Miracles in Medicine

8/8/2019 Miracles in Medicine

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MIRACLES IN #MEDICINESTORIES OF THE GREAT DISCOVERIESTHAT CHANGED MANKINDby K.R.Srinivasan


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MIRACLESINMEDICINEK . R . S r i n i v a s a n

I l l u s t r a ted by G .R . Na i k

p Mm RI N D I A B O O K H O U S E E D U C A T I O N T R U S T

B O M B A Y 5


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C o p y r i g h t All rights reserved

F i r s t p u b l i s h e d : J a n u a r y 1 97 4

P r i n t e d b y H . K . N a s t a a t I B H P r i n t e r s , M a ro l N a k a ,M a t h u r a d a s V i s a n j i R o a d , A n d h e r i E a s t , B o m b a y 59 a n dp u b l i s h e d b y H . G . M i r c h a n d a n i , T r u s t e e , In d i a B o o kH o u s e E d u c a t i o n T r u s t , 1 2H D a l a m a l P a r k , 2 2 3 C u f f eP a r a d e , B o m b a y 4 0 0 0 0 5 .


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C O N T E N T S

H a r v e y U n r a v e l s t h e M y s t e r y o f B l o o d C i r c u l a t i o n 1P as teu r C on fue r s the S c ou r ge o f D ogs and Men 7L i s t e r M a k e s S u r g e r y S a f e 1 4T h e S t o r y o f P e n i c i l l i n 2 1Wak s man and the" W h i t e P l a g u e " 3 1T h e S t o r y o f B l o o d T r a n s f u s i o n 3 6R o e n t g e n D i s c o v e r s R a y s t h a t C a n L o o k i n t o t h e Hu m an B o d y 4 8D r . B a n t i n g a n d H i s I n s u l i n M i r a c l e 5 5


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A f t e r g r a d u a t i n g f ro m t h e C a i n s C o l l e g e ,Cam br idge in 1957 , H arvey w en t to P a d u a w hichhad a ve ry f amous med ica l schoo l headed by the

surge on F ab r i c i u s . He w as a g rea t man and knewmore abou t the human body than any o the r doc to rof his t ime.

.Harvey s tu d i ed un de r him fo r ne a r l y f i vey e a r s a n d r e t u r n e d t o E n g l a n d . H e s t a r t e d h i sp r a c t i c e in L o n d o n w i t h t h e p e r m i s s i o n o f t h eR o y a l C o l l e g d o f P h y s i c i a n s . A w e e k b e f o r eW i l li a m _ S h a k e s p e a r e , t h e g r e a t p l a y w r i g h t , d i e da t S t r a t fo rd -on-Avon , Harvey became a l ec tu re ra t t h e R o y a l C o l l e g e o f S u r g e o n s .

H e a l s o b e c a m e t h e s u r g e o n t o K i ng C h a r l e s Iand was by h i s s ide when he fough t h i s lo s ing

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ba t t l e s aga ins t O l ive r Cromwel l . Bu t in 1642 hedec ided to l eave the k ing and devo te h i s l i f e tothe pu rsu i t of s c i e n c e . I t w as for t un a te for h imb e c a u s e s o o n a f t e r w a r d s t h e k i n g w a s b e h e a d e d ,toge the r wi th many o f h i s fo l lower s .

S i n c e h i s s t u d e n t d a y s h e h a d b e e n i n t e r e s t e din the ana tomy of the hear t and the b lood vesse ls .B u t h i s k n o w l e d g e a b o u t t h i s w a s i n c o m p l e t e a n dHarvey now dec ided to f i l l i n the gaps .

S u r g e o n s b e f o r e h i m h a d d i s s e c t e d deadbodies to f ind how the hear t and the b loodv e s s e l s b e h a v e d . T h e y o b v i o u s l y c o u l d n o t f i n dou t much because the hea r t s in these bod ie s had

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s t o p p e d a nd t h e b l o o d w a s n o l o n g e r c i r c u l a t i n g .H a r v e y d e c i d e d t o d i s s e c t l iving a n i m a l s a n d s e ewha t wen t on ins ide them.

H e o p e n e d t h e c h e s t c a v i t y a n d o b s e r v e dhow the hear t worked . One moment i t th robbeda n d t h e n e x t m o m e n t i t w a s m o t i o n l e s s . T h i swent on and on with a regular rhythm.

He took the l iv ing hear t in h is hand ando b s e r v e d s e v e r a l o t h e r i n t e r e s t i n g f a c t s . I t b e -came hard f i r s t and then sof t , and th is too re -p e a t e d i t s e l f e n d l e s s l y . H e a l s o n o t e d t h a t w h e ni t was ha rd i t became sma l le r in s i ze and whensof t i t became l a rge r . A lso when i t was sma l le ri t looked pa le and when la rger i t looked very red .

He d rew some impor tan t conc lus ions f romt h e s e o b s e r v a t i o n s . T h e h e a r t i s h o l lo w a n d a c t sl ike a pump. When i t g row s sm a l le r it s q u e e z e sou t the b lood in to the b lood vesse l s and so i tbe co m es pa le . When i t i s l a rge r i t su ck s in b loo dand becomes r ed .H e n e x t c o n c e n t r a t e d o n t h e b l o o d v e s s e l s .He t raced the pa th of b lood throughout the body.He foun d tha t b lood f lo w ed out of the he ar t th rougha r te r i e s and r e tu rn ed to i t t h rough v e i n s . An o the ri n t e r e s t i n g f a c t t h a t h e n o t e d w a s t h a t t h e s eb l oo d v e s s e l s w e r e o n e w ay p a s s a g e s . T h e ya l low ed the b lood to f low on ly in one d i r ec t io n .T h e f lo w in t h e o p p o s i t e d i r e c t io n w a s p r e v e n t e d

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by num erous v a lv es s i tu a t ed in the hea r t and theb l o o d v e s s e l s t h e m s e l v e s .

H e t h e n c a l c u l a t e d t h e quantity of blood thatwen t th rough the a r t e r i e s and ve ins . The hea r tpum ps two o u nc es of b lood on every s t ro ke andt h e r e a r e s e v e n t y - t w o s t r o k e s ev e r y m i n u t e . H emade a qu ick ca lc u la t io n and found tha t tne h ea r tpumped 1 ,500 ga l lons per day . S ince the bodycou ld no t p roduce th i s f an ta s t i c amount o f newblo od , th e on ly ex p l an a t io n w as tha t the b loo dth a t f low ed out of the hea r t f in a l l y re turn ed to i t .

The only myste ry tha t he could not so lvewas how the a r t e r i e s and the ve ins were connec -ted . Soon a f t e r h i s de a th an o the r sc ie n t i s t d i s -co ve red , w ith the he lp of a c rude m ic ro sco pe ,tha t th i s connec t ion was made th rough ve rym i n u te blo od v e s s e l s c a l l e d c a p i l l a r i e s .

Wha t i s the impor tance o f Harvey ' s f ind ings?We now know that the body gets i ts energy andnu t r i t ion from d ig es te d food and tha t the u nw ante dwas te s a r e th rown ou t . Bo th o f the se v i t a l func -t i o n s would not be p o s s i b le if the re were nob lood c i r cu la t ing in the body .

I t i s the b lood tha t co l l ec t s the nu t r i en t sf rom the d ig es ted food and d i s t r ib u te s them a l love r the body . I t i s the b lood tha t ca r r i e s body ' swas te s to the lungs and the k idneys to be th rowno u t .

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We owe a l l th is kn ow ledg e to H arvey . I t w ash i s work tha t gav e u s a fu l l e r un de r s ta nd in g ofthe marve l lous mach ine tha t i s the human body .

He d ied a t the age of seventy-n ine a f te r as h o r t i l l n e s s . H i s b o d y w a s b u r i e d i n H a m p s t e a dC h u r c h , E s s e x .

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P A S T E U R C O N Q U E R S T H ESCOURGE OF DOGS AND MEN

A SMALL boy s tood before the smi thy and watch-ed w i th awe and p i ty the te r r ib le sc en e tha t wenton in s i d e . A man who had bee n b i t te n by a maddog had been b rough t to the b lacksmi th . Theblacksmi th hea ted an i ron rod unt i l i t was redho t . As h i s a s s i s t a n t s h e ld the man down f i rmly ,he p lunged i t in to the wound caused by the maddog . The man sc reamed wi th pa in un t i l he becamet o o e x h a u s t e d t o e v e n g r o a n .

The year was 1831 and the boy was LouisP a s t e u r , t h e s o n of J e a n J o s e p h P a s t e u r , t h elo ca l tan ner . What he saw in the smi thy wa s theonly t rea tment then known for the bi te of a dis-e a s e d d o g , w h i ch r e s u l t e d in a f a t a l d i s e a s eca l l e d r ab ie s . Ha lf a cen tu ry l a t e r , t h i s boy wasto beco m e a g rea t s c ie n t i s t and f ind a cu re fo rt h i s d e a d l y d i s e a s e .

R a b i e s i s a d i s e a s e t h a t i s c o n t r a c t e d a n d7


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s p r e a d by d o g s , w o l v e s , f o x e s a nd e v e n b a t s , b utm os t ly by do gs . T he s i ck dog s become mad andrun abou t b i t ing eve ryone wi th in the i r r each . Thed i s e a s e s p r e a d s f ro m th e 3 o g s to o t h e r a n i m a l sand human be in g s. If le f t un tre at ed a l l of themwould d ie a very ho r r ib le de a th .

d i s e a s e a n d t h e c u r e , th e t r e a tm e n t c o n s i s t e d of" c a u t e r i s i n g " o r b u r n i n g t h e w o u n d w i t h a r e dho t i ron . Th i s burn ing neve r cu red the d i seasebut only added to th e ago ny of the su f f e r e r .

L ou i s P a s te u r was born in 1822, in theF r e n c h v i l l a g e of D o l e . T h e r e w a s n o t h i n g s p e c i a labo ut the boy L o u is an d nobody who knew himcou ld have p red ic ted tha t he wou ld one daybecom e f amo us and be r emembered wi th g ra t i tu de

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al l over the world.But as a young man he took grea t in te re s tin phys ic s and chemis t ry . He was ab le to ga in

a t h o r o u g h k n o w l e d g e i n t h e s e s u b j e c t s a n dl a t e r b e c a m e a p r o f e s s o r of c h e m i s t ry a t L i l l e ,a town in a famous wine-growing reg ion . I t washere tha t he s ta r ted the work tha t f ina l ly led h imto the d i s co v e r ie s f rom w hich man k ind h a s bene -f i t ed so much .

He proved tha t sour ing of wine , mi lk andb u t t e r w a s c a u s e d b y s m a l l l i v i n g o r g a n i s m sk n ow n a s g e rm s o r m i c r o b e s . T h e s e g e r m s c a n n o tbe seen by the naked eye , bu t only under a micro-s c o p e . H e a l s o s h o w e d t h a t t h e s e g e r m s c o u l db e d e s t r o y e d by h e a t i n g , a m e t h o d t h a t i s s t i l lu s ed fo r p re se r v in g mi lk . T h i s f ind in g l e d h imt o t h e c o n c l u s i o n t h a t m o s t o f t h e d i s e a s e s o fm e n , a n i m a l s a n d p l a n t s w e r e c a u s e d b y h a r m f u lm i c r o b e s .

