Dawson's opponents, not Dawson, had special concern about SBE patients in September 1940

Pity the poor historian ( like me !) trying to recover the substance of the visual glances,the brief shoulder shrugs,  the sotto voce verbal hints and half finished sentences, all very typical of conversation within small cliques in a small staff room, when the group is divided up into various opposing factions of colleagues, who must still at least pretend to get along at work.

I believe that in September 1940, upon his return to medical school and hospital, Dr Martin Henry Dawson half overheard some conversations between members of a group of his colleagues who not well disposed to social medicine, even in peacetime.

The Fall of France had happened and many Americans believed the Fall of Britain was soon to follow.

The American medical elite, made up mostly of  conservatives not in favour of medical intervention towards the weak at home or abroad, were now all claiming to be preparing for a possible war.

Maybe they were - in part.

But for many of them, talk of war preparation allowed them to reduce the alarming amount of social medicine (treating the poor dying like the rich dying) being practised.

They insisted they were only seeking to reduce medical intervention among the domestic weak and small because all existing resources (and more) were needed for possible future medical intervention in support of Europe's weak and small nations.

Reducing domestic comfort and aid because of possible foreign intervention ---- which they were still strongly opposed to !

I call that classic 'Bad Faith' and template Orwellian Double Talk.

I think it was these colleagues who mentioned the SBE patients as the classic sort of 'bed waster' that a war medicine hospital could no longer afford.

We know there was already some existing consensus on ignoring the SBEs under war conditions because there was almost no resistance from doctors in America in the Fall of 1942, when the disease was declared by the NAS 'death panels' to be of no military value and so denied penicillin - the only medicine that could save its patients' lives.

This censenus was also found among doctors in Canada, the Uk and Australia as the NAS ban on the use of wartime penicillin for dying SBE patients was extended by the medical establishment in those countries again without almost any controversy.

But Dawson himself had never before spoken or written or researched on SBE and its patients.

His sudden concern in September 1940 to make the 4F SBEs the focus of his wartime natural penicillin crusade, I believe, came from him half overhearing his conservative colleagues dismissing them as worthy of equal treatment to the war wounded 1As.

Dawson's empathy for the unjustly neglected simply kicked in ....

Why the only real civil war has always been over healthcare : because the right to life is the ultimate civil right, above the right to vote or a right to apply for a job

Give Blacks and Jews the right to vote and the right to apply for jobs and education, if you must, but don't - for Jefferson Davis's sake ! - give them to right to be treated fairly when they turn up in a hospital ER.

Because DOAs can't vote or take jobs or occupy your stupid son's rightful seat at Yale.

Accept what I claim and you begin to see the real bite in the unholy but quiet battle between medical proponents of Social Medicine and War Medicine (Thomas Parran versus Lewis Weed), circa October 16th 1940.

On that day, Professor Martin Henry Dawson gave history' first ever injections of microbe-made penicillin to two 4Fs, a Jew and a Black, opening our Age of Antibiotics, on a day otherwise devoted to registering America's 1As in the first ever peacetime draft.

His impetus ?

Returning that Fall from vacation to learn that his medical school and hospital was downgrading any focus on social medicine, his area of interest, to up its preparation for war-oriented medicine.

His response ?

Parry, and then thrust, deep, with  .1 ml of Pen "G" in butyl alcohol.....

battling penicillins : ancient & modern / battling medicines : social & warlike

Whom would make wartime penicillin ?

Henry Dawson's tiny ancient "natural" fungi factories with a few hundred million of years of experience under their belt ?

Or Howard Florey's big clumsy lumbering "synthetic" chemists' factories, built along lines more familiar to Heath Robinson or Rube Goldberg fans than to fans of the ever graceful Nijinski ?

To whom would wartime penicillin go to ?

Just to lightly injured front line Allied troops, but only after D-Day, with penicillin used for a secret weapon of war, as Florey and the American OSRD planned ?

Or to everyone in a war-shattered world who was dying for lack of it, as Dawson wanted ? Penicillin to be used both as a medical lifesaver and as tardy but tangible proof of the long claimed moral difference between Allies and Axis ?

Social Penicillin : the story of 'Penicillin-For-All'

Was October 16th 1940 the date of the world's first ever injections of social penicillin ?

Well, first, let us consider this question :

Can a hospital system actually make citizens feel sick or feel well, even if they never ever visit in their entire lives ?

On the surface, that seems a very ridiculous question - what earthly good are hospitals if they don't actively try to make sick people better?

But I argue to the contrary.

That, perhaps, over all people and over all their lifetimes, a hospital's greatest value or damage is the sort of moral values it radiates forth, on behalf of the society around it.

If it has a great reputation for serving all equally, regardless of their income, ethnicity, gender or age, if it says 'everyone is valued' - it raises everyone's self esteem.

And it is medical fact that high self esteem, all by itself, is a powerful, cheap and non-toxic preventive and curative medicine.

Or perhaps the hospital is best known for first testing your financial worth before it even tests your blood pressure and is also well known for ill-treating patients, even if they have sufficient income, if they are of the wrong ethnicity, gender or age group.

That sentiment is damaging to the self esteem of the people in those unfortunate groups.

Again, it is a medical fact that the stress of lifelong low self esteem acts to lower our immune response --- indirectly making us, if not actually 'sick', a whole lot 'sicker' whenever we do fall ill.

I believe that History's first ever injections of penicillin, ushering in the Age of Antibiotics, offered no drug-induced clinical value whatsoever to the patients receiving them and that the doctor giving those injections (Henry Dawson) well knew that.

