The Demon Under the Microscope: From Battlefield Hospitals to Nazi Labs, One Doctor's Heroic Search for the World's First Miracle Drug

Within the first fifty pages this book took it's place in my top ten non-fiction works. It includes history, science, biography and business wrapped together in a fast-paced and clear manner. It's a shock to see some of the often fatal diseases our grandparents faced that today have been all but forgotten. A world where a boil, insect bite, or cut finger could result in an ugly death. The author states that this is a book about "antibiotics," he includes the sulfa drugs to be part of this class, rather than just the traditional antibiotics derived from molds. With his description the author is being a bit disingenuous, I suspect to help market his book. The book is about the sulfa drugs which were the first effective and industrially manufactured family of drugs. This entire class of drugs have been all but forgotten. The details of the discovery and use of traditional "antibiotics" is well documented. I personally might have skipped a book subtitled "The Story of the Sulfa Drugs". I am very happy to have been slightly mislead and directed to this excellent history.

Some dolt on a bicycle slammed into me yesterday. Fortunately I did not break any bones, but the bruises are giving me an uncomfortable time since then. After rinsing both knees with chlorhexidine and iodine, I was not concerned; if there was an infection, antibiotics would take care of it. But it wouldn't have been that way seventy years ago, when the most you could do to prevent a wound from getting infected...was wait, and perhaps apply some crude remedies. That was how it had been for two hundred years. For all the progress we had made, bad bugs still mostly got the better of us. It is appalling that about fifty percent of deaths in WW1 were from infections that riddled shrapnel wounds, and not from explosives or gunfire themselves. Once infection set in and gas gangrene made its hideous appearance, all one could do was wait, and maybe hope that the suffering would end soon...until sulfa drugs appeared on the scene. That era of sulfa drugs, and not the one of penicillin, was the first heroic age of antibiotics. Most of us, if asked to name the first wonder-drug antibiotic, would name penicillin. But long before penicillin, sulfa saved thousands of lives. Without sulfa around, Hoover's son died. With sulfa, FDR's son, and Winston Churchill, survived. Thomas Hager has done an excellent job in bringing this forgotten but extremely important story to life in "The Demon Under the Microscope". The former biographer of Linus Pauling has shown us how different it was to suddenly have a drug that cured infections that previously would have almost certainly killed you. The time until the 1930s was a scary time, with every kind of Strep and Staph waiting to kill you after entering your body through the slightest cut, and diseases whose names we don't even remember now were rampant and much feared. It was sulfa that first declared war on and largely eradicated all these infections. At the center of the sulfa story is the remarkable doctor and biochemist Gerhard Domagk. Domagk was an officer in WW1 and saw thousands needlessly die around him in agony, all because nobody could prevent the infection that set in after they were hit. After the war, Domagk went through a succession of jobs and finally ended up at Bayer, where he had a trailblazing career in the discovery of new cures for old infections. Building upon Paul Ehrlich's convictions about azo dyes as bacteriocidal agents, he and his colleagues tested hundreds of analogs, until he hit on the right one. This was the beginning of SAR as we know it today. And here, we can see the chemist's tragedy. Domagk tested the compounds, but it were two chemists who actually made them. Yet, they were excluded from the prize that Domagk would gather. This was not his fault, but really the workings of the Swedish committee, which did not behave this way for the first and last time. Patriotic and yet conscientious, Domagk stayed put after Hitler came to power, losing himself in his work to distract himself from th

Everyone knows how penicillin revolutionized medical treatment of infections, most know about how Alexander Fleming discovered it, and some even know how Howard Florey and Ernst Chain took the discovery and made it something that could be used practically. Everyone knows that penicillin was a miracle drug, but almost everyone has forgotten that it was not the first miracle drug. The sulfa drugs came a decade before, producing unprecedented cures that physicians and patients thought of as miraculous; and then the penicillin-type antibiotics surpassed them. The history of the sulfa drugs is told in _The Demon Under the Microscope: From Battlefield Hospitals to Nazi Labs, One Doctor's Heroic Search for the World's First Miracle Drug_ (Harmony Books) by Thomas Hager. It is clear that sulfa deserves much more attention in the history of medicine than it has gotten. By some definitions, since they are not made by living organisms, sulfa drugs are not really antibiotics, but they certainly fought microbial infections in their time, and got medicine beyond the limits of mere antisepsis or disinfecting. They also proved a model for scientific evaluation of drug effectiveness. Chances are that you have never even heard the name of the doctor whose work is the backbone for this story, Gerhard Domagk. Domagk makes a tenacious but unspectacular hero, working day after day through clinical trials, mostly with mice, but he was inspired by his harrowing experiences as a medic in the First World War to fight against the infections he had seen there caused by the strep germ, a feared killer, one that killed in many different ways, infecting tissue, blood, or spinal fluid. For five years, there were no results of his labwork, until he was sent a molecule with sulfonamide attached to it. Sulfa worked in mice; did it work in humans? It is quite amazing to read about how the drug was tested for human use, because it is nothing like the trials of any new drug today. The tests did not involve, for instance, assigning patients randomly to drug versus placebo groups, or doing double blind testing. The drug was simply leaked to hospitals who had serious cases, patients who had gotten all the usual treatments and were simply going to die if nothing out of the ordinary was tried. Domagk was awarded the Nobel Prize in 1939, and was thrilled to be following his heroes Koch and Ehrlich. But because four years previously, the Peace Prize had been awarded to a German pacifist, Hitler had forbidden any German citizen to accept any further Nobel. Not only could Domagk not claim his award, he was put in jail for being "too polite to the Swedes" who awarded the prize. After the Nazi blight was cleared away, Domagk was able to claim his prize in 1947, when sulfa was old news. When he gave his speech of acceptance, he alluded to the emergence of resistant strains of bacteria, a prescient warning which could not have been fully appreciated by his audience at the time.

THE DEMON UNDER THE MICROSCOPE: FROM BATTLEFIELD HOSPITALS TO NAZI LABS, ONE DOCTOR'S HEROIC SEARCH FOR THE WORLD'S FIRST MIRACLE DRUG tells of a world-wide race to find a drug which would change and save lives. Research Domagk saw hundreds of his fellow German soldiers die of infected wounds during the first world war, and worked for a solution for years before achieving a breakthrough which would lead his government to punish him. His discovery of the benefits of sulfa would eventually be overrun by penicillin - but in the meantime he'd languish in jail for his efforts. From how sulfa changed perceptions of drug treatments to why wartime needs spurred the discoveries in antibiotics, this is a rare history that should be a part of any comprehensive college-level medical library - and many a public library collection. Diane C. Donovan California Bookwatch

In a time when Bird Flu, AIDS, Ebola, Marberg and God-only-knows what other viruses threaten life today, its easy to forget that not too long ago bacteria posed an even greater menace. Anyone with as little as a cut or a scrape, nevermind battlefield wound, could fall victim to infection any viriety of which could become life ending. Medical Science at the time was, in the author's words, no more effective than "a medicine man with a mask and bone rattle." This book is the fascinating, and little known story of those who changed all of this. Thomas Hager has so painstakingly researched every minute detail of the story and assembled a richly informing narrative. Yet, the story he tells moves like a well writen novel, keeping the reader fastened to the end. My only regret is that the publisher did not see fit to include photographs of places and persons mentioned. Nevertheless, for anyone like myself, who enjoys reading science and history at its best, you won't be dissapointed.