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

by Thomas Hager Narrated by Stephen Hoye

Overview

Fast-paced, suspenseful, and utterly satisfying, The Demon Under the Microscope is a sweeping history of the discovery of the first antibiotic and its dramatic effect on the world of medicine and beyond.



The Nazis discovered it. The Allies won the war with it. It conquered diseases, changed laws, and single-handedly launched the era of antibiotics. This incredible discovery was sulfa, the first antibiotic medication. In The Demon Under the Microscope Thomas Hager chronicles the dramatic history of the drug that shaped modern medicine.



Sulfa saved millions of lives-among them Winston Churchill and Franklin Delano Roosevelt, Jr.-but its real effects are even more far reaching. Sulfa changed the way new drugs were developed, approved and sold; transformed the way doctors treated patients; and ushered in the era of modern medicine. The very concept that chemicals created in a lab could cure disease revolutionized medicine, taking it from the treatment of symptoms and discomfort to the eradication of the root cause of illness.



A strange and vibrant story, The Demon Under the Microscope illuminates the colorful characters, corporate strategy, individual idealism, careful planning, lucky breaks, cynicism, heroism, greed, hard work, and the central, though mistaken, idea that brought sulfa to the world. This is a fascinating scientific tale with all the excitement and intrigue of a great suspense novel.

Editorial Reviews

In the history of medicine, sulfa was just a short blip: The antibiotic achieved wide distribution in the mid-1930s; a decade later, it had all but disappeared. But during its short lifetime, this miracle drug saved millions of lives; helped shape the course of WWII; and set the stage for the transformation of pharmaceutical research and medical practice. Thomas Hager's The Demon Under the Microscope is a fast-paced, fact-filled chronicle of a drug that changed the world by changing microscopic bacteria.

Kirkus Reviews

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 theMassengill 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.

From the Publisher

Fascinating . . . A rousing, valuable contribution to the history of medicine.”
—Kirkus Reviews (starred)

"A well-told tale of trail-blazing science."
—Booklist

"Highly recommended."
—Library Science

"This is a grand story, and Mr. Hager tells it well...one can easily imagine 'The Demon Under the Microscope,' like 'Microbe Hunters' before it, inspiring in young, idealistic readers the enthusiasm for medical research and the zeal for healing that generates great physicians."
—Wall Street Journal

"Surprisingly entertaining...[Hager's] enthusiasm for the search for a 'magic bullet' drug in the early 20th century is infectious. He convincingly credits sulfa drugs for some of the most revolutionary and catastrophic moments in medicine. And anecdotes about famous people affected—from Calvin Coolidge to Eleanor Roosevelt—are narrative spoonfuls of sugar."
—Entertainment Weekly

"Grips the reader from the first paragraph...a story of dedication, luck, tragedy and triumph that's still relevant today."
—Bookpage

"Hager, a biographer of Linus Pauling, does a remarkable job of transforming material fit for a graduate biology seminar into highly entertaining reading. He knows that lay readers need plenty of personality and local color, and his story is rich with both. This yarn prefigures the modern rush for corporate pharma patents; it is testament to Hager's skills that the inherently unsexy process of finding the chemicals that might help conquer strep is as exciting an account of the hunt for a Russian submarine."
—Publishers Weekly

Product Details

BN ID:	2940169560268
Publisher:	Tantor Audio
Publication date:	11/16/2006
Edition description:	Unabridged

Read an Excerpt

Chapter One

Gerhard Domagk looked at the blood soaking his tunic. It was 1914, a few days before Christmas. The German army had just finished an artillery barrage. Domagk's unit had been sent in, the young men and their officers walking slowly through the yellowing grass toward a Polish farmhouse, their breath showing white, when shots came from somewhere to their left. Domagk saw the officer nearest him fall. Then he felt a blow to his head. His helmet flew off and landed somewhere in the grass. His chest felt hot. When he looked down, he saw the blood. He had attended a single term of medical school before joining the army and knew enough to give himself a quick exam. He found no wound on his body. Then he discovered the source. Blood was streaming from his head, down his neck, and onto his shirt. He explored his scalp gently with his fingers. Hard to say how bad the gash was, but it had probably opened when the bullet knocked his helmet off. He bandaged himself with a large handkerchief. Then he passed out. When he awoke, he was jolting through trees in a farmer's cart toward what had been a church, now a German field hospital, where he was examined, his bleeding stopped, and his wound dressed. When the staff decided that it appeared likely he would survive, he was packed onto a train to Berlin, to recuperate in a central hospital. The wound did not look serious, but there was no way to know if there would be permanent brain damage. Time would tell.

The blow to his head did not change Domagk's mind about the war. He, like most of his fellow university students, had been infected and rendered mildly delirious during the epidemic of patriotic fever that swept Germany in the summer of 1914. The tall, thin boy volunteered for service with more than a dozen of his classmates and friends soon after war was declared. They were inducted as a group into the Leibgrenadier Regiment of Frankfort on the Oder, a unit specializing in the use of grenades. They were given a few weeks of cursory training. Then they were loaded onto a train for Flanders.

