago School, the scientific method, too big to fail, transaction costs, tulip mania, Works Progress Administration, yield curve
There is perhaps no better example in the decision sciences of the evolution of ideas that are so revolutionary. Certainly, Newton’s equations of motion and Leibniz’s development of calculus, and the Nobel Laureate Einstein’s Theory of Relativity in 1905 and its E ⫽ mc2 prophecy had comparable transformational potency on society and our economy. So too was the discovery of penicillin attributed to the Nobel Laureate Alexander Fleming in 1928. These innovations revolutionized pure science, engineering, or humanity itself. However, before the rise of the quants, finance or economics had known no such profound insight that truly transformed markets. No other discovery or innovation has directly generated the sort of profits and economic activity that these innovations in finance created.
The new village green: living light, living local, living large by Stephen Morris
back-to-the-land, Buckminster Fuller, clean water, cleantech, collective bargaining, Columbine, Community Supported Agriculture, computer age, cuban missile crisis, deindustrialization, discovery of penicillin, distributed generation, energy security, energy transition, Fellow of the Royal Society, financial independence, Firefox, index card, Indoor air pollution, invisible hand, Kevin Kelly, Louis Pasteur, Mahatma Gandhi, McMansion, Menlo Park, Negawatt, peak oil, rolodex, Silicon Valley, Steve Jobs, Stewart Brand, Whole Earth Catalog, Whole Earth Review
The drugs have been extracted or synthesized, but many owe their origins to the herbalist. You argue that herbal medicine isn’t nearly so steeped in superstition as some skeptics believe. For example, the folk remedy of applying bread mold to wounds to prevent infection dates back to long before scientiﬁc medicine and the discovery of penicillin. Just how much can homesteaders rely on folk cures today? Herbal remedies can help cure most of the simple illnesses. Nature, for instance, can regulate your bowels in either direction. Cascara bark is still used in a great many commercial laxatives, such as Ex-Lax. Most of the medicines for diarrhea are based on tannin... though the natural ones don’t have opiates added to relieve pain or quiet muscles.
Vaccinated: One Man's Quest to Defeat the World's Deadliest Diseases by Paul A. Offit
They purified penicillin, described its physical and chemical properties, studied its effects in animals and humans, and showed how to mass-produce it, just in time to save the lives of tens of thousands of Allied soldiers. Ten years after abandoning his research on penicillin, Alexander Fleming won the Nobel Prize in medicine “for the discovery of penicillin and its curative effect in various infectious diseases.” Although our understanding of what penicillin is, how it works, and how it can be used to save lives couldn’t have happened without Howard Florey, few know his name. When people think of penicillin, they think of Alexander Fleming. The story of Fleming and Florey would be repeated with the discovery of the first substance to inhibit the growth of viruses and treat cancer.
Albert Einstein, British Empire, Build a better mousetrap, conceptual framework, discovery of penicillin, double helix, Drosophila, epigenetics, Fellow of the Royal Society, life extension, mouse model, phenotype, stem cell, stochastic process, Thomas Kuhn: the structure of scientific revolutions
Isaac Asimov There are multiple instances in science of a relatively chance event leading to a wonderful breakthrough. Probably the most famous example is Alexander Fleming’s observation that a particular mould, that had drifted by chance onto an experimental Petri dish, was able to kill the bacteria growing there. It was this random event that led to the discovery of penicillin and the development of the whole field of antibiotics. Millions of lives have been saved as a result of this apparently chance discovery. Alexander Fleming won the Nobel Prize for Physiology or Medicine in 1945, along with Ernst Chain and Howard Florey who worked out how to make penicillin in large quantities so that it could be used to treat patients.
