Sir Alexander Fleming (6 August 1881 – 11 March 1955) was a Scottish
biologist and pharmacologist. Alexander published many articles on bacteriology,
immunology and chemotherapy. His best-known achievements are the discovery of
the enzyme lysozyme in 1923 and the antibiotic substance penicillin from the
fungus Penicillium notatum in 1928, for which he shared the Nobel Prize in
Physiology or Medicine in 1945 with Howard Walter Florey and Ernst Boris Chain.
Biography
St.Mary's Hospital, Paddington, London.Alexander was born on 6 August 1881 at
Lochfield, a farm near Darvel in East Ayrshire, Scotland. He was the third of
the four children of Hugh Alexander (1816 – 1888) from his second marriage to
Grace Stirling Morton (1848 – 1928), the daughter of a neighboring farmer. Hugh
Alexander had four surviving children from his first marriage. He was 59 at the
time of his second marriage, and died when Alexander (known as Alec) was seven.
Alexander went to Loudoun Moor School and Darvel School, and then for two years
to Kilmarnock Academy. After working in a shipping office for four years, the
twenty-year-old Alexander inherited some money from an uncle, John Fleming. His
older brother, Tom, was already a physician and suggested to his younger sibling
that he follow the same career, and so in 1901, the younger Alexander enrolled
at St Mary's Hospital, Paddington, London. He qualified for the school with
distinction in 1906 and had the option of becoming a surgeon.
By chance, however, he had been a member of the rifle club (he had been an
active member of the Territorial Army since 1900). The captain of the club,
wishing to retain Alexander in the team suggested that he join the research
department at St Mary's, where he became assistant bacteriologist to Sir Almroth
Wright, a pioneer in vaccine therapy and immunology. He gained M.B. and then
B.Sc. with Gold Medal in 1908, and became a lecturer at St. Mary's until 1914.
On 23 December 1915, Alexander married a trained nurse, Sarah Marion McElroy of
Killala, Ireland.
Alexander served throughout World War I as a captain in the Army Medical Corps,
and was mentioned in dispatches. He and many of his colleagues worked in
battlefield hospitals at the Western Front in France. In 1918 he returned to St.
Mary's Hospital, which was a teaching hospital. He was elected Professor of
Bacteriology in 1928.
After the war Alexander actively searched for anti-bacterial agents, having
witnessed the death of many soldiers from septicemia resulting from infected
wounds. Unfortunately antiseptics killed the patients' immunological defences
more effectively than they killed the invading bacteria. In an article he
submitted for the medical journal The Lancet during World War I, Alexander
described an ingenious experiment, which he was able to conduct as a result of
his own glass blowing skills, in which he explained why antiseptics were
actually killing more soldiers than infection itself during World War I.
Antiseptics worked well on the surface, but deep wounds tended to shelter
anaerobic bacteria from the antiseptic agent, and antiseptics seemed to remove
beneficial agents produced that actually protected the patients in these cases
at least as well as they removed bacteria, and did nothing to remove the
bacteria that were out of reach. Sir Almroth Wright strongly supported Fleming's
findings, but despite this, most army physicians over the course of WWI
continued to use antiseptics even in cases where this worsened the condition of
the patients.
"When I woke up just after dawn on September 28, 1928, I certainly didn't plan
to revolutionize all medicine by discovering the world's first antibiotic, or
bacteria killer," Alexander would later say, "But I guess that was exactly what
I did."
By 1928, Alexander was investigating the properties of staphylococci. He was
already well-known from his earlier work, and had developed a reputation as a
brilliant researcher, but his laboratory was often untidy. On 3 September 1928,
Alexander returned to his laboratory having spent August on holiday with his
family. Before leaving he had stacked all his cultures of staphylococci on a
bench in a corner of his laboratory. On returning, Alexander noticed that one
culture was contaminated with a fungus, and that the colonies of staphylococci
that had immediately surrounded it had been destroyed, whereas other colonies
further away were normal. Alexander showed the contaminated culture to his
former assistant Merlin Price who said "that's how you discovered lysozyme"
Alexander identified the mould that had contaminated his culture plates as being
from the Penicillium genus, and—after some months' of calling it "mould juice"—
named the substance it released penicillin on 7 March 1929.
He investigated its positive anti-bacterial effect on many organisms, and
noticed that it affected bacteria such as staphylococci, and many other
Gram-positive pathogens that cause scarlet fever, pneumonia, meningitis and
diphtheria, but not typhoid fever or paratyphoid fever—which are caused by
Gram-negative bacteria—for which he was seeking a cure at the time. It also
affected Neisseria gonorrhoeae, which causes gonorrhoea although this bacterium
is Gram-negative.
