The term miracle drug is used to describe the class of pharmaceuticals known as antibiotics, introduced for widespread use in the 1940s and 1950s.
The period after World War II was one of MEDICINE’s golden ages. It is hard to imagine another comparable span of time that witnessed the introduction of so many new and genuinely important drugs. Innovations such as cortisone (1952), a steroid used to treat arthritis, Jonas Salk’s polio vaccine (1955), the birth control pill (1960), and minor tranquilizers gave physicians vastly expanded powers to treat a host of physical and mental illnesses, many of them for the first time. But antibiotics comprised the true miracle drugs of the period, and it is these drugs that brought about the most significant changes in the fight against disease.
“Antibiotic,” a term coined by soil microbiologist Sel-man Waksman in 1942, literally means “life against life” and refers to “a chemical substance produced by a microorganism which destroys or inhibits the growth of other microorganisms.”
Although the antibacterial properties of the penicil-lium mold had been known since the 1870s, and Alexander Fleming had published his famous paper on the subject in 1929, not until 1940 did researchers conceive of administering penicillin internally instead of as a topical antiseptic. When used in this way the drug precipitated striking recoveries even in severely infected patients, but the drug was difficult to make—several early recipients recovered only to worsen and die after the supply ran out. War-pressed governments quickly funneled money into developing the drug on a larger scale. The most successful such effort took place in America, where in 1941 the War Production Board coordinated a penicillin production program to supply the army. Production techniques advanced rapidly, and, by the end of the war, all restrictions on the drug’s availability to civilians were waived.
Three new important antibiotic discoveries followed closely upon penicillin’s heels: streptomycin (1943), the broad-spectrum antibiotics chloramphenicol (1947), and the first tetracyclines (1948-50). This powerful crop of new drugs gave the physician potent weapons against a wide range of infectious diseases, including bacterial pneumonias and meningitis, tuberculosis, dysentery, and sexually transmitted diseases such as syphilis and gonorrhea. While most infectious diseases had already declined drastically since the 19th century as the result of better hygiene, nutrition, and sanitation, antibiotics proved remarkably effective in combating those that remained. Mortality from the eight most important diseases treatable by antibiotics decreased 56.4 percent between 1945 and 1955, while the corresponding decline for all other causes of death was only 8.1 percent. Mortality from tuberculosis alone dropped 75.2 percent. The impact was perhaps even greater in surgery, especially in areas such as cardiac surgery, organ transplantation, and the management of severe burns. One statistician estimated in 1958 that 1.5 million American lives had already been saved by antibiotics and their weaker predecessors the sulfanil-amides. Before antibacterials, four out of five children’s deaths were microbially related; 20 years after their introduction, four out of five were nonmicrobial. Across the board, the chronic illnesses of aging and lifestyle-related health problems—those associated with smoking, drinking, and poor nutrition—replaced infectious diseases as the primary health scourges.
The impact of antibiotics was not limited to mortality statistics. The systematic screening of soil samples that had produced the second round of antibiotics served as a model for later pharmaceutical research. The wealth of new drugs discovered over the next decades owed much to this inspiration. Physicians basked in an unprecedented degree of prestige and public confidence. And, not least, the pharmaceutical industry was transformed. In the name of efficiency, the wartime penicillin program had encouraged the growth of large firms that could produce and ship finished products. This raised the value of brand names just as valuable new drugs were being developed. Suddenly, pharmaceuticals became one of the nation’s most profitable industries, and high-pressure ADVERTISING and fierce competition between firms soon followed. The stakes were high: Antibiotics were the best-selling class of drugs on the market and provided from one-sixth to one-third of the profits of such major producers as Lilly, Parke Davis, and Pfizer. Inevitably, excesses occurred. Critics charged that dangerous side effects were deliberately downplayed or even ignored in drug advertisements. A series of price-fixing and corruption scandals erupted, culminating in Senator Estes Kefauver’s drug industry hearings in 1959. And many physicians worried that the drugs were being used against viral illnesses like the common cold over which they held no sway. Resistant strains of bacteria would certainly result from such overexposure, they warned—a chilling possibility given that all major classes of antibiotics had been discovered by 1959. But even such concerns over profiteering and overuse were, in a sense, only testimonies to just how wondrous the postwar miracle drugs really were.
Further reading: Helmuth Maximilian Bottcher, Wonder Drugs: A History of Antibiotics, trans. by Einhart Kawerau (Philadelphia: Lippincott, 1964); Mark S. Gold, Wonder Drugs (New York: Pocket Books, 1987).
—David Herzberg
World History
