Alexander Fleming (1881-1955)

Penicillin is one of the earliest discovered and widely used antibiotic agents, derived from the Penicillium mold. Antibiotics are natural substances that are released by bacteria and fungi into the earth. In 1928, Sir Alexander Fleming observed that colonies of the bacterium Staphylococcus aureus could be destroyed by the mold Penicillium notatum. Proving that medicines could kill certain types of disease-causing bacteria inside the body. At the time, however, the importance of Fleming's discovery was not known. Use of penicillin did not begin until the 1940s when Howard Florey and Ernst Chain developed a powdery form of the medicine.

Alexander Fleming was born at Lochfield near Darvel in Ayrshire, Scotland on August 6th, 1881. He attended Louden Moor School, Darvel School, and Kilmarnock Academy before moving to London where he attended the Polytechnic. He spent four years in a shipping office before entering St. Mary’s Medical School, London University. He qualified with distinction in 1906 and began research at St. Mary’s under Sir Almroth Wright, a pioneer in vaccine therapy. He gained M.B., B.S., (London), with Gold Medal in 1908, and became a lecturer at St. Mary’s until 1914. He served throughout World War I as a captain in the Army Medical Corps, being mentioned in dispatches, and in 1918 he returned to St.Mary’s. He was elected Professor of the School in 1928 and Emeritus Professor of Bacteriology, University of London in 1948. He was elected Fellow of the Royal Society in 1943 and knighted in 1944.

Early in his medical life, Fleming became interested in the natural bacterial action of the blood and in antiseptics. He was able to continue his studies throughout his military career and on demobilization he settled to work on antibacterial substances which would not be toxic to animal tissues. In 1921, he discovered in ?tissues and secretions? an important bacteriolytic substance which he named Lysozyme. About this time, he devised sensitivity titration methods and assays in human blood and other body fluids, which he subsequently used for the titration of penicillin. In 1928, while working on influenza virus, he observed that mould had developed accidently on a staphylococcus culture plate and that the mould had created a bacteria-free circle around itself. He was inspired to further experiment and he found that a mould culture prevented growth of staphylococci, even when diluted 800 times. He named the active substance penicillin.

Alexander Flemming wrote numerous papers on bacteriology, immunology and chemotherapy, including original descriptions of lysozyme and penicillin. They have been published in medical and scientific journals.

In fact, Fleming was not even the first to describe the antibacterial properties of Penicillium. John Tyndall had done so in 1875 and, likewise, D.A. Gratia in 1925. However, unlike his predecessors, Fleming recognized the importance of his findings. He would later say, “My only merit is that I did not neglect the observation and that I pursued the subject as a bacteriologist.” Although he went on to perform additional experiments, he never conducted the one that would have been key: injecting penicillin into infected mice. Fleming’s initial work was reported in 1929 in the British Journal of Experimental Pathology, but it would remain in relative obscurity for a decade.

By 1932, Fleming had abandoned his work on penicillin. He would have no further role in the subsequent development of this or any other antibiotic, aside from happily providing other researchers with samples of his mold. It is said that he lacked both the chemical expertise to purify penicillin and the conviction that drugs could cure serious infections. However, he did safeguard his unusual strain of Penicillium notatum for posterity. The baton of antibiotic development was passed to others.

In 1939 a specimen of Fleming’s mold made its way into the hands of a team of scientists at Oxford University led by Howard Florey, an Australian-born physiologist. This team had technical talent, especially in a chemist named Ernst Boris Chain, who had fled Nazi Germany. Armed with funding from the Rockefeller Foundation, these scientists made it their objective to identify and isolate substances from molds that could kill bacteria. The mission was inspired by the earlier work of Gerhard Domagk, who in 1935 showed that the injection of a simple compound, Prontosil, cured systemic streptococcal infections. This breakthrough demonstrated that invading bacteria could be killed with a drug and led to a fevered search in the late 1930s for similar compounds. Fleming’s Penicillium notatum became the convenient starting point for Florey’s team at Oxford.

In a scientific tour de force, Florey, Chain and their colleagues rapidly purified penicillin in sufficient quantity to perform the experiment that Fleming could not: successfully treating mice that had been given lethal doses of bacteria. Within a year, their results were published in a seminal paper in the Lancet. As the world took notice, they swiftly demonstrated that injections of penicillin caused miraculous recoveries in patients with a variety of infections.
The Oxford team did not stop there. Rushing to meet the needs of World War II, they helped the government set up a network of “minifactories” for penicillin production. Florey also played a crucial role in galvanizing the large-scale production of penicillin by U.S. pharmaceutical companies in the early 1940s. By D-day there was enough penicillin on hand to treat every soldier who needed it. By the end of World War II, it had saved millions of lives.

Pneumonia, syphilis, gonorrhea, diphtheria, scarlet fever and many wound and childbirth infections that once killed indiscriminately suddenly became treatable. As deaths caused by bacterial infections plummeted, a grateful world needed a hero. Fleming alone became such an object of public adulation, probably for two reasons. First, Florey shunned the press, while Fleming seemed to revel in the publicity. Second, and perhaps more important, it was easier for the admiring public to comprehend the deductive insight of a single individual than the technical feats of a team of scientists.

Awards and accolades came to Fleming in rapid succession, including a knighthood (with Florey) in 1944 and the Nobel Prize for Medicine (with Florey and Chain) in 1945. By this time, even Fleming was aware that penicillin had an Achilles’ heel. He wrote in 1946 that “the administration of too small doses ... leads to the production of resistant strains of bacteria.” It’s a problem that plagues us to this day.

When he died of a heart attack in 1955, he was mourned by the world and buried as a national hero in the crypt of St. Paul’s Cathedral in London. Although Fleming’s scientific work in and of itself may not have reached greatness, his singular contribution changed the practice of medicine. He deserves our utmost recognition. At the same time, we must bear in mind that the “Fleming Myth,” as he called it, embodies the accomplishments of many giants of antibiotic development. Fleming is but a chosen representative for the likes of Florey, Chain, Domagk, Selman Waksman and Rene Dubos, many of whom remain, sadly, virtual unknowns. Their achievements have made the world a better, healthier place.