A t t h i s t im e d i s a s t e r s t r u c k t h e s i l k i n d u s t r yin F rance . S i lkworms d ied in thousands o f anu n k n o w n d i s e a s e . T h e l i v e l i h o o d o f t h e f a m i l i e st h a t p r o d u c e d s i l k w a s t h r e a t e n e d . P a s t e u r s t u d i e dt h e p r o b l e m a n d d i s c o v e r e d t h a t t h i s d i s e a s etoo , was due to harmful germs. He was ab le toteach the g rowers how to avo id the con tag ion .

H i s n e x t d i s c o v e r y w a s th e o n e th a t f i n a l l ye n a b l e d him t o w i n t h e b a t t l e a g a i n s t r a b i e s . H e

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c o n d u c t e d a s e r i e s of e x p e r i m e n t s f o r w h i c h h egrew co lon ie s ( cu l tu re s ) o f cho le ra ge rms whichh e i n j e c t e d i n t o h e a l t h y c h i c k e n s . T h e c h i c k e n ss ickened and d ied . Th i s was ye t ano the r p roofof h is theory tha t harm ful m icrob es we re resp on -s i b l e f o r d i s e a s e s .

In one exp e r im en t he in je c t ed a cu l tu re tha thad becom e o ld , in s t ea d of a f r e sh on e . Th ec h i c k e n s s i c k e n e d , but did not die. H e d i s c o v e r e dt h a t t h e y h a d d e v e l o p e d a r e s i s t a n c e t o t h ew ea ke ne d ba c te r i a in the o ld cu l tu re . He theni n j e c t e d l ive cho le ra ge rms in to them and foundt h a t th e y s t i l l r e s i s t e d th e d i s e a s e . H e h a ds tum bled upon a me thod by which he cou ld p r o te c tc h i c k e n s a n d p r o b a b l y o t h e r a n i m a l s a n d e v e nm a n , a g a i n s t a d e a d l y d i s e a s e l i k e c h o l e r a .

E n c o u r a g e d b y t h e s e r e s u l t s h e n e x t t u r n e dh i s a t t en t ion to r a b i e s . H is f i r s t aim w as to f indo u t w h e r e t h e m i c r o b e s c a u s i n g th e d i s e a s e w e r e .He suspec ted tha t thev were in the sa l iva o f themad dogs s ince i t was the i r bite t h a t p r o d u c e dt h e d i s e a s e i n m a n .

To make sure of th is he had to co l lec t thes a l i v a f ro m s i c k d o g s . T h i s w a s a d a n g e r o u sta sk . Two s tu rdy men would l a s so a s i ck dog ,s t r e t c h the s t rugg l ing an im a l on a ben ch an dho ld i t down. Pas teu r wou ld then inse r t a g la s stube be tw een the d o g ' s l ip s and ex t r ac t a l i t t l e

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of i t s sa l iva . I t was the i r he ro i sm and ded ica t iontha t made them tak e such r i s k s . A s in g l e b i t ef rom the dog could have proved fa ta l to any oneof them.

H e t h e n i n j e c t e d t h i s s a l i v a i n t o h e a l t h yd o g s . B u t h e r e h e w a s u p a g a i n s t a d i f f i c u l t y .S o m e t i m e s t h e d i s e a s e t a k e s m a n y m o n t h s t od e v e l o p a n d u n t il t h e n th e a f f e c t e d a n i m a l a p p e a r sto be normal . Whenever th is happened he had towa i t s eve ra l months to see i f the in jec t ion wouldp roduce r ab ie s in the dogs .

H e o v e r c a m e t h i s d i f f i c u l t y by i n j e c t i n g t h esa l iva d i r ec t ly in to the b ra in o f the dog becausei t was the bra in of the an imal tha t the microbesa t t a c k e d . B y d o i n g t h i s h e s u c c e e d e d i n p r o -d u c i n g t h e d i s e a s e i n a h e a l t h y d o g in tw o w e e k s .

The nex t s t ep was to see i f he cou ld p ro tec th e a l t h y a n i m a l s fro m t h e d i s e a s e by i n j e c t i n gin to them w eak en ed r a b i e s m ic rob es . If th i smethod could work in the case of chole ra i tsh o ul d work he re , too .

H e t h e n i n t r o d u c e d t h e d i s e a s e i n a r a b b i tb y i n j e c t i n g t h e m i c r o b e - c a r r y i n g s a l i v a i n t o i t sbr a in . A fter i t d i ed h e rem ov ed a bi t of i t s bra inand kep t i t i n a s t e r i l i s ed bo t t l e fo r four teen daysby which t ime the mic robes in i t became weak .He then powdered th is p iece of bra in , mixed i tw i th wa te r and in jec ted i t i n to some hea l thy

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d o g s .The nex t day he in jec ted them wi th the b ra inmat te r tha t had been kept only for thirteen d a y s

and so on . He thus wen t on in jec t ing in to them,s t a g e b y s t a g e , t h e p o w d e r c o n t a i n i n g m o r e a n dmore o f the mic robes . Las t ly , he gave them ani n j e c t i o n o f t h e s u b s t a n c e t h a t h a d b e e n k e p to n l y o n e d a y f o r w e a k e n i n g .At the end o f the expe r imen t which l a s t edfo r four teen days he a l lowed h i s dogs to be b i t t enby r ab id dogs . He was exc i t ed to f ind tha t thed o g s c o u l d e a s i l y r e s i s t t h e d i s e a s e .

The me thod had now to be t e s t ed on humanb e i n g s . F o r t h i s h e c h o s e a b oy n a m e d , J o s e p hM eis te r , who had been r ep ea ted ly b i t t en by a maddog . T he wo und s on h i s body were so nu m erou st h a t t h e y c o u l d n o t b e c a u t e r i s e d .

H e g a v e t h e i n j e c t i o n s t h e s a m e w a y h e g a v ethem to the dogs . He gave ten of them, and everyt i m e h e i n c r e a s e d t h e v i r u l e n c e o f t h e d o s e . T h eb o y d i d n o t g e t th e d i s e a s e a n d h a p p i l y r e t u r n e dt o h i s v i l l a g e .

H i s n e x t p a t i e n t w a s a b o y n a m e d , J u p i l l e ,who had been bad ly b i t t en whi le he was b rave lyt ry ing to p ro tec t h i s f r i ends f rom a f e roc ious madd o g . P a s t e u r r e p e a t e d t h e t r e a t m e n t a n d c u r e dJ u p i l l e in a f e w d a y s .

T h e n e w s o f P a s t e u r ' s w o n d e r f u l d i s c o v e r y

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s p r e a d a l l o v e r t h e w o r l d . P e o p l e s t a r t e d c o m i n gto h im not only f rom d i f fe re n t p ar t s of F ra n c e , bu ta l s o fro m d i s t a n t c o u n t r i e s l i k e A m e r ic a . H o n o u r swere showered upon h im and he came to be knownas one o f the g rea te s t sons o f F rance .

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L I S T E R M A K E SSURGERY SAFE

T H I R T Y - E I G H T y e a r o ld J o s e p h L i s t e r w a sa l r ead y the p r o f e s so r of su rge ry a t the U niv e r s i t yof Glasgow. He had marr ied the daughte r of thegre a t Dr . Syme, the pr of es so r of su rg ery a tEd inburgh , and h i s f a the r w as a w e l l -know ns c i e n t i s t . A b r i l l i a n t f u t u r e l a y b e f o r e h im .

But he was not a happy man. As the surgeona t tached to the inf i rmary (hospi ta l ) o f the uni -ve r s i ty he had to pe rfo rm sev e ra l op e r a t i on s tos a v e l i v e s . B u t p a r a d o x i c a l l y m an y of h i s p a t i e n t sd i e d .

Pe op le cam e to the ho sp i t a l w i th compo undf rac tu re s . The b roken bones s tuck ou t o f the i rl imbs a f t e r p ie rc in g the f l es h and sk in . Hes t r a igh tened the i r b roken l imbs by se t t ing thebo ne s toge th e r and ban dag ed the w ou nd s . Bu tonly a few of them su rv i ve d and the o th er s d i ed .

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And aga in he had to ope ra te on pa t i en t s whowere b rough t to the h o sp i t a l w i th c ru she d l im bs .To save the i r l ive s he had to amputa te , tha t i scu t off," the a f f ec te d l im bs . Much to h is d is m aym a n y o f t h e s e p a t i e n t s t o o d i e d .

The cour se o f th i s ma lady was the sameeve ry t ime . The wound became in f l amed and pusw o u l d c o l l e c t i n t h e s w e l l i n g . T h e n t h e r e w a sh i g h t e m p e r a t u r e a n d f i n a l l y d e a t h .

Doc to r s d id no t know wha t caused a l l th i s . I nfa c t , they were so ign ora nt tha t they thoug ht th efo rma t ion of the p u s w as n ec es sa ry fo r thehea l ing o f the wound .But there were a few who remained doubt fu labou t suc h b en e f i t s . L i s t e r w as one of them. Hewas conv inced tha t the appea rance o f pus on ly

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i n d i c a t e d t h a t t h e p a t i e n t ' s c o n d i t i o n w a sw o r s e n i n g .He was so engrossed in h i s p rob lem tha t hew o u l d o f t e n d i s c u s s i t w i t h h i s f r i e n d s . In s u c hd i s c u s s i o n P r o f e s s o r A n d e r s o n , o f t h e c h e m i s t r yd e p a r t m e n t , s u g g e s t e d t h a t h e m i g h t f i n d P a s t e u r ' sd i s c o v e r i e s a b o u t m i c r o b e s u s e f u l .

The p rb fe sso r took the young su rgeon to h i sc h a m b e r a n d g a v e h i m t h e c o p i e s o f P a s t e u r ' ss c i e n t i f i c p a p e r s . It w a s in o n e of t h e s e t h a tL i s t e r r e a d a b o u t P a s t e u r ' s d i s c o v e r y t h a t f e r -menta t ion of wine and sour ing of mi lk werec a u s e d b y u n s e e n m i c r o b e s i n t h e a i r .

The a i r ! Tha t was i t ! I f microbes in the a i rcou ld make wine f e rmen t they cou ld a l so ber e s p o n s i b l e f or s e p s i s of th e w o u n d s . ( S e p s i si s the condi t ion of the wound when i t ge ts in-f l amed and pus s t a r t s co l l ec t ing in i t . ) The morehe thou gh t abou t i t t he more he w as co nv in ce d .

In a s imple f r ac tu re the bones mere ly c r ack ;they a re s t i l l p ro tec ted by the f l e sh and sk intha t cov er i t . B ut in a compoun d f r ac tu re thebroken ends of the bones cu t through the f leshand sk in , and leave a wound tha t i s e x p o s e d tothe air.

Lis te r wonde red i f bac te r i a in the a i r en te redthe wou nds of h i s pa t i e n t s and mad e them se p t i c .The wounds were o f cour se , cove red wi th l inen

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b a n d a g e s . B u t w a s i t n o t p o s s i b l e th a t t h e s eb a n d a g e s w e re t h e m s e l v e s c o n t a m i n a t e d w i thb a c t e r i a ? In t h o s e d a y s , d ir ty o l d l i n e n o b t a i n e dfro m h o u s e w i v e s w e re u s e d a s d r e s s i n g s . T h e ywere no t washed be fo re use , and so cou ld ve ryw el l be fu l l of g erm s.

