The Demon Under the Microscope: From Battlefield Hospitals to Nazi Labs, One Doctor's Heroic Search for the World's First Miracle Drug by Thomas Hager
My rating: 5 of 5 stars
Thomas Hager's tale about the discovery of the worlds first true antibiotic is an excellent narrative filled with equal parts drama, medical thriller, human interest, scientific inquiry, and science history. The Demon Under the Microscope primarily focuses on the life and work of a German research doctor, Gerhard Domagk, who, along with talented chemists at Bayer, identified the first drug from a chemical that was effective against a variety of bacteria. The story of sulfa's discovery, and it's impact on the world, is masterfully told by Hager.
I learned a lot from Hager's story, not only about Domagk but about the history of the modern pharmaceutical industry. As somebody who has worked for over 17 years in pharmaceutical quality assurance I was very interested to learn about this part of the history of the industry. Sulfa was the first true modern drug, rigorously researched and tested before being released. I was fascinated by many of the connections that Hager weaves together to tell the story of the first miracle drug, and how many seemingly different events all had an impact on not only sulfa's discover, but the revolution in antibiotics and the modern pharmaceutical industry.
One part of the story that I most enjoyed was Hager's recounting of the tragic Elixir of Sulfanilamide event. During the early craze over sulfa drug makers - many of them makers of "patent" medicines that had almost no testing for safety or effectiveness - made a plethora of sulfa containing drugs. All in the hopes of getting in on the sulfa crazy and earning money. Elixir of Sulfanilamide was a sweet tasting syrup that contained the wonder drug sulfa and was sold over the counter by pharmacists across the United States. The elixir had another component used to dissolve the sulfa (sulfanilamide was notoriously difficult to put into solution and couldn't be dissolved in water) - diethylene glycol. Today we know that diethylene glycol is a very toxic chemical and will attack the kidneys and lead to death. In the 1930's almost nothing was known about this chemical. In the rush to join the sulfa bandwagon the maker of the elixir used a harmful chemical without knowing it. No testing or research was done, and as a result over 100 people in the US were killed. Hager's recounting of the events around the Elixir of Sulfanilamide, and how it related to not only to the history and discovery of sulfa, but also to the evolution of the modern drug regulatory environment, was very well done. (The deaths cause by the elixir spurred the US Congress to pass new laws that gave more oversight and power to the Food and Drug Administration - FDA - effectively changing overnight how drugs were to be manufactured, tested, and sold in the US. In essence I owe my own career in pharmaceutical quality assurance to sulfa and the tragic events of the elixir.)
Spanning across decades and tying together not only the research from Germany, France, and England, but also the lives of the researchers and doctors, The Devil Under the Microscope is a compelling narrative about one of the pivotal points in modern history. Had sulfa not been discovered and its benefits been shown to the world the modern antibiotics we have today may still have been discovered, but the process by which new drugs are researched, tested, and brought to market may never have come about. Even though sulfa was soon overshadowed by the end of WWII by penicillin and other antibiotics its discovery was instrumental in paving the way for our modern pharmaceutical industry. Hager's research into the history of sulfa, and the clear and entertaining way that the story of sulfa is delivered to the reader, makes The Demon Under the Microscope a book well worth the read.
I listened the the wonderful audiobook version from Tantor media read by Stephen Hoye and downloaded from my local library. Hoye does a great job of narrating the events, bringing the lives of the different characters in the discovery of sulfa to life, and making the pronunciation of so many different tongue-twisting chemical names seem easy and effortless.
I highly recommend this book for anybody interested not only in history or the history of science, but for people who are interested in real-life drama and medical mysteries.
