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The Life of Sir Alexander Fleming
Chapter V - The prentice years


Science is the tool and the reinforcement of the spirit, and the spirit will find its salvation, not in turning back upon itself, which is the pursuit of a shadow, but in seeking out the object and grappling with it. alain

Wright and his disciples believed in vaccines and the opsonic index. They proved their faith by devoting their days and their nights to the practice of their religion. Other scientists in other parts of the world were hoping to conquer the dangerous microbes by other means. One of Wright's German friends, a scientist in horn-rimmed spectacles, with bright eyes and a loud, cheerful voice, was looking, in a mood of passionate confidence, for the 'magic bullet5 which should kill the invaders without harming the invaded.

Born in 1854, Ehrlich had been a student at the time when the great German dye-enterprises were coming into their own. Being a chemist as well as a doctor, he had been deeply interested, while still a young man, in the colouring of animal and human tissues. This staining turned out to be selective; that is to say that a particular dye became fixed to one particular part of the body. For example, methylene-blue coloured predominantly the nerve tissue, and this made it possible to follow the course of the nerves. Ehrlich had also established the fact that the noxious microbes 'took' certain colorants better than the cells of the organism which harboured them.

Why? For the same reason, said Ehrlich, who was accustomed to thinking as a chemist, that the toxins of diphtheria attack the cardiac muscles, or those of tetanus the nerve-cells, in a selective manner, which is as much as to say that there is a chemical affinity between the molecules. It follows, therefore, that the beneficent antitoxins must consist of molecules which, by affinity, are led to combine with the toxins and neutralize them.

In 1904, Ehrlich, who at that time was Director of the Institute of Serotherapy in Frankfurt, embarked with his assistant, a Japanese doctor called Shiga, on an immense programme of experiments. He tried out all his coloured projectiles against the trypanosomes — a more than usually formidable species of parasite. Following the practice of Maurice PsTicolle and Mesnil, he employed particularly active products — the trypan-red and the trypan-blue — with reasonably encouraging results. Shortly afterwards he was to win his greatest victory, not against the trypanosomes, but against the pale treponema, or spirochaete, which causes syphilis, and this by employing not dyes but arsenical compounds. One may not always find what one is looking for but, if one looks hard enough, one often finds something. Ehrlich scored a bull on a target at which he was not aiming.

In the sixteenth century, Paracelsus had tried using arsenic against syphilis, but without much success, and consequently doctors turned to mercury, and were to remain loyal to it for a long time. Between 1905 and 1907, the chemists had produced an arsenical compound — atoxyl — which had the desired effect both on the trypanosomes and the spirochaetes. Unfortunately, this product, in spite of its name, was toxic. Ehrlich set himself, therefore, to transform atoxyl and to make a new magic bullet of it. The necessary research demanded infinite patience. For each new derivative of atoxyl which the chemists created under Ehrlich's direction, it was essential to determine, first of all, the curative dose, the one that would destroy the microbes (C), and then the maximum dose which the body could tolerate (T). The relationship — indicated the efficacy or the danger of the drug. If C was greater than T, then obviously the new product was worthless. Thousands of mice and guinea-pigs were sacrificed in this battle. In 1909 the compound No, 418 seemed to offer hope, but no more than hope. Ehrlich, exhausted but enthusiastic, continued with his massacre of mice. At last, in May 1909, the compound 606 destroyed all the trypanosomes without Idlling either mice or guinea-pigs. Some time later, when the substance was used for treating syphilitic lesions in rabbits, complete cures were achieved in three weeks. From now on, so it seemed, a magic bullet really did exist with which to attack and overcome one of humanity's worst enemies. It flew straight to the target, namely, the parasite, without doing any harm to the sufferer's tissues. Ehrlich gave it the name 'salvarsan' (that which saves by arsenic).