The Knowledge: How to Rebuild Our World From Scratch by Lewis Dartnell
agricultural Revolution, Albert Einstein, Any sufficiently advanced technology is indistinguishable from magic, clean water, Dava Sobel, decarbonisation, discovery of penicillin, Dmitri Mendeleev, global village, Haber-Bosch Process, invention of movable type, invention of radio, invention of writing, iterative process, James Watt: steam engine, John Harrison: Longitude, lone genius, nuclear winter, Richard Feynman, Richard Feynman, technology bubble, the scientific method, Thomas Kuhn: the structure of scientific revolutions, trade route
Mold cultures were grown in racks of shallow bedpans and makeshift extraction equipment built using an old bathtub, trash cans, milk churns, scavenged copper piping, and doorbells, all secured in a frame made from an oak bookcase discarded by the university library—inspiration, perhaps, for the scavenging and jury-rigging necessary after the apocalypse. So while the discovery of penicillin is often portrayed as accidental and almost effortless, Fleming’s observation was only the very first step on a long road of research and development, experimentation and optimization, to extract and purify the penicillin from the “mold juice” to create a safe and reliable pharmaceutical.
Every Patient Tells a Story by Lisa Sanders
data acquisition, discovery of penicillin, high batting average, index card, medical residency, meta analysis, meta-analysis, natural language processing, pattern recognition, randomized controlled trial, Ronald Reagan
Lemierre wrote up several cases of this illness, which begins with a fever and tonsillitis and progresses to a painful and often swollen neck as the infection moves into the jugular vein. Once there, the bacteria induce the formation of blood clots, which then shower the rest of the body with tiny bits of infected tissue. Before the discovery of penicillin the disease was usually fatal. The widespread use of penicillin to treat all severe sore throats during the 1960s and 1970s virtually wiped out the disease. But over the past twenty years, Lemierre’s has staged something of a comeback—an unintended consequence of a more cautious use of antibiotics and the development of new drugs—like Biaxin, which is what Tamara was given—that are easier to take but far less effective than penicillin against this potentially deadly infection.
P53: The Gene That Cracked the Cancer Code by Sue Armstrong
There was, however, more direct experimental evidence to back it up. It came from the laboratory of cancer geneticist Henry Harris, an obstinate (by his own admission) and independent-minded Australian who had been recruited in 1952 by fellow countryman Howard Florey – famous for his collaboration with Alexander Fleming in the discovery of penicillin, for which they won a Nobel Prize – to work with him at Oxford University. Talking of his move from Sydney to Oxford many years later, Harris told an interviewer, ‘I got a telephone call from Hugh Ward, the Professor of Bacteriology [at Sydney], to say that he had Florey in his office and would I like to meet him.
The End of Illness by David B. Agus M. D.
Danny Hillis, discovery of penicillin, double helix, epigenetics, germ theory of disease, Google Earth, impulse control, information retrieval, meta analysis, meta-analysis, microbiome, Murray Gell-Mann, pattern recognition, personalized medicine, randomized controlled trial, risk tolerance, Steve Jobs, the scientific method
The Inescapable Statistics To understand how we’ve arrived at a place where we focus so much on DNA, and why it’s critical to respect the body as an elaborate system beyond genetics, it helps to explore the evolution of our thinking processes against the backdrop of the challenges we’ve faced—and continue to face—in our quest for health and longevity. Most of our transformative breakthroughs in medicine have occurred only recently, in the last sixty or so years. Following the discovery of penicillin in 1928, which changed the whole landscape of fighting infections based on the knowledge that they were caused by bacteria, we got good at extending our lives by several years and, in many cases, decades. This was made possible through a constellation of contributing circumstances, including a decline in cigarette smoking, changes in our diets for the better, improvements in diagnostics and medical care, and of course advancements in targeted therapies and drugs such as cholesterol-lowering statins.
Asperger Syndrome, Barry Marshall: ulcers, Berlin Wall, biofilm, clean water, correlation does not imply causation, discovery of penicillin, Drosophila, Fall of the Berlin Wall, friendly fire, germ theory of disease, Ignaz Semmelweis: hand washing, illegal immigration, John Snow's cholera map, Louis Pasteur, Maui Hawaii, meta analysis, meta-analysis, microbiome, phenotype, placebo effect, the scientific method
He, like many other scientists and doctors, predicts we may soon enter a post-antibiotic era much like the pre-antibiotic era, in which surgery carried a high risk of death, and minor cuts could kill. This prediction is as old as antibiotics themselves. Sir Alexander Fleming, after making his discovery of penicillin, repeatedly cautioned that using too little of it, for too short a time, or without good reason, would bring about antibiotic resistance. He was right. Time and time again, bacteria evolve resistance to antibiotics. The first penicillin-resistant bacteria were discovered just a few years after penicillin was introduced.