These injections then were not of penicillin-the-chemical-drug but rather shots of 'social penicillin', a phrase I have coined in homage to 'social medicine' .

The very real clinical value these injections represented was in the uplift in spirits it gave to these two young patients and to all others suffering from their disease.

For SBE (heart valve endocarditis caused by Rheumatic Fever) - was a disease their families were always being told was invariably fatal.

And totally resistant to all known treatments, in fact the very Mount Everest or Gold Standard of resistant infectious disease.

Abandon hope, all ye that enter here.

But Dr Dawson believed that three combined characteristics of penicillin ( with only the last being totally unique) would beat the unique set of difficulties presented by this dreaded disease and finally conquer infection's Mount Everest.

That is he knew that (a) penicillin killed strep bacteria readily(b) was small & highly diffusible and (c) was totally non-toxic, even if given in enormous amounts.

Only a recently acquired medical community revulsion against injected crude fungus slime into the human bloodstream had denied this lifesaver to tens of millions of dying patients over the previous twelve years.

Dawson resolved to break that medical taboo, a taboo perhaps even held by the other members in the tiny four person team working with penicillin at his hospital.

Dawson, as a busy ward clinician, was actually the junior member of the team, at least in the beginning.

Karl Meyer, gifted biochemist, together with his chemist assistant Evelyn Chaffee, would destructively analyze the fungus penicillin grown mostly by microbiologist Gladys Hobby and then chemically synthesize artificial penicillin.

Hobby would confirm that both the natural and artificial penicillin indeed had biological activity - testing it on killing microbes.

In the beginning, Dawson would mostly run interference with the hospital authorities, above all in securing rare permission to deliberately grow gallons of fungus, with all their highly mobile spores, in a normally highly antiseptic hospital setting.

Only a planned four months after the beginnings of the project would Dawson take centre stage, when he injected synthetic penicillin into actual patients assigned to 'his' ward.

Now Dawson knew that chemically either natural or synthetic penicillin were equally good at defeating SBE.

But defeating SBE required more than just an effective bug-killing medication ---- SBE uniquely needed simply enormous amounts of medicine, particularly to kill such relatively small amounts of a very fragile bacteria.

SBE bacteria live on the heart's Rheumatic Fever damaged valves, sheltered behind a tough but semi-porous barrier of biofilm (then known as vegetation).

Normally medications diffuse gently and slowly into and around the individual cells of an organ via the incredibly tiny blood capillaries.

And like a lobster trap, once in around the cells it is not that easy for the medication to leave, and the molecules of the drug have a long time to work their magic.

But like ear lobes, the valves of the heart have virtually no capillaries. Yes, they are literally bathed in blood all the time, but the blood surges by them at an incredibly fast pace, as measured in terms of the motion of molecules.

The chances of a molecule successfully diffusing (aka moving via random thermal motion) its way over to the biofilm and finding its way in by the rare small opening in the biofilm, in the millisecond it pulses over the valve surfaces, is near zero.

About as likely as U235 separating from U238 simply by their varying rate of diffusion through tiny holes.

And we all know the trillions it has cost the world to make that diffusion technology work !

But in both cases, brute force technology will indeed slowly win through.

For penicillin, that meant about a thousand steady hours of the constant pulsings of trillions of tiny penicillin molecules a second bouncing their way past the biofilm surface.

The laws of probability would eventually ensure enough made their way into the biofilm's rare tiny holes to kill the bacteria within and end the infection.

In plain english, while a single unit of penicillin might cure an infant from lifelong blindness caused by a meningitis eye infection, easily over a billion units of penicillin today might be needed to cure a particularly stubborn case of SBE.

That a seriously ill patient can receive that much of any medication without any ill effects is why doctors still call penicillin magic.

In October 1940, Dawson could only guess at the ultimate amount of the SBE medication needed for a permanent cure.

But he did know the small amount of penicillin the team had grown in the five weeks since they started the project and its relative strength, by weight, against number of bacteria per a unit of mouse body weight.

He could even compare his figures against similar calculations performed by Howard Florey's team in Oxford a few months earlier.

And as a very experienced bacteriologist and clinician, Dawson was particularly good at converting lab mouse cures rates per weight of medicine into their effective impact on adult sick humans weighing two thousand times as much.

But that was actually for infections by highly virulent bacteria, but in readily accessible organs.

SBE involved very weak bacteria but in very inaccessible locations - perhaps the two conditions could thus be crudely equated.

Still no matter how he sliced it, the penicillin at hand was far far too small an amount and far too weak in strength to really combat SBE.

But on this day, it wasn't really the SBE bugs that Dawson was seeking to combat - but rather it was the moral values of the society around him.

He didn't like the values his hospital and his society was radiating to a world at war - and he sought to change it.....

History's first ever antibiotics injections were expected to be of pure synthetic penicillin

Back at the start of the 1940s, two highly skilled biochemists (Karl Meyer and Ernst Chain) both confidently expected to quickly synthesize artificial penicillin, as they knew natural penicillin was a relatively small biological molecule of only about 350 Daltons.

After 100 weeks of hearing this reoccurring promise of quick results from Chain, his imperious boss, Howard Florey, reluctantly decided to inject his first human patients in February 12th 1941 with still-impure natural penicillin.

Henry Dawson, normally the most diffident of men, changed his mind about waiting till  co-worker Meyer's synthetic penicillin arrived in January 1941, and after only five weeks into their joint penicillin efforts and without so much as a backward glance, injected his first patients with impure natural penicillin on October 16th 1940.