Ehrlich was a pleasant companion and a passionate talker. The freakishness of his mind delighted Wright, and he was soon a great favourite at the lab. When he came to London to lecture on chemotherapy (which Wright, punctilious in all linguistic matters, tried, in vain, to rename 'pharmacotherapy') he entrusted some doses of salvarsan to the scientists of St Mary's and, at once, Fleming became a past master in the art of applying the new treatment. This was no easy task. The substance rapidly became oxidized when in contact with the air, and the intramuscular injection was extremely painful. Ehrlich's new Japanese assistant, Hata, a technician of quite extraordinary skill, had administered salvarsan to rabbits by the intravenous route, but in 1909 few doctors knew how to make an injection into the bloodvessels.

Dr G. W. B. James remembers how in 1909 he and a friend watched Flem give 606 to a patient. These young men of St Mary's knew and admired Fleming as the winner of the Gold Medal. eI have a vivid recollection of him standing beside the bed in a long white coat,' says Dr James, 'setting up a glass reservoir containing a yellow fluid, inserting a needle into a vein on the patient's arm, and running the fluid directly into the blood stream. It must be remembered that intravenous therapy was new and strange to the students of 1909 or 1910. This vivid picture of Flem has always had a dramatic value for me, for, in addition to the exciting intravenous method, there was the rapidity with which the 606 took effect, so different from the slow working of the mercurial treatment with which I was familiar from my having attended in the Out-Patients Department of the hospital.

T remember speaking to Flem (greatly daring) while he was at the bedside, and asking him what the yellow fluid was. His manner was slightly alarming in those days. He fixed me with a blue eye, and gave me the chemical formula of 606: "Dioxy-diamide-arsenobenzol-dehydro-chlorine."

T was none the wiser.

'"What is it you want to know?" he asked.

"Well, sir, just look..."

'"What d'you think this is?" — and he pointed to the man in the bed, who only too visibly was suffering from the most horrible syphilitic lesions.

'We both of us replied: "Syphilis."

'"And how would you treat it?" said he. "Mercury, I suppose, eh? Well, just you watch. This stuff acts much more rapidly."

'When I came to know him better, I realized that his icy and laconic manner had no hostile intention but was "just Fleming"<. After we had left the patient's bedside on this now far-distant occasion, Flem took my friend and me into the laboratory where he worked, and told us the whole story of salvarsan, impressing both of us with his encyclopedic knowledge. At that phase of a student's life, a difference of four years in age means a great deal. I know that my friend and I felt that we had "discovered" Flem. Certainly we found him a most stimulating and interesting teacher and, looking back, I realize how good he was to two eager and callow youths. When leaving us, he said: "Come back and take a look at this chap tomorrow." We did so. Everything was clean and cleared up. We were staggered, and he thoroughly enjoyed our stupefaction.

'After that he was always willing to see us. The amount of work he put in at the lab. was tremendous. One of the most interesting occupations was to sit and watch him making things out of glass and tubing. He seemed able to do anything with molten glass, constructing not only the pipettes he needed for his work, but small models of every sort of animal. One, I remember, was a cat which he moulded from red-hot glass. When it had cooled it looked positively alive, and he added a whole series of tiny creatures running away from pussy.

'We remained good friends until his death. I was constantly impressed by his fidelity in friendship. It seemed to be impossible ever to offend Fleming. One could say exactly what one thought to him — things, very often, which another person would have taken in bad part, but not so Fleming.

'He had a somewhat materialistic outlook in medical matters — as was probably inevitable, given the nature of his work — and found it very hard to accept what he called the "rot" talked by psychologists. We had many tussles in later years, after I had specialized in psychiatry. He stuck doggedly to his scientific facts. Either bacteria existed or they didn't. He was determined, I felt, never to go beyond facts which could be seen and measured. I remember trying to explain to him the theory of the unconscious mind. "What's the use of talking about the unconscious mind?" he protested. "There's no such thing. If you are unconscious, you don't have a mind for the time being."

