Back In The Day: Alexander Fleming, the farmer's son whose discovery saved millions

Scotland has been the birthplace and home to many inventors and innovators, of whom this country is rightly proud, but one Scotsman above all can be credited with saving millions of lives – the biologist and pharmacologist Sir Alexander Fleming.

Looking back at the record of Scottish invention in the 20th century, there were world-changing developments by Scots such as radar and television. In terms of the beneficial effect on humanity, however, Fleming was undoubtedly the greatest Scottish innovator of the last century. Without antibiotics, hundreds of millions of people could have died, and that is perhaps why Fleming is the most revered of all Scottish inventors.

Of course, Fleming did not actually “invent” penicillin. It was there all the time, just waiting to be discovered, and it was Fleming’s genius, and not a little luck, which saw him make the single most important medical discovery of the last century.

The greatest moment in the history of Scottish medicine did not actually take place in Scotland, and its significance was not even recognised at first, while the man who made the discovery had to rely on others to take penicillin forward.

Fleming was born on August 6, 1881, on a sheep farm near Darvel in Ayrshire. He was the third of four children of his father Hugh and mother Grace Morton, Hugh’s second wife. There were also four children from Hugh Fleming’s first marriage.

Fleming attended Louden Moor and Darvel schools before moving on a scholarship to Kilmarnock Academy. He moved to London and studied at the Royal Polytechnic Institute before starting work in the office of a shipping line.

Luckily for the human race, he inherited money from an uncle and his elder brother Tom suggested he might like to try medicine. He began by studying at St Mary’s Hospital in Paddington, London.

When he had moved to London in 1900, Fleming enrolled in the London Scottish Regiment of the Volunteer Force which later merged into the Territorial Army. He also practised his shooting skills at the rifle club of St Mary’s from where he graduated with distinction in 1906.

By chance, the rifle club’s captain suggested that Fleming, who was a crack shot and an important member of the team, should stay on at St Mary’s and join the pioneering research department which, under the supervision of Sir Almworth Wright was a leader in the fields of immunology and bacteriology. On such whims are great careers often made. Fleming certainly had sufficient qualifications to become a top surgeon, but was also keen on the possibilities of research, and so took a further degree, a BSc in bacteriology, winning the Gold Medal as top student.

He became a lecturer at St Mary’s and while there he met a nurse, Sarah McElroy of County Mayo in Ireland, whom he married in 1915. That came after the outbreak of the First World War, in which Fleming served with distinction as a captain in the Royal Army Medical Corps, being mentioned in despatches for his heroic work.

After the war, Fleming returned to St Mary’s and began work on anti-bacterial agents, because he had become convinced in the wartime battlefield hospitals that the normal antiseptics – developed from those pioneered in Glasgow by Joseph Lister – that were used to treat wounded soldiers were actually killing more men than they saved because they damaged healthy tissue. Research proved that he was correct, and Fleming began to investigate the possibility of finding or creating an anti-bacterial agent which did not damage the human body – substances that we now know as antibiotics.

IN 1922, Fleming made his first important discovery, the naturally occurring human anti-bacterial substance lysozyme. He famously said he made his discovery because he had a bad cold and accidentally excreted some nasal fluid into a culture dish.

The human body produces lysozyme in small quantities but the enzyme is unable to kill deadly bacteria so Fleming began to search for something much stronger to deal with pathogens which cause some of the worst infections.

He became Professor of Bacteriology in 1928, and by summer of that year, Fleming was working in his usually rather disorganised laboratory in St Mary’s on research into influenza and the staphylococci bacteria. He was almost a caricature of a mad scientist, a brilliant researcher but often hopeless at basic things – like washing dishes, for example.

In August, Fleming went off on holiday, completely forgetting that he should have washed his glass petri dishes on which he had been examining bacteria. He left these beside an open window and at some point during his holiday, some fungus spores blew in off the street outside and settled on a petri dish.

Fleming came back from holiday on September 3, 1928, and noticed that a fungus had started to grow on one of his dishes. “That’s funny,” he famously said out loud, and took a closer look.

What he saw astonished him. Fleming noticed that one culture of staphylococcus bacteria had stopped growing around one of the fungus moulds, and he realised that the fungus had killed the colonies of staphylococci.

