Lives of the fellows

Alexander (Sir) Fleming

b.6 August 1881 d.11 March 1955
Kt(1944) MB BS Lond(1908) †Hon MD Rome( ) Hon DSc Harvard(1945) Hon LLD St And(1947) MRCS LRCP(1906) FRCS(1920) FRS(1943) *FRCP(1944) FRCPE(1946) FRSE(1947)

Alexander Fleming was born on 6th August, 1881, the third of the four children of Hugh Fleming, a farmer of Lochfield in Ayrshire, by his second marriage to Grace Morton, the daughter of a neighbouring farmer. He was educated first in a small country school at Loudoun Moor, then at Darvel, and for eighteen months at Kilmarnock Academy. At the age of fourteen he went to live with a doctor brother in London, where he continued his education for two years at the Polytechnic in Regent Street. The next four years were spent as a clerk in a shipping office in the City, but in 1901, with the help of a small legacy, he entered St. Mary’s Hospital Medical School, where besides the senior entrance scholarship in natural science he won virtually every class prize and scholarship during his student career.

Immediately after qualification Fleming began his association with Almroth Wright as an assistant bacteriologist in the inoculation department at St. Mary’s Hospital. He also held for some years the post of pathologist to the London Lock Hospital. He was appointed lecturer in bacteriology in 1920 and eight years later he was given the title of professor of bacteriology in the University of London. He retired from the chair with the title of emeritus in 1948, but continued until the end of 1954 as principal of the Wright-Fleming Institute of Microbiology in which he had succeeded Almroth Wright in 1946. From the beginning of his career Fleming showed originality and ingenuity in devising simple apparatus and techniques for tackling laboratory problems; for example in his work on the opsonic index, recently introduced by Wright as a method for assessing the effect of vaccine therapy, and in a brilliant essay, ‘Acute bacterial infections’, published in St. Mary's Hospital Gazette (1920,15, 67-9, 72-7), which won him the Cheadle gold medal. His capacity for original and accurate observation was also demonstrated in 1920 by a well written article in The Lancet (1920, 1, 1035-8) on the aetiology and treatment, with autogenous vaccines, of acne. About this time, Ehrlich had introduced salvarsan for the treatment of syphilis and Fleming made a typical contribution by devising a simple micromethod for the serological diagnosis of this disease.

Soon after the outbreak of the First World War Almroth Wright was invited by the Medical Research Committee to establish a research laboratory in Boulogne to study the treatment of war wounds. Fleming, who had joined the Royal Army Medical Corps, was a member of the team, and although much of the work done during this period was published jointly with Wright and others, Fleming himself made some outstanding contributions to knowledge of the bacteriology and treatment of septic wounds. In a paper published in The Lancet (1915, 2, 638-42), he noted the evil significance of streptococcus pyogenes, which he demonstrated in the blood of about a quarter of the more severe cases. Later, with A. B. Porteous, he showed that most streptococcal infections occurred after the patient was admitted to the base hospital (ibid., 1919, 2, 49-51), thus giving forewarning of the dangers of hospital cross-infection with this organism. He also made a significant contribution to the knowledge of gas gangrene, and by numerous ingenious experiments supported Almroth Wright in his advocacy of physiological principles rather than the use of antiseptics for the control of infection in war wounds.

In 1922 came the discovery of lysozyme, an antimicrobial substance produced by many tissues and secretions of the body, particularly in leucocytes, tears, saliva, mucus and cartilage. Fleming probably regarded lysozyme, which he later called the body’s natural antibiotic, as his most important discovery and, with V. D. Allison, he showed its wide distribution in nature, its enzymic quality and remarkable stability, and the interesting phenomenon of the development of bacterial resistance to its action. In September 1928 he made the world-famous observation which was to lead in time to the new antibiotic era. He was studying colony variation in the staphylococcus in relation to the chapter he was writing on that organism for the Medical Research Council’s A System of bacteriology (1929, 2, 11-28). This necessitated frequent examination of plate cultures of the organism over a period of days; he noted that around a large colony of a contaminating mould the staphylococcus colonies became transparent and were obviously undergoing lysis. In his original paper, published in the British Journal of Experimental Pathology (1929, 10, 226-36), he described most of the essential properties of penicillin. He undoubtedly had some appreciation of its potentiality as a systemic chemotherapeutic substance before the Oxford team demonstrated it, for he suggested its injection into infected areas and predicted that it could be used in the treatment of venereal diseases. Some attempt was made to concentrate it, but as Fleming said in his Nobel lecture, ‘We were bacteriologists—not chemists—and our relatively simple procedures were unavailing.’