And aga in , the su rgeons wore coa t s tha t werefu l l of b lood and pu s s t a in s . I t nev e r occ ur red tothem tha t i t m igh t be necessa ry to c l ean the i rcoa t s now and then . Wi th these coa t s on theyl o o k e d m o re l i k e b u t c h e r s t h a n d o c t o r s . T h e ynev e r w as he d the i r ha nd s be fo re o r a f t e r ano p e r a t i o n e i t h e r .

T h e h o s p i t a l w a r d s t h e m s e l v e s s t a n k t o t h eh e a v e n s . T o r em o v e t h i s u n p l e a s a n t s t e n c h a l lthe w indo w s and do ors had to be kep t op en a l lthe t ime .

L i s t e r though t deep ly abou t a l l t h i s and cameto the conc lus ion tha t the ge rms tha t lu rked int h e d r e s s i n g s , i n t h e s u r g e o n s ' c l o t h e s a n dhands , in the wards , and in the a i r were thec a u s e of the d ea th s . I t w as easy for them toen te r in to open wo unds and m ul t ip ly the re .

The obv ious so lu t ion once the na tu re o f theproblem w as know n, w as to k i l l thes.e b ac te r i a .T h i s open ed up ano the r p rob lem s in ce no an t i-bac te r i a l agen t was then known to anyone .

On e da y , a v is i t in g su rge on f rom the town ofC a r l i s l e c a s u a l l y t o ld L i s t e r how t h e o f f e n s i v e

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o d o u r i n t h e t o w n ' s s e w e r s w a s s u c c e s s f u l l yremoved by add ing the che m ica l , c a r b o l i c ac id ,to them.

L i s t e r ' s m i n d s t a r t e d w o r k i n g . T h e b a d s m e l lin the sewage had obv ious ly been due to thes a m e c u l p r i t s , b a c t e r i a . If c a r b o l i c a c i d c o u l dk i l l t h e s e b a c t e r i a a n d p u r i fy t h e s e w a g e , c o u l di t no t a l so k i l l t he bac te r i a tha t in f e s ted thew o u n d s ?

He put h is theo ry to p ra c t ic e in h is n extc a s e of c o m p o u n d f r a c t u r e . A f t e r s e t t i n g t h ebo nes he pa in t ed the wound wi th ca rb o l i c ac idand b and age d i t . Bu t much to h i s f ru s t r a t io n thep a t i e n t ' s c o n d i t i o n b e c a m e w o r s e a n d h e t o od i e d .

O b v i o u s l y , s o m e t h i n g e l s e h a d t o b e d o n eb e s i d e s p a i n t i n g t h e w o u n d s w i t h c a r b o l i c a c i d .When th e n ex t pa t i en t cam e to him he had as t r o k e o f i n s p i r a t i o n .

B e fo re d re ss in g the wound he o rde red thenurse to br ing the cleanest t o w e l a v a i l a b l e a n dboi l i t in w ate r . A f te r t rea t in g the wound wi thc a r b o l i c a c i d h e d r e s s e d i t w i t h t h i s t o w e l .Every day a f te r tha t he removed the bandage ,c le an ed the wound wi th ca r bo l i c ac id ag a in , andapp l i ed a new d re ss in g of c l ea n l inen o ve r i t .N ow h i s e x p e c t a t i o n s w e re f u l f i l l e d . H e w a sth r i l l e d to f ind tha t the pa t i en t s t e ad i ly improved

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day by day . The much d readed in f l ammat ion andp u s d id not ap pe ar . Th e wound h ea le d in a fewd a y s , t h e b o n e s j o i n e d a n d t h e p a t i e n t w a s d i s -ch a rg ed from the h o sp i t a l . T he wh ole c i ty m arve l -l ed a t th i s phenom enon .

L i s t e r ' s a t t a c k on b a c t e r i a w a s tw o f o l d . B yc l e a n i n g t h e w o u n d w i t h c a r b o l i c a c i d h e k i l l e dthe bac te r i a tha t were a l r eady p re sen t . When hes t e r i l i s e d t h e d r e s s i n g b y b o i l i n g i t i n w a t e r , h ek i l l e d the ba c te r i a a t on e of the i r so u rc es , thu spre ve n t in g them from ge t t in g in to the wound .

A f te r th i s he wen t on from one s u c c e s s toa n o t h e r . P a t i e n t a f t e r p a t i e n t l e f t th e h o s p i t a lcomple te ly cu red and dea ths became much r a re r .Some of the o ther surgeons were quick to adopth is method when they cam e to know of h i sa c h i e v e m e n t . B u t m a n y o t h e r s s t i l l r e s i s t e d t h en e w i d e a s . It w a s m a n y y e a r s b e f o r e s t e r i l i s a t i o na n d c a r b o l i c a c i d c l e a n i n g w e r e u n i v e r s a l l yaccep ted . Bu t they were a t l a s t in t roduced in a l lt h e h o s p i t a l s a n d t h i s c r e a t e d a r e v o l u t i o n ins u r g i c a l p r a c t i c e .

T h e s u r g e o n s n o w w o r e c l e a n c o a t s a n dg l o v e s . T h e s u r g i c a l i n s t r u m e n t s w e r e s t e r i l i s e dt h e s a m e w a y t h e d r e s s i n g l i n e n w a s s t e r i l i s e d .O p e r a t i o n t h e a t r e s a n d t a b l e s w e r e s c r u b b e d a n dc l e a n e d r e g u l a r l y .

T h e p a t i e n t an d h i s s u r r o u n d i n g s w e r e k e p ta s c l e a n a s p o s s i b l e . W o u nd s w e r e c l e a n e d w i t h

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c a r b o l i c a c i d a s a r u l e , a n d d r e s s e d w i th b o i l e dl i n e n . A l l t h e s e m e a s u r e s e f f e c t i v e l y r e m o v e dt h e t h r e a t o f i n f e c t i o n t h a t h a d m a d e h o s p i t a l ss o u n s a f e .

A t o n e t i m e d e a t h s i n h o s p i t a l s w e r e s ocommon tha t the re w as even an ou tc ry fo r c l os in gth em d o w n . Y e a r s l a t e r , a f t e r L i s t e r ' s m e t h o d sw e r e w i d e l y e m p l o y e d , t h i s s i t u a t i o n c o m p l e t e l yc h a n g e d . B o t h , d o c t o r s an d p a t i e n t s , g a i n e dc o m p l e t e c o n f i d e n c e i n s u r g i c a l o p e r a t i o n s w h i c hhad become qu i t e sa fe by now.

T h e p r e s e n t - d a y o p e r a t i o n t h e a t r e s l o o kd i f f e r e n t fro m t h o s e of L i s t e r ' s d a y s . N o w a d a y s ,bac te r i a a r e k i l l ed whereve r they a re l ike ly tobe found . Even the a i r in the thea t r e i s s t e r i l i s edby f i l t e r in g i t be fo re i t en te r s the th ea t r e . T h i sme thod i s known a s a sep t i c su rge ry and i s d i f -f e r e n t fro m L i s t e r ' s a n t i s e p t i c s u r g e r y in w h i c hc a r b o l i c a c i d p l a y e d t h e i m p o r t a n t p a r t .

B u t i t w a s L i s t e r w h o f i r s t s h o w e d t h a tb a c t e r i a w e r e r e s p o n s i b l e f o r t h e a l a rm i n g l y h i g hnumber o f dea ths in the hosp i t a l s . I t was he whofound a way to combat them. Unl ike a l l the o thers u r g e o n s h e r e f u s e d t o t a k e t h e d e a t h s f o r g r an t -ed . The wor ld wi l l a lways remember h im as oneof the grea t heroes in the h is tory of Medic ine .

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T H E S T O R Y O FP E N I C I L L I N

T H E so i l in the ga rden and o the r p la c e s ha s ini t hundreds and thousands o f mic robes . Whi lemany of them are harmful to man, qui te a few oft h e m a r e a l s o f r i e n d l y . l t i s t h e f r i e n d l y m i c r o b e s ,fo r example , tha t he lp p lan t s to g row.T h e r e a r e a l s o c e r t a i n m i c r o b e s i n t h e s o i l ,t h a n c a n s a v e l i v e s . T h e s e m i c r o b e s p r o d u c e s u b -s t a n c e s t h a n c a n k i l l b a c t e r i a t h a t c a u s e s o m a n yof t h e d i s e a s e s f a t a l t o m a n . T h e s e s u b s t a n c e s a r ec a l l e d antibiotics and the f i r s t o f th e s e , pe n i c i l -l i n , w a s d i s c o v e r e d by a s c i e n t i s t c a l l e d A l e x a n -d e r F l e m i n g .

T he s to ry of th i s d i s co ve ry i s a ve ry d ram a t icone . The beg inn ing o f the s to ry goes back to thee a r l y t w e n t i e s o f t h i s c e n t u r y . F l e m i n g w a s t h e nto i l ing in h i s l abo ra to ry a t S t. M ary ' s H os p i t a l ,Lo ndo n , to f ind a po w er fu l k i l l e r o f ba c t e r i a .His a im was to f ind a subs tance tha t wou ldk i l l d i s e a s e - c a u s i n g b a c t e r i a in a s i c k m a n

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without doing any harm to him. T h e m o s t p o w e r f u lb a c t e r i a - k i l l e r s k n o w n a t t h a t ti m e d e s t r o y e dno t on ly the bac te r i a bu t a l so the whi te b loodc e l l s . T h e s e c e l l s , a s y ou k n o w , a r e t h e o n e stha t f igh t ag a i ns t the ha rmfu l ba c t e r i a tha t a r e

c o n s t a n t l y e n t e r i n g t h e b o d y . T h e y a r e t h e b o d y ' sn a t u r a l d e f e n c e a g a i n s t h a r m f u l o r g a n i s m s .

So, by k i l l ing the w hi te ce l l s th e s e an t i -b a c t e r i a l a g e n t s i n d i r e c t l y helped t h e b a c t e r i a !

For many yea r s F leming had been on thelook-ou t fo r an an t i s ep t i c th a t wou ld de s t ro y on lythe bac te r i a and no t the whi te ce l l s . Once in1922 he thoug ht he had found on e , bu t i t co uld

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no t k i l l t he ba c t e r i a tha t a r e r ea l ly d an ge ro us .Then , in 1928 , when he had a lmos t lo s t

h o p e s o f s u c c e e d i n g i n h i s v e n t u r e , h e o n e d a yre ce iv ed a l e t t e r from a pu b l i sh e r . "We w an t tob r ing ou t a book on b ac te r i o lo g y , " i t r ead . "W i l lyou wr i t e a chap te r on the staphylococci?"

T h e s e b a c t e r i a c a u s e d a n g e r o u s b o i l s i n m a nt h a t c o u l d b e f a t a l . T h e y a r e a l s o r e s p o n s i b l ef o r m a n y d e a d l y d i s e a s e s of t h e s p i n e , t h e h e a r t ,a n d b l o o d . F l e m i n g k n e w a l l a b o u t t h e s e b a c t e r i a .For seve ra l yea r s he had g rown them in g la s s ands t u d i e d t h e i r b e h a v i o u r .