'The only time he listened, with a somewhat humorous and inquiring look on his face, was when I asked him to tell me how much of an iceberg is visible above water. He said he had no idea. "One-eighth," I told him. "The other seven-eighths are beneath the surface, and the invisible part is like the unconscious mind." A mischievous twinkle came into his eyes. One never knew what he was really thinking, or whether one had convinced him. He loved argument, and contradicted for the sake of contradicting. He could infuriate you as an adversary even though he was on the best of terms with you as a friend. In his own field, he was invincible. His knowledge of bacteriology was monumental.5

He could never resist the pleasure of bringing 'down to earth' any interlocutor who had taken flight into those 'upper regions' which he considered to be inaccessible. Once, when arguing with a friend of his about the Universe, Time and Space, he said, showing his watch: ' Thistime is quite enough for me.' So impenetrable was the mask he habitually wore that one could never be sure whether he was just enjoying an argument as an argument, or was serious. Only the twinkle in his eyes gave him away to those who knew him.

In collaboration with Colebrook, he published in the Lancet, a note on 'The Use of Salvarsan in the Treatment of Syphilis'. The results had been astonishing and, from now on, he had great hopes of chemotherapy. Wright, on the other hand, was sceptical. At the beginning of his career, he had said: 'The doctor of the future will be an immunizer,' and he stuck to that opinion. 'My anticipations have already been justified. I do not know anybody who, having tried vaccine therapy in the treatment of local bacterial affections, has not been convinced of its efficacy. The time when the doctor will be, for the most part, an immunizer is visibly drawing nearer.' In spite of his honesty of mind and his long intimacy with Ehrlich, he watched with a suspicious eye the entry of chemical remedies on the scene. To the Medical Research Club he declared: 'The use of chemotherapy for the treatment of bacterial infections in human beings will never be possible.'

His disciples were less dogmatic. They were beginning to realize that the opsonic index, interesting though it might be, was unlikely to become a factor in ordinary practice, because of the superhuman work it entailed. Only Wright's prestige and authority could keep his team of brilliant young men in the laboratory, night after night, counting microbes. Some of them found it very difficult to stay awake when they resumed their duties next morning, though Flem, after a sleepless night spent with his eye to the microscope, was able to retain his capacity for work. He would be the first to turn up, looking as fresh and alert as though he had just got back from a country holiday. Several of the research staff — Fleming, Noon, Brinton — had to run a practice outside laboratory hours in order to make a living. Freeman, who had taken a house at 30 Devonshire Place, provided consulting-rooms for his colleagues. Fleming and Colebrook were for some time, thanks to Ehrlich, almost the only doctors in England to make use of salvarsan, and this very soon resulted in a flow of patients. At that time it was necessary, when employing the treatment, to inject great quantities of the liquid. Fleming had invented a very simple apparatus (two glass jars, a syringe, two rubber tubes, and two taps with double nozzles) which made possible the treatment of four patients in the same time as would previously have been occupied in making a single injection. In the London Scottish, from which more than one unhappy victim of the pale tryponema had recourse to him, he was known as 'Private 606', and a caricature showed him armed with a syringe in place of a rifle. He loved the spectacular character of salvarsan cures.

His diagnoses were absolutely reliable. Professor Newcomb gives a characteristic example of this. A patient suffering from an ulcer on the lip had been for six months in University College Hospital for tubercular ulceration. Every known treatment had been tried, but without success. Then the patient was sent to St Mary's for vaccination. The ulcer continued to get worse. One day, the doctor in charge of the case being absent, Fleming took his place for twenty-four hours. Now medical etiquette lays it down that a deputy must never modify a treatment. But Fleming, who cared little about orthodoxy, at once did three highly irregular things. He took a sample of the man's blood, gave him an injection of salvarsan, and sent Newcomb a section from the tissues, labelled: 'Ulcer of the lip: tubercle?'

