Miracle Cure: The Creation of Antibiotics and the Birth of Modern Medicine

by William Rosen

The epic history of how antibiotics were born, saving millions of lives and creating a vast new industry known as Big Pharma.

As late as the 1930s, virtually no drug intended for sickness did any good; doctors could set bones, deliver babies, and offer palliative care. That all changed in less than a generation with the discovery and development of a new category of medicine known as antibiotics. By 1955, the age-old evolutionary relationship between humans and microbes had been transformed, trivializing once-deadly infections.

William Rosen captures this revolution with all its false starts, lucky surprises, and eccentric characters. He explains why, given the complex nature of bacteria—and their ability to rapidly evolve into new forms—the only way to locate and test potential antibiotic strains is by large-scale, systematic, trial-and-error experimentation. Organizing that research needs large, well-funded organizations and businesses, and so our entire scientific-industrial complex, built around the pharmaceutical company, was born.

Timely, engrossing, and eye-opening, Miracle Cure is a must-read science narrative—a drama of enormous range, combining science, technology, politics, and economics to illuminate the reasons behind one of the most dramatic changes in humanity’s relationship with nature since the invention of agriculture ten thousand years ago.

Genres: Science, History, Nonfiction, Medicine, Medical, Biology, Audiobook

368 pages, Library Binding

First published May 9, 2017

About the author

William Rosen was an historian and author who previously was an editor an publisher at Macmillan, Simon & Schuster, and the Free Press for nearly twenty-five years. He lived in Princeton, New Jersey.

From recent obituary

William Rosen PRINCETON JUNCTION Author William Rosen, 61, whose works of narrative nonfiction include "Justinian's Flea" and "The Most Powerful Idea in the World: The Story of Steam, Industry and Invention," died at home on April 28, 2016, of gastrointestinal stromal cancer, according to his agent. Born in California, Rosen worked for nearly 25 years as an editor and publisher at Macmillan, Simon and Schuster and the Free Press before becoming an author. With a writing style that used anecdotes to pull together the threads of discovery and innovation, Rosen authored or co-authored books on education, traffic, antibiotics, and climate change. Bill Gates said of Rosen's work, "Rosen argues that only with the ability to measure incremental advances--such as whether a lighter part lowers fuel consumption, or one engine produces more power than another--can you achieve sustained innovation. Rosen's view fits my own view of the power of measurement." Rosen grew up in Los Angeles, CA, attended UCLA and, after a brief stint at John Wiley and Sons, moved east for publishing. He edited books authored by George Will, as well as William Bennett, Bernard Lewis, Maya Lin, and Leon Kass. But he found true fulfillment writing books instead of only publishing them.

Reviews

[Ian · Rating 5 out of 5]

An excellent book, recommended. The history of scientific medicine, with particular attention to antibiotics, beginning largely in the 19th century, but with a nod to earlier eras. The men and women who developed scientific medicine are described warts and all, a history of sometimes animosity, pride, and errors. Also the all too commercial side of medicine which has led to costs and resistant infections.

Of note is the clear exposition of the scientific method. The great difficulty of uncovering the medical challenges of nature, a vast and complex tapestry that had to be teased apart strand by strand, often with limited resources. Also clear is how fortunate we are to live in the era of scientific medicine, where disease is not feared and we can reasonably expect to live a full and long life—inlike every other era of humanity when early death was a near certainty.

Again, recommended.

[Susan · Rating 4 out of 5]

Yet another fantastic book on the history of modern science; this one on the development of a number of antibiotics we use today (or try not to use too much of!). I particularly enjoyed the story of the discovery of penicillin which is not only just, as we tend to be told often, about Fleming's serendipity in the lab but also the hard work that Florey and team at Oxford put in to actually develop the application of the drug.
The book also describes the stories of the development of the synthetic sulfanamides and the multi patent battle over tetracycline and its generous use as a broad spectrum antibiotic, which brought us into the world of antibiotic resistance. It closes with describing how antibiotics were the drugs that led to the development of the modern pharma industry as we know it and also love to hate!
Great narrative, with the science described with beautiful clarity. Can appeal to anyone and highly recommended.

