Penicillin: Triumph and Tragedy (review)

This is a well-written book that draws on a wide variety of sources to reveal some less well-known facts about the otherwise well-known history of penicillin. It does so by describing the fate of the wonder drug during and after World War II in various parts of the world, including countries not normally referred to in standard accounts, and by studying it as a “brand” as well as a chemical. Although this is not an economic history of the pharmaceutical product “penicillin,” Robert Bud uses the marketing concept of a “brand” in order to overcome the artificial boundaries that exist between society and technology. In Bud’s own words, “So great is the drug’s public presence, that it transcends any divide between society and technology. . . . Penicillin is so closely associated with ‘strong medicine,’ scientific triumph, social improvement, and reliability that the very writing of a prescription gives hope to the patients and a sense of power to the doctor” (p. 2).

In Penicillin: Triumph and Tragedy, what we have, therefore, is a cultural history of a technological artifact that was shaped by the wartime and postwar context out of which it emerged, and that in turn helped to transform the medical market place in which it was deployed. Hence, like its object, the book is situated at the nexus between history of science, technology, society, and politics.

Furthermore, studying penicillin as a brand as well as a chemical enables Bud to explore the twin faces of penicillin, as triumph and as tragedy, and attempt to resolve the apparent dichotomy between the two. As he convincingly shows, the tragedy of penicillin is intimately related to its success as a brand, and the “unrealizable ambitions” that it nurtured throughout the second half of the twentieth century (p. 213). Indeed, resistant strains of bacteria appeared almost as soon as the drug began to be widely used, but it was not until the 1960s—when crises such as thalidomide threatened to undermine the public’s trust in the medical profession—that an alternative appeared to the triumphalist discourses surrounding penicillin. Thus, “a darker story was formulated by an increasing number of people dismayed by the misuse of valued medicines” (p. 3). At first, armed with new antibiotics and other technical solutions, the medical profession largely succeeded in countering the threat and deflecting potential criticism, and blame was cast principally on the uses and abuses of antibiotics in agriculture. However, according to Bud this strategy only served to aggravate the problem of resistance, and by the beginning of the twenty-first century, AIDS, BSE,MRSA, and the threat of a flu pandemic have brought the limits of doctors’ ability to combat infectious diseases into sharper relief.

Hence there is an important message at the center of the book, a message with which the reader is invited to engage. It is that “all of us who have ever taken penicillin or any other antibiotic have been actors” (p. 3), for in this way we have contributed to the huge weight of expectation placed on our medical systems. Thus Bud ends with a mobilizing cry, so that responsibility may be taken for “preserving a sustainable microbiological environment,” for “reformulating a global brand trusted for half a century and finding new methods of managing health care” (pp. 215–16). In sum, Penicillin: Triumph and Tragedy is a scholarly work, yet it reads as a popular history and offers much of interest to a broad audience, including readers of Technology and Culture.