scientists learned that grinding hard work and a little good luck achieved
something that physicians and scientists would have thought impossible a
mere fifty years earlier: the control, if not cure, of TB, and the ability to
address almost any infection that may arise ... at least until drug
resistance and bacterial evolution outfox modern intellectuals.
Cockroaches have nothing on bacteria.
The ability to identify, stain, culture, and test bacteria helped lead to the
formation of a new industrial behemoth of pharmaceuticals as we know
them today. It is stunning to realize that “penicillin, streptomycin, the
versions of tetracycline, chloramphenicol, and erythromycin had all been
introduced between 1941 and 1948,”^23 simply by working the soil. I’ve
asked dozens of patients how drug companies bring new antibiotics to the
market, and most draw a blank expression and say something like, “Don’t
they design them in their corporate drug offices?” The fact is that
pharmaceutical scientists rely on billions of years of evolution among the
tiniest inhabitants of our world, deciphering which molecules have novel
methods of defense and confrontation, and utilize these newcomers in the
battle against our attackers.
Given the stakes, both financial and of legacy, one would think that
hundreds of drug companies would have discovered and modified
thousands of antibiotics over the last seventy-five years, but from “1938 to
2013, only 155 antibacterial compounds received FDA approval. Because
of resistance, toxicity, and replacement by a newer-generation derivative,
only ninety-six antibiotics remain available today.”^24 The partnership
among microbiologists, chemists, statisticians, physicians, and
businessmen has yielded a relatively limited palette of weapons to prevent
and fight infections, but if modern man is incompletely garrisoned, we can
glory in the fact that, over the last several generations, mankind is no
longer vulnerable to the caprices of microbes. The antibiotic revolution,
building on the breakthroughs of the understanding of the organ and
cellular basis of disease, and the founding of bacteriology meant for the
first time ever that it was worth going to a doctor when you were sick.
Pathetic treatments with Dr. Rush’s heavy-metal laxatives (so-called
“thunderbolts”), snake oil patent medicines, arsenic poisoning, toxic
industrial solvents, noxious animal feces, and lethal plant material were in
their twilight by mid-century. (Though never gone—witness the never-say-
die cottage industry of home remedies, alternative medicine “experts,” and