'Well,' says Newcomb, 'I thought — according to Flem it's tubercle, so tubercle it is ... but there was one odd thing about it, it was full of plasma cells. So I wrote it up as "Tubercular lesioxi of the lip. Great number of plasma cells present, probably the result of secondary infection". Next day, at lunch, Flem gave me a solemn look and said: "Funny sort of tubercular lesion I sent you the other day, wasn't it?" I said: "Yes, it was, rather." "Very funny indeed," said Flem. "I treated the patient with salvarsan and the thing healed up completely. Extremely odd tubercular lesion to yield to salvarsan like that!" He never let me forget it and, whenever I got a bit uppish, would say "What about that tubercular lesion of the lip?" '*

'I think it says a lot for Flem's character', writes Dr Fry, 'that everyone liked him, though he was always right, and always had the last word. People don't usually like those who are always right. But he was so nice about it, that you couldn't not like him. Of course he couldn't resist saying "I told you so," but he said it as a child might have done. He loved pulling your leg if he had done something better than you, and enjoyed it all thoroughly. By great good luck, there were very few in the lab. who hadn't got a sense of humour. No one without it would have lasted long with Wright and Fleming always ready to poke fun at them, each in his own way.'

There were times at the laboratory teas when Fleming seemed to take an impish pleasure in saying something about somebody which would compel the blushing victim to stammer out a denial. 'Did you know, sir,' he would say, for instance, 'that Giles is in love?' The question, put to the Chief, before an audience. consisting of the whole of the lab. staff, had the effect of a stone dropped into a pond. Flem took a particular pleasure in studying the reactions produced by such utterances. He never said anything malicious, but found much amusement in the horrified explanations of the particular colleague to whom he might have drawn attention with his chaff.

His sometimes caustic humour was not resented. 'We were all very fond of Flem,' says Freeman, 'he was a lovable character, but not expansive. He would answer a question in one word, and then go mum when the others joined in. We used to say that he was a typical Scot, and that his conversation consisted mostly of grunts. It wasn't, of course, strictly true, but just a little joke between us and him.'

He was always ready to help a friend. Hayden, one of the doctors at St Mary's, had fallen a victim to poliomyelitis and was partially paralysed. This disaster was made the worse for him by reason of the fact that he had a family to keep. 'The legs have nothing to do with science,' Fleming told him. 'If you want some real work to do, come along to the lab.' He found no difficulty in persuading Wright to take on this excellent research-worker and Hayden used to move about the laboratory in a wheelchair. The team was a happy and united family with a strong feeling of solidarity. When Hayden died, his colleagues, though they had little money to spare, took it upon themselves to educate his two sons.

This comradeship in work and play had a sort of cosy charm unlike anything to be found elsewhere. Dr Porteous, who joined the Department in 1911 as a junior, found the climate of the lab. delightful. 'A lot of people had told me that Fleming was reticent and forbidding, but I never found him so. The impression he made on me was that of a kindly colleague who was always ready to help a newcomer. His enjoyment of fun sometimes led him to indulge in practical jokes, as when, for instance, he put a smear of Plasticine on the lens of a microscope, to see how the victim would react. It was true, of course, that he was always a bit shy, but his shyness never came from lack of self-confidence. He knew that he knew, and that gave him a great feeling of security. Certain inhibitions,'dating from far back, made it difficult for him to express himself freely about anything involving the emotions. But where a practical problem was concerned, he would deal with it easily, directly and unaffectedly. If one of his colleagues, even Wright, put forward some technical absurdity, he would cut it to pieces in fine style. But he found it impossible to talk about his feelings, and those of others, when they were publicly displayed, made him uncomfortable. He was inclined to think exaggerated and highfalutin what anybody less severe would have thought only human.'