Why did Dawson uncharacteristically proceed to Plan B so very much quicker than Florey?

Partially it was because Dawson was so angry on his return to his medicine school from his vacation in September 1940 to discover that all American medicine was using the excuse of preparing for war medicine to drop their feeble efforts at social medicine aimed at improving the health care of the poor and the weak.

But it also seems from Dawson's own words that it was a civil rights activist and dying SBE patient, Aaron Leroy Alston from Harlem, whose angry eloquence on this neglect of the poor and minorities that so moved Dawson.

Moved him to defiantly thumb his nose at an uncharitable world by deliberately treating two 4F SBE patients with this historical first ever injected antibiotics, on the very day when all of the rest of America was focused only upon its 1A population ...

The Double V victory : the Last shall be First

On October 16th 1940, it is said, Dr Martin Henry Dawson gave history's first ever antibiotic injections to a black man, Aaron Leroy Alston and to a Jew, Charles Aronson.

"And" : not "and then to".

But how ? How on earth do you give two injections at the same time ?

I struggled recently with the actual mechanics while thinking how to present this event as a single painted image.

Eventually I realized that a painting of this athletically double-jointed historic event might also symbolize the ambiguous "Double V victory" of Manhattan's two biggest war projects : the autarkical A-Bomb and Dawson's openly commensal natural penicillin.

My proposed image for the first volume of my book Janus Manhattan's Children ?

It shows the soon-to-be-injected arm of Alston (to the left) and Aronson (to the right) joined at their hands, making one natural "V".

Above them, the limitations of human anatomy ensures that the arms of Dr Dawson (preparing to inject the penicillin into each patient's arm at the same time) would also form another natural "V" above and inside the patients' "V".

As anyone struggling to emulate Dawson's twin effort soon realizes, it is probably easiest and most natural to let their left hand inject rightward and their right hand inject leftward --- the twin hypo needles crisscrossing at the hands.

The criss crossing also helps emphasize Dawson secondary goal.

On that October 16th, he particularly wanted to exalt the 4Fs of the 4Fs, the smallest, sickest and weakest ("The Last") among 1940 America's minorities.

Because on this day, set aside in law for the first ever peacetime draft registration, the rest of America was otherwise exalting the biggest and the strongest (the 1As) among its population.

True, the 1As might do all the actual military fighting overseas to end Nazi mistreatment of minorities.

But Dawson and others realized that all the 1As' deaths and the eventual victory would be useless, if at home the values of the Nazis continued in America's treatment of its own minorities.

To really put paid to Hitler, we needed to defeat his thinking, abroad and at home.

But instead, American medical conservatives
were moving to emulate Hitler even more !

They had long been hostile to 1930s liberals and their efforts to try and save all of the dying even if they couldn't pay for their treatment (Social Medicine).

Hitler's Aktion T4 program had begun in September 1939, deliberately using the cover of war efforts to begin the killing off all of Germany's handicapped.

So too, these American conservatives were actually using the medical preparations for a possible war with Hitler (War Medicine) as an excuse to cut off medical efforts towards the poorest minorities !

So with 'enemies' like the AMA's Morris Fishbein leading the charge, Hitler hardly needed friends.

Instead, on this day, he got a moral enemy in Dr Dawson ...

Henry Dawson's Social Medicine vs The Holocaust

Sometimes anonymous online commentators glibly refer to Canada's Medicare (a system of taxpayer-supported medical care for all) as a holocaust.

It has plenty of problems but it is not a holocaust - in particular it is not The Holocaust.

That because Social Medicine , to use that term in its 1930s popular political sense rather than in today's restricted academic sense , was in fact the very antithesis of all the medical holocausts that WWII threw up.


The Holocaust , the Hunger Plan , Aktion T4 and certain German and Japanese medical experiments are merely the most infamous of those moral disasters.

Canadian Medicare is a good 21st century example of 1930s Social Medicine.

In theory (and hopefully in practise too) it says that a guilty war criminal with a life threatening infection is triaged to greater and earlier medical care than his innocent victim who has a broken finger - though both will be treated as promptly as we can , to the best extent we can.

Regardless whether or not that they can pay , regardless of whether they are criminal , regardless of whether they brought the illness upon themselves, regardless of their future economic contribution (or burden) to society.

It says all life has an intrinsic absolute right to life and the best health humanly possible and -crucially - it says this right is not contingent but is permanent.

All other medicines can also value any individual life as highly as Social Medicine does but when circumstances change against their own criteria, they are then inclined to view that same life as a 'life unworthy of life-saving medical care'.

Medicine for Profit has no inherent bias against any sexual orientation, race, gender, social class etc : their skin color may vary but the color of their money remains the same.

But if an injury causes someone to lose work and to be no longer able to afford medical care that could get them back to work , Medicine for Profit no longer want to treat them.

At a turn of a dime, an individual goes from "most favoured nation 1A" to "4F outlaw state".

Even in wartime, Medicine for Profit will continue to give the best possible care to people who can't or won't contribute anything to the war effort, - regardless of their race or gender - as long as they can pay handsomely.

But uniquely during wartime , War Medicine emerges and it is equally unbiased as Medicine for Profit seemingly is.

It is willing to give the best possible medical care - free or cheaply - as long as the person will be, after treatment , able to return to combat or can continue to provide a scarce skill vital to the war effort.

But if in wartime, one is both too poor and too permanently disabled to continue to do vital war work, one falls between two harsh cracks and becomes the 4Fs of the 4Fs, now becomes a life judged 'life unworthy of life-saving medicine'.

