Recalling the miracle that was penicillin: two memorable patients
Authors: J N Morris
Journal: Journal of the Royal Society of Medicine (2004)

I recall two soldiers whose lives were saved, if somewhat unconventionally, by the newly developed penicillin, the new magic. Were they the first British soldiers so fortunate?

Early in 1943, at the 38 British General Hospital in Bangalore, South India, we were instructed to make friendly contacts locally. The director of the city's Institute of Science and Technology took me on a tour that was indeed impressive. But what shook me was the encounter with two young biochemists who proudly displayed a flask of what looked like porridge that they claimed was penicillin: ‘we've read all the articles.’ Alongside was a dish with a heavy growth of streptococci, they said, and another quite clean whence they assured me the same bacteria had been cleared by their ‘penicillin’. In 1943 we knew a little about penicillin from the journals that arrived regularly from home and the USA and had the highest expectations of it.

Soon after, we admitted an officer-cadet, in extremis, with infected cavernous sinus thrombosis and septicaemia. Our several surgeon-specialists would not touch him. We tried everything else, to no avail.

It seemed a crazy idea, but what was the alternative? We discussed and discussed, doctors and nurses; there were no other answers. Meanwhile the patient was increasingly comatose. We resolved to give him the chance.

So off on my bike to the Institute. I explained the situation and they readily gave me a flask of the gruel, a little thinned. We selected the widest bore needle in the hospital, filled a large syringe, and I somehow injected the stuff intramuscularly. Next morning the patient asked for tea. Recovery was uneventful. The one dose it appeared was enough. We thanked the Institute officially and of course personally.

In 1944 we were in Assam, preparing for the recapture of Burma. One evening in July we admitted 401 Chindits whom Wingate had withdrawn from behind enemy lines.1 The sickest among them was a young officer with a badly infected gunshot wound of the chest, empyema necessitatis as I remember, and septicaemic. My opposite number, Philip Hawe, surgeon from Liverpool, did what he could, so did we all, without effect. He was sinking.

Suddenly, I recalled a rumour, goodness knows from where, that the recently arrived American hospital 50 miles to the north in Dibrugarh (back-up for General Stillwell as 38 BGH were for General, later Field Marshal, Slim) had penicillin. I have quite forgotten the bacteriology, but it must have looked hopeful. We had to get to the Americans as quickly as possible.

Our Commanding Officer, however, was a stickler for the rules, which meant seeking approval first from HQ Delhi, who might have to refer to HQ SE Asia Command in Ceylon, who might contct the Americans, who... But there wasn't the time. We couldn't risk it. Hawe and I deliberated anxiously and decided unhappily to go it alone.

Off the two of us drove, confiding only in Night Sister, along what passed for a road, to the US hospital. Arriving at their casualty department, we explained to the orderly that we were doctors from the British hospital in Golaghat: one of our soldiers was at death's door and we wondered if they had some penicillin. ‘Penicillin’, he replied. ‘That's what we give for the clap. Come in.’ He led us to a huge refrigerator cabinet, found the keys—and there was a glorious vision, hundreds, thousands, of vials of penicillin. ‘Help yourselves.’ In our agitation we hadn't brought any container, so we filled our pockets and departed with thanks, blessings and such dignity as we could muster.

By now some information on dosage was available in the journals and we straightaway started the patient on a loading dose and course of injections. He was soon fit to evacuate to base hospital in Dacca, with a small confidential package for his surgeon. We ascertained later that all went well.

Our carpeting by the Commanding Officer was desultory. He was so chuffed with the outcome that his heart plainly wasn't in it. We pressed him to raise with authority our unpreparedness for life-saving compared with the parallel US front-line service. We ourselves sent a letter of apology and thanks to the American Commanding Officer who replied in a friendly way and suggested a joint clinical meeting. This was a great success.

Penicillin reached us officially in September 1944.