THE DEMON UNDER THE MICROSCOPE

The fascinating story of the world’s first antibiotic.

Science-writer Hager (Force of Nature: The Life of Linus Pauling, 1995) asserts that sulfa, which was eventually displaced as a miracle drug by penicillin, holds a unique place in the history of medical science. It banished the notion, widely held among doctors, that chemicals would never be able to cure most diseases; it established the research methods for finding new drugs; and it created the business model for developing them. Hager’s account opens on the battlefields of World War II, where wound infection was a gruesome killer, then moves to postwar Germany, where industrial chemists manipulating azo dye molecules discovered that the addition of sulfanilamide (sulfa) created a chemical with bacteria-fighting properties. In England, doctors tried the new dye-based German wonder drug Prontosil on hospital patients; in France, researchers found that sulfa alone was the effective agent; and in the U.S., great quantities of sulfa-containing patent medicines were soon developed and marketed. The author enlivens his tale with a host of personalities, including German industrialist Carl Duisberg, head of the Bayer company; Heinrich Horlein, who ran Bayer’s pharmaceutical division; researcher Gerhard Domagk, whose work won him a Nobel Prize, which the Nazis would not permit him to accept; and French chemist Ernest Fourneau, whose discovery of the power of sulfa on its own greatly dismayed the German makers of Prontosil. Hager also provides a vivid picture of Germany at the peak of its prestige in the international scientific community and of a very different country under the Nazis. Of special interest is the cautionary tale of the Massengill Company’s Elixir Sulfanilamide, which contained an industrial solvent and killed more than 100 people in the U.S. This disaster led to an overhaul of the nation’s drug laws, including passage of the 1938 Federal Food, Drug and Cosmetic Act. It put an end, the author states, to the era of patent medicines and launched the age of antibiotics.

A rousing, valuable contribution to the history of medicine.