With a friend of whom he was genuinely fond, and who obviously took pleasure in being with him, he would drop his rather dour mask for a second or so, and his whole face would light up. His look of rather tense concentration would break into a charming smile, and an almost touching expression of sweetness would show in his blue eyes. But such occasions were exceptional, and never lasted for long. In spite of his small stature, which his great breadth of shoulder seemed to make more obvious, one always got the impression that he was 'a presence. Of this he was not aware and suffered much from being a small man. Speaking of the son of a friend who was sitting for an examination, he said: He doesn't need to bother about exams: he is tall, and tall people can do anything and go anywhere!There was about his walk a sort of easy swing, accompanied by an almost aggressive hunching of the shoulders. This curious gait may have had something to do with his having worn a kilt when in the London Scottish, but it was also a form of challenge, an exhibition of self-confidence. The way in which he could control his body was exceptional and accounted for his skill in shooting and at croquet, in which game his proficiency was almost uncanny and quite fascinating.

In London he had got to know several people who had no connection with either the hospital or his own family. An Australian doctor named Page, who was on a course at St Mary's, introduced him to friends of his, the Pegrams, who lived in Warwick Gardens. He was a great success with them, more especially with the small, twelve-year-old Maijory Pegram. 'Alec5, she writes, cwas then in his late twenties, a serious and silent young man, with a massive head, beautiful eyes and broad, strong hands. He had a simplicity of mind which made him really enjoy playing with a child, and he would invent games with a zest which was completely free from any hint of condescension. To me he was the ideal companion. We used to play eccentric games of golf together which were terribly exciting.

' "I'll tell you what," he would say, "you do the whole round with a putter and I'll beat you with nothing but a niblick." I knew that he would, and he always did. On wet days he devised elaborate games of golf on the carpet, where it needed extreme delicacy of touch to make the ball stop dead on one small spot. But Alec could always do it.

'My parents were devoted to him and my mother talked to him as though he were the same age as me. "Now, Alec, don't be silly!" she would say when he made one of those outrageous assertions which he loved to toss into a conversation to liven it up. One of his favourite gambits, which unfailingly got a rise out of her, was to say, apropos of one of his miraculous cures: "Oh, it was nothing to do with me; he'd have got well anyway," or to reply, if somebody asked him what some patient he had cured had been suffering from: "Damned if I know!" '

Marjory Pegram had an uncle, a painter named Ronald Gray, who was afflicted with tuberculosis of the knee. Fleming suggested vaccine therapy, looked after Gray with the utmost devotion, and cured him.

He was less successful with Marjory herself, who was prone to attacks of asthma. He tried so many treatments on her that she was nicknamed in the family 'Alec's guinea-pig'. She loved her visits to the laboratory, which she found mysterious and fascinating. She admired especially the glass slides on which the stains had made little patches. 'One day Alec told me that there was a new method of finding out to what asthmatics were sensitive, and in some trepidation I bared my thigh on which Alec made a series of scratches and then dropped different liquids into them, saying, as he did so, "eggs, feathers, horsehair, seaweed, fish" — and so on. We then sat in breathless silence to see if any of them became inflamed. The result was bitterly disappointing, since only seaweed showed anything at all. Alec said, the next time we met: "Did you have a very sore leg?" "Yes," I said, "I did." "I thought as much," he remarked gaily, "you see, I did it all wrong!"

'He had some curious mannerisms which enthralled me. When asked a question, there was always a time-lag before he answered and, when the answer came, he shut his eyes. The far-back-in-the-throat Scottish "1" was exaggerated with him into something more like a guttural French "r", and this made it difficult for foreigners to understand him when he said "I must take a specimen of your blood" ...'

Ronald Gray, at the time when Fleming was looking after him, lodged with a Mrs Hammersley, the wife of Hugh Hammers-ley, who was one of the directors of Cox & Co., the Army agents. She had a lovely eighteenth-century house and a wide circle of friends among painters and writers. George Moore, Wilson Steer and Ronald Gray were 'regulars' of long standing, and their conversation was animated and witty.