Alexander published his discovery in 1929 in the British Journal of Experimental
Pathology, but little attention was paid to his article. Alexander continued his
investigations, but found that cultivating penicillium was quite difficult, and
that after having grown the mould, it was even more difficult to isolate the
antibiotic agent. Fleming's impression was that because of the problem of
producing it in quantity, and because its action appeared to be rather slow,
penicillin would not be important in treating infection. Alexander also became
convinced that penicillin would not last long enough in the human body (in vivo)
to kill bacteria effectively. Many clinical tests were inconclusive, probably
because it had been used as a surface antiseptic. In the 1930s, Fleming’s trials
occasionally showed more promise, and he continued, until 1940, to try and
interest a chemist skilled enough to further refine usable penicillin.
Alexander soon abandoned penicillin, and not long after Florey and Chain took up
researching and mass producing it with funds from the U.S and British
governments. They started mass production after the bombing of Pearl Harbor.
When D-day arrived they had made enough penicillin to treat all the wounded
allied forces.
Ernst Chain worked out how to isolate and concentrate penicillin. He also
correctly theorised the structure of penicillin. Shortly after the team
published its first results in 1940, Alexander telephoned Howard Florey, Chain's
head of department to say that he would be visiting within the next few days.
When Chain heard that he was coming he remarked "Good God! I thought he was
dead".
Norman Heatley suggested transferring the active ingredient of penicillin back
into water by changing its acidity. This produced enough of the drug to begin
testing on animals.
Sir Henry Harris said in 1998: "Without Fleming, no Chain; without Chain, no
Florey; without Florey, no Heatley; without Heatley, no penicillin." There were
many more people involved in the Oxford team, and at one point the entire Dunn
School was involved in its production.
After the team had developed a method of purifying penicillin to an effective
first stable form in 1940, several clinical trials ensued, and their amazing
success inspired the team to develop methods for mass production and mass
distribution in 1945.
Alexander was modest about his part in the development of penicillin, describing
his fame as the "Alexander Myth" and he praised Florey and Chain for
transforming the laboratory curiosity into a practical drug. Alexander was the
first to discover the properties of the active substance, giving him the
privilege of naming it: penicillin. He also kept, grew and distributed the
original mold for twelve years, and continued until 1940 to try to get help from
any chemist that had enough skill to make penicillin.
Fleming's accidental discovery and isolation of penicillin in September 1928
marks the start of modern antibiotics. Alexander also discovered very early that
bacteria developed antibiotic resistance whenever too little penicillin was used
or when it was used for too short a period. Almroth Wright had predicted the
Antibiotic resistance even before it was noticed during experiments. Alexander
cautioned about the use of penicillin in his many speeches around the world. He
cautioned not to use penicillin unless there was a properly diagnosed reason for
it to be used, and that if it were used, never to use too little, or for too
short a period, since these are the circumstances under which bacterial
resistance to antibiotics develops.
The popular story of Winston Churchill's father's paying for Fleming's education
after Fleming's father saved young Winston from death is false. According to the
biography, Penicillin Man: Alexander Fleming and the Antibiotic Revolution by
Kevin Brown, Alexander Fleming, in a letter to his friend and colleague Andre
Gratia, described this as "a wondrous fable." Nor did he save Winston Churchill
himself during World War II. Churchill was saved by Lord Moran, using
sulphonamides, since he had no experience with penicillin, when Churchill fell
ill in Carthage in Tunisia in 1943. The Daily Telegraph and the Morning Post on
21 December 1943 wrote that he had been saved by penicillin. He was saved by the
new sulphonamide drug, Sulphapyridine, known at the time under the research code
M&B 693, discovered and produced by May & Baker Ltd, Dagenham, Essex - a
subsidiary of the French group Rhône-Poulenc. In a subsequent radio broadcast,
Churchill referred to the new drug as "This admirable M&B."
Fleming's first wife, Sarah, died in 1949. Their only child, Robert Fleming,
became a general medical practitioner. After Sarah's death, Alexander married
Dr. Amalia Koutsouri-Vourekas, a Greek colleague at St. Mary's, on 9 April 1953;
she died in 1986.
In 1955, Alexander died suddenly at his home in London of a heart attack. He was
cremated and his ashes interred in St Paul's Cathedral a week later.
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