He agreed to wr i t e the chap te r , bu t be fo reth a t h e w an ted to con du c t an imp or tan t ex pe r i -m e n t . T o d o t h i s h e n e e d e d s e v e r a l c o l o n i e s o ft h e b a c t e r i a g ro w n i n g l a s s d i s h e s , c a l l e dcultures.

T o p r e p a r e t h e c u l t u r e s h e t o o k c l e a n d i s h e sand ad ded to ea ch of them a sp ec ia l j e l ly . T h i sj e l ly i s the food tha t th e ba c te r i a ne ed fo r the i rg rowth . He then took the d i shes one by one , andp l an te d a f ew of the b ac te r i a to i t . As soon a st h i s w a s d o n e , h e q u i c k l y p l a c e d a g l a s s c o v e ro v e r t h e d i s h t o p r e v e n t o t h e r b a c t e r i a f l o a t i n gin the a i r from se t t l in g on the j e l ly .

A f t e r s e v e r a l w e e k s h e d e c i d e d t o t a k e alook a t the cu l tures . He took out one of them,

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kep t i t unde r a mic roscope and looked in to i t .T he cu l tu re w as no t ye t r ead y . H e ke p t the d i shb a c k in i t s p l a c e .

H e w a i t e d fo r a f e w d a y s a n d a g a i n o b s e r v e dthe d ish . At f i r s t i t looked a l l r igh t , bu t a f te r af ew seconds o f look ing a t i t , he found tha t amould was g rowing in the d i sh toge the r wi th theb a c t e r i a .

I t was a mould that is grown in the soi l bym i c r o b e s . T i n y p a r t i c l e s of i t a l s o d r i f t w i t h t h ewind. In sp i te of a l l the ca re he had taken aspeck o f i t had se t t l ed on the j e l ly and hadth r ived in i t .

E v e r y s c i e n t i s t w h o p r e p a r e s b a c t e r i a lcu l tu re s f in d s now and then th a t som e o f h i sc u l t u r e s a r e s p o i l e d b y u n w a n t e d b a c t e r i a . W h en-e v e r t h i s h a p p e n s h e p o u r s t h e s p o i l e d c u l t u r e sdown the d ra in .

F l em ing w as abou t to do the sam e wh ens o m e t h i n g h e h a d s e e n i n t h e c u l t u r e s t o p p e dh im. H e h e s i t a t e d and on th i s moment of he s i -t a t i o n d e p e n d e d t h e l i v e s o f m i l l i o n s o f p e o p l e .

H e s l i d t h e d i s h a g a i n u n d e r t h e m i c r o s c o p eand pee re d through i t . What he saw th ere w a sno th ing sho r t o f a m i rac le . On on e s i d e thebac te r i a was g rowing in the usua l way and onthe o ther s ide the mould was growing on top oft h e b a c t e r i a . But imm ediately around the mo uldthere were no bacteria at all. The mould had

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p r o d u c e d a s u b s t a n c e t h a t h a d d i s s o l v e d t h eb a c t e r i a !F l e m i n g ' s d i s g u s t o n s e e i n g t h e s p o i l e dc u l t u r e n o w t u r n e d i n t o e x c i t e m e n t . H e d e c i d e dto s tudy th i s mo uld fu r th e r ; pe rh ap s the sub-s t a n c e i t p r o d u c e d w a s th e o n e h e w a s l o o k i n gfo r .

In t h e n e x t f e w w e e k s h e p r e p a r e d s e v e r a lc u l t u r e s o f t h e m o u ld i t s e l f . H e f i l t e r e d o f f t h e s ec u l t u r e s a n d c o l l e c t e d t h e l i q u id c o n t a i n i n g t h es u b s t a n c e t h a t c o u l d k i l l b a c t e r i a . H e t h e n t e s t e dt h i s l iq u i d a g a i n s t t h e v a r i o u s d i s e a s e p r o d u c i n gb a c t e r i a .

H e s o o n f o u n d t h a t t h e m o u l d - s u b s t a n c ec o u l d k i l l b a c t e r i a of p n e u m o n i a , d i p h t h e r i a a n da s c o r e o f o t h e r d i s e a s e s . H i s n e x t d i s c o v e r yw a s e v e n m o re r e m a r k a b l e . T h e s u b s t a n c e c o u l ds t i l l k i l l t he ge rms even when i t was d i lu ted wi th800 pa r t s o f wa te r !

H e n e x t t e s t e d t h e s u b s t a n c e o n w h i t e b l o o dc e l l s and foun d th a t i t d id no" harm to them . H ein jec ted a s t rong dose o f i t i n to a r abb i t . Ther a b b i t r a n a b o u t a s t h o u g h n o t h i n g h a d h a p p e n e d .

H e r e a t l a s t w a s t h e a n s w e r s t o h i s p r a y e r sH e h a d m a d e a d i s c o v e r y t h a t h a d e l u d e d h i m f o rs o m an y y e a r s , q u i t e a c c i d e n t a l l y .

But in the wake of th is t r iumph came a b i t te rd i s a p p o i n t m e n t . W hen h e t r i e d t h e s u b s t a n c e o n

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one o r two p a t i en t s in a ho sp i t a l i t f a i l ed to cu ret h e m . T h e r e a s o n w a s c l e a r . T h e s u b s t a n c e w a stoo l i t t l e to ac t aga ins t the swarms o f bac te r i a inthe body of a s ick man.

Al l h is e f f o r t s to prod uce eno ug h of thes u b s t a n c e p r o v e d h o p e l e s s . A t l a s t h e g a v e upw o r k in g o n i t . H e g a v e th e n a m e " p e n i c i l l i n " t othe su b s t a n ce a s the mould be lon gs to thepenicil l ium f ami ly . He wro te an a r t i c l e on pen ic i l -l in and p ub l i s h ed i t i n a m ed ica l m ag az ine . T he rethe m a t te r end ed a s f a r a s he w as co nc e rn ed .

No one took any in te r e s t in pen ic i l l in fo ra n o t h e r s i x y e a r s . T h e n , in 19 35 , tw o s c i e n t i s t sby name How ard F l ore y and E rn s t B . C ha in , bo thof the Oxford Unive r s i ty , s t a r t ed a f r e sh hun t fo ran ide a l ba c t e r i a - k i l l e r . By th i s time a new a r r ayof weapons , the su lpha d rugs , had been addedto the a r sena l of Medic ine .

T h e s e s u l p h a d r u g s n o d o u b t w e r e p o w e r f u l ,b ut e v e n t h e y w e r e u s e l e s s a g a i n s t c e r t a i nb a c t e r i a w h i c h s t u b b o r n l y r e s i s t e d t h e m .

When C ha in w as loo kin g for a c l u e to the newdrug he remembered a b i t o f goss ip he had over -hea rd in a l abora to ry . I t was abou t F leming andh i s p e n i c i l l i n . H e d u g o u t F l e m i n g ' s a r t i c l e o np e n i c i l l i n a n d c a r e f u l l y r e a d it .

He dec ided to make a f r e sh s tudy o f themould and s t a r t e d p repa r ing i t s cu l tu re . S ince

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n o o n e e l s e s h o w e d a n y i n t e r e s t i n t h i s r e s e a r c hhe ha d to work a lm os t a lo ne .

Th en on e mo rn ing in Sep tember 1 9 3 9 , ' t heB B C a n n o u n c e d th a t H i t l e r h a d i n v a d e d P o l a n d .World War I I had s tar ted and Bri ta in had to rusht o th e h e l p of F r a n c e . B e s i d e s g u n s , p l a n e s a n dtan ks the coun t ry n ee d ed new and pow er fu l d ru gs .D i s e a s e s w o u ld p l a y h a v o c am on g t h e s o l d i e r swounded in the ba t t l e f ron t s . Wi thou t new drugst h e d o c t o r s w o u ld b e h e l p l e s s a g a i n s t d i s e a s e s .

P r o d u c t i o n o f p e n i c i l l i n in l a r g e q u a n t i t i e ssudden ly became ve ry impor tan t . I f i t cou ld bed o n e i t w o u l d b e a b l e s s i n g . C h a i n , e n c o u r a g e db y F l o r e y , r e s o l v e d t o a c h i e v e j u s t t h i s .S o o n C h a i n h a d s e v e r a l a s s i s t a n t s w o r k i n gwi th h im. Mould food s ta r ted coming to h isl a b o r a t o r y in b i g e a r t h e n w a r e j a r s . T h e y b e g a nc u l t i v a t i n g h u g e q u a n t i t i e s o f t h e m o u l d .

They then sepa ra ted a s much o f pure pen ic i l -l in f rom th i s mould a s po ss ib le . Th e d rug d id no ta m o u n t t o m u c h a n d t h i s t h e y i n j e c t e d i n t o r a t s ,m ice , c a t s , and dog s , a l l of them s u f f e r in g f romt h e sa m e d i s e a s e s t h a t a f f e c t h u m an b e i n g s .

T h e r e s u l t s o f t h e s e t e s t s c o n f i r m e d t h o s eo b t a i n e d b y F l e m i n g fro m h i s e x p e r i m e n t s . T h ed ru g w a s h a r m l e s s t o a n i m a l s an d i t s c u r a t i v ep o w er w a s a s t o n i s h i n g .

The n ex t s t ep w as to try i t on human p a t i e n t s .

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But fo r th i s they needed much more o f the s tu f f .S o t h e y a g a i n s t a r t e d p r e p a r i n g p e n i c i l l i n i n t h esame t ed ious way . F ina l ly , in 1941 , they though tthey had eno ug h of i t for on e p a t ie n t .

T h e p a t i e n t c h o s e n w a s an O x f o r d p o l i c e m a nwho w as abou t to d ie from a se ve re in fe c t io ntha t had sp read a l l ove r h i s body . As soon a s heb e g a n t o r e c e i v e p e n i c i l l i n h i s c o n d i t i o n i m p r o v e ddr am a t ic a l ly . Bu t a f t e r a week when he cou ldh a v e b e c o m e c o m p l e t e l y w e l l a g a i n , t h e t i n ys t o c k o f t h e d ru g w a s e x h a u s t e d . T h e d i s e a s etook a turn for the worse and he d ied wi th in aw e e k .

I t w as a t rag ed y. But for the men who pre -p a r e d t h e d r u g , i t w a s a l s o a s u c c e s s . N o w t h e yknew tha t they co uld cure a p a t ie n t if on ly th eyhad enough of the drug .

F i v e m o n t h s l a t e r t h e y w e r e a g a i n r e a d y .T h i s t i m e i t w a s a w o r k m a n w h o s e i n f e c t i o ns t a r t e d f rom a bo i l an d had s p re ad to a l l pa r t s ofh is body. And th is t ime they had enough of thedrug to t r e a t h im . T h e t r ea tm en t which ca n bec a l l e d a " s e v e n - d a y - m e d i c a l - m i r a c l e " c o m p l e t e -ly cured h im.