Dr (Martin) Henry Dawson successfully cured many such 4Fs of the 4Fs, public ward SBE patients regarded as having an invariably fatal disease , despite the wish of the Anglo American medical establishment that they be quietly Slow Coded to death.

They were to be denied the only medicine that could save them - penicillin - and instead deliberately given medical treatments that had always proven useless to stop their disease.

They were passively put to death because they judged - morally - as having no permanent inherent instrinsic value - only one contingent on their continuing to have lots of money or lots of health and scarce skills.

Others were actively put to death during wartime in America to aid the war effort.

Poor , confined, powerless people , 4Fs of the 4Fs, who were manipulated into contracting a potentially fatal disease that the scientists experimenting on them sometimes then proved unable to cure, despite their best medical efforts.

Prisoners, GIs, orphans, people in mental institutions or poorhouses, blacks, aboriginals, the rural poor and uneducated in foreign lands.

All varieties of the powerless, with families unlike to bite back effectively even when they awoke to what was happening to their relatives.

These poor subjects - not patients , because they did not start out with the disease that the experimenters were examining - were reduced to mere tools - on the moral level of the 100 million animals we kill annually for medical science or the countless disposable hand wipes we throw into the landfill.

All this Anglo American wartime abuse of inherently worthy life is a long way from today's Canadian Medicare.

But what it is morally very close to is the sort of values the Allies claimed they were willing to die to defeat - the medical values of Hitler and Tojo ....

Utilitarianism's "War Medicine" and its "Collectivist Fallacy"

Just a beginning note on a big big subject:

WWII's proponents of 'War Medicine', citing their utilitarian philosophy of 'the greatest good for the greatest number' forced some humans to undergo horrific and even fatal medical experiments and also refused to give some other humans the medicine needed to keep them alive.

Their moral claim for doing all this horrific stuff was that these relatively few people would only endure short term (fatal) pain while the vast body of humanity would benefit from this painfully necessary research , now and into the future.

Unstated in all this was their rhetorical claim that their overall medical vision was a collectivist one, where some would willingly give their lives for the medical good, like fit young soldiers, so that their grandfathers, mothers and little baby brothers would go on living.

But in fact the people behind War Medicine oppose peacetime's collectivist Social Medicine with all their individualist, libertarian, heart and breath.

Social Medicine's vision  was truly collectivist - it said wealthy people should be taxed so that no human, no matter how poor, would be denied lifesaving medical care.

But War Medicine proponents - to a man - felt that individually one should only get the medicine one could pay for - case of every individual for themselves.

But against this was their 'collectivist' vision for War Medicine that included injecting metallic plutonium into sick people - without telling them why - so we could learn the effects of internal radiation and heavy metal poisoning from metallic plutonium and how to reduce its dire effects.

But - a tremendously BIG but - these sick civilians did not and would not ever benefit from suffering this horrific treatment.

They would never even come into contact with metallic plutonium in their daily lives - not even during an atomic attack.

The only people who would benefit from this horrific research were the fit young doctors and scientists who ordered up these horrible experiments.

They were all fit and young enough to be real gun-toting soldiers , but who were living safe at home during a war andfearful lest they ingested any of the plutonium they were experimenting with as part of the Manhattan Project.

In this revised scenario we see grandfather and baby brother dying horrible deaths ---- all to keep young healthy soldier boy away from harm.

That has to be the sick sick sickest version of how war sacrifice normally plays out - in the long history of the abusive use of American medicine , this shameful episode has to be the moral low point ....

when chickenhawks fantasize about war ...

War medicine was from Mars, Social medicine from Venus ?

The very word "war" medicine seems to stir something vaguely Mars-like, deep within the soul of the chickenhawk doctor or scientist.

Successfully conceiving ,in an academic lab at the University of  Chicago, a way to reduce combat deaths from shock seems to transport one almost up to the frontline evacuation hospitals, directly under hostile fire.

Being there, doing it, roughing it , all sweaty and virile-like : medical science with the smell of the locker room and the men's shower stall about it.

By contrast, what can any doctor - any real doctor - actually do about those dying of subacute bacterial endocarditis (SBE) ?

These hopeless cases shouldn't even be occupying an acute hospital bed - particularly in wartime.

They should be handled by women - nurses - in a secondary hospice or in a palliative care situation at home.



And arthritis 'care' - not really medicine is it ? Helping impoverished old ladies too frail to bend over properly to get dressed and to do their toiletry.

Again - women's work. A job for personal care assistants and social work case workers. Social medicine.

But (Martin) Henry Dawson persevered , hung on in there , all through the war, treating those chronically ill with arthritis and the very 4Fs of the 4Fs, those dying of SBE .

Perhaps because he was that rarity : an American medical researcher in 1940 who already had a stirling war record in the front lines (in the medical corp, infantry and artillery), with a medal for valour and two serious war wounds to back him up.

The Military Cross winner from Venus, as it were ......

WWII was all about who we include , who we exclude ...

When we say that Henry Dawson's vision of wartime penicillin was 'inclusive', while that of Howard Florey was 'exclusive' , we are really getting at the key issue that divided all the world during, before and after WWII.

 " Just who do we include in ;  just who do we exclude out of our civil society's blessings ?"

Florey never called his vision for wartime penicillin 'exclusive' , but he did much use another term that means the same thing and in any case , his definite actions spoke much louder than his unspoken assumptions.

The word he always used to describe his goals for penicillin was 'pure' , chemically pure.

