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The Life of Sir Alexander Fleming
Chapter XIII - War and glory


If you can meet with Triumph and Disaster
And treat those two impostors just the same,
 rudyard kipling

It is good to know that honours can find their way to the quiet scientist, too. k. a. jensen

In September 1939 when coming back on the Manhattan, Fleming had had as a fellow traveller another bacteriologist, Allan W. Downie of Liverpool. The two men had spent almost every evening together in the smoking-room with glasses of beer before th^m, talking about their work, the war, wounds and infections. Downie found that, contrary to what some people said, Fleming, when he fell in with somebody who was interested in the same things as he was, could be very good company. Far from St Mary's and the colleagues who expected him to be always the same, he was a different man. Mrs Fleming and Mrs Downie complained that their husbands spent the whole night talking.

When he got back Fleming learned that he had been appointed a Regional Pathologist, with headquarters at Harefield in Middlesex. This did not prevent him from going on with his work at St Mary's. He thought that he would be most useful there by sticking to the subject which he had studied with such good results from 19x4 to 1918: infections consequent on war-wounds. The young had forgotten, if they had ever known, what Wright and Fleming had established at that time with so much difficulty. Whenever there were wounded at St Mary's, after every surgical operation on purulent injuries, he had samples of tissue sent to him. These he examined under the microscope and gave a great deal of valuable advice. Thanks to the sulphonamides, the surgeons were now better equipped than they had been in the first war. All the same, Fleming frequently spoke to his students about penicillin which, in their eyes, was little more than a laboratory curio. 'Just you wait,' he said to Dr Reginald Hudson, 'one of these days you'll find that penicillin can beat all the sulphonamides when it comes to the treatment of wounds.'

From time to time he went to Harefield to have a look at his Regional laboratories, accompanied by his assistant who is, today, Professor Newcomb. There was a fine avenue of trees which Fleming the gardener much admired. Professor D. M. Pryce, who was working under his orders, says that Fleming had a way of turning up unexpectedly and that they were always glad to see him. He was anxious to help, efficient and never discouraged. Going from laboratory to laboratory, as he was obliged to do as Regional Chief, he had to remember the many requests made to him. His method was to scribble brief notes on odds and ends of paper which he then stuffed into his trouser pockets, hoping that they would turn up again some day, and that he would be able to decipher them — which was all very much in the Wright tradition.

At the beginning of the war he was living in Chelsea with his family. In September 1940 bombs fell near by and broke some of the windows. Then, in November, incendiaries scored several hits on the house. Robert was away at school. Alec and Sareen, who had been dining with friends, returned home to find their flat flooded, the firemen still at work, and themselves refused right of entry. They went to lodge with Professor Pryce at Rickmansworth.

In March 1941 they tried to go back, but one night in the following month, a land-mine fell between the famous Chelsea Old Church — which stands at the corner of Old Church Street and Cheyne Walk — and the house. The shock was tremendous. Alec, Sareen, Robert and his cousin, as well as Sareen's twin sister, who were all sleeping there, suddenly saw doors and windows moving in on them, and ceilings collapsing over their heads. One door was flung on to the bed in which Alec was lying, and would have killed him, had it not been stopped by the wooden framework. It hung suspended above him.

Next morning he brought one of his laboratory attendants, Dan Stratful, to Chelsea to help him rescue the most necessary objects. 'We got there,' says Dan Stratful, 'and things looked pretty grim. The damage all round us was bad. Inside the flat everything was covered in dust and plaster from the ceiling. In the bedrooms it was worse. The ceilings were down and the window-frames awry.

It was a shambles. I said to him: "It must have been grim when the mine went up."

'He nodded, and then said, with a grin: "When I saw the entire window-frame moving towards me, I decided to get out of bed."

'We took a lot of stuff to the Institute and I rigged up a bed for him in the dark-room. He bought a radio and settled down there, at nights, quite happily.5

The family first went to live with Robert Fleming, Alec's brother, at Radlett. Then Dr Allison, who had been moved to another Region, offered them his house at Highgate. It had a garden, and there the green-fingered couple grew vegetables, fruit and flowers. When Allison returned after the war, he found flowers and fruit growing everywhere, sometimes in the most unexpected places. Fleming's horticultural 'experiments5 had been successful. He spent most nights at the hospital. During the raids someone had to do duty as a fire-watcher on the roof. Generally, it was arranged that only one man at a time should take this risk, but Fleming, always attracted by the spectacular, could not resist going up there when he heard the alert.