In the nex t f ew m onth s pa t i e n t a f t e r pa t i e n tw as g iv en a new le a s e of l i f e wi th th e h e l p ofpe n i c i l l in . Bu t the d rug cou ld s t i l l be p ro du cedo n l y in m e a g r e q u a n t i t i e s . U n l e s s it c o u l d b em a d e a v a i l a b l e t o t h e t h o u s a n d s o f w o u n d e d

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s o l d i e r s a nd c i v i l i a n s , t h e s c i e n t i s t s c o u ld n o tc l ai m t o h a v e a c h i e v e d f u l l s u c c e s s .A t t h i s s t a g e t h e O x f o r d te am of s c i e n t i s t s

moved over to Amer ica a t the invi ta t ion of tha tcount ry . They cont inued the i r work there in am o d e r n l a b o r a t o r y w h i c h h a d a l l t h e f a c i l i t i e sthey c ou ld a sk fo r . T he i r so le a im now w as to

f ind the pa r t i cu la r va r i e ty o f the mould tha twould g row ve ry r ap id ly and p roduce b ig quan t i -t i e s of p e n i c i l l i n . In N a t u r e d i f f e r e n t s t r a i n s ofthe mould ex is t and some of them can mul t ip lythemse lves ve ry qu ick ly and y ie ld the d rug inl a r g e a m o u n t s .

T h e y l o o k e d i n e v e r y p l a c e f o r t h i s s t r a i n .T he y as k ed th e men of th e Air F o rc e to br ingba ck sa m pl es o f s o i l s from a l l a i r f i e ld s . In them e a n t i m e t h e d e m a n d f o r p e n i c i l l i n w a s b e c o m i n gmore and more every day .

F in a l ly , in 1943 , they ha d a s t ro ke of lu ck . A2 9


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g r ou p of m e n d e s p e r a t e l y s e a r c h i n g f o r t h esup e r io r s t r a in found two such on es . On e hadbeen the re a l l the t ime in the cu l tu re co l l ec t ionof the l abora to ry i t se l f , and the o the r was ona melon in a nearby f ru i t marke t .

Tha t was the tu rn ing po in t in the h i s to ry o fpe n i c i l l in . With the he lp of th e se s t r a in s theyw ere ab le to ge t a lo t more of the dru g. In Ja n u a ry1943, only two ounces of i t could be made . Butby the end of the war the product ion went up totwo po un ds . I t w as a g re a t v ic to ry .

F lo rey h im se l f w en t to A lge r ia wi th the d rugt o t r e a t t h e i n j u r e d s o l d i e r s e v a c u a t e d f r o m I t a l y .The drug worked wonders even in the hot andd u s t - r i d d e n f i e l d h o s p i t a l s .

B a c k i n A m e r i c a a c a r e f u l l y c o n d u c t e d t e s to n p a t i e n t s p r o v e d a g a i n t h a t t h e d r u g w a s s a f eif i t w as u se d wi th ca re . D oc to r s w ere mak ingn ew an d p r o m i s in g d i s c o v e r i e s . D i s e a s e s h i t h e r tor e g a r d e d a s i n c u r a b l e w e r e r e s p o n d i n g t o p e n i c i l -l i n .

T h e b a t t l e f or p e n i c i l l i n w a s w o n . T h edemands o f doc to r s a l l ove r the wor ld cou ldn o w b e s a t i s f i e d . I t h a d t a k e n s e v e r a l y e a r s , ahuge amount of money, and the ta len ts of manys c i e n t i s t s t o w i n t h i s b a t t l e . Y e t a n o t h e r s e c r e thad bee n w ren ch ed f rom N a tu re and b ec au se ofth i s m i l l io ns o f pe op le a re a l iv e today .

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W A K S M A N A N D T H E" W H I T E P L A G U E "

A B O U T t h e t i m e C h a i n a n d F l o r e y r e d i s c o v e r e dp e n i c i l l i n i n 1 9 40 , a n A m e r ic a n s c i e n t i s t c a l l e dDr . Se lman Waksman a l so took keen in te r e s t ina n t i b i o t i c s . H e a n d h i s s t u d e n t s s t a r t e d a f r e s hq u e s t f o r o t h e r a n t i b i o t i c s t h a t c o u l d d e s t r o y t h eb a c t e r i a l e f t u n t o u c h e d by p e n i c i l l i n .

T h e d i f f i c u l t y w i t h p e n i c i l l i n i s t h a t i t i su s e l e s s a g a i n s t t h e g r o u p of b a c t e r i a k n ow n a sgram-negative b a c t e r i a . I t s d e s t r u c t i v e a c t i o n i sl i m i t e d t o t h e g r a m - p o s i t i v e g ro u p of b a c t e r i a .

T h i s g r o u p i n g o f b a c t e r i a i n t o g r a m - p o s i t i v ea n d g r a m - n e g a t i v e w a s m a d e by th e D a n i s hb i o l o g i s t , D r. H a n s C h r i s t i a n G r am . S i n c e m o s tb a c t e r i a a r e c o l o u r l e s s , i t i s v e ry d i f f i c u l t t o s e et he m u n d e r a m i c r o s c o p e . T o o v e r c o m e t h i sd i f f i cu l ty Dr . Gram added a dye ca l l ed gen t i anv i o l e t , and a l i t t l e iod ine and a lco ho l to th eb a c t e r i a l s a m p l e s . H e f o u n d t h a t sO m e b a c t e r i a

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cou ld be co loured by the dye , wh i le o the r s r e -j e c t e d i t . T h o s e w h i c h c o u l d b e s t a i n e d b y t h ed y e w e r e c a l l e d g r a m - p o s i t i v e b a c t e r i a , a n dt h o s e w h i c h r e m a i n e d c o l o u r l e s s c a m e t o b e

k no w n a s g r a m - n e g a t i v e b a c t e r i a .I t w as W aksm an ' s aim to f ind new an t ib io t i c s

t h a t c o u l d k i l l g r a m - n e g a t i v e b a c t e r i a a l s o . H ew a s a l s o h o p e f u l t h a t h i s s e a r c h w o u l d l e a d himt o a m i c r o b i a l s u b s t a n c e t h a t c o u l d c u r e t h et e r r i b l e d i s e a s e , t u b e r c u l o s i s ( T B ) , w h i c h k i l l e dthousands o f peop le eve ry day a l l ove r the wor ld .

T h i s d i s e a s e k n o w n a s t h e " w h i t e p l a g u e "s t i l l t a k e s a h e a v y t o ll of l i v e s i n d e v e l o p i n gcoun t r i e s l ike Ind ia , in sp i t e o f the f ac t tha t

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se v e r a l d rug s a r e now av a i l ab le to comb a t i t . I nt h e e a r l y f o r t i e s a n d i n t h e d e c a d e s b e f o r e t h a t ,t h e d i s e a s e h a d w o n t h e r e p u t a t i o n o f b e i n g t h enumber one k i l l e r .

T h e d i s e a s e k ne w no f r o n t i e r s a n d i t a t t a c k -ed a l l c l a s s e s of p eo p l e , a l though the poor wereu s u a l l y t h e w o r s t a f f e c t e d . A p e r s o n a f f l i c t e dw i t h T B w a s u n d e r d e a t h s e n t e n c e , a nd h i sd a y s w e r e n u m b e r e d .

Wi th h i s knowledge and expe r ience , Waksmanknew where to s t a r t . A pa r t i c u la r f ami ly of s o i lm i c r o b e s , c a l l e d " a c t i n o m y c e t e s " , w a s k no w nt o h a v e a s t r o n g a v e r s i o n f o r d i s e a s e - c a u s i n gb a c t e r i a a n d h e d e c i d e d t o c o n c e n t r a t e on t h e s em i c r o b e s .

He ca r r i ed ou t h i s r e sea rch in the mos tm e t h o d i c a l a nd p a i n s t a k i n g m a nn e r. H e s e p a r a t e dth ou sa nd s of cu l tu re s from so i l and o th e r na tu ra ls o u r c e s . H e t h e n g r e w l a r g e c o l o n i e s o f t h e s e i nn u t r i e n t " s o u p s " in h i s l a b o ra t o r y . F i n a l l y , h ep u r i f i e d t h e c u l t u r e s , a n d r em o v e d t h e a n t i b i o t i cs u b s t a n c e s fro m t h em .

T o t e s t th e i r u s e f u l n e s s a s d r u g s h e t h enin jec ted them in to an ima ls . He had nea r ly f i f tya s s i s t a n t s t o h e l p him in t h i s g i g a n t i c t a s k ofe x t r a c t i n g t h e s u b s t a n c e s a nd t e s t i n g t he m .

From th i s p ro c e s s of t r i a l and e r ro r , th e reemerged a s in g l e a n t ib io t i c tha t ap pe a re d to

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s a t i s f y th e m . T h e y n a m ed i t " s t r e p t o t h r i c i n " .But they had to re jec t i t when they found tha t i th a d a d e l a y e d p o i s o n o u s e f f e c t o n t h e i r t e s ta n i m a l s .

I t w as a d i sa pp o i n tm en t , bu t i t d id no t l e adt o f r u s t r a t i o n . T h e y k n e w t h a t t h e y w e r e v e r yne a r the end o f the sea rc h . A t l a s t , i n S ep tem ber1943 , they found wha t they had been look ing fo r .

T h e y i s o l a t e d a s u b s t a n c e fro m a t y p e ofa c t i n o m y c e t e s m i c r o b e s , w h i ch w a s a s go o d a ss t r e p t o t h r i c i n , b u t w a s m u ch l e s s t o x i c . T o th i sthey gave the name , streptomycin.

St rep tom yc in ind eed p roved to be an o the rmirac le . I t no t only k i l led most of the gram-n e g a t i v e b a c t e r i a , b u t a l s o t h e o l d e s t an d m o s td e a d l y e n e m y o f m a n k i n d , t h e t u b e r c u l o s i sb a c t e r i a .

Waksman sa y s in h i s au to b iog raph y tha t hea n d h i s m e n h a d t o s e p a r a t e , p u r i f y a n d t e s tn e a r l y a h u n d r e d t h o u s a n d m i c r o b i a l c u l t u r e s .O u t o f t h e s e o n l y o n e , s t r e p t o m y c i n , t u r n e d o u tto be the r ight one .

T h e f a m o u s d r u g - m a n u f a c t u r i n g f ir m , M erckand C om pan y, now und er took to f in d the m ethodof p roduc ing the d rug in l a rge quan t i t i e s . Merckh a d s h o w n a l i v e l y i n t e r e s t i n W a k s m a n ' s w o r k ,and had a l r eady he lped h im wi th l a rge sums o fm o n e y .

In the mean t ime , doc to r s o f the f amous Mayo34


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C l in ic t e s t e d the new drug on human p a t i e n t s andproved tha t Waksman ' s d ream had indeed comet rue . M ankind had a t l a s t found a weap on ag a i n s ta m a l a d y t h a t w a s a s o l d a s c i v i l i z a t i o n i t s e l f .

Thousands o f men , women and ch i ld ren whowere l iv ing in the shadow of dea th , could nowlook forw ard to a co m ple te reco ve ry . W aksmanb e c a m e a c e l e b r i t y a n d h a d a r o u s i n g r e c e p t i o nwherever he went . For h is monumenta l work hewas awarded the Nobe l P r i ze in 1952 .