A dose of penicillin that excludes everything else in the original penicillin juice, whether that be helpful, neutral or harmful.

A 100 gram Vitamin C rich orange not merely concentrated into Vitamin C rich orange juice but further purified until it is a mere 100 mg of 100% chemically pure Vitamin C powder ... with all that impure orange taste and texture safely removed.

If Calvinists ever become our leading chefs, this is what our food will look like : pure carbohydrate, protein, fat, vitamins and minerals in enormous pill form and worked down with many cups of sterile water.

Hitler wanted to exclude Jews, Romas, Queers, the chronically ill and the handicapped , socialists, Blacks - you name it - to make Germany one big pure homogeneous Aryan nation and race.

Left-leaning Social Medicine, of which Dawson was a proponent , wanted to see that Medicine helped all those sick : it was inclusive.

 And not just by helping those American blacks, aboriginals and immigrants usually neglected under 'for-profit' medicine either.

Its proponents also wanted to intervene (medically and otherwise), overseas ,to help those under attack by Hitler, Stalin and Tojo.

By contrast, the conservatives behind the idea of "War Medicine"  wanted to use the defence of America as an excuse to roll back the New Deal emphasis on Social Medicine by claiming that in a Total War lead-up, all precious resources had to shift away from the (generally poorer) 4Fs to the (generally better off) 1A citizens.

Just because they talked war did not mean they were pro intervention overseas, just the opposite.

Their vision not just excluded helping sick 4F Americans at home, it also excluded helping sick 4Fs overseas as well.

Florey and Fleming both wanted penicillin to be chemically 100% pure and synthetic before it was produced in big volumes.

They were also both in intimate lockstep with the War Medicine proponents at Britain's Ministry of Supply and America's OSRD who wanted to restrict civilian access to (and knowledge of) the miracle cure , all the better to make penicillin a weapon of war.

If it could be kept exclusively as a secret weapon of war, the Allies could return wounded troops to combat quicker than the Germans or Japanese could.

By contrast, Dawson felt that doctors should help the sick and wounded soldiers of both sides (including Allied POWS !) and help the civilians of all sides : Neutral , Axis and Allied.

And  he wanted penicillin - whether synthetically pure or naturally impure* he didn't care - produced in mass levels now , not after the war was over.

(* His team never let the impurity of their self-proclaimed "crude penicillin" stop them from being the first in history to give it systemically, via needle, to save a life.

 They later even published a journal article speculating crude penicillin had additional beneficial substances that made it a better medication than just pure penicillin itself...)

Dawson definitely did not want to see the medicine produced in tiny levels so as to render acceptable the rationing of it, to justify   giving it only to those civilians who were useful because of their involvement in the war effort.

He felt even a person incapable of almost any work still deserved penicillin, a warm meal, a warm bed and a warm smile.

Dawson felt this sort of American medical establishment thinking was far too close to that of Hitler's Aktion T4 projects - where people judged non-useful were starved, denied warm shelter and medicine or killed outright.

He believed if the Allies were seen saving the lives of people most of the educated world saw as 'useless' - even during an all-out Total War - this would help defeat Hitler morally in the many many Neutral countries and also strengthen the resolve of those Allied frontline troops facing death to defeat him militarily.

If the OSRD and Florey used penicillin as a weapon, we need ask did Dawson use it as a weapon, as well ?

Yes he certainly did.

As a weapon in a moral battle.

Dawson's touting of the inclusive use of wartime medicine definitely did have a moral cum political/diplomatic impact, in addition to the extra patients it medically admitted to be saved.......

War medicine was from Mars, Social medicine from Venus ?

The very word "war" medicine seems to stir something vaguely Mars-like, deep within the soul of the chickenhawk doctor or scientist.

Successfully conceiving ,in an academic lab at the University of  Chicago, a way to reduce combat deaths from shock seems to transport one almost up to the frontline evacuation hospitals, directly under hostile fire.

Being there, doing it, roughing it , all sweaty and virile-like : medical science with the smell of the locker room and the men's shower stall about it.

By contrast, what can any doctor - any real doctor - actually do about those dying of subacute bacterial endocarditis (SBE) ?

These hopeless cases shouldn't even be occupying an acute hospital bed - particularly in wartime.

They should be handled by women - nurses - in a secondary hospice or in a palliative care situation at home.

And arthritis 'care' - not really medicine is it ? Helping impoverished old ladies too frail to bend over properly to get dressed and to do their toiletry.

Again - women's work. A job for personal care assistants and social work case workers. Social medicine.

But (Martin) Henry Dawson persevered , hung on in there , all through the war, treating those chronically ill with arthritis and the very 4Fs of the 4Fs, those dying of SBE .

Perhaps because he was that rarity : an American medical researcher in 1940 who already had a stirling war record in the front lines (in the medical corp, infantry and artillery), with a medal for valour and two serious war wounds to back him up.

The Military Cross winner from Venus, as it were ......

Wartime Manhattan : from Mars ... or from Venus ?

If I might be permitted to gently chide the citizens of Manhattan, may I suggest that they had done very little, themselves, to balance the horrific wartime image of their city created by being tagged as the place that 'birthed' the atomic bomb and its potential destruction of the entire world.

To the 911 bombers, it is the best known image of the borough.

(And by the way, it is only men, like the bosses of the best known wartime Manhattan Project , who talk about 'birthing the bomb' and think of naming it 'Little Boy'.)

Woman know better.

They actually do birth children and know that a bomb isn't a baby.

