Medicine: New Magic Bullet

Last week it looked as if Britain’s Professor Alexander Fleming had discovered the greatest therapeutic drug of all time. Not since penicillin became a wonder drug in 1941 has it made such news. A jam-packed session of the American Public Health Association’s meeting in Manhattan heard the Public Health Service’s Dr. John F. Mahoney announce that penicillin had apparently cured four cases of early syphilis. The penicillin treatment lasted eight days. The standard treatment takes 18 months. (The one-and five-day treatments with artificial fever and drugs, though sometimes dramatic, are still considered risky.)

Each of Dr. Mahoney’s patients was given an injection of 25,000 units of penicillin in the buttock muscles every four hours. Each received 48 injections. After 16 hours of treatment, the corkscrew-shaped spirochetes no longer showed up under the microscope in serum from the lesion. Dr. Mahoney was “stunned”; this is the first case on record in which penicillin has killed spirochetes, a higher form of life than bacilli. Yet the patients had no bad reaction from the injections.

During treatment and in the following weeks, the men’s blood was repeatedly put through seven different syphilis-finding tests. One by one, beginning about the 20th day, the tests became negative. In one case all six tests became negative in 30 days. The others were completely negative by the 110th day except for one man for whom one delicate test remained doubtful (but Dr. Mahoney says “a clever technician” could easily have read that as negative too). Now, 130 days after treatment began, all the men are apparently well. But as syphilis often returns when doctors think they have it licked, the patients’ blood and health are being rechecked every week.

Before penicillin can be called a cure for syphilis, says Dr. Mahoney. it must succeed in a huge number of cases over a long period. Such a workout must wait until more penicillin is available, probably after the war. But Dr. Mahoney, whom other syphilologists call a “sound” man, was enough impressed by penicillin’s performance to say that “a reconstruction of syphilis therapy may be necessary.” And a doctor who took the platform to comment on his speech went even further. Said he: “This is probably the most significant paper ever presented in the medical field.”

Other important penicillin news: Drs. George H. Robinson and James E. Wallace of Pittsburgh have used crude green penicillium mold (which produces the drug penicillin) in healing stubborn surface wounds. Highly refined penicillin, on which the armed forces have priorities, is necessary for bloodstream injections, but the doctors did not see why surface poultices needed to be so fancy. Their idea was that the living mold might make penicillin right in the wound. They are not sure what actually happens, but the results are good. With mold-inoculated gauze they cured a man with an acute bone infection in ten days, greatly improved a patient with multiple abscesses on his back, cured or improved several others.