Meanwhile he turned his attention to the new sulphonamides. Having shown that these drugs were bacteriostatic and not bactericidal and were inhibited by large numbers of living or dead bacteria, he believed, prophetically, that they would not be effective in the local treatment of septic wounds. Here again, and later when penicillin became available for clinical use, he demonstrated his technical skill and ingenuity in devising micro-methods for measuring the concentration of these drugs in the patient’s blood. But technical inventiveness is worth much more to the research worker than technical skill, and Fleming was equally well endowed with both. He was keenly interested in staining methods, and when India ink became unavailable he introduced nigrosin as a negative method of staining and showed how it could be used for demonstrating spores and capsules. He was probably the first to grow bacteria and moulds on paper or cellophane placed on top of nutrient agar, and he demonstrated the suitability of paper for bringing out the pigment of chromogenic bacteria.

Innumerable honours were conferred upon Fleming in the last ten years of his life. He was knighted in 1944, and was awarded the Nobel prize for medicine, jointly with Sir Howard (later Lord) Florey and Dr E. B. Chain, in 1945. He became a fellow of the Royal Society in 1943, of the Royal College of Physicians, London, in 1944, of the Royal College of Physicians, Edinburgh, in 1946, and an honorary fellow of the Royal Society of Edinburgh in 1947. In 1945 he was Moxon medallist of the College and in 1946 gold medallist of the Society of Apothecaries. Doctorates of medicine, science and law were conferred on him by many British, European, and American universities. He was Commander of the Legion of Honour, member of the Pontifical Academy of Sciences, fellow of important societies and academies in several countries, and the recipient of many of their medals and honorary lectureships. He was elected rector of the University of Edinburgh (1951-4), was a convocation member of the senate of the University of London, a member of the Medical Research Council (1945-9), and president of the Society for General Microbiology (1945-7). Besides becoming an honorary citizen of numerous cities in Europe, he was a freeman of the burgh of Darvel where he was born, of Chelsea where he lived, and of Paddington where his work was done.

Fleming had most of the qualities which make a great scientist: an innate curiosity and perceptiveness regarding natural phenomena, insight into the heart of a problem, technical ingenuity, persistence in seeing the job through, and that physical and mental toughness which is essential to the top-class investigator. He was keenly observant of natural phenomena and very knowledgeable about birds, flowers and trees. He drew and wrote beautifully and was an expert amateur photographer. He had a combativeness and urge to win, which was very apparent in the games he played. He had tremendous constancy and loyalty—to his friends and colleagues, to the inoculation department, to St. Mary’s and to its staff and students, and this quality of steadfastness inspired the confidence of his companions which was never misplaced. He had a quiet, unruffled wisdom which made him a shrewd judge of men, but tolerant of weaknesses in his friends and colleagues. He was not an easy man to know well, partly because of his natural reluctance to talk and express his feelings; awkward silences were sometimes broken by awkward remarks. But this was shyness, not intentional rudeness, for he liked company and had many friends in various walks of life before he became famous. His association with the Chelsea Arts Club and some of its members gave him particular satisfaction and an outlet for his artistic sense, for he enjoyed beauty wherever he saw it.

He died suddenly from a heart attack at his home in Chelsea, and was buried in St. Paul’s Cathedral. He was twice married; first, in 1915, to Sarah (Sareen) Marion, daughter of a farmer, John McElroy, of Killala, co. Mayo, Ireland, and herself a trained nurse, who died in 1949; secondly, in 1953, to Amalia Voureka Coutsouris, daughter of a Greek doctor, and herself a medically qualified bacteriologist. There was one son of the first marriage, who qualified in medicine and entered general practice.

Richard R trail

* He was elected under the special bye-law which provides for the election to the fellowship of "Persons holding a medical qualification, but not Members of the College, who have distinguished themselves in the practice of medicine, or in the pursuit of Medical or General Science or Literature..."

[Ann. roy. Coll. Surg. Engl., 1955, 16, 343-5; Antibiotic Med. clin. Ther., 1955,1,187-91; Biogr.Mem.Roy.Soc., 1956, 2, 117-27 (p), bibl.; Brit.med.J., 1955, 1, 732-6 (p), 795; Bull. Acad. nat. Med., 1955, 139, 183-4, 237; Dis. Chest, 1955, 27, 702-03;J.Path.Bact., 1956, 72, 697-707 (p); J. Amer. med. Ass., 1955, 157, 1421; Lancet, 1955, 1, 624-6 (p); Nature (Lond.), 1955, 175, 663; L. J. Ludovici. Fleming, discoverer of penicillin. London, 1952 (p); A. Maurois. The Life of Sir Alexander Fleming. London, 1959 (p). Bust by Frank Kovacs.]

(Volume V, page 132)

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