But little Patty Malone was a baby - and it was only the fearless challenging spirit of the native born Manhattanite that saved her life ... when a heartless government refused to help.

So, People of Manhattan, take a bow.

True, it was only men that did all the heavy lifting in saving this particular child, but I am convinced that her story moved millions of Doctor Moms to demand that their men get off the sofa and start making penicillin for real, right away.

In particular, her story moved one Doctor Mom with the real power to move mountains of inertia : Mae Smith.

She was the wife of the boss of Brooklyn-based Pfizer,  John L Smith.

In the summer of 1943, his firm was best positioned (culturally) in the world to make the needed penicillin ---- all by its self.

But he was a very cautious and frugal man and he refused to do the right thing, rather than the financially safe and lucrative thing.

Until his wife reminded him, once again, that Dr Henry Dawson had always insisted that their eldest daughter would have remained alive, if only penicillin had been earnestly produced, not long after its discovery.

Learning of little Patty Malone plucked from death's door touched Smith's heart ; finally made Dawson's claim seem real to John L.

In a few short months, Pfizer was indeed producing enough penicillin for all those in the world dying of susceptible infections.

Abundant amounts of Pfizer Penicillin created an opportunity for America to practise influential penicillin diplomacy , replacing Pax Britannia with Pax Americana.

Britain and its Dominions had the most moral capital, from standing all alone against Hitler for years, and it had the moral first claim on penicillin.

But for want of a price of a single additional bomber squadron for Butcher Harris, the Conservative Party-dominated British government threw all that moral capital away, handed it over to the Americans on a platter, gratis.

That price, of just one bomber squadron among many, would have given Glaxo a Pfizer's sized plant, months before Pfizer.

By contrast, WWII is usually seen as the process that finally killed the hopes of the New Deal.

But I argue, that the New Deal's final act was actually its finest hour.

Britain's Ministry of Supply set the amount of penicillin it wanted produced during the war years to just be enough ( barely) for front line troops.

It forbade the bigger colonies like India to make their own penicillin (postwar export market considerations dominated official thinking.)

The supply amounts set by the gutless Dominions perfectly reflected Britain's niggardly attitude to the needs of their own civilians and the civilians of the occupied lands.

By contrast, in May 1943, one of the last big New Deal organizations created, the American WPB (War Production Board) , set the amounts of American penicillin it wanted produced so high that it could easily supply America ( military and civilian) and most of the world besides.

Thirties style "Social medicine" concerns had finally won out over the Forties "War medicine" niggardliness.

Henry Dawson's long, lonely defence of heightened social medicine in a time of war against an enemy who didn't believe in it even in peacetime had finally borne fruit : now America was preparing to combat the Nazis morally , as well as just militarily.

Venus Manhattan was in the driver's seat, along with Mars Manhattan ....

Re-setting the Allies' moral compass : the acid test of penicillin for wartime endocarditis

Please correct me : but in all my research I could find no indication that in his 15 years of medical research before October 16th 1940, (and he was a world-class expert in the area of strep bacteria) Henry Dawson had never written or spoken one peep - not one peep - on the subject of endocarditis, a very common and deadly disease, usually caused then by a variant of strep bacteria.

Dawson was a scientist who spoke and wrote a lot , so his silence , until October 16th 1940, was surely hardly from lack of opportunity.

Nor was it bureaucratically and professionally easy, in October 1940 anymore than it would be today, to go from being the director of an outpatients' clinic on chronic arthritis to suddenly becoming the lead doctor on a totally new treatment of such an acute cardiac illness as subacute bacterial endocarditis (SBE).

At least not in a big teaching hospital, with all boundary-conscious specialists rigidly defined in each area.

So we are still left with the puzzle explaining why Dawson literally gave his life to suddenly treat and cure this hitherto incurable disease, endocarditis.

It helps to recall that as a paid up member on the side of Social medicine at a time when War medicine was in the ascendancy in the corridors of Columbia Presbyterian Medical Centre that Fall, Dawson's ears must have zeroed in on the disease quickly voted "the absolutely lowest priority disease in all War medicine" : and that SBE.

The overall consensus that that the SBEs consumed endless amounts of medical care, generally only to quickly die anyway.

Or if they did by some weird chance recover - this time - they couldn't much useful war work with their weakened heart and anyway would surely succumb to a second bout of SBE.

Dawson might even have agreed with this assessment , albeit reluctantly, before October 1940 : nothing, not even the much vaunted brand new sulfa drugs, did anything to extend the SBEs' chances.

But to Dawson, if not to any one else in the world,  the written claims about this new , as yet untested, drug penicillin seemed to offer a way out.

It promised activity against SBE's green strep bacteria, good diffusibility and above all , near absolute non-toxicity.

The latter was critical because ("Blood, blood everywhere and not a drop to drink") ironically the heart's values have almost no internal blood supply and must be 'dabbed' by a drug filling the entire blood supply, as it whistles past the heart valves at break neck speed.

An internal "antiseptic" as it were.

Any drug strong enough to instantly push its way through the thick vegetation on the heart valves and quickly kill the strep within , as it rushed on by at 'breaking the speed limit speeds' was also strong enough to be toxic to the entire human body.

SBE was a "disease designed by a committee" : a committee of Devils creating a disease so devilish as to even frustrate God Himself.

SBE seemed an impossible cure -- surely a quick death following upon benign neglect was the most merciful choice ?

But none of the SBE experts seemed to feel as he felt ; none was willing to do the sort of heroic medicine required to at least give crude penicillin and SBE  the old school try.

