Howard Fischer
Uppsala, Sweden

“It’s not that I’m so smart, it’s just that I stay with problems longer.”
– Albert Einstein

Dr. Gerhard Domagk (1895–1964) was a German pathologist and bacteriologist whose research led to a discovery that saved innumerable lives. He worked for the Bayer chemical company and was also a professor at the University of Münster. In 1927 he became director of Bayer’s Institute of Pathology and Bacteriology.¹ One of his interests was developing dyes to stain bacteria to make them more visible under the microscope. These dyes entered the bacteria and most likely killed them. He wondered if some of these dyes could be used to kill infectious organisms in living patients.

After many dead ends, he tried an azo dye, “prontosil,” which had been developed earlier. The dye cured mice that had been first infected with streptococci.² He published these results in 1935. Group A streptococci have the potential, in humans, to cause a variety of serious, often life-threatening infections. This broad group of infections includes meningitis, endocarditis, peritonitis, erysipelas, mastoiditis, tonsillitis, peri-tonsillar abcess,³ and childbed (puerperal) fever,⁴ also called “birth fever,” and “puerperal sepsis.”⁵ At that time, about 40% of patients with puerperal fever were infected by a streptococcus. In 1936, thirty-eight women with puerperal fever in a London maternity hospital were treated with prontosil. The amazing result was that thirty-five women survived.⁶

One of the first people to be treated with prontosil was Domagk’s six-year-old daughter, Hildegarde. She had fallen down some stairs with a sewing needle in her hand. The needle penetrated her wrist and broke off. It was removed but an infection set in. Red streaks of lymphangitis moved up her arm and she developed septicemia. Conventional treatment did not stop the infection and she was near death. Her father, in desperation, injected her with a single dose of prontosil and she recovered.⁷ The following year (1936) prontosil was used to successfully treat severe streptococcal tonsillitis and sinusitis in Franklin D. Roosevelt Jr., the twenty-two-year-old son of the American president.^8,9

It was later determined that prontosil (sulfonamidchrysoidine) was converted to sulfanilamide (the active agent) in the body. Further research led to even more effective sulfa drugs. The antibiotic era had begun.^10,11

Domagk’s revolutionary research earned him the 1939 Nobel Prize in Physiology or Medicine. Unfortunately, no German national had been allowed to accept a Nobel Prize since 1937, because in 1935 the German anti-Nazi Carl von Ossietzky was awarded the peace prize. Domagk wrote a letter to the Karolinska Institutet in Stockholm thanking them for the award. He was arrested by the Gestapo and briefly jailed until he informed Stockholm that he would not accept the prize. He finally went to Stockholm to accept his award in 1947.¹²

Near the end of his life he wrote, “If I could start again, I would perhaps become a psychiatrist and search for a causal therapy of mental disease which is the most terrifying problem of our times.”¹³ He did not suspect that infectious diseases would not be conquered, but instead would continue to cause disease by previously unknown organisms.

References

1. Gerhard Domagk. Wikipedia.
2. Robert Youngson. Medical Curiosities, New York: Carroll & Graf Publishers, Inc., 1997.
3. Gerhard Domagk. “Further progress in chemotherapy of bacterial infections,” Nobel Lecture, 1947. nobelprize.org
4. NA. “Prontosil,” Time, December 28, 1936.
5. Leonard Colebrook. “Control of puerperal fever,” BMJ, December 31, 1938.
6. Youngson, “Curiosities.”
7. Youngson, “Curiosities.”
8. “Prontosil.”
9. Franklin D. Roosevelt Jr. Wikipedia.
10. Domagk. Wikipedia.
11. Youngson, “Curiosities.”
12. Sven Widmalm. “Hitler’s boycott: cultural politics and the rhetoric of neutrality,” In Attributing Excellence in Medicine: The History of the Nobel Prize, Nils Hansson, Thorsten Halling, et al, eds, Leiden: Koninklijke Brill, 2019.
13. NA. “Gerhard Domagk (October 30, 1895-April 24, 1964) German biochemist, physician, scientist, bacteriologist, World Biographical Encyclopedia, 2021. prabook.com