Download A. Plan of the investigation

Cadena 1
Anthony Cadena
Candidate Number: 000852
Word Count: 1,644
Thesis: To what extent did the use of the antibiotics sulfanilamide and penicillin perform in the
European and Pacific Theaters of World War II? Additionally, what was the impact of these two
antibiotics in the development and implementation of modern medical practice?
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Table of Contents
Plan of Investigation
3
Summary of Evidence
3
Evaluation of Sources
5
Analysis
6
Conclusion
7
List of Sources
9
Appendix I
10
Cadena 3
A.
Plan of the investigation
To what extent did the use of the antibiotics sulfanilamide and penicillin perform in the
European and Pacific Theaters of World War II? Additionally, what was the impact of these two
antibiotics in the development and implementation of modern medical practice? To clearly
establish and ascertain the significance of sulfanilamide and penicillin, the candidate first
formulated a background and history of each drug. Once an overview of each drug was
established, the candidate utilized actual first-hand accounts of various medics, nurses, and
physicians from World War II as well as statistical data to verify the success of each drug.
Lastly, the candidate attempted to draw correlations between the two antibiotics and their
impacts upon modern medicine.
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B.
Summary of Evidence
Sulfanilamide, or more commonly referred to as “sulfa powder”, proved to be a useful
combatant against many bacterial diseases during World War II. First discovered in 1932 by
Gerhard Johannes Paul Domagk (1895-1964), a German biochemist, it proved to be an effective
treatment against streptococcal bacteria. (Steinert, 2000) This antibacterial chemical “provided
the first effective treatments for pneumonia, meningitis, and other bacterial diseases”. (Steinert,
2000) Sulfa powder was first introduced in 1936 and would become “the grandparent of
Sulfonamide family of drugs that are still extremely useful today”. (Steinert, 2000) An account
of a medic’s routine according to Ambrose: “Once the medic reached the wounded man, he did
the briefest examination, put a tourniquet on if necessary, injected a vial of morphine, cleaned up
the wound as best he could, sprinkled sulfa powder on it, slapped on a bandage, and dragged or
carried the patient toward the rear.” (Ambrose, 314) Obviously from this account, regardless of
the actual injury, sulfa powder was used to lower the chances of infection and therefore was
readily administered on the front lines for all US medics and infantry. Each foot soldier was
administered sulfa in powder form as well as twelve tablets for oral intake with which they could
treat themselves. (78, Pyle) Furthermore, sulfa drugs were used and distributed in larger
quantities than was the “miracle drug” penicillin. “Dramatic proof of the effectiveness of this
new agent was provided during an outbreak of meningitis in the French Foreign Legion in
Nigeria. While sulfanilamide was available, there was an 11% mortality rate. After the supply
was exhausted, mortality climbed to 75%.” (Steinert, 2000) Clearly, the use of sulfa drugs was
effective in eradicating bacterial diseases and lowering mortality rates during the war. However,
it was not perfect. Sulfa drugs did not prove successful in treating a number of illnesses such as
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tetanus.1 This antibacterial chemical “provided the first effective treatments for pneumonia, and
meningitis”. (Steinert, 2000) Perhaps more important, sulfa powder is the “grandparent” of the
sulfonamide drugs that are used extensively today. (Steinert, 2000)
Scottish bacteriologist, Sir Alexander Fleming (1881-1955) discovered Penicillin.
During World War I Fleming experimented on antibacterial substances and in 1928 he
discovered the germ-destroying properties of penicillium. Penicillin proved to be wonderfully
effective in treating soldiers for infection during World War II. This is an account of one such
soldier: One unfortunate pilot whose plane crashed had suffered terrible burns that had quickly
become infected. The soldier also suffered from a raging fever, he would not survive for much
longer. Penicillin was rushed to his aid. It only took 30 minutes before the “wonder drug” took
affect. In two hours the pilot’s raging fever disappeared and he had a successful recovery.
(Gates, 27) Yet to become effective for humans, a method would be needed to mass-produce
penicillin. During the early stages of the war, the one drawback for penicillin was that it was not
producing in sufficient quantities to treat every soldier to be administered a dose. Kathryn Van
Wagner, a flight nurse in the Pacific theater, explains the dilemma of penicillin:
We had on board a huge wooden box with whole blood and mediciations, mostly sulfa
drugs. Although penicillin was in existence at that time, I only knew it St. Albans [Naval
Hospital] where it was given by injection every three hours in doses of about 50,000 units
per cc. But all we had was just the sulfa drugs in powder form. (Herman, 109)
It was not until ten years later after its original discovery that two scientists, Howard Florey and
Ernest Chain, developed a method in which purified penicillin could be mass-produced. (Gates,
26) Eventually the pharmaceutical company Pfizer teamed up with the Oxford scientists to
develop a method to mass-produce purified penicillin. Pfizer was just one of the many
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companies hired by the US government to develop a method of mass-producing penicillin. “In
the fall of 1942, Pfizer scientist Jasper Kane suggested a completely different approach,
proposing that the company attempt to produce penicillin using the same deep-tank fermentation
methods perfected with citric acid. Ultimately Pfizer produced 90 percent of the penicillin that
went ashore with Allied forces at Normandy on D-Day in 1944. Penicillin was, and is, “one of
the most active and safe antibacterial drugs available today”. (Steinert, 2000) Medical care
during World War II boasted a fifty percent reduction in deaths from World War I to World War
II.2
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C.