Big Bang by Simon Singh
Albert Einstein, Albert Michelson, All science is either physics or stamp collecting, Andrew Wiles, anthropic principle, Arthur Eddington, Astronomia nova, Brownian motion, carbon-based life, Cepheid variable, Chance favours the prepared mind, Commentariolus, Copley Medal, cosmic abundance, cosmic microwave background, cosmological constant, cosmological principle, dark matter, Dava Sobel, Defenestration of Prague, discovery of penicillin, Dmitri Mendeleev, Edmond Halley, Edward Charles Pickering, Eratosthenes, Ernest Rutherford, Erwin Freundlich, Fellow of the Royal Society, fudge factor, Hans Lippershey, Harlow Shapley and Heber Curtis, Harvard Computers: women astronomers, Henri Poincaré, horn antenna, if you see hoof prints, think horses—not zebras, Index librorum prohibitorum, invention of the telescope, Isaac Newton, John von Neumann, Karl Jansky, Louis Daguerre, Louis Pasteur, luminiferous ether, Magellanic Cloud, Murray Gell-Mann, music of the spheres, Olbers’ paradox, On the Revolutions of the Heavenly Spheres, Paul Erdős, retrograde motion, Richard Feynman, Richard Feynman, scientific mainstream, Simon Singh, Solar eclipse in 1919, Stephen Hawking, the scientific method, Thomas Kuhn: the structure of scientific revolutions, unbiased observer, V2 rocket, Wilhelm Olbers, William of Occam
Walpole also highlighted this in his original letter when he described serendipity as the result of ‘accidents and sagacity’. Furthermore, those who want to be touched by serendipity must be ready to embrace an opportunity when it presents itself, rather than merely brushing down their seed-covered trousers, pouring their failed superglue down the sink or abandoning a failed medical trial. Alexander Fleming’s discovery of penicillin depended on a speck of penicillium mould floating in through the window, landing in a petri dish and killing off a bacterial culture. It is highly likely that many microbiologists had previously had their bacterial cultures contaminated by penicillium mould, but they had all discarded their petri dishes in frustration instead of seeing the opportunity to discover an antibiotic that would save millions of lives.
Andrew Wiles, Asian financial crisis, Berlin Wall, bonus culture, British Empire, business process, Cass Sunstein, computer age, credit crunch, Daniel Kahneman / Amos Tversky, discounted cash flows, discovery of penicillin, diversification, Donald Trump, Fall of the Berlin Wall, financial innovation, Gordon Gekko, greed is good, invention of the telephone, invisible hand, Jane Jacobs, Long Term Capital Management, Louis Pasteur, market fundamentalism, Nash equilibrium, pattern recognition, purchasing power parity, RAND corporation, regulatory arbitrage, shareholder value, Simon Singh, Steve Jobs, The Death and Life of Great American Cities, The Predators' Ball, The Wealth of Nations by Adam Smith, ultimatum game, urban planning, value at risk
The nineteenth-century French scientist Louis Pasteur made numerous important scientific discoveries, including that of immunization based on artificial tissue cultures. His method of discovery was oblique: Pasteur observed the effect when a botched experiment by his assistant produced unexpected results. That fortunate accident anticipated the similar obliquity of the most important of all pharmacological discoveries, that of penicillin. Pasteur’s pioneering innovation was not even an intermediate goal. The invention of immunization was a means of realizing the high-level objective—the advance of scientific knowledge—that was made possible by an open process of experiment and adaptation. “Fortune,” Pasteur observed, “favors the prepared mind.”10 PART TWO The Need for Obliquity: Why We Often Can’t Solve Problems Directly Chapter 7 MUDDLING THROUGH—Why Oblique Approaches Succeed In 1959, Charles Lindblom described “the science of muddling through.”