[Cupboard Horsington · Rating 3 out of 5]

A well researched and factual recount of one of the most important scientific breakthroughs in history. Well researched and fairly easy to understand, Rosen analyses every aspect in painstaking detail.

Not particularly exciting but I would recommend it to those who work in medicine. I found that the information was unnecessarily dense and in hindsight, I probably should have just watched a documentary on it instead.

[Casey · Rating 4 out of 5]

A good book, providing a thorough history of the discovery and marketing of antibiotics. The book dives deep into the history of bio-chemistry research, detailing the slow but methodical efforts that went into developing the family of antibiotic drugs used today. The author, William Rosen, does a great job combining detailed descriptions of the science with the human story of the scientists. Their education, employment, collaboration, and rivalries provide a tale larger than just rote descriptions of chemical processes. The book also covers the wider array of medical professionals, industrialists, data scientists, and government officials who slowly brought to fruition the pharmaceutical industry as we know it today. The international nature of this community was an interesting element. Far from being the result of the dedicated work of a few scientists in university laboratories, antibiotics was much more the product of a vast network of public sponsored education, private scholarships, big-business enterprises, government directed production measures, and modern commercial marketing. In short, it is a good case study of 20th century industrial development, a type of storytelling that Rosen is very good at. My one issue with the book - there wasn’t a central figure in the story. There is neither a person or drug, nor even a clear sickness, around whom the story revolves. In his previous book, “The Most Powerful Idea In The World”, Rosen did a good job of telling a wide ranging tale of industrial development, but kept it centered on the steam engine. In this work he does not keep a singular drug at the center, but rather covers the whole family of known antibiotics. This increases the scope of the book and lessened some of the human nature aspects he was trying to describe. A good book for those wanting to understand the birth of the pharmaceutical industry. Highly recommended for those interested in the history of research and development in the field of chemistry

[Paul · Rating 4 out of 5]

I liked this book. It gives a lot more detail about the people and companies involved in the development and manufacture of antibiotics, with a bunch of stories and color that I had never heard before. Very interesting to learn that basically all the major pharmaceutical companies today got their start making antibiotics. I also appreciated how Rosen clearly portrays the creation of the FDA with ambivalence — I consider that a mostly sad ending at this point, and I get the impression that Rosen is at least sympathetic to this view.

The stories about various scientists fighting over credit, and generally the information about their petty in-fighting is boring, but I feel like it's a useful bit of narrative compared to the heroic stories of individual genius you usually get in the popular press, so good on Rosen for including it but not over-doing it.

[Tirath · Rating 3 out of 5]

I had to quite the book a little more than half way through.
Extremely verbose and badly edited, such that I would go through a chapter and there was very little to take back with me.
Intg stuff about how penicillin started the industry and how the political and scientific climates were in Europe and US; intg stuff about how the US succeeded where european nations ought to have.

The synopsis is a little misleading as the book has more to do with antibiotics more than other medicine, and it largely deals with the pre 1970 era of medicine.

I wish the editing was better and I guess the synopsis promised more than what was really there.

[Tom · Rating 3 out of 5]

I learned a lot from this book. I had never considered the advent of the medicine age spurring the advent of real scientific research with double blind studies and control groups and everything, but the two went hand in hand. The author was largely a reporter and went through the chronology of trying to find cures for infectious diseases. The end was satisfying, though, with good analysis of pharmaceutical companies and research and the future of anti-biotics.
It made me wish I had paid attention in chemistry. Sorry Mrs. Rae.

[Mark Stidham · Rating 5 out of 5]

Rosen is an excellent writer, and his efforts here are top rate. He accomplishes something very tricky in science writing. That is, he conveys some difficult science deftly and accurately without delving into the technical too far. He is equally adept at including mini-biographies, again with enough detail and some human interest side notes but not so much that the story lags. It all fits together nicely; I wonder if he wrote the last chapter first before constructing an outline to describe how we have arrived at our present crisis (i.e., antibiotic resistant infections).