They were young and full of energy, eager to join Germany's march, giddy with visions of a short, glorious war. Domagk, the son of a village schoolmaster, was eighteen years old and ready for adventure. He was also a young gentleman who brought his lute to training camp and played folk tunes around the campfire. He wanted to take the instrument with him to the front. When his officers told him that regulations forbade it, he dismantled it, sent the body back to his parents, and kept the neck attached to his knapsack as a memento. Inside the knapsack he carried a photo of his village sweetheart dressed in her white Communion gown.

Now, months later, he was beginning to miss his home, Lagow in the lake country of far eastern Germany. Picturesque and quiet, Lagow became the source of ever-sunnier memories the longer he spent in the army: cannonballing into the river below the mill; a swarm of children flying out of school at the end of the day; a group of friends concocting homemade gunpowder; sneaking his first cigar; the taste of a ripe pear in late summer. He spent his nineteenth birthday in the trenches of Flanders under fire from British ships, huddled in the dirt, "the heavens lit," he wrote his parents, "from burning villages." The glory of war began to fade. He and his comrades were soaked by freezing autumn rains, exhausted, starving, their uniforms caked with muck. Once while digging for drinking water, they broke open an abscess in the earth, a cache of rotting French soldiers, men killed and buried, he figured, by his own unit's grenades.

The Germans were dug in near the Belgian coastal town of Nieuport, where in late October the Leibgrenadier Regiment of Frankfort on the Oder was ordered to participate in a massive attack. Their officers told them that following a 4:00 a.m. German artillery barrage they would charge forward from their trenches and drive the enemy from their trenches. The young men synchronized their watches. They wrote last letters home and put them in their pockets, promising each other that the living would deliver them for the dead. They waited for what seemed a very long time in the dark, listening to shells screaming overhead, watching the flashes.

When the barrage stopped, the young German soldiers struggled and slipped out of their holes. They slogged through a football field's length of mud before they started falling, then heard the chattering of machine guns at short range, each one firing as many bullets as 250 rifle-equipped soldiers. Most of the boys Domagk had joined with were dead within a few seconds. The rest ran. Domagk later figured that only he and two or three others out of his group of fifteen student volunteers survived the battle alive and unwounded. They learned later that their charge was part of a huge failed offensive in which the Germans lost 135,000 soldiers, many of them recent university students, in the course of four weeks of fierce fighting. The British called it the First Battle of Ypres. The Germans called it Kindermord: "The Massacre of the Innocents."

Too ripped up to fight any longer in Flanders, Domagk and what remained of the Leibgrenadiers were transferred to the Eastern Front. A few weeks later, he lost his helmet near the Polish farmhouse. When he began to gather his senses about him in a Berlin hospital room, he discovered that his knapsack was gone, along with the neck of his lute and the photo of his sweetheart. All he now had of his childhood were memories. He remembered his father sitting at the window, waiting for the lamp man. The gas streetlights in Lagow were lit every evening by the lamp man, who came came by with his white horse. Then one day the man stopped coming. When Gerhard's father explained to him that the lamp man had been delayed because his horse was sick, the young boy was stricken by the idea. "I said at the end of the evening prayer with my mother, 'Good God, please make the lamp man come again,'" he remembered. "'Make his horse better again.' "

The German army hospital administration in Berlin, on reviewing their records, found that wounded Leibgrenadier Gerhard Domagk had attended a bit of medical school. It was decided that rather than send him back to the front lines, they would set him to the task of providing medical care for the wounded. Domagk was placed in a training program for medical assistants, one of hundreds of novices hastily pressed into service. After a few weeks of first-aid training, he was sent back to the Eastern Front, through Krakow to a field hospital in the Ukraine. He was fascinated by his trip through "the culture of the East," as he called it, the lands of Germany's destiny, the "beautiful but dirty streets," the Jews with "caftans reaching over their long boots and their corkscrew-like curls hanging down from their temples." He was especially impressed by the architecture he saw.

Flanders had been bad, but the Eastern Front was in many ways worse, especially when it came to medical care. The German casualties were just as heavy, but the hospitals were cruder, doctors fewer, supplies scarcer. The field hospital to which Domagk was assigned was stark, a farm in the middle of the woods roughly converted into a care facility with tents for wards and a barn for an operating room. Every day a miscellany of ambulances, cars, trucks, and farm carts arrived, disgorged their loads of quiet, white-faced wounded, and left for more. There was a constant, deep rumble from big guns a few miles away.

They were seeing wounds no one had ever seen before, thanks to the advance of military and industrial science. Newly deployed and unprecedentedly powerful weapons—artillery that could shoot shells 120 kilometers, high-explosive shells like the giant "Jack Johnsons" that geysered black earth a hundred feet in the air, airplanes and aerial bombs, tanks and poison gas—were slaughtering men at a rate and in ways unimaginable a few years earlier. In previous wars men had been shot or stabbed. Now they were blown to bits. The new weapons changed both the manner of fighting—more trenches, fewer cavalry charges—and what happened after. Because of the new weapons, the number of dead and wounded on both sides was staggering. During the entire Franco-Prussian War in the 1870s, a total of a quarter of a million men were killed and wounded on both sides over ten months of battle—roughly the same total number of killed and wounded at the First Battle of Ypres alone. Military leaders realized within a few months of the war's start that they needed to quickly expand their medical services. Anyone with any medical ability was pressed into service in the rapidly growing network of hospitals. That was how Domagk ended up in the woods of the Ukraine.

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