Did Dawson begin to feel that this indifference to the possibility of curing SBE, "the polio of the poor", was just an excuse?

Did he not buy the claim that the difficulties of preparing penicillin together with all the preparations for war medicine and  for prioritizing medicine for the 1A fit  was the real reason for inactivity on SBE ?

Or was it really just an excuse to roll back New Deal efforts to do something medically for the poorest and weakest (the 4Fs) among us ?

Were there not strong rumours about that the Nazis were also abandoning the poorest and the weakest among the German patients, also using the necessities of war to justify their actions ?

Whatever ethical speculation led him to his decision, it is a fact that on October 16th 1940, Henry Dawson made the wartime treatment of the weakest of the weak, the 4Fs of the 4Fs, the ultimate acid test for the moral compass of the Allied cause.

It took him years - and cost him his life - but he got that moral compass set right, right in the middle of a bloody war.

Finally, treating the SBEs, the least of these, as we would want ourselves to be treated, became the practise of the Allies, not just another plank in their hollow public rhetoric....

Like Germany, Howard Florey effortlessly won all the tactical battles, losing only the strategic war to Henry Dawson

Eugenics was on the side of the Big Battalions...

Howard Florey was a WWII chicken-hawk, so it little surprises that his chosen hobby-horse, Allied war medicine, was vigorously and publicly 'On the Side of the Big Battalions'.

That meant making a virtue of denying aid to dying 4Fs, to give it instead to healthy 1As.

 But as Hitler had earlier found out to his cost, this was not a position designed to win over the small battalions of the world's hearts and minds.

Dawson's Folly

Dr Dawson's 'folly' - by contrast - was to give up his own life, during a Total War against the Ultimate Evil, trying to save the lives of the 4Fs of the 4Fs, those 'useless mouths' young people with SBE.

His folly was near-universally damned by those in America's scientific and medical elite who knew of it.

Only those who the British call "the punters" : ie, the housewives, the customers and the voters all over the world, approved his idea.

They chose not to judge the Allied Cause by when it ventured into Nazi like behavior (denying aid to the weakest) but only in its better moments, as when it changed its mind and came to the aid of the SBEs' small battalions, aiding the least of these.

A small gesture perhaps, but in the end, more than enough ....

The Allied battle for the world's 'hearts and minds' : NS-born Henry Dawson's patient-penicillin vs OSRD war-penicillin

Army is - wrongly - blamed for her SBE death

The idea that successful American governments need first to win over the 'hearts and minds' of people, before they rush to impose their objectives by legal and military fiat is an old, old , old one.

Presidents John Adams used the phrase "hearts and mind" in this sense early in the 19th century, long before Presidents FDR, Kennedy and Johnson made it famous in the 20th century - and before recent presidents George W Bush and Obama dragged it out of the archives to use in this century.

(And to share the blame around, their wartime Ally Britain also used the phrase during its 1950s war in Malaysia.)

When American finally joined The Coalition of the Willing  (December 1941), many of the world's nations still remained strictly neutral in the battle against Nazi evil , or were, at best,  nominal friends but in reality merely laying back on the oars.

The world's largest, richest, most militarily-advanced economies in the world (America and the British Commonwealth) had a real job on their hands trying to convince the neutrals (all much smaller and weaker than these two superpowers) that their interests would not be subsumed before the interests of these global colossus.

Unhelpfully, America and Britain's scientific and medical elite - centred in the American National Academy of Science (NAS) and the British Medical Research Council (MRC)  made the job much harder.

Reactionaries of all stripes (from Germany to America) had been determined to roll back the1930s move to Social Medicine (the claim that more poor people got sick than rich people because they were too poor to pay for adequate housing, food or routine medical care).

However, the dire effects of the Great Depression had put wind behind Social Medicine's sails and confounded the reactionaries.

Now - Thank God ! - war, or even just the possibility of war, gave the reactionaries new hope.

 Hitler killed off his first "useless feeder" the same week that he declared war on the Poles and soon his Aktion T4 program was killing Germany's weakest and smallest members by the tens of thousands.

In America, people like Dr Lewis Weed (a mid-level medical researcher) dropped his unsuccessful research to become a war-medicine advocate at the NAS and its action-oriented NRC (National Research Council).

War medicine wins opening rounds against social medicine

He locked horns with Dr Thomas Parran, the American Surgeon General from 1936 to 1948, who was a strong (and powerfully-positioned) advocate of social medicine.

A war medicine proponent advocates that any nation at war - even the richest, least attacked nation at war - needs to divert resources normally assigned to civilian medicine towards making bullets instead.

 In addition, much more money would have to be spent providing for the high medical requirements of an activity (war) whose stated aim is maiming and killing people on muddy fields miles away from the nearest hospital.

Limited research dollars would have to focus on war-related  medical needs ( such as finding new ways to keep factory workers and bomber pilots alert for long hours) and put before finding  new ways to keep elderly retirees alive) .

War medicine is, in a very real sense, 'eugenics in uniform' : the best citizens (those that are tested and rated physically and mentally to be A1) end up in the military and get top notch medical care at no cost.

Those citizens who fail these tests and end up as 4F, are second rate eugenically and get second rate medical care during the war.

Proudly promote this concept to the outside world - and America's still relatively free press during WWII did just that - and it comes across quite differently in those neutral nations still sitting on the fence with regards to whole-heartedly backing the Allied cause.

As individuals, the elites in these neutral nations could see themselves as A1s  --- but as nationalistically minded citizens they could only see their nations as 4Fs in America's eyes : mere inconvenient dirt beneath their advancing wheels.