The Great Influenza by John M. Barry
Albert Einstein, Brownian motion, centralized clearinghouse, Chance favours the prepared mind, conceptual framework, discovery of penicillin, double helix, Fellow of the Royal Society, germ theory of disease, index card, Louis Pasteur, Marshall McLuhan, Mason jar, means of production, statistical model, the medium is the message, the scientific method, traveling salesman, women in the workforce
CHAPTER TWENTY-THREE LABORATORIES EVERYWHERE had turned to influenza. Pasteur’s protégé Émile Roux, one of those who had raced German competitors for a diphtheria antitoxin, directed the work at the Pasteur Institute. In Britain virtually everyone in Almroth Wright’s laboratory worked on it, including Alexander Fleming, whose later discovery of penicillin he first applied to research on Pfeiffer’s so-called influenza bacillus. In Germany, in Italy, even in revolution-torn Russia, desperate investigators searched for an answer. But by the fall of 1918 these laboratories could function only on a far-reduced scale. Research had been cut back and focused on war, on poison gas or defending against it, on preventing infection of wounds, on ways to prevent diseases that incapacitated troops such as “trench fever,” an infection related to typhus that was not serious in itself but had taken more troops out of the line any other disease.
Ghosts of Empire: Britain's Legacies in the Modern World by Kwasi Kwarteng
Ayatollah Khomeini, banking crisis, British Empire, colonial rule, Corn Laws, corporate governance, Deng Xiaoping, discovery of penicillin, Etonian, illegal immigration, imperial preference, invisible hand, Khartoum Gordon, land reform, Scientific racism, Scramble for Africa, trade route, urban planning, Yom Kippur War
Unusually for their class and for the time, the boys, first under their father and later abroad, had a modern education, learning Mathematics, History, French and German, instead of Latin and Greek.4 A defining moment in the life of the young family came in 1863, when Frances Kitchener’s tuberculosis worsened and the doctors concluded that the damp conditions of south-west Ireland would never allow her to recover. The Colonel, with characteristic decisiveness, sold the estate and moved the family to Switzerland, which the doctors had recommended for its mountain air. This was a common prescription for tubercular and bronchial diseases in an age before the discovery of penicillin. The Kitchener family soon settled in the little spa town of Bex and the boys started attending a French school near Geneva. The move to Bex failed to improve Frances Kitchener’s health, and, in a desperate final attempt to remedy her condition, the family moved once again to Montreux, a town on the north-east shore of Lake Geneva, where a colony of British invalids and retired officers could be found.
The Emperor of All Maladies: A Biography of Cancer by Siddhartha Mukherjee
Barry Marshall: ulcers, conceptual framework, discovery of penicillin, experimental subject, iterative process, life extension, Louis Pasteur, medical residency, meta analysis, meta-analysis, mouse model, New Journalism, phenotype, randomized controlled trial, scientific mainstream, Silicon Valley, social web, statistical model, stem cell, women in the workforce, éminence grise
In 1997, the NCI director, Richard Klausner, responding to reports that cancer mortality had remained disappointingly static through the nineties, argued that the medical realities of one decade had little bearing on the realities of the next. “There are far more good historians than there are good prophets,” Klausner wrote. “It is extraordinarily difficult to predict scientific discovery, which is often propelled by seminal insights coming from unexpected directions. The classic example—Fleming’s discovery of penicillin on moldy bread and the monumental impact of that accidental finding—could not easily have been predicted, nor could the sudden demise of iron-lung technology when evolving techniques in virology allowed the growth of poliovirus and the preparation of vaccine. Any extrapolation of history into the future presupposes an environment of static discovery—an oxymoron.”
