Military medicine in the years Great The Patriotic War has become almost a key force on the battlefield and in the rear. Thanks to her, many wounded soldiers quickly returned to service, ensuring the victory of the Red Army. But it became possible as a result of the selfless work of doctors who were constantly working on the creation of new drugs, such as antibiotics.
A century and a half ago, one of the main problems facing medicine was high mortality. Despite the good surgical treatment of wounds, people died from subsequent infections, the pathogens of which managed to penetrate the human body. Therefore, gunshot and shrapnel wounds very often led to the death of soldiers, and those of them who were lucky enough to survive often remained disabled.
Doctors fought microbes in different ways. Some performed bloodletting, with the help of which blood containing a large number of pathogens was excreted from the body. Others applied herbs with a bactericidal effect to the wound area. Either decoctions or infusions were made from these herbs, which the patient had to drink. Still others used mercury, arsenic or charcoal, but their use could not be called effective and safe, because along with the healing effect they caused serious burns.
In full growth, this problem arose during the First World War. There is an urgent need to find medicines that can destroy microbes. The first to achieve success was a young and unknown Dr. Alexander Fleming, who worked for a long time at St. Mary’s Hospital in Scotland. He was a general practitioner, but he was actively interested in infectious agents and how they cause various diseases.
After a series of failures, he finally got lucky: by a lucky chance, a piece of moldy bread fell into the cup where the microorganisms were in the nutrient medium. Around each spot of mold, Fleming noticed an area in which there were no bacteria. From this he concluded that mold produces a substance that kills bacteria. Alexander Fleming was extremely interested in this fact. However, he could not correctly determine what kind of healing mold belongs to, nor isolate the substance, it was very unstable.
But he showed how it affects the most common microorganisms: Streptococcus, staphylococcus, diphtheria bacillus, anthrax causative agent, etc. And, most importantly, I kept his samples. One of them got to Oxford University, where in 1939 a German immigrant Ernst Chain isolated pure penicillin from it, and on May 25, 1940 his boss Howard Florey tested the drug on animals. In 1943, the technology for obtaining the drug was transferred to American scientists, who established its mass production in the United States. And two years later Ernst Chain, Howard Florey and Alexander Fleming received the Nobel Prize in Physiology or Medicine for their work with penicillin.
At the presentation of the Nobel Prize, Alexander Fleming said: “It was interesting to me to see how a simple observation made in the bacteriological laboratory of a London hospital eventually turned into a huge industry and how what everyone at one time took for one of my toys, by purification, became the closest approach to creating an ideal substance for treatment of many known diseases”.
Unlike their Western colleagues, Soviet doctors did not have penicillin, so they had to create a medicine literally from scratch. The project was entrusted to microbiologist Zinaida Vissarionovna Ermolyeva, who already had successful experience in fighting infections in combat conditions: in 1942 she managed to stop an outbreak of cholera and typhoid fever in Stalingrad.
In the same year, Z.V. Ermolyeva appeared in Moscow. First of all, she formed her team, which included microbiologist-virologist T.I. Balezina, surgeon N.N. Burdenko and other specialists. Their primary task was to find a special type of mold that could be used as a producer of penicillin. They searched for him in the grass, in the ground, even on the walls of bomb shelters. Fungal cultures were isolated from the samples found and their effect on pathogenic staphylococcus bacteria, which die upon contact with an antibiotic, was checked.
But only the 93rd sample showed the necessary penicillin activity: According to T.I. Balezina, he was found on the second floor of a building on Yauzsky Boulevard. “Our” mold belonged to the species Penicilliumcrustosum, and the Soviet antibiotic was named “penicillin-krustosin”. In 1943, in several Moscow hospitals, under the guidance of Professor I.G. Rufanov, his tests were carried out, which showed a positive result. So, with the help of this drug, a Red Army soldier wounded in the shin with bone damage, who had sepsis after hip amputation, was cured in a hospital on Yauza.
After that, it was decided to introduce an antibiotic into military medical practice. Tests on the frontline took place during the Baltic offensive operation in the autumn of 1944, when Soviet troops began the liberation of Latvia, Lithuania and Estonia. Thanks to krustosin, mortality from wounds and infections in the army decreased by 80%, and the number of amputations of limbs — by 20-30%. Z.V. Ermolyeva herself told about the successful use of the drug: “Patients with severe wounds who received penicillin from the first day had no complications — neither blood poisoning nor gas gangrene. Our drug has also been used to treat pneumonia, erysipelas and other diseases.”
The work of Z.V. Ermolyeva also received international recognition: in 1944, one of the creators of penicillin, Professor Howard Florey, arrived in the USSR, bringing with him a strain of the American drug. He proposed to conduct an experiment — to compare the domestic development with the American counterpart. As a result, it turned out that the Soviet medicine was 1.4 times more effective, after which the amazed Flori respectfully called Ermolyeva “Madame Penicillin”.
At the same time, the drug was put into industrial production in the USSR: at the end of 1944, an experimental workshop was opened in Moscow, which began producing liquid concentrated penicillin.
The work continues
After the war, work in this direction continued. So, N.N. Burdenko summarized the experience of using an antibiotic in the work “Letters to surgeons of the fronts about penicillin”. In it, he writes about what doses of an antibiotic should be used for intramuscular injections, for injection into the cavities of joints or pleura, into veins or arteries, into the spinal canal and ventricles of the brain.
Z.V. Ermolyeva also continued her scientific work, creating a strong team of microbiologists. Together with colleagues, she improved Alexander Fleming’s method for determining the activity of antibiotics, which allows you to correctly calculate the therapeutic dose for various diseases. The technology is based on “the ability of pathogenic microorganisms to ferment glucose by changing the reaction of the medium from alkaline to acidic.”
Microorganisms of hemolytic streptococcus or Staphylococcus were placed in a nutrient solution, forming samples with different concentrations of bacteria. Then an antibiotic was added to the flasks with the infected liquid, and after 16-18 hours, experts evaluated its effectiveness by changes in the acidity of the samples, which could be traced by color.
In 1945-1947 Z.V. Ermolyeva was appointed director of the Institute of Biological Prevention of Infections. In 1947, on the basis of this institute, the All-Union Penicillin Research Institute was established, in which she headed the department of Experimental therapy. Simultaneously, from 1952 until the end of her life, Z.V. Ermolyeva headed the Department of Microbiology and the Laboratory of new antibiotics Central Institute of Advanced Medical Training (CIUV). It was there that such important antibiotics as levomycetin and streptomycin, as well as the antiviral drug interferon, were developed. Later, more modern, effective and easy-to-use antibiotics appeared, among which ampicillin, amoxicillin, amoxiclav and other drugs known to many.
A source: https://e-cis.info/news/569/108968/