He reasoned that if the mouldy substance which had stopped the bacteria in its tracks could be cultivated, it could be used to halt those bacteria deadly to humans.

Fleming identified the mould as penicillium notatum, and he began to grow some in a pure culture. The substance produced by the penicillium notatum was first isolated by Fleming on September 28, the day he himself credited as when he made his great step forward.

At first Fleming called the substance “mould juice” but by March 1929 he had given it the name penicillin.

By a process of investigation and some luck, Fleming had discovered the world’s first man-made antibiotic. The only problem was that he did not really know the significance of what he had done, and had difficulty in communicating the facts about his new wonder drug.

Fleming wrote a report on his discovery in a medical journal in 1929, and the popular myth is that he then forgot about it. But that is not true. The problem was that Fleming was actually seeking an agent that could battle the bacteria in typhoid – he famously said “one sometimes finds what one is not looking for” – and penicillin in tiny amounts could do little about such a devastating disease.

Penicillin also did not last long enough in the body, and Fleming knew he needed chemists to work on the substance to create sufficient quantities for it to be useful.

Dr Amalia Koitsouri-Vourekas married Flemming in 1953 following the death of his first wife Sarah. In the 1970s and 1980s she was a member of the Greek parliament

THE fact is that Fleming could not attract a collaborator and he simply did not have time to look further at penicillin, so he went off to work on more likely cures for bacterial diseases, though he continued to experiment with his mould now and again until 1940.

In a development that was years ahead of its time, he also correctly predicted that if tackled by anti-bacterial agents, bacteria as living things would mutate to avoid the “enemy” – what we now know as antibiotic-resistant bacteria.

Just before the outbreak of the Second World War, a team of Oxford scientists led by Howard Florey and Ernst Chain began to look again at Fleming’s research and they started work on developing a commercial manufacturing process for penicillin.

Fleming himself joined the other scientists in developing penicillin, while American pharmaceutical companies began the process of making it for commercial use. There was some disagreement between those involved as to who should be credited for penicillin, but there was no disagreement about its effects – penicillin saved lives and limbs.

The manufacturers succeeded in time for the Allies’ invasion of Europe in 1944 – Winston Churchill insisted that the new wonder drug be kept from the Germans, because he knew that if they were cured of infection, Hitler would send wounded troops back to the Front.

By the end of the war, thousands of Allied soldiers, sailors and air crew had benefited from penicillin and Fleming was world famous. The news about Fleming and penicillin was first spread by the BBC, and in 1944 they broadcast an interview with Fleming in which he said “moulds are allotted by botanists a very humble place in the vegetable kingdom.”

PENICILLIN quickly became the most effective life-saving drug in the world, conquering such dreaded diseases as syphilis, tuberculosis, gangrene, pneumonia, diphtheria and scarlet fever.

Scientists have estimated that penicillin has saved at least 200 million lives since its first use as a medicine in 1942, and, of course, new antibiotics that trace their roots back to Fleming’s original research are being developed all the time.

Fleming was knighted in 1944 and the following year he was awarded the Nobel Prize for Medicine along with Florey and Chain, and after that he gained many more honours around the world – his Nobel Prize can be seen today in the National Museum of Scotland.

For his Nobel lecture Fleming warned: “The time may come when penicillin can be bought by anyone in the shops. Then there is the danger that the ignorant man may easily underdose himself and by exposing his microbes to non-lethal quantities of the drug make them resistant.”

Sadly his prediction has become all too true.

Fleming’s first wife died in 1949. They had a son, Robert, who became a GP and died only last year. Fleming married his second wife, Dr Amalia Koitsouri-Vourekas in 1953, just two years before he died of a heart attack.

She returned to her native Greece after his death and become a prominent politician.

Sir Alexander Fleming received the singular honour of having his ashes interred in St Paul’s Cathedral.

His obituary in The Guardian said: “Fleming was a homely, frank, even blunt Scot. He pursued his own work without being much affected by others.

“He did not care at all for fashion. His rugged independence and native thoroughness helped him to make that single vital observation which might so easily have been overlooked...this plain Scotsman started one of the greatest and most beneficial discoveries in the history of science and medicine.”