Taking off my science hat, Rosen gives life to the players in this history. The full range of human virtue and foibles are evident. Two stories are especially well done, and they occupy the center of the book. The first is the winding tale of penicillin. It appears that the Alexander Flemming's account is at best semi-fictional. The long list of other players and their herculean efforts is the true story, and one that dispels the notion of a simple, serendipitous genius. The streptomycin story is as contorted and full of characters. I was sorry to learn of some of the pettiness involved by icons of the field (Selman Waksman comes off particularly badly). It fits in well with my personal experience and my understanding of history: if you want flawless heroes, it is best to stay in the fiction section.

As I am a researcher/entrepreneur in antibacterials with a Ph.D. in biochemistry, so please keep this in mind when interpreting the five star rating. It is difficult for me to be objective about how interesting the subject matter is given my devotion to it and my depth of background. However, as an avid reader of a wide range of history, science, and history of science, I am confident of this high rating. In addition, I believe it is a story of relevance for average people. Health care and modern medicine depend on prescription drugs, and Rosen's book illuminates how this has come to be.

[Christina · Rating 4 out of 5]

Беше ми страшно интересна не само историята около създаването на първите класове антибиотици, а всички - икономически, политически и други обстоятелства - които се събират в един [erfect moment in time, за да направят възможни откритията. Някак книгата представя един bird eye view на целия процес, който беше наистина впечатляващ. Съдебните битки, събраните наблюдения и съображенията, довели до началото на регулацията на лекарствата също бяха представени фактологично и интересно. Безкрайно впечатляващ остава и образът на Франсис Келзи, която не само спасява Щатите от ефектите на талидомида заради фанатичното й запъване с 4 копита и постоянното искане на още и още информация, преди да даде одобрение (което, за щастие, не дава!), а и създава процеса за одобрение на лекарствата, който продължава да е в почти непроменена форма до днес. Отражението му върху цената на лекарствата и върху готовността за разработка на нови лекарства беше също много отрезвяващо...

[Jerrod · Rating 3 out of 5]

A nice history of the creation of antibiotics. You'll learn about sulfa drugs and the myriad of peddlers that sold pharmaceuticals in the US, the importance of the development of academic and private research institutions for drug development, why the dye industry kick started modern chemical pharmacology (hint: that's where all the chemists worked), that penicillin was probably not discovered accidentally, that marketing drugs is actually an important part of doctors' drug knowledge, and that anti-biotic resistant bacteria were known to be a problem almost from the very beginning. This book definitely only deals with the creation and birth parts of the story (which essentially ends in the 1950s (there is some coverage of later decades)). I wish the author had included at least a chapter on what has been learned since then.

Recommended for those who enjoyed The Gene and Bellevue.

[Cynthia Marcus · Rating 2 out of 5]

I have a general interest in the history of medicine, and while this book was very informative, it was also very technical. I have a basic understanding of biology (college level) and an even more basic understanding of chemistry (high school level), so much of the book was over my head. In addition, there is a litany of names and places, some familiar and some obscure, so the book can be dry and bloated. Someone involved in the medical field will have an easier time with this book and get more out of it. Despite this, I did learn many interesting things about the development of antibiotics and the pharmaceutical industry like the relationship between the dye industry in Germany and the medical community.

[Lauren Little · Rating 4 out of 5]

A really solid book on anti-biotics, history of medicine, and even delving into regulation of drugs in the US. The book is a bit dense, bit has a lot of great information and insight. I had not realized all the fighting that happened over who should be credited with the "discovery" of penicillin and streptomycin. I've actually used a lot of the antibiotics mentioned in this book in the lab or as a patient so I felt a deep connection to their mention. I also enjoyed learning how the assessment of drug efficacy has evolved over time. I definitely recommend this book to anyone who works in the drug/CRO industry, works in a biology lab, or just wants to learn more about antibiotics.

