Black Market Penicillin During World War II: “The Third Man”

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Penicillin was used by US and British military during WWII and saved a lot of soldier’s lives from infected wounds and contagious illness [i.e., pneumonia and venereal disease]. People outside of the military relied on black market penicillin.  Since it was not regulated, the use varied and many uses were questionable [i.e., taken prophylactively to prevent disease in sex workers and their customers]. In addition, as Graham Greene portrays in his novella “The Third Man”, the medication was either diluted down with colored water or the powder penicillin was diluted with sand. Many people died due to ether ineffectiveness of therapy or side effects of dirty diluents

In the novella, Rollo Martins learns his friend Harry Lime [thought to be dead] was trafficking black market penicillin:

POLICE INVESTIGATOR:  “…Stage three was when the organizers decided that the profits were not large enough.  Penicillin would not always be impossible to obtain legitimately; they wanted more money and quicker money while the going was good. They began to dilute…You can be immunized from the effects of penicillin…A number of children simply died, and a number went off their heads. You can see them now in the mental ward…”

This quote brings up a number of contemporary issues:  be wary of non-regulated medications, overuse or inappropriate use of an antibiotic can lead to resistance, antibiotics don’t immunize—vaccines do, and children with meningitis—whether they receive proper medication or not--can suffer severe sequelae. Later posts will take these issues further, but adaptation of organisms and their resistance to antimicrobials is alluded to by the police investigator when he mentions “You can be immunized from the effects of penicillin.” When organisms are exposed to repeated amounts of an antibiotic, if not killed, they adapt and become less susceptible; they can appear immune.

Around the time when Alexander Fleming discovered penicillin in 1928 he knew that resistance in Staphylococcus existed, and warned that resistant organisms may become a problem. They did, and a lot of organisms, pneumococcus included, developed resistance. Resistance didn’t take long to develop in many organisms, and is the reason why penicillin has very few legitimate uses today.  Newer antibiotics are becoming less useful with time—due to unnecessary and unregulated use, but also because these organisms adapt.  Much like the black marketeers, they are survivors—they profit in gaps or niches they see for themselves.