When the Patty Malone vs Marie Barker debate broke in the United States media (basically, scarce penicillin for dying civilians : yes or no ?) , it broke even bigger overseas, as worried American and British diplomats noted.

Heartless or caring : the public image of the Allied cause had reached past the unimportant front pages and onto the most important page of any newspaper or magazine --- the women's page : home to Doctor Mom.

It suddenly mattered what the mothers and parents and grandparents from neutral nations thought of America and Britain's harsh dictates on penicillin.

Put your small neutral nation, say Eire or Turkey, in the place of the unfortunate Marie Barker and then ask yourself, how would you feel to just be Marie Barker-like 'incidental collateral damage' , on the pathway to the ultimate Allied Victory ?

And the Home Front within the Allied nations was just as caustic about their own governments' inactions : 'penicillin the miracle cure' had been around for 15 years and still no one in charge had bothered making enough of it for all ?

Don't the bosses know "there's a war on" ???!!!

And let us set this debate (occurring between the late Summer of 1943 and the early Spring of 1944) in its full context.

The western Allies still hadn't invaded Europe and left the heavy lifting of killing German soldiers to the beleaguered Russians.

Instead they were busy bombing Europe into rubble : busily killing civilians from both Axis and neutral nations alike.

The Germans and Allies had co-operated on censoring the results of the fire-bombing of Hamburg of July 1943, (right before the story of little Patty Malone broke) but on-site reports from neutral Swedish journalists had laid the whole horrific affair out on the newspaper pages of the world.

It had led to considerable unease - in neutral country and allied country alike.

Hadn't FDR himself raged that the bombing of civilians was a crime against all humanity and now weren't the Americans and British far out-doing the earlier Nazi efforts to bomb enemy and neutral civilians ?

Allied fire bombing of  innocent babies in occupied Europe - denying life-saving penicillin to innocent young moms in America so that their unfaithful husbands in Italy could be get a quicker ( via penicillin) cure for the Clap - it all didn't seem morally right.

Perhaps surprisingly, the American Army revealed far greater political and cultural savvy on this matter than American doctors and scientists were capable of.

The Army was sick and tired of being blamed for hogging all the penicillin and refusing to give any to the nation's dying babies.

'For Christ's Sake', they could rightfully protest, 'we can't get anywhere enough penicillin for our own dying boys, and we hadn't even heard of this stuff penicillin till a few months ago --- you ask the drug companies and the doctors what they were doing with the stuff for the last 15 years !'

Somewhere in the American Army Air Force some bright mind (s) decided to solve both PR problems (the fire bombing uproar and the penicillin uproar) at one stroke.

(And before you ask, no .)

No academic historian has yet brought us the true story behind this highly imaginative response: I see a great PhD thesis for some bright light.)

Soon, American Army "heavy" bombers were pulled off their bombing practises and were sent out on a still risky flight (because at top speed and at night) "pounding" across country with a tiny 8 grams of penicillin (instead of the normal 8000 pounds of TNT) to deliver to a dying ten pound patient.

Upon arrival, Klieg lights lit the tarmac as an ambulance, along a police escort with blazing lights and piercing sirens, raced to the hospital and the waiting doctor and patients.

Need I add to this purple-prosed drama that, thoughtfully, the local press had been notified well ahead of time ?

Quickly Army bombers were even on far more perilous missions of mercy, dangerously new cross-ocean flights, from places like San Francisco  all the way to Brisbane Australia or from New York to Havana, --- to save dying children.

In 1943, Martin Henry Dawson was dying ,but not quite dead yet, not by a long shot...

Life-saving penicillin had moved 180 degrees from being censored and rationed to being the subject of  radio, newsreel and pamphlet propaganda as an example - the example - of the better things ahead if only all joined in to hasten the Allied Cause.

Neutrals could reassure themselves that just like with dying babies and Martin Henry Dawson's useless-mouthed SBE patients, the Allies would do right by all, as they were doing so now for the least of these.

The Allied battle for the world's hearts and minds, had been won (unexpectedly) by the proponents of social medicine - thanks largely to the example of Martin Henry Dawson.

And decades before Joni Mitchell and Woodstock, the American Army Air Force itself turned its shotgun bombers into butterflies, above a wondering nation and world....

1940's ISOLATIONISTS abandoned Europe's 4Fs and America's 4Fs

1A =  53%

From 1938 till 1941, Europe's small and weak nations - its 4F states - were gobbled up one after another, while the majority of Americans sat on their hands and did frack-all.


Then in the Fall of 1940, these same Isolationists, using the excuse of preparing for an European war - a war that they were actually working all out to avoid - pushed for an abandonment of Social Medicine , in favour of War Medicine.

Translation of this hypocrisy ?

In Eugenics-speak, this meant abandoning efforts to provide medical care to both the well-to-do 1As and the poorer 4Fs, in favour of research on making the 1As into better fighters.

Rooseveltcare as unpopular then as Obamacare is today

Actually, the Isolationists had high hopes that America's 1As would never have to fight : this was all just an excuse to roll back the clock on providing care for the 47% in 1940s America.

Rooseveltcare was no more popular then among the well-to-do than Obamacare is today. (Or Romneycare was in Boston a few years ago - but that is another story altogether isn't Mitt ?)

It was this Isolationist hypocrisy that I believe pushed Martin Henry Dawson over the edge into his all out effort to rescue some American 4Fs (his equivalent of 1915's Belgians), with 4F natural - impure- penicillin,  as his rebuke to uncaring America.....