[Tom Elliott · Rating 4 out of 5]

Full disclosure, my grandfather was one of the many scientists who played a role in the story of development of antibiotics, so this had more than just historical interest for me. What I did not expect was to come away with an appreciation for how recently the pharmaceutical industry was created since it is so omnipresent in our lives now. It also helps to explain the drastic shifts in population growth and longer life expectancy. (The toll that tuberculosis alone took on human life prior to the latter half of the 20th century is breathtaking - no pun intended...)

[Kendal · Rating 3 out of 5]

More of a 3.5 star read. I learned a lot about the history and politics behind the development of our modern day drug companies. And I discovered an amazing new hero, Frances Kelsey, who single handedly prevented the sale of Thalidomide in America! However, there were definitely a lot of long, dry sections. Not sure how interesting this would be to someone who isn’t related to the healthcare field.

[Fiza Pathan · Rating 5 out of 5]

Excellent & very enlightening. Couldn't put it down. Loved the way the whole history of Antibiotics is presented. I was new to this subject & I have gained a lot by reading this awesome book. If you are looking for an erudite & informative read about the history of antibiotics, an introduction to pharmaceutical companies & the many people that shaped major medical events in history, then this is the book for you. Happy reading !

[Gioia · Rating 5 out of 5]

Another excellent book on a very important, interesting topic by Rosen. Well written and very readable. I love how Rosen can take complicated scientific information and make it accessible to the general public in a concise way. He tells a compelling story about how an unlikely cast of characters changed the face human history by discovering antibiotics.

[Christine · Rating 3 out of 5]

Interesting—I loved the history and stories of drug development. The book got a bit dull in spots and I zoned out while listening. If you enjoy learning the history of medication therapy, this is a good introduction. There is a lot of technical information, so it helps to have a chemistry or medical background.

[Aneil · Rating 4 out of 5]

Excellent discussion of the history and key individuals behind the development of the life-saving antibiotics we take for granted today, even though they are becoming less useful thanks to overuse and misuse (as part of animal feeds). The Audible narration is superb.

[John Patrick · Rating 4 out of 5]

This was a very revealing book about the development of antibiotics and how the pharmaceutical industry exploited it. The level of detail was incredible making it a bit tough to read, but it was so informative, it was worth it.

[Joel · Rating 4 out of 5]

Indeed a great history of how the explosion in medicine started wtih antibiotics. Weaves wartime history, industrial techniques, regulatory oversight, and the press of capitalistic motives in medicine into a very readable and informative book.

[Dino · Rating 3 out of 5]

First half of the book is a little slow with too much detail around antibiotic discovery process. The second half really picks up in laying out industry development. So 2 stars for 1st half, 4 stars for second half yields 3 stars in aggregate.

[Sam · Rating 3 out of 5]

I'm not a scientist so sometimes this got too far into the cellular level weeds for me. However it is a fascinating account of the discovery of antibiotics, their enormous benefit to humanity and the birth of big pharma. It's worth struggling through the weeds every so often. Read it.

[Paul · Rating 5 out of 5]

Very good book. An excellent follow up for "Demon Under the Microscope." It does bog down a bit here and there with the sections on goverment regulation but it adds to the overall subject so it is ok.

[Crystal · Rating 5 out of 5]

It was quite an interesting to find out the complex series of events of perspectives on such a milestone in human discovery.

[Dorothy Caimano · Rating 5 out of 5]

Fascinating look at the development of antibiotics and how much our lives - and medicine - have changed as a result. A look at history of the 20th century from another angle.

[Jo · Rating 5 out of 5]

Excellent documentary of how the pharmaceutical industry became what it is today.

[Bill Yancey · Rating 5 out of 5]

Entertaining, readable history of antibiotics and the history of pharmaceutical companies.

[Tomas Gieni · Rating 5 out of 5]

Truly excellent book.

[David · Rating 5 out of 5]

Only qualm about five stars is that I wish he discussed the nature of resistance more at the end of the book. Fascinating read.

[Kelsey · Rating 4 out of 5]

For those who are looking for a thorough but easily accessible history to antibiotics, this is it!