Book review: The Demon Under the Microscope, By Hager

As human beings, we have relatively short memories; we have largely forgotten what life was like barely 90 years ago, when human lives were far too often cut short by relatively simple infections (by today's standards). Most of us have lost touch with the time when epidemics of "childbed fever" meant that almost all women giving birth in the hospital would die from infection; when a simple blister on the toe could lead to deadly, incurable bacterial sepsis.

Hager's book is an excellent reminder of how far we've come. It is largely narrative history, written with the aim of communicating the processes and ideas that led to the development of sulfa (the world's first true antibiotic), rather than a straightforward chronological account.

Hager begins right at the start, when microscopic world was first discovered, and how it led to the development of germ theory. He carries us through the development of antiseptic use and serum therapy, moving us from a time where surgeons merely placed their instruments on any convenient table, to a period when theatres were constantly filled with aerosolised antiseptic blown from a bellows.

The real start of the show, however, is Nobel Prize winner Domagk (and of course his much neglected chemists), who led the clinical research that culminated in the discovery of the antimicrobial properties of sulfa. Their pains and toils are remarkably communicated by Hager, giving us a definite sense of disappointment after years of unfruitful research. At the same time, due credit is given to other parties involved in the discovery - including French researcher Forneau.

The stories doesn't just stop at the discovery of sulfa - Hager also gives us an account of how the FDA and a haphazard medicinal drug market was transformed overnight into a well organised, highly vigilant industry.

All in all, this is a fantastic book - not just for an insight into the discovery of sulfa, but the ideological and scientific struggles surrounding the idea of a antimicrobial "magic bullet", and the challenges that sulfa placed forth to the world - that of the need for careful, well designed and executed clinical drug research. Most of all, this is a book that reminds us of where we've come from, where we are now, and raises question of where we are headed, in our constant battle with the microscopic enemies in our midsts - an issue particularly pertinent with worrying trends in bacterial resistance.