It h a s s in ce b een found tha t two more d rugsi s o n i a z i d a n d P A S , a r e a l s o e f f e c t i v e a g a i n s tt h i s d i s e a s e . I n f a c t , t h e s e d r u g s a l o n e c a n c u r ei t i f i t i s in the ea r ly s tages . But i t was s t rep to-myc in which f i r s t won the ba t t l e aga ins t th i sd r e a d f u l s c o u r g e . B u t fo r i t s d i s c o v e r y t h o u s a n d sof peop le who now l ive happ i ly wou ld have longs i n c e b e e n d e a d .

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T H E S T O R Y O FB L O O D T R A N S F U S I O N

A MAN is h i t by a p a ss in g car as he w al k s a lon gthe road . As he l i e s on the road b leed ing p ro fuse -l y , s o m e o n e s e n d s a n u r g e n t a p p e a l t o t h e n e a r e s th o s p i t a l . A n a m b u l a n c e s o o n c o m e s w i th i t ss i r e n w a i l i n g a n d t a k e s t h e m a n t o a h o s p i t a l .

In the ho sp i t a l the do c to r s who exa m ine h imf ind tha t he i s in danger of los ing h is l i fe ; heh as lo s t a lo t of b lood through the w ou nd s onh i s body . Un le ss he i s g iven new b lood and theloss i s made good he wi l l soon d ie .

At the r eques t o f the doc to r s a nur se b r ingsa bo t t l e o f b lood . She then hangs th i s bo t t l eups ide down f rom a s t and and connec t s a rubbe rtub e to i t . She c o n n ec ts the o th er end of th e tu beto a ve in in the pa t i en t ' s hand . The b lood in theb o t t l e s t a r t s t r i c k l i n g i n t o t h e p a t i e n t ' s b o d y .

Af te r abou t th ree hour s , the bo t t l e becomesempty . The man has now got back some of the

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b lood he had los t . I n the fo l lowing days moreb lood i s sen t in to h i s b lood in the same way .With in a w eek , a f te r he h a s re ce iv ed a l l the b loo dhe had lo s t , t he doc to r d ec la re s him ou t ofd a n g e r .

Al l ove r our coun t ry thousands o f men ,women and ch i ld ren who have los t the i r ownblood fo r on e r e a s on o r ano the r , a r e g iv en su ch" t r a n s f u s i o n s " of b l oo d . V i c t im s of a c c i d e n t sa r e n ot t h e o n ly o n e s w h o g e t t h e s e t r a n s f u s i o n s .P a t i e n t s o n w hom d o c t o r s h a v e c a r r i e d o u ts u r g i c a l o p e r a t i o n s a l s o g e t n e w b l o o d .

T h e b l o o d f o r s u c h t r a n s f u s i o n s c o m e sfro m a p l a c e c a l l e d t h e " b l o o d b a n k " . H e r eb lood i s a lw ay s kep t r eady to be se n t to thev a r i o u s h o s p i t a l s a t t h e r e q u e s t of d o c t o r s . T oke ep the b lood f r e s h fo r u se , i t i s s t o r ed in co ldc h a m b e r s .

H u n d r e d s o f h e a l t h f p e o p l e donate s m a l lq u an t i t i e s o f the i r b lood eve ry day t o the v a r io usb lood ba nk s in our c i t i e s and tow ns . Bu t fo rt h e s e g i f t s of b l o o d , t r a n s f u s i o n s w o u l d n o t b ep o s s i b l e . Y ou c a n im a g i n e w h a t w o u l d h a p p e nif p a t ie n ts who a re gra ve ly i l l from l o s s of b loo ddo not get new blood in t ime.

I t i s ve ry ea sy and ha rmless fo r a hea l thyperso n to m ake a g i f t of h is b lood . T h er e i s anaverage of f ive to e ight l i t r es of b lood in a

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he a l th y p eo p l e , s to r ing it and g iv ing i t t o ne ed yp a t i e n t s w a s d e v e l o p e d in 19 14 . B e f o r e t h a t ,s i n ce t ime imm emor ia l, doc to r s ha d tr i ed tot r an sf e r b lood f rom one pe rso n to an oth er . On a fewo c c a s i o n s t h ey w e r e s u c c e s s f u l . B u t m o s t ofsuch a t t empts r e su l t ed in the dea th o f those whor e c e i v e d b l o o d .

T h i s i s b e c a u s e t h e y k n e w v er y l i t t l e a b o u tb lood and what i t does in the human body. Thean c i en t s , f o r exa m ple , though t tha t b lood w asprep ared in the he ar t , f low ed in to the body andwas used up by i t . As we know now, i t was theE ng l i sh su rge on , William H arvey , who f i r s ts h o w e d t h a t b l o o d c i r c u l a t e d c o n t i n u o u s l y i n t h eb o d y .

P e o p l e a l s o b e l i e v e d t h a t an o l d m a n c o u l dbe made young aga in by g iv ing h im the b lood ofa young man . A p hy s ic ian on ce t r i ed to mak ePope Innocent VII I young aga in by g iv ing h imblood t ake n from th ree sma l l bo ys . Th e P op eof course d id not become young, and the boysd ied . T he p hy s i c i an f l e d the p la ce in te r ro r .

A n o t he r f a l s e b e l i e f w a s t h a t d i s e a s e s w e r ec a u s e d b y t h e b l o o d b e c o m i n g " b a d " i n t h e b o d y .So b lo od - le t t in g bec am e the t r ea tm en t fo r a l ld i s e a s e s . T h e d o c t o r m a d e a c u t i n t h e p a t i e n t ' sb o dy a n d l e t s o m e " b a d " b l o o d o u t . T h i s b l e e d -ing was don e aga in and ag a in un t i l t he doc to rthough t h*e ha d cu re d the d i s e a s e . B e c a u s e of

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t h i s f o o l i s h p r a c t i c e m a n y p e o p l e l o s t t h e i rl i v e s .Yet another myth in which the doc tors oft h o s e d a y s b e l i e v e d w a s t h a t t h e b l o o d i n a l lp e o p l e w a s t h e s a m e . T h e m o d er n d o c t o r k n o w stha t the re a r e some v i t a l d i f f e r e n c es in the b loodof d i f f e r e n t p e o p l e . H e a l s o k n o w s t h a t h e m u s tt a k e in t o a c c o u n t t h e s e d i f f e r e n c e s b e f o r e s e n d -i n g o n e m a n ' s b l o o d i n t o a n o t h e r ' s b o d y . B e c a u s ethe anc ien t doc to r s were ignoran t o f th i s f ac t , som a n y o f t h e i r a t t e m p t s a t b l o o d t r a n s f u s i o n e n d e df a t a l l y .

Th e ea r ly doc to r s who t r i ed to t r a ns fe r b loodfound tha t many o f the i r pa t i en t s d ied a f t e rsu f f e r ing f rom seve re pa in a l l ove r the bodya c c o m p a n i e d b y h i g h t e m p e r a t u r e . T h i s w a sbecause the i r own b lood ha rdened when the newblood mixed wi th i t . When th is happened thev a r i o u s o r g a n s l i k e t h e l u n g s , t h e h e a r t a n dbra in , s t a rv ed of b lood , ce a s e d to work andd e a t h r e s u l t e d .

Why some pa t i en t s shou ld d ie a f t e r a b loodt r a n s f u s i o n , w h i l e o t h e r s i m p r o v e d i n h e a l t h a n dbec am e norm a l aga in r em a ined a m ys te ry fo rm a n y c e n t u r i e s .

F i n a l l y , i n 1 9 00 , t h e A u s t r i a n s c i e n t i s t , K a r lL a n d s t e i n e r s o l v e d th e m y s t e r y a f t e r y e a r s ofpa t i en t work . For th i s work , wh ich l a t e r saved

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Karl Landsteinerpioneered the work onblood groups for whichhe received theNobel Prize in 1930

t h e l i v e s of t h o u s a n d s , h e r e c e i v e d t h e N o b e lP r iz e for M edic ine in 1950. I w i l l now br ie f l ye x p l a i n h i s d i s c o v e r y .

B e f o r e t h a t w e m u s t r em i n d o u r s e l v e s o f t h ew a y t h e h u m a n b o d y f i g h t s d i s e a s e s . M o s t o f t h ed i s e a s e s a r e c a u s e d w h en f o re i g n a g e n t s l i k eb a c t e r i a a n d t h e v i r u s e s i n v a d e t h e b o d y . T h e s ef o r e i g n a g e n t s a r e c a l l e d antigens. When thisi n v a s i o n o c c u r s , t h e b o d y a l w a y s f i g h t s b a c kby p rod uc in g i t s own -weapons ca l l e d antibodies.

A n t i g e n s a r e a l w a y s i n v a d i n g o u r b o d y a n da n t i b o d i e s a r e c o n t i n u o u s l y p r o d u c e d to d e s t r o yt h e a n t i g e n s . In s h o r t , th e r e i s a c o n s t a n t w a rb e t w e e n t h e i n v a d e r s an d t h e a n t i b o d i e s .

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AB h a s both A and B but no an t i -A or an t i -B , andgroup 0 h a s bo th the an t ib od ie s an t i -A and an t i -B bu t no A o r B . T h i s g roup ing i s c a l l e d theA B O s y s t e m .

I t i s now easy to see why so many of thet r a n s f u s i o n s f a i l e d b e f o r e L a n d s t e i n e r m a d e h i si m p o r t a n t d i s c o v e r y . B y m i s t a k e d o c t o r s w o u l ds e n d i n t o t h e i r p a t i e n t s ' v e i n s b l o o d t h a t did notbelong to their own groups. T h e r e s u l t w a s t h a tthe an t ig en s in the i r b lood (A or B) w ere mix edw i th t h e i r c o r r e s p o n d i n g a n t i b o d i e s ( a n ti - A o ra n t i - B ) , a n d t h e p a t i e n t s d i e d o f t h e r e a c t i o n .

When the blood f rom a wrong group is t rans-f u s e d , a r e a c t i o n c a n o c c u r e i t h e r i n t h e b l o o dbe lo ng in g to the pa t i e n t o r in th e new ly t r an s -f u s e d b l o o d . B u t a r e a c t i o n t a k i n g p l a c e i n t h et r a n s f u s e d b l o o d i s m u c h m o r e d a n g e r o u s t h a nt h e o t h e r r e a c t i o n .

L e t us s u p p o se tha t by an e r ro r g roup A o rg r o u p B b l o o d i s i n t r o d u c e d i n t o a p a t i e n t w h o s eg r o u p i s 0 . S i n c e h i s b l o o d c o n t a i n s o n l y t h ea n t i b o d i e s , t h e s e w o u l d r e a d i l y r e a c t w i t he i t h e r of t h e a n t i g e n s in t h e t r a n s f u s e d b l o o d a n dmake the l a t t e r ha rden . The end can on ly bef a t a l t o t h e p a t i e n t .

F o r t h i s r e a s o n i t i s a b s o l u t e l y n e c e s s a r yt h a t 0 g r o u p p a t i e n t s r e c e i v e 0 g r o u p b l o o d o n l y .F o r t h e s a m e r e a s o n , A B g r ou p p a t i e n t s c a n

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Grouping tests are performed on white tiles like th is. Known SERUM andBLOOD CELLS are used to group unknown Wood.h/o\vr; fiw/jlcs arc placed Mm

btRUM BL UOl) CELLS

Vic mthtuwu Mood isplaced in cuch d> opUnknown if g>>.'//> O

Utrttmit if group A B

Unknown /V group B

Ihik'toixH is group A

']t,ti-~ B A B

W # ft tVH a /uv ; . vs&T**s.