Evaluation of sources
Stephen E. Ambrose’s Citizen Soldier draws upon numerous interviews of actual
participants to paint a vivid account of the European Theater of World War II. Using first hand
perspective and brief vignettes, Ambrose attempts to re-create the horrific experience of war
exactly as it happened with as little limitation as possible. As a result, the descriptive and
accurate medical accounts included in Citizen Soldier greatly reinforce and support the
candidate’s thesis. The inclusion of the drugs themselves in the accounts alone sheds light upon
the gravity and importance these antibiotics were given during World War II. Finally, Ambrose
deliberately attempts to provide an impartial basis for the novel so as to not taint the authenticity
of the accounts.
A second critical source to this investigation was David Steinert’s website dedicated
solely to the medics of World War II. Since the site offers a wealth of information in regard to
the practices, institutions, and procedures of combat medics during World War II, the candidate
was able to formulate an overview of the two antibiotics providing a foundation for the
investigation. Steinert fashioned the site in an impartial manner lending the information great
credibility further adding to its accuracy and cohesion. Additionally, the site had a plethora of
contacts and references that helped to focus and pinpoint the investigation.
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D.
Analysis
As mentioned earlier, the medical care department claimed, “Out of every hundred
soldiers receiving medical care, deaths in our last two wars were: 8 out of 100 for World War I
and 4 out of 100 for World War II. (Steinert, 2000) The dramatic reduction in deaths (50%
reduction) from World War I and World War II is no doubt in part to the implementation and
usage of sulfanilamide and penicillin. Furthermore, the ordeal of the French Foreign Legion in
Nigeria heavily supports the effectiveness of sulfanilamide on bacterial disease and infection.
During treatment with sulfa drugs, the mortality rate was well below twenty-five percent (11%),
but as sufficient supplies dwindled the mortality rate skyrocketed to seventy-five percent.
Additionally, according to Ambrose “85 percent of the soldiers who underwent emergency
operations in a mobile field or evacuation hospital survived. Fewer than 4 percent of all patients
admitted to a field hospital died. In the Civil War it had been more like 50 percent.” (311) Again,
sulfanilamide and penicillin played a major role in lowering these figures.
The drugs, however, did have their shortcomings. Sulfanilamide did not prove successful
in eradicating all bacterial infections. As previously mentioned, during vigorous testing in Nazi
concentration camps, sulfa drugs “did not work miracles” specifically in regard to tetanus. (Aziz,
163) Penicillin, on the other hand, suffered from inefficient and time-consuming purification
methods; as a result, not every wounded soldier received the “wonder drug” that needed it.
Yet in spite of these shortcomings, the antibiotics greatly blessed the medical department
and corps. An undeniable advantage for sulfanilamide was that sulfa was produced in such high
quantities that it was readily available in all theaters during the war. The United States Military,
in particular, took advantage of this by administering sulfa powder and tablets to all the foot
soldiers. Even before a medic arrived to the wounded, the soldier himself could have applied
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sulfa to lessen the chance of infection. Penicillin, on the other hand, proved highly effective in
treating burn victims and bacterial infections. As a result, the “wonder drug” became the priority
for countries around the world. Finally in 1942 a method was discovered that immensely sped
the purification process of penicillin enabling penicillin to be shipped worldwide especially for
use on the fronts.
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E.
Conclusion
Medical advancements, particularly advancements in antibiotics, undoubtedly saved a
number of lives during the Second World War. By far, the main advantage attributed to these
two antibiotics is their profound effect on modern medicine. The sulfa drugs of World War II
have given “birth” to a multitude of derivatives that are extremely useful and important into
today’s practice. Penicillin, again, continues to remain as a dominant figure in combating many
bacterial infections with a low risk for side effects. Despite the terrible atrocity of World War II,
there have been highly influential breakthroughs in medicine that have successfully evolved our
modern medical institution.
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Works Cited
Written sources:
Ambrose, Stephen E. Citizen Soldiers. New York: Touchstone, 1997. 315-319
Aziz, Philippe. Doctors of Death. Geneva: Ferni Publishers, 1976. 162-163
Gates, Phil. The History News: Medicine. New York: Scholastic, 2000. 26-27
Herman, Jan K. Battle Station Sick Bay: Navy Medicine in World War II. United States: Library
of Congress Cataloging-in-Publication Data, 1997. 108-109
Pyle, Ernie. “Here is Your War.” Tess Press, 2004. 87
Non-written sources:
Steinert, David. “The History of World War II Medicine”. 2000. 4 December 2004
<http://home.att.net/~steinert/wwii.html>
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Appendix I
1.
In perverted Nazi tests, Sulfa drugs did not prove successful in treating a number of
illnesses such as tetanus. “Just as I [Gebhardt] always said. Sulfa drugs don’t exactly
work miracles.” (Aziz, 163)
2.
Figure I. (Steinert, 2000)