At Gray's bedside Fleming met Mrs Richard Davis, a good-looking and elegant woman, the daughter-in-law of an antiquarian dealer in Bond Street who was a specialist in old French furniture. She was brilliantly intelligent and entertained many artists and men of letters in the lovely house which she and her husband had in Ladbroke Terrace. The whole of this group immediately attached itself to Fleming. His medical skill amazed them and they were impressed by his modest silences. Ronald Gray had to go twice a week to St Mary's for treatment. Mrs Davis used to go with him, and Sir Almroth, who loved the company of artists, invited them to have tea with him. Fleming, now more sociable and tame, called Mrs Davis cDavey' and used to greet her, when she visited the laboratory, with 'Oh! I am glad to see you! I badly need some of your delicious blood!'

His new friends decided that Flem must go out more, relax a bit, and learn to dance. Mrs Davis was on intimate terms with the Wertheimers, rich collectors known all over the world and great patrons of the arts, whose portraits were painted by Sargent (the whole family is now in the Tate Gallery). Fleming was delighted at discovering under their roof a world which was entirely new to him, the existence of which he had never so much as suspected. Their house was more like a palace, full of beautiful furniture and rare porcelain, with a perfectly trained staff, and a table which abounded in delicious food and wines. Fleming loved going there and meeting the artists who frequented it. He had a natural good taste and all his life long, so far as his means permitted, was an assiduous attendant at auction-sales, and built up a collection of objets d'art.

Once a week the Wertheimers, who had installed a ball-room, invited their daughter's friends to what, in those days, were called 'hops'. Fleming often took part in them, though he never became a good dancer. It was then that he ordered his first dress-suit and solemnly said to the tailor: 'Don't make me look like Carl Brisson, but a sober scientist.' (Carl Brisson was a very charming musical-comedy star!)

It was Ronald Gray who introduced him to another pleasant circle, which was to play a great part in his life. The Chelsea Arts Club. It had as its premises an old house in a quarter traditionally associated with painters and writers. Strictly speaking, only artists were eligible for membership, but there were a few honorary members, of whom Fleming was one. He made a point of treating his fellow-members free, and got them into St Mary's whenever he thought that any of them needed a period in hospital. He got into the habit of going to the club for a game of snooker whenever he had a free hour or so.

The other players soon noticed his schoolboyish zest for the game, his dislike of playing Tor safety', his obvious delight when he brought off a good stroke and balls went bang into the pockets. If ever anyone offered him gratuitous advice on how to play a shot, he would immediately relapse into silence, stare at the speaker for a few moments, and then play the shot in his own way — often a very unorthodox one. Frequently those who were looking on were staggered by the success of these unusual methods.

If, after the spin of a coin had decided the opposing sides, the odds, on form, seemed to be against him and his partner, he played with an even greater zest than usual. 'I often played with him against reputedly better men', says A. Murray, 'and we quite frequently won. We were both stubborn Scots, determined not to be outdone by mere Englishmen.'

Gray told him that he would have to paint a picture to justify his admission to the club. Fleming said he was sorry, but he wasn't an artist. Gray forced a brush into his hand, and ordered him to paint a farm scene. Much against his will, Fleming produced a cow, though it was difficult to recognize it as such.

'Thank you,' said Gray, 'it is a masterpiece, and exactly what I wanted.'

Some time later, he took Fleming to an exhibition where the famous picture was prominently displayed. The painter of the 'Portrait of a Cow' was much amused, the more so since several critics were loud in their praise of his 'sophisticated naivety'. He heard two elderly ladies of distinguished appearance discussing his 'work'. 'Perhaps you are right,' said one of them, 'this modern art must mean something, though I confess that I cannot make out what it is.'

To make quite certain that his election to the club would stand, he asked one of his friends, Dr E. J. Storer, to buy the picture — he himself providing the money. It then occurred to him that he would also have to pay the gallery's commission. An agreement was therefore come to that Storer should do no more than ask the price and then declare that it was too high. The committee fell in with this little plot and Fleming was made a life-member. He constantly, until the day of his death, met most of the great artists of the day there. He had a great fondness for the place and soon became very popular among his fellow members.