I *. ./! J l A ' ^ ' . V ! )I l l ' ! ( j s ire ce iv e b lo od from any of th e four gro up s . T h isg ro u p d o e s n o t c o n t a i n a n y a n t i b o d i e s t h a t c a nc a u s e a f a t a l r e a c t i o n i n t h e t r a n s fu s e d b l o o d .

On th e o the r han d the e f f e c t of a n t ib od ie si n t h e t r a n s fu s e d b l o o d o n t h e a n t i g e n s i n t h ep a t i e n t ' s b l o o d i s r e l a t i v e l y m i l d . Th i s i s b e -cause the b lood tha t i s s en t in to h im i s dilutedby the b lood tha t i s a l ready in h i s body. Anave rage pe rson has abou t 5000 cc . o f b lood , andin a s in g l e t ra ns fu s io n on ly a t en th of th i s quan*

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t i ty , t ha t i s abou t 500 cc . , i s s e n t in . T h i ss m a l l e r q u a n t i t y t h e r e f o r e g e t s d i l u t e d i n t h el a r g e r a m o u n t o f t h e p a t i e n t ' s b l o o d .

So any r e ac t io n tha t m igh t oc cu r when th e twob l o o d s m ix i s u s u a l l y m i ld . F o r t h i s r e a s o n , 0g r o u p p e o p l e c a n donate b lood to p a t i e n t s in anyof the fou r groups. , s in c e they hav e only th ea n t i b o d i e s a n d n o t t h e a n t i g e n s .

I f you a re a doc tor and i f you have a pa t ien tw h o n e e d s a t r a n s f u s i o n , y o u m u s t f i r s t of a l lf ind the b lood g roup o f the pa t i en t . Once th i si s known i t i s then easy to choose the group oft h e b l o o d t o b e t r a n s f u s e d . T h e i d e a l g r o u p w o u l db e t h e p a t i e n t ' s g r o u p i t s e l f o r g r o u p 0 .

A B g r o u p , a s w e h a v e s e e n , c a n r e c e i v eblood f rom any of the groups . But i f your pa t ien ti s in the 0 group you must see tha t he ge ts theblo od f rom 0 grou p onl y .

But if for som e rea so n b lood from h is owngroup i s no t ava i l a b le , you may then t ry p la s m at r a n s f u s i o n i n w h i c h a d i f f e r e n c e i n g r o u p w o u l dno t ma t t e r much . For i t ha s been found tha t thea n t i g e n - a n t i b o d y r e a c t i o n i s n e g l i g i b l e i n b l o o dp l a s m a t r a n s f u s i o n s . B l o o d b a n k s u s u a l l y h a v ew h a t i s k n o w n a s p o o l e d p l a s m a , w h i c h i spre pa red f rom th e b lood drawn from s o manyd o n o r s .

T h e m e t h o d o f t r a n s f u s i n g p l a s m a i n s t e a d o f

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wh ole b loo d w as dev e lo ped dur ing the SecondWorld War . During the war get t ing blood fort h o u s a n d s o f w o u n d e d s o l d i e r s b e c a m e a s e r i o u sprob lem. The p rob lem was pa r t i cu la r ly acu te inve ry ho t p laces l ike the Midd le Eas t whe re i tw a s i m p o s s i b l e t o p r e s e r v e b lo o d a t a lo wt e m p e r a t u r e .

T o s o l v e th i s d i f f i c u l t y , s c i e n t i s t s t r ie d t of i n d o u t i f o t h e r f l u i d s c o u l d b e t r a n s f u s e d i n t othe human body ins tead o f b lood . They f i r s t t r i eda so lu t ion of common sa l t in wate r , bu t the bodyr e j e c t e d t h i s . A f t e r s e v e r a l f a i l u r e s , * t h e y h itupon the me thod o f us ing p la sma .

T h i s i s h o w t h e y p r e p a r e d p l a s m a . A f t e rdraw ing b loo d from the donor , they p l ac ed i t ina drum tha t ro ta t ed a t a very h igh s p ee d . A f te rsome t ime the b lood in the drum separa ted in toa so l id pa r t con ta in ing the r ed and whi te ce l l s ,a n d a l i q u i d p a r t w h i ch i s c a l l e d " p l a s m a " .

T h e n t h e y a d d e d a c h e m i c a l c a l l e d s o d iu mc i t r a te to the l iqu id to p rev en t i t from ha rde n in g .L a s t l y , t h e y c o n v e r t e d t h e l i q u i d p l a s m a i n t o ap o w d e r b y c a r e f u l l y e v a p o r a t i n g i t . T h i s d r yp o w d e r c o u l d b e e a s i l y p r e s e r v e d i n b o t t l e s f o ra l o n g t i m e a n d t r a n s p o r t e d o v e r l o n g d i s t a n c e s .W h e n a t r a n s f u s i o n w a s n e c e s s a r y , a l l t h a t w a sto be done was to add wate r to a bot t le of p lasmaand shake i t we l l . I t cou ld then be sen t in to the

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p a t i e n t ' s b o d y l i k e w h o l e b l o o d . T h o u s a n d s o fl i v e s w e r e s a v e d b y p l a s m a t r a n s f u s i o n d u r in g t h eWar . Th i s me thod i s s t i l l w ide ly used wherew h o l e b l o o d i s n ot e a s i l y a v a i l a b l e .

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R O E N T G E N D I S C O V E R S R A Y ST H A T C A N L O O K I N T O

T H E H U M A N B O D Y

R O E N T G E N w a s n e i t h e r a d o c t o r n o r a s c i e n t i s tt ry ing to expose the mys te r i e s o f the human body .Ye t wi thou t the X- rays which Roen tgen d i s -cove red , mode rn med ic ine wou ld no t be wha ti t i s now.

I t was Roen tgen who showed tha t w i th thehe lp o f X- rays , shadow p ic tu re s o f the inne ro rgans o f the body cou ld be ob ta ined .

Wilhe lm Konrad Roentgen was born in 1845in L en ne p , G ermany . H is f a th e r w as a Germanfa rmer , bu t h i s mothe r was Dutch . Af te r a t t end ingsch oo l in H ol land he jo ine d the U niv e r s i ty o fZ u r i c h i n S w i t z e r l a n d w h e r e h e s p e c i a l i z e d i np h y s i c s .

A f t e r r e c e i v i n g h i s D o c t o r o f P h i l o s o p h yde gre e in p h y s i c s he r e tu rne d to Germany andt a u g h t in s e v e r a l u n i v e r s i t i e s t h e r e . In 1 8 8 5. h eb e c a m e t h e p r o f e s s o r of p h y s i c s a t t h e U n iv e r-

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s i ty of Wurzburg.I t w a s h e r e t h a t h e s t a r t e d t h e e x p e r i m e n t s

i n w h i ch h e o b s e r v e d t h e e f f e c t s o f p a s s i n ge l e c t r i c i t y t h ro u g h v a c u u m t u b e s , t h a t i s , t u b e sf ro m w h i c h a i r h a d b e e n r e m o v e d . O t h e r s c i e n t i s t s

l ik e , M ichae l F a r ad ay and S ir Wi ll iam C roo ke sh a d a l r e a d y c a r r i e d o u t s i m i l a r e x p e r i m e n t s a n dC r o o k e s h a d a l r e a d y d i s c o v e r e d t h e " c a t h o d er a y " .

C r o o k e s ' m e t h o d of p r o d u c i n g c a t h o d e r a y sc o n s i s t e d in c o n n e c t i n g t w o e l e c t r o d e s f i x e d i na vacuum tube to a mach ine capab le o f p roduc ingan e le c t r i c cu r r e n t of a h igh vo l t a ge . When th i s

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w as do ne r ay s made up of s t r ea m s of e l ec t ro n sw a s e m i t t e d by t h e n e g a t i v e e l e c t r o d e ( c a t h o d e ) .E l e c t r o n s , a s y o u k n ow , a r e t h e p a r t i c l e s t h a tbuzz around the core of an a tom.

R o e n t g e n i n h i s e x p e r i m e n t s u s e d a C r o o k e stube , bu t he covered i t wi th a b lack cardboard . Inone ex pe r im en t he p la ce d a p ie ce of pap e r c oa te dwi th a p la t inum -ba r ium ch em ica l nea r the tube ,made th e room da rk and p a s s e d e le c t r on ic cu r r en tth rough the tube . The pape r g lowed in da rkness .

He immedia te ly knew tha t he had made ad i scove ry . The r ays tha t made the pape r g lowcou ld no t be ca thode r ays . Ca thode r ays canneve r l eave the vacuum tube a s they canno t passth rough g la s s . The new rays tha t Roen tgen hadj u s t d i s c o v e r e d c o u l d l e a v e t h e t u b e , h i t t h ecoa ted pape r and make i t g low.

Fur ther work wi th the new rays which hen a m e d " X - r a y s " r e v e a l e d t h a t t h e y w o u l d a l s op a s s th rough o the r m a te r i a l s l ik e t in fo i l , a lu -minium sh ee t i n g and rubbe r . One day he acc i -den ta l ly kep t a pho tograph ic f i lm wrapped in adark paper near h is X-ray tube and he la te r foundtha t the f ilm w as ex po sed .

R o e n t g e n s o o n f o u n d t h e e x p l a n a t i o n f o r t h i sphenomenon . X- rays were p roduced when thec a t h o d e r a y s o r i g i n a t i n g fro m t h e n e g a t i v e e l e c -t r o d e s t r u c k t h e p o s i t i v e e l e c t r o d e .

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Soon a f t e r th i s he found an exc i t ing new usefo r X- rays . He p laced h i s hand on a pho tograph icp la te cove red wi th b lack pape r and d i r ec ted theX- rays on h i s hand . The f i lm when deve loped hadon i t a c lea r shadow pic ture of the bones of h ishand . He thus demons t r a ted tha t X- rays can bemad e to re v ea l wh at i s h idd en f rom the nak ede y e .

The X- ray mach ine soon became an ind i s -pens ib le too l in the hands o f the doc to r whowanted to know wha t was wrong inside h i sp a t i e n t ' s b o d y . N o m o d er n h o s p i t a l c a n a f f o r d t obe wi thout a t leas t one X-ray machine . In a b igh o s p i t a l d o z e n s of X - ra y p h o t o s a r e t a k e n e v e r yd a y t o d i a g n o s e a n u m be r of d i s e a s e s .

