Read Happy Accidents: Serendipity in Major Medical Breakthroughs in the Twentieth Century for Free Online

thumb and index finger. The wound became infected with streptococcus, and the infection spread to the arm and then into the bloodstream. Swollen lymph nodes in the armpit were lanced of pus fourteen times, but the infection was relentless, and the surgeon recommended amputation of the child's arm. Domagk refused. In desperation, he took one of his precious experimental drug samples and treated Hildegard with it. Within two days her fever broke, and after repeated courses of the drug, she went on to recover fully—with, however, one unfortunate and permanent side effect: her skin turned a light reddish, lobsterlike color. This was not true of all patients who used Prontosil.
    Early reports that “something was brewing in the Rhineland” regarding chemotherapy cures of streptococcal infections reached Britain by the summer of 1935. The brew was Prontosil. Used in an outbreak of puerperal sepsis (childbed fever) in 1936 in Queen Charlotte Maternity Hospital in London, the new “miracle drug” slashed mortality from 25 to 4.7 percent.
    In February 1935 Domagk finally published his classic paper, which was modestly titled “A contribution to the chemotherapy of bacterial infections.”competitors. IG Farben would have recognized that the active principle, sulfanilamide, was not patentable.
No One Ever Thought of Testing It
Sulfanilamide itself had been synthesized and described long before, in Vienna in 1908 by Paul Gelmo in the course of working on his doctoral thesis. Like many other synthetic chemicals of no use, it had been gathering dust on some laboratory shelves. It had been produced in huge quantities as a by-product in the dye industry, and nobody had ever thought of testing it as an antibiotic. Had its properties been known, sulfanilamide might have saved 750,000 lives in World War I alone. After the war, Gelmo was found eking out a precarious existence as an analytical chemist for a firm of printing ink manufacturers.
    Domagk and his team of chemists may have been in a frantic race for a patentable analog. This concern for secrecy would explain why the IG Farbenindustrie did not respond to researchers at the Pasteur Institute in Paris who requested samples of Prontosil to investigate its inactivity in the laboratory. The Germans, of course, were pursuing an exclusive commercial product with huge potential profits. Not only scientific but also nationalistic rivalry was undoubtedly at stake.
    In a breathtaking series of events, the French scientists Jacques Tréfouël and his wife Therèse, together with Frédéric Nitti and Daniel Bovet, quickly succeeded in synthesizing similar compounds on their own. Within nine months of Domagk's publication, their experiments not only verified his results but, in a compelling instance of fortune, uncovered what would prove to be the essential “wonder drug.”
    They intended to test the curative powers of their chemical dyes on eight groups of mice injected with a highly virulent culture of streptococcus. Only seven dyes were readily available. For the eighth group, they reached for a long-neglected dust-laden bottle on their laboratory shelf containing a colorless mixture. This would turn out to be sulfanilamide, the chemical common to all the compounds in theexperiment. The next morning, the control group of mice—those not treated with a synthesized dye—were all dead. Those treated with Prontosil and analogs had been protected—as had, most surprisingly, the eighth group of mice treated with the colorless chemical. A “Eureka!” moment had been occasioned by chance.
    Why Prontosil was inactive in vitro (in the test tube) but effective in vivo (in the body) became apparent and was soon proved. In the body, Prontosil is broken down to liberate the active principle, sulfanilamide, which alone is the agent against streptococcal growth. Furthermore, Tréfouël and his team demonstrated that sulfanilamide in contrast to Prontosil is active not only in vivo but also in vitro.