The Chelsea Arts Club gave an annual fancy-dress ball. Mrs Davis and Ronald Gray dragged him to it. But he had to take a partner, and Steer suggested a pretty girl, Lily Montgomery, who had often sat for him. Flem went as a negro and thoroughly enjoyed the evening. In the following year he again went to the ball, this time with his friend Dr Porteous, both of them dressed as little girls in short red frocks and black stockings. Even bacteriologists can unbend on occasion.

At the laboratory, he went on with his own work in addition to his routine duties. In 1909 he published in the Lancet an excellent article on acne. He next devised a simple modification of the Wasserman Reaction in the diagnosis of syphilis, a small-scale reaction requiring only a tiny blood-sample drawn from the tip of the finger in a capsule. He enjoyed nothing better than tinkering and mending defects in pieces of laboratory equipment with any odd thing that came to hand, a bicycle-clip, for instance. Little by little, he elaborated, for his own use, a philosophy of research. This consisted in making no rigid plans, but in going on with his regular work with one eye always cocked so as not to miss the unexpected a,nd gauge its importance.

The Chief still played the part of an inspired Olympian. One of Wright's virtues was that he allowed his disciples complete freedom in research. He himself continued to devise new and difficult techniques. One of these he called 'wash and afterwash5. It enabled them to make, in the specially long capillary stem of a pipette, serial dilutions of infected material.

When Freeman and Noon went, at the invitation of Professor

Jules Bordet, to demonstrate these techniques at the Pasteur Institute, Maurice Nicolle said: 'These methods are more suitable for conjurers, or as a means of amusing children.5 That was true. They demanded great dexterity. They delighted Fleming. He knew that they were complicated, but also that he was more able than anybody else, thanks to his own skill, to operate them. Besides, the Chief championed them, and Fleming was nothing if not a loyal disciple.

There was merit in his loyalty, for in the world outside St Mary's the waves of hostility now breaking over Wright were becoming more and more violent. Some of his fellow scientists had invented a nickname for him, 'Sir Almost Right5, and even inside the hospital many of the doctors and surgeons were growing sceptical about therapeutic vaccines. Vaccinate in order to prevent — YES: vaccinate in order to cure — NO. 'Wright5, says Professor Newcomb, 'produced storms wherever he went.5 Some scientists used to say that his work was all nonsense. Fleming continued to support his master strongly and, if there was a storm round him, he was sure to be in it.

Some of the big-wigs of Harley Street, annoyed by Wright5s contempt for what he called cnon-scientific medicine, took their revenge by denying the results obtained at St Mary's. The statisticians, who had already been up in arms against Wright in the days of anti-typhoid vaccination, now returned to the charge. Wright replied by saying that for facts as different among themselves as are medical cases mathematical statistics should give way to what — again inventing a name — he called the 'diacritical judgment5, that supreme quality of the human mind which makes it possible to pronounce on individual, and not concordant, phenomena. He added: 'Diacritical judgment is notably lacking in women and in Bernard Shaw.

There were times when even the disciples had doubts. 'In our enthusiasm', said Colebrook, 'we had attached too little importance to the vis medicatrix naturae.5 Was it by vaccine therapy or by nature that local infections were cured? In fact, ulcers did close, tubercular glands did disappear, boils were reabsorbed. Obviously there were cases of failure, but when these occurred the reason given was that the infection had become generalized before treatment. Another charge brought against the St Mary's team had to do with the sale of vaccines by the Inoculation Department to a large firm of pharmaceutical chemists. But what was wrong with that? The sums produced by these sales were used exclusively in developing the laboratories. The research-workers, including Wright, were still in receipt of ludicrously inadequate salaries.

