1. HSTCMP 410 A: Medicine, History, & Society
Medical Advances during WWII
August 4, 2016
Laura Harkewicz, Ph.D.

2. Today’s agenda
Recap
Medicine & War
Film
Blood
Penicillin

3. Recap:
Medicalization reached an extreme pitch in the interwar years ( )
Eugenics – essentially application of Darwinist ideas to “human stock” - “Social Darwinism”

4. Recap In Germany, eugenics was institutionalized & medicalized
Doctrine of racial hygiene was deployed to justify the euthanasia of, first, institutionalized children, then, institutionalized adults, & eventually, the genocide in the concentrations camps

5. Medicine and War
Revolutionary and Napoleonic Wars ( ) - extensive surgical experience
Scientific medicine surgical in its outlook
Crimean War ( ) - Florence Nightingale & sanitation in hospitals
Colonial wars - treatment & understanding of various diseases
WWI - facial wounds & plastic surgery, shell shock & neuroses of all kinds

6. Two major medical advances resulted from World War II:
Ensuring blood supply
Mass production of penicillin

7. The Wonderful World of Blood
Film
The Wonderful World of Blood

8. Break

9. Blood Blood transfusion - experimented with since the 17th C Difficult
Dangerous

10. Karl Landsteiner (1868 – 1943) 1900 = Discovered blood types
Identified 2 antigens & two agglutinins
Later, O was designated as a type

11. Other Blood Groups In 1940, Landsteiner and others described Rh factor
Sparked renewed interest in blood groups

12. Direct blood transfusion
Direct donation
Doctors recruited donors
Required cut- down

13. Indirect transfusion Cannulas Indirect transfusion=
The movement of blood mediated by needles, stopcocks, & bottles made transfusions easier also

14. Sodium citrate 1915 - experiments with sodium citrate
Established the precise dose
Widespread use of blood transfusion for the first time

15. Blood banks
Soviet Union cadaver blood collection – build blood storage network
Chicago physician
Blood Preservation Laboratory
Blood bank

16. Blood supply & War
Systematic testing, storage, and transportation - leftists and their sympathizers during Spanish Civil War ( ).
London organized a network of blood banks to
American physicians began work on the problem of supplying Britain

17. Plasma John Elliott - plasma alone as a substitute for whole blood
Breakthrough for combat
Plasma was easier to preserve and didn’t have to be “typed”

18. Success of Plasma use Could be frozen & dried
Equipment for reconstitution - package
Available conditions of war

19. “Plasma for Britain”
August 1940, at Elliott’s urging, Red Cross launched program
African-American physician Charles Drew was put in charge of it

20. Charles Richard Drew
Grew up in a middle class family in Washington, DC
Attended medical school at McGill in Montreal
Pursued postgraduate fellowship at Columbia
(1904 – 1950)

21. Drew & Treatments for Shock
The condition where their arteries collapse after loss of blood
War wounds
At Columbia, Drew wrote a thesis on blood banking as a response to this situation

22. “Negro blood”
Summer of 1941, American Red Cross began large-scale of blood for Allied & American troops
To accept Negro blood or not?
Reasons for segregating social not scientific

23. Dry Plasma Large scale manufacturing Included in soldiers’ field kits
Transfusion kit in ammo box

24. Albumin Edwin J. Cohn (1892 – 1953) studied blood components
Managed to divide blood into five different fractions
Arrived at a stable, highly absorbent white powder called albumin

25. Winning the blood supply war
Public opposes Red Cross segregation & labeling of blood policy
Germans had expelled or killed many of their leading scientists & rejected foreign technologies.
Use only “Aryan” blood

26. Penicillin

27. Alexander Fleming (1881 – 1953) Born on a farm in Scotland
During World War I, his attention was focused on the wounded under bombardment
Saw terrifying rates of staphylococcus infection in the injured

28. At St. Mary's, Fleming performed countless experiments growing staphylococcus bacteria
One cool day early in September, 1928…
Closed the door
Windows of his lab were not open

29. A month later...
In the center was a yellow-green growth, & around that growth was a clear halo where no bacteria grew
SOMETHING had “destroyed” the bacteria

30. Penicillin
Under a microscope, Fleming identified a rare mold called Penicillium notatum
Mold had apparently come from the Mycology department
And found its way in one of his Petri dishes

31. Serendipity?
If the Penicillium had landed in a culture plate where bacteria had begun to grow, Fleming would never have seen the halo
The weather had also been helpful
Fleming published a report on his finding in the British Journal of Experimental Pathology
No one seemed interested

32. Penicillin, the sequel
In 1938, Oxford biochemists Howard Florey (1898 – 1968) and Ernst Chain (1906 – 1979) read Fleming’s paper
Decided to perform clinical trial
Penicillin was extremely time- consuming & expensive

33. The long road to Penicillin, the drug
Rockefeller Foundation funds
With the help of Norman Heatley (1911 – 2004), began growing mold, and refining it
Five months make enough to treat few mice 
It took the resources of the whole department to produce enough to treat one patient

34. Penicillin difficult to produce because…
Chemical structure unknown until 1945
Could only use natural forms
Able to manufacture large quantities by producing mold via fermentation
Beer vats

35. Penicillin, the success
July petition American drug companies to manufacture
By 1944 they were able to produce enough to treat the Allied forces
On D-Day it helped save 3,000 soldiers on Normandy Beach