One-way systems to keep patients separate

Eastern Dispensary, Bath Photo: William Rogers,

The Corona virus pandemic prevention measures were not the first one-way system in British health care, as William Evans explains.

One feature of the measures imposed or encouraged by the UK government to stop Corona virus spreading was one-way systems for human traffic. In premises such as doctor’s surgeries, one-way systems aimed to reduce close contact between people and avoid transmission of the virus.

One-way systems are not new. We are familiar with them in the management of road traffic. Although fewer accidents and a reduction in personal injuries are some results, the main aims are to relieve traffic congestion and reduce conflict among road users. Another example comes from the household goods sector. The retailer Ikea makes customers follow a prescribed route through its stores. In this case, the aim is not safety, but more sales by bringing to customers’ attention all the goods offered, not just those the customer may be interested in.

There is a historic precedent for a one-way system in a medical context from the Eastern Dispensary in Cleveland Place East, Bath. Opened in 1845, it was designed by the local architect, Henry Edmund Goodridge (1797-1864). The external design is neo-classical: the entrance at the front through a portico with columns and a pediment. Inside, the design was innovative. On entering, patients were directed into one of two waiting rooms at either side of the building (one for women, one for men?). In each waiting room, the patients sat on, and moved along, benches. The first bench was attached to the left side wall, the next one to the right, and so on.

As a result, patients moved along the benches in queue until they were summoned to rooms at the back of the building where they were seen by an apothecary or surgeon or went into a dressing room. They then left the building by a back door from the room where they were seen or treated.

Plan of the dispensary The Builder, (1849) 160

The purpose of that layout may have had much to do with keeping order in what could otherwise have been a melee, but no doubt it also helped to limit the transmission of infectious or contagious diseases. Goodridge’s radical design was commended by The Builder magazine as a model for future dispensaries. It would be interesting to know whether his Bath layout was followed elsewhere.

After it ceased being used as a dispensary, the building housed various activities: in the 1910s, for example, colleges and pharmacies. It is now a bistro.


Plan of the dispensary: Bath & NE Somerset Council Archives, 0033

The Builder, (1849) 160;

Michael Forsyth, Bath, in the Pevsner Architectural Guides series, Yale UP 2003

For Goodridge: HM Colvin, A biographical dictionary of British architects 1600-1840, Yale UP 1997

For dispensaries: Michael Whitfield, The dispensaries: healthcare for the poor before the NHS, Author House 2006

William Evans is treasurer of Avon Local History & Archaeology, the umbrella group for local history in the Bristol and Bath area.

Recycling Penicillin from Urine in Post-War Germany

Limited supplies of penicillin and Allied restrictions on German access to the drug in the immediate aftermath of World War II led to its recovery from the urine of treated patients. Susanne Krejsa MacManus explains.

German research on penicillin started only in 1942 and then on a very small scale.[1]  Gerhard Domagk (1895-1964), the German scientist who in 1935 had developed sulfonamides, had advised the Nazi government to concentrate on improving of “his” type of antibiotics instead of trying to get its own penicillin production going.

It took Germany till the end of 1943 to really understand the importance of penicillin, but because of the efforts of the Allies to restrict information and materials,[2] German scientists were not able to learn about the right mould, nor could they develop the process to get a good supply.

From autumn 1945, British and American forces increased the amount of penicillin flown into hospitals in Berlin – mostly for their own soldiers as a treatment for sexually transmitted diseases. But the occupying forces faced a dilemma: on one hand, they had to look after the health of the population of the occupied areas; on the other hand, there was a hostile atmosphere against the German population – at least in the first months after the end of the war. Germany was categorised as a “defeated enemy” – in contrast to Austria which was categorised as a “victim”.

There was even a third aspect. The German pharmaceutical industry was known as being innovative and effective. The occupying forces hoped for “penicillin made in Germany” and encouraged companies like I.G. Farben, Hoechst and Chemie-Grünenthal to start such an undertaking.

The USSR did not have penicillin production of its own, although they claimed two of their scientists had invented the antibiotic long before Alexander Fleming. As early as early May 1945, Soviet forces who were eager to get penicillin as part of German reparations were pushing the German company Schering .[3]

Since one of Schering’s production sites lay in British territory, the company got support from the British element of the occupation forces for building laboratories and getting raw material (as this ad shows.).[4] 

Salzburger Nachrichten, 9/1/1946  Schering AG produces penicillin Berlin,  As the British broadcast has reported, the Germany pharmaceutical company Schering AG in Berlin will manufacture penicillin for Germany. The British military government has promised its support to the company in procuring the laboratory and the necessary material, so far as it is available in Germany.

But sufficient output was not available before the end of 1946/the beginning of 1947.

Two-thirds excreted

During their struggle to set up a production site, scientists at Schering recalled that two- thirds of penicillin given by injection left the body very quickly, so quickly that injections had to be repeated every few hours.[5] “If we could get the urine of patients treated with penicillin”, the scientists speculated, “we might be able to reclaim and concentrate this substance.”

The British and American forces permitted them to collect the urine from their hospitals on the condition that they got their share of the recycled substance. From March 1946, Schering’s scientists organised milk-churns and bicycles and went from hospital to hospital to collect patients’ urine. The recycling process was successful, and in spring 1947 it was extended into American and British areas of West Germany. In April 1949, nearly 5000 liters of urine from 3153 patients were collected from hospitals. This activity lasted till 1950, when the manufacturers’ penicillin production was sufficient to meet demand.

Recycling penicillin from urine was not a new idea, but its use on this scale was was exceptional. It showed that the German researchers had clearly understood the character of penicillin being excreted from the organism so quickly. Secondly, the process of recycling penicillin purified the substance, which at the initial injection had produced sharp and unpleasant feelings for the patient. And third, it shows how Schering’s researchers could act on their own initiative, without having to ask boards and committees for permission as they would have to do today.

Susanne Krejsa MacManus PhD is an independent journalist, author and archivist in Vienna. She is a member of the History of Medicine/Medical Humanities working group of the Commission for History and Philosophy of the Sciences at the Austrian Academy of Sciences (ÖAW).


[1] I. Pieroth: Penicillinherstellung – Von den Anfängen bis zur Großproduktion, Heidelberger Schriften, 1992, p. 103.

[2] P. Rostock: Die Wunde, Berlin: De Gruyter, 1950, p. 290.

[3] J.-P. Gaudillière, B. Gausemeier: Molding National Research Systems, OSIRIS 2005, 20:180-202.

[4] Schering A.G. Berlin produziert Penizillin, Salzburger Nachrichten, 9. 1. 1946, p. 2.

[5] J.H. Humphrey: Excretion of Penicillin in Man, Nature 3920, 1944, 765.