Wright had made still other loud-voiced enemies by reason of his attacks on the Suffragettes. He obstinately maintained that there is an unbridgeable gulf between the functioning of the male and female minds. In this connection Colebrook quotes something Wright once said about women: 'The reason we feed them and keep them is that they shall have no freedom of expression.3 He had written a whole book, The Unexpurgated Case against Woman Suffrage, for the purpose of showing that the Suffragettes were unsatisfied women who dreamed of an epicene world ('epicene5 from the Greek 6epikoinos\ common to, or identical with, both sexes) in which men and women should work as equals, shoulder to shoulder at the same tasks. In fact, said Wright, women were receiving preferential treatment and preventing men from doing the best work of which they were capable. This was a doctrine which he could impose within the four walls of his own laboratory, but in the world at large the powerful forces of femininity held it to be an abomination.

Finally, Wright delighted in adopting for his own purposes the policy of'divide and rule5. He told Freeman that he looked upon him as his 'son in science5, and that, as such, he would one day take his place as the Head of the Department. But he had made almost identical promises to Fleming. Was he deliberately trying to foster an antagonism between two men who, though very different from one another, had so far been friends? By reason of his title as Director, of the prestige which his work legitimately gave to him, and of the financial support which he could secure for the Department, he continued to wield the supreme power of an absolute monarch. Leonard Noon and John Freeman had carved out for themselves a small, self-governing principality within which they concentrated on hay-fever and allergies in general, with considerable success. Fleming, for his part, worked directly with the Chief.

This he did not in the least mind, for he felt a deep veneration for that illustrious and picturesque figure. He admired the Old Man who for so many years, seated at his work-table, 'using ridiculously simple equipment, a few test-tubes, glass slides and pipettes, a few rubber teats, some scraps of cardboard, a little paraffin and sealing-wax, and with no other resource than the inexhaustible ingenuity of his mind and the dexterity of his hands', had devised a whole arsenal of microtechniques for following and measuring the processes of infection and immunity. This hard and monotonous existence, devoted to the cause of science, gave Fleming a deep and secret happiness.

Would he some day have the good fortune to make the brilliant discovery which so much enthusiastic work and so hard a discipline deserved? Breathing the air of the laboratory in which 'the delicate scent of cedar-oil mingled with that of melting paraffin', he felt a profound satisfaction in the knowledge that he had been born into an extraordinary epoch which was witnessing a continuous revolution in the theories and practice of medicine. Within fifty years, Pasteur — whom Fleming regarded as the ideal of what a scientist should be — Behring, Roux and Wright had transformed the control and treatment of infectious diseases. With the coming of Ehrlich and salvarsan hope had dawned that chemotherapy might become a practical reality. What of the future? Only a small number of micro-organisms were killed by 606. All the others were still invincible. The solution of the problem of how they could best be attacked must, thought Fleming, be linked with the natural defences of the human body. The more one studied these tiny mechanisms, the more marvellous did they seem.

But he was careful not to let himself be lured away into expressing general ideas. His job was to demonstrate facts without any additional padding. Being his own technician, he worked every hour of the day and had no time for talking. At the lab. his colleagues set their watches by the moment of his daily arrival. He valued a skilfully constructed piece of apparatus, a 'neat' elaboration of a method, more highly than any theory. Wright's intelligence did not impress him: it was the man he loved. Deep down, Fleming was sensitive and affectionate, but his shyness made him brusque. Often of an evening in the laboratory a heated discussion would start, then lose direction and seep away into the sand. Flem would be there, listening attentively, but taking no part in the debate until, just as the arguments were becoming quite crazy, he would jerk all the great minds back to earth with a brief, quiet remark in which there was no hint of 'showing off'.

Others overestimated the results of their experimental work. He, on the other hand, was inclined to underestimate his. Wright said to him one day: 'You treat research like a game: you find it all great fun.' It was perfectly true. He liked having fun. In Freeman's house, where he had a consulting-room, he liked, whenever possible, to slip away and, with Mrs Freeman, play at pitching coins on to a small square of the drawing-room carpet. At the laboratory, his 'amusements' were ingenious, practical and precise. In his childhood he had learned to use his eyes, and he never forgot anything he had seen.


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