X - r a y s c a n r e v e a l f r a c t u r e s i n b o n e s , t h ed a m a g e c a u s e d t o t h e l u n g s by t u b e r c u l o s i s ,u l c e r s in t h e s t o m a c h , a n d n u m e r o u s o t h e rd e f e c t s i n t h e v a r i o u s i n t e r n a l o r g a n s . W h e r eX - r a y s c a n n o t d i r e c t l y p r o d u c e t h e s h a d o wpic tu re of a f au l t in an o rgan sp ec ia l m e tho dsa re us ed . When u lc e r s and tumours in th e s to m acha n d ' i n t e s t i n e s a r e t o b e X * ra ye d, f o r e x a m p l e , t h ep a t i e n t i s f i r s t a s k e d to s w a l l o w t h e c h e m i c a l ,bar ium su lp h a t e , mixed in w ate r . Tw o or moreX- ray pho tos a r e then t aken a t r egu la r in te rva l s o ft ime a s the "b a r iu m m e a l" , a s the ba r ium su l -p h a t e - w a t e r m i x tu r e i s u s u a l l y c a l l e d , p a s s e s

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th rough the va r ious pa r t s o f s tomach and in te s -t i n e s . U lc e r s and tumours wh ich a re no t no rma l ly" v i s i b l e " i n X - r a y s b e c o m e v i s i b l e w h e n t h e ya r e c o a t e d w i t h b a r i u m s u l p h a t e .

Y e t a n o t h e r e x a m p l e of t h e s e s p e c i a l m e t h o d si s t h e X - r a yi n g of o b j e c t s k no w n a s " s t o n e s "tha t a r e so m e t im es fo rmed in the k i dn ey s . T op r o d u c e a p i c t u r e of t h e s e s t o n e s w h i c h a r e n o td i r ec t ly r e v ea led by X - rays the do c to r first

c o l o u r s t h e s t o n e s w it h a d y e a n d t h e n t a k e s t h ep i c t u r e . T h e d y e m a k e s t h e s t o n e s o p a q u e t othe X- rays and the i r shadow images can then bee a s i l y o b t a i n e d o n p h o t o g r a p h i c f il m .

The modern doc to r a l so uses ano the r k indo f X - r a y m a c h i n e c a l l e d " f l u o r o s c o p e " w h i c h

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enab le s h im to see ins ide the body wi thou t thea id of f i lms . In a f luoroscope the X-rays f rom thevacuum tube pass th rough the body o f the pa t i en tand cas t the shadow of the X-rayed par t on as c r e e n c o a t e d w i th a s u b s t a n c e c a l l e d z i n cc a d m i u m s u l p h i d e , w h i c h i s c a p a b l e o f p r o d u c i n gt h e s h a d o w i m a g e . T h i s m e th o d of " l o o k i n g "i n to t h e b o dy i s c a l l e d " s c r e e n i n g " .In the modern X-ray machines the rays a rep r o d u c e d b y m a k i n g t h e e l e c t r o n s fro m t h en e g a t i v e e l e c t r o d e s t r i k e a p o s i t i v e e l e c t r o d em a d e o f t u n g s t e n . T h e e l e c t r o d e s a r e p l a c e d i nthe tube in su ch a way tha t the X-ray beam th u sp r o d u c e d e m e r g e s t h ro u g h a s m a l l w i n d o w . L i k ea camera the X- ray mach ine a l so has a shu t t e rto con t ro l the quan t i ty o f X- rays pass ing th rought h e b o d y . T h i s i s b e c a u s e i t i s h a r m f u l t o e x p o s ethe human body to an excess o f X- rays .

In 1896 th e Ro ya l So c ie ty in Br i t a in hon ouredRoen tgen by p re sen t ing h im the Rumford Meda land in 1901 he r ece ived the Nobe l P r i ze fo r h i sm o m e n t o u s d i s c o v e r y .

X- rays a r e a l so use d by pe op le o th e r thando c to r s fo r o th e r pur po se s . Bu t i t i s in the w or ldof medic ine tha t X-rays p lay the i r most impor tan tr o l e . B e f o r e t h e i r d i s c o v e r y , d o c t o r s c o u l d o n l yg u e s s w h a t w a s w ro n g w i th t h e i r p a t i e n t s . T r e a t -ment of many of the i l lnesses was by t r ia l and

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er ror . But X-rays changed a l l tha t , and medica lt r e a t m e n t b e c a m e r e a l l y s c i e n t i f i c .

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D R . B A N T I N G A N D H I SI N S U L I N M I R A C L E

J IM HAVENS, the twen ty -yea r -o ld son o f JamesHavens , l ay dy ing in h i s home in Roches te r nea rNew York . Every dawn was tak ing h im neare r toh i s end . On ly s ix yea r s be fo re he had been al i v e l y t e e n a g e r e a g e r to l e a r n p a i n t i n g . H i steachers and o thers thought tha t he had a lo t ofta len t . But now he lay in h is bed unable to evenl i f t h i s h a n d s .

H e w a s s u f f e r i n g fro m t h e t e r r i b l e d i s e a s e ,d ia b e t e s . H is body , un ab le to con ve r t sug a r in tou s e f u l e n e r g y , w a s b e i n g p o i s o n e d e v e r y m i n u t e ,a n d h i s d y i n g n e r v e s w e r e c a u s i n g h i m u n b e a r a b l ep a i n .

He w as a l lo w ed to ea t on ly a l i t t le foodeve ry da y . A r ig id ly co nt ro l led d ie t w as the onlyt r ea tmen t in those days by which a doc to r cou ldhope to pro long the l i fe of a pa t ien t suf fe r ingf rom th i s f a t a l s i ckness . J im had l ived fo r e igh t

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y e a r s w i th t h e d i s e a s e , t h e l o n g e s t p e r i o d f o rwhich a young man or woman had l ived a f te rg e t t i n g t h e d i s e a s e . No w i t l o o k e d a s t h o ug hd e a t h w a s a b o u t t o o v e r t a k e h im .

A l t h o u g h J i m ' s f a t h e r w a s d e s p e r a t e h ehe ld on to the hope tha t the re was someonesomewhere who had found a cu re fo r the d readedd i s e a s e . H e j u s t c o u l d n o t f a c e t h e f a c t t h a t h ewould soon lose h i s son un le ss a mi rac le tookp l a c e .

O n e d a y h e h e a r d t h a t a s c i e n t i s t c a l l e dDr . B an t ing , work ing in the Un ive r s i ty of To ron to ,C a n a d a , h a d f ou n d a s u b s t a n c e c a l l e d i n s u l i nt h a t c o u l d c o n t r o l d i a b e t e s . H e i m m e d i a t e l y r u s h e dto h is fami ly doc tor and begged h im to go toC a n a d a , g e t th e s u b s t a n c e a n d try i t o n h i s s o n .With grea t d i f f icu l ty the doc tor brought back al i t t l e o f the d rug and in jec ted i t i n to the boy . Bu the was d ismayed to f ind tha t i t d id not seem toh a v e a n y e f f e c t .

B u t J i m ' s f a t h e r r e f u s e d t o a c c e p t f a i l u r e . H es u c c e e d e d i n p e r s u a d i n g D r. B a n t i n g h i m s e l f t ocom e to R o ch es te r to t r e a t h i s son . Unde r th es c i e n t i s t ' s g u i d a n c e J i m ' s d o c t o r i n j e c t e d sm a l ld o se s of in s u l in in to h im eve ry two ho ur s . T h i swent on a l l n ight and the next morning Dr .Bant ingp e r f o r m e d a c h e m i c a l t e s t to s e e if t h e i n j e c t i o n shad any e f f e c t on the suga r tha t w as p o i s on ing

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Jim's bodyThe test showed that the drug had indeedremoved all the unwanted sugar. This was a

great moment for Jim, his parents and Dr. Banting.The treatment continued and Jim became normalwithin a few days, regained his strength andhappily started working or his drawings. Dr.Banting h ad pulled Jim away from the jaw s ofdeath. Jim Havens l ived for another 40 years, andhis death at 60 had nothing to do with diabetes.

Dr. Banting , who worked th is m iracle andlate r on gav e a new hope to thou san ds of d iab eticsufferers patiently waiting for their death, wasa Canadian. He looked more like a farmer thana doctor. His family had wanted him to becomea minister of the Church, but his halt ing speechmade him decide that the Church was no placefor him. Instead he took up medicine and incollege he was considered only an averages t u d e n tHis career as a doctor was colourless exceptfor the Military Cross he won for the bravery heshowed as an Army surgeon in the First WorldWar. After the war he set up practice as a bonespecial is t but i t did not f lourish.

His next venture was into sc ie n t i f ic resea rch.As a boy he had seen a pretty fifteen-year-oldclass-mate back in his native town die slowly of

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d i a b e t e s . T h i s t r a g e d y p e r h a p s p r o m p t e d h i m t otake up the problem of the cause and cure ofd i a b e t e s . H e a p p r o a c h e d t h e U n i v e r s i t y o f T o r o n t owi th a r e qu es t to g iv e h im the f a c i l i t i e s fo r th i swork . The un ive r s i ty gave h im a l abora to ry fo re i g h t w e e k s , o n e a s s i s t a n t , t e n d o g s a n d m o n e yeq u i va len t to abou t f iv e hund red ru pe es . Now-a d a y s s u c h m e a g r e h e l p w o u l d n o t p e r s u a d e a n yg o o d s c i e n t i s t t o u n d e r t a k e an y i m p o r t a n t s c i e n t i -f i c pu r su i t . Bu t in 1921 Ba n t in g r ega rd ed h im se l flucky to ge t i t .

What i s d i ab e t e s ? S uga r i s the m os t imp or tan tsource of energy for the human body, and thesu ga r i s conv e r ted in to ene rg y by a g land ca l l edth e pancreas. T o d o t h i s t h e g l a n d p r o d u c e s as u b s t a n c e c a l l e d i n s u l i n . In a p e r s o n s u f f e r i n gfro m d i a b e t e s t h e p a n c r e a s f a i l s to d o i t s w o r k .S ince the sug a r i s no t co nv e r ted to ene rgy i ta p p e a r s a s s u c h in h i s b lo o d a n d u r i n e . T h epa t i en t i s s t a rved o f ene rgy and the p re sence o fs u g a r i n h i s b od y p r o d u c e s p o i s o n o u s c h e m i c a l swhich are fa ta l to him in the long run. In addi-t i o n , f a t a c c u m u l a t e s in h i s b lo o d v e s s e l s r e s u l t -i n g in h e a r t d i s e a s e .

A F r e n c h c h e m i s t , M i c h e l C h e v r e u l , w a s t h ef i r s t t o s h o w t h e c o n n e c t i o n b e t w e e n s u g a r a n dd i a b e t e s . In 1 8 15 , h e p r o v e d t h a t d i a b e t i c s , t h a ti s , v i c t ims o f d iabe te s , had in the i r u r ine ab -

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normal am ou nts of su g ar . In 1869 cam e the d is -cove ry tha t the panc reas i s invo lved in the suga r -t o - e n e rg y c o n v e r s i o n . T w o G e rm a n s c i e n t i s t sshowed tha t by r emoving panc rea t i c g lands f romd o g s t h e a n i m a l s c o u l d b e m a d e d i a b e t i c .

How the pa n c r ea s d id th i s r em a ined a mys-te ry un t i l 1916 wh en a Sc o t t i s h ph ys ic ia n sug-g es ted tha t a pa r t i cu la r type o f ce l l , in thep a n c r e a s kn ow n a s " i s l e t s " c r e a t e d a s u b s t a n c etha t b r ings abou t the suga r conve r s ion . Bu ts c i e n t i s t s c o u l d n o t i s o l a t e t h i s s u b s t a n c e fro mt h e g l a n d . T h e g l a n d a l s o s e c r e t e s d i g e s t i v ej u i c e s i n a d d i t i o n t o t h e s u b s t a n c e , a n d w h en

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