By Chet Yarbrough
By: Thomas Hager
Narrated by: Stephen Hoye
Those born after 1945 take anti-bacterial medicine for granted. Before 1932, approximately 100,000 people died from pneumonia in the United States; an estimated 2,000 mothers died from “child birth” fever. There were no effective treatments for syphilis or malaria. Sore throats, commonly referred to as “strep throat”, were notorious killers. The spread of germs from poor hygiene and contaminated surgical procedures killed as many surgery patients as it saved. With the advance of WWI, wound infection became as great a danger to survival as combat.
Thomas Hager tells the story of I.G. Farben Industry and their employment of Gerhard Domagk, a German pathologist that discovered, with the help of Josef Klarer, sulfonamides in the 1930s. Domagk won a Nobel Prize for medicine but was unable to accept the award in 1939 because of Germany’s rejection of the Nobel institution’s support of pacifism; i.e. the institute had awarded an earlier Nobel Peace Prize. I.G. Farben grew to be one of the four largest companies in the world.
As WWII approached, the growth and success of I.G. Farben increases while its reputation becomes besmirched by its research ethics and growing cooperation with Nazi Germany.
Thomas Hager is well suited to write about anti-bacterial medicine; i.e. his master’s degrees in microbiology, immunology, and journalism offer insight and clarity to the scientific investigation, discovery, and consequence of pharmacological science. “The Demon under the Microscope” begins at the turn of the twentieth century and carries through two world wars.
I.G. Farben’s drive for market domination is freighted with greed. I.G. Farben started as a dye maker but began hiring medical researchers to expand into the pharmacological industry. The theory underlying Farben’s widening industrial interest is that dye became a useful tool to more clearly mark microbial organisms. Gram staining became a useful
diagnostic tool in the medical field. As gram staining became more refined, Paul Ehrlich (winner of the 1908 Nobel Prize in medicine) began working with the idea of dye targeted drug delivery to attack biological killers in the human body. Ehrlich’s collaboration with I.G. Farben hugely expanded Farben industry’s pharmacological research effort.
What Hager reveals is that the value of sulfonamides, the first family of drugs to combat bacterial infection, had little to do with dye. I.G. Farben obscured that truth of sulfa as the active ingredient in the war against biological disease because no patent could be acquired for sulfa as a naturally produced chemical.
The French chemist, Ernest Fourneau, working in the Pasteur Institute in France, realizes Farben’s paring of sulfa with dye is unnecessary for drug production. Hager notes that Fourneau’s discovery made Farben’s “questionably ethical” effort to corner the market impossible. Farben’s domination disappeared within two years of Fourneau and his associate’s discovery.
Sulfa drugs saved millions of lives during and after two world wars. Until penicillin is discovered in 1928 by Alexander Fleming, the only anti-bacterial drugs available were sulfa-based.
The craze for sulfa medication led to manufacturing mistakes that, at the least, caused liver and kidney damage, and at the worst, death. Hager writes that growth of the Federal Drug Administration is directly attributed to the story of S. E. Massengill Company’s manufacture of “Elixir Sulfanilamide”. Massengill chemically bonds diethylene glycol, a toxic solvent, with sulfa because it creates a more consistent mixture. More than 100 people in 15 states died from the Elixir. The FDA is shown by Hager to have been instrumental in limiting the number of deaths. Soon after the Massengill’ disaster, patent laws are refined, manufacturer
standards are established, and drug testing is regulated.
Hager tells a terrific story that resonates with today’s complex societal relationship with the drug manufacturing industry. On the one hand, huge investment is needed to discover patentable new drugs; on the other hand, millions of people cannot afford new medicines that are manufactured and controlled by drug companies that seek better return on their investment. The opportunity for a manufacturer to hide behind patent law to unreasonably dominate a critically important drug is as possible today as it was in the early 1900s. One wonders how much rising medical costs are a function of greed.