QI: The Book of General Ignorance - The Noticeably Stouter Edition by Lloyd, John, Mitchinson, John
Admiral Zheng, Albert Einstein, Barry Marshall: ulcers, British Empire, discovery of penicillin, Dmitri Mendeleev, Fellow of the Royal Society, Ignaz Semmelweis: hand washing, invention of the telephone, James Watt: steam engine, Kuiper Belt, Magellanic Cloud, Mars Rover, Menlo Park, Olbers’ paradox, On the Revolutions of the Heavenly Spheres, placebo effect, Pluto: dwarf planet, trade route, V2 rocket, Vesna Vulović
3D printing, Affordable Care Act / Obamacare, airline deregulation, airport security, Apple II, barriers to entry, big-box store, blue-collar work, Capital in the Twenty-First Century by Thomas Piketty, clean water, collective bargaining, computer age, deindustrialization, Detroit bankruptcy, discovery of penicillin, Donner party, Downton Abbey, Edward Glaeser, en.wikipedia.org, Erik Brynjolfsson, everywhere but in the productivity statistics, feminist movement, financial innovation, full employment, George Akerlof, germ theory of disease, glass ceiling, high net worth, housing crisis, immigration reform, impulse control, income inequality, income per capita, indoor plumbing, industrial robot, inflight wifi, interchangeable parts, invention of agriculture, invention of air conditioning, invention of the telegraph, invention of the telephone, inventory management, James Watt: steam engine, Jeff Bezos, jitney, job automation, John Maynard Keynes: Economic Possibilities for our Grandchildren, labor-force participation, Loma Prieta earthquake, Louis Daguerre, Louis Pasteur, low skilled workers, manufacturing employment, Mark Zuckerberg, market fragmentation, Mason jar, McMansion, Menlo Park, minimum wage unemployment, mortgage debt, mortgage tax deduction, new economy, Norbert Wiener, obamacare, occupational segregation, oil shale / tar sands, oil shock, payday loans, Peter Thiel, pink-collar, Productivity paradox, Ralph Nader, Ralph Waldo Emerson, refrigerator car, rent control, Robert X Cringely, Ronald Coase, school choice, Second Machine Age, secular stagnation, Skype, stem cell, Steve Jobs, Steve Wozniak, Steven Pinker, The Market for Lemons, Thomas Malthus, total factor productivity, transaction costs, transcontinental railway, traveling salesman, Triangle Shirtwaist Factory, Unsafe at Any Speed, Upton Sinclair, upwardly mobile, urban decay, urban planning, urban sprawl, washing machines reduced drudgery, Washington Consensus, Watson beat the top human players on Jeopardy!, We wanted flying cars, instead we got 140 characters, working poor, working-age population, Works Progress Administration, yield management
In that era, pharmacists actually compounded the ingredients of drugs, instead of merely reselling drugs manufactured by large pharmaceutical firms. Trial and error by consumers had more effect on purchase decisions than any influence of government regulation.60 The rate of discovery of effective pharmaceutical drugs increased rapidly after the 1935 discovery of sulfonamide drugs and penicillin during World War II. Because most of the effects of this acceleration were felt after 1940, it is treated in chapter 14. The regulatory environment was radically changed by the successor to the 1906 food and drug legislation, which was passed in 1938 after years of debate. The first important change was the requirement that the FDA approve the introduction of newly developed drugs.
The first antibiotic, penicillin was versatile enough to cure “almost instantly such diseases as pneumonia, rheumatic fever, and syphilis, which had been greatly feared and often fatal.”14 Indeed, cases of syphilis, which occurred at a rate of 372 per 100,000 people in 1938, had fallen to 154.2 by 1950 and to sixty-eight in 1960, a testament to the antibiotic’s ability to kill the infection before it spread.15 Pneumonia, previously called the “Captain of the Men of Death,” was now easily curable, and by 1954 it caused only a quarter as many deaths of children ages 1–4 as in 1939. The effect on rheumatic fever and rheumatic heart disease was even greater, with the death rate falling 90 percent between 1940 and 1960.16 The discovery and subsequent development of penicillin came about largely by accident when, one night in 1928, the Englishman Alexander Fleming discovered a large patch of mold surrounded by a sterile ring on a dirty dish that had been left out for weeks. After finding that the mold had killed the growth of some types of bacteria, Fleming began experimenting to uncover the antibacterial feature of the mold.