Many of the doctors and students slept in a dormitory which had been arranged in the basement, with hot-water pipes round them, and their clothes hanging all over the place. They took their meals in the school canteen. Professor Fleming shared this life, not without a certain sense of satisfaction. 'There was a good deal of the bachelor in him, and he enjoyed the company of men. Sometimes, when a research-worker was kept late in the laboratory, the door would open, and in would walk the professor with his neat little bow-tie, and a cigarette dangling from his lips. With an eager and expectant look, he would say: "What about a pot of beer?55 The worker would abandon his microscope and the two of them would go off together to the near-by pub, the Fountains, where they would find other St Mary's men.'

Fleming loved this atmosphere of youth where he was treated with affection and respect. The constant banging of the slot-machines and the cascade of coins when somebody struck lucky made the bar-parlour a lively place. Sometimes he ordered beer, sometimes an M&B, which was a play on words for the bacteriologists, because the two initials stood for both 'mild and bitter5 and 'May & Baker'. He would spend a happy hour of relaxation there and then go back either to the hospital or to Highgate with Allison, who had kept a pied-a-terre in the house which he had lent to the Flemings.

Meanwhile at Oxford, while Florey was absent on his successful trip to America, the team under Chain's direction had been doing a great deal of work. The method of extraction had been perfected. What amounted to a factory was springing up, with Dr Sanders in charge. Several young women, known as the 'Penicillin Girls', worked in the bitterly cold room, muffled in woollen comforters and wearing warm gloves. The most serious problem was the contamination of the cultures. In vain did the 'Penicillin Girls' watch their every step so as not to stir up dust or create a draught. In vain were the floor and the benches painted with oil. In vain did the young women wear protective masks over their mouths. In vain was a curtain hung in front of the door and gone over every day with a vacuum cleaner. One single germ was enough to spoil a whole 'batch'.

Nevertheless, a small stock of the precious powder was being built up in the refrigerator against the day when it should be needed for a case. Florey was waiting for his ten thousand litres from America, but time was passing, and nothing came. He did not fail, however, to give part of his store for the treating of infected wounds. The first patients on whom it was used were some R.A.F. pilots who had been seriously burned during the Battle of Britain. Then the Oxford team sent a small parcel of penicillin to Professor (at that time, Lieutenant-Colonel) Pulvertaft, a bacteriologist working in Egypt, for the use of the Desert Army.

'We had an enormous number of infected wounded,' says Pulvertaft, 'terrible burn cases among the crews of the naval armoured cars, and fractures infected with streptococci. The medical journals told us that the sulphonamides would get the better of any infection. My own experience was that the sulphonamides, like other new products sent us from America, had absolutely no effect on these cases. The last thing I tried was penicillin. I had very little of it, something like ten thousand units, maybe less. The first man I tried it on was a young New Zealand officer called Newton. He had been in bed for six months with compound fractures in both legs. His sheets were saturated with pus and the heat in Cairo made the smell intolerable. He was little more than skin and bone and was running a high temperature. Normally, he would have died in a very short while, as did all our wounded when infection was prolonged. We introduced small rubber tubes into the sinuses of the left leg and injected with a very weak solution of penicillin (a few hundred units per cubic centimetre), because we had so little. I gave three injections a day and studied the effects under the microscope. I noticed, much to my surprise, that after the first treatment the streptococci were inside the leucocytes. That was a tremendous moment. Out there in Cairo, I knew nothing of what was being done in England, and the thing seemed like a miracle. In ten days the left leg was cured, and in a month's time the young fellow was back on his feet. I had enough penicillin left for ten cases. Nine of them were complete cures. We at the hospital were now convinced that a new and important therapeutic had been found. We even got a culturc sent out from England, so's we might produce the stuff ourselves. A sort of factory was set up in the Old Citadel. But, of course, we hadn't the means to concentrate the substance ...'

Between 1940 and 1942 very little was said about Alexander Fleming. His publications had been forgotten. Several research-workers, in perfect good faith, published as original discoveries facts which had already been described in his early papers. In August 1942 he was led in dramatic circumstances to carry out his first therapeutic test with purified penicillin, on a patient whose condition appeared to be hopeless. The patient was a friend of his, a man of fifty-two. He was one of the directors of Robert Fleming's firm (which made optical instruments) and had been admitted to St Mary's in a dying state about the middle of June. The diagnosis was difficult. The patient showed symptoms of meningitis, but examination of the cerebro-spinal fluid did not reveal the presence of the expected microbe. Fleming worked tooth and nail on this rebellious case and finally succeeded in disclosing the presence of a streptococcus. He tested its sensitivity to sulphonamides but without success, and then to penicillin, in the only form he had (an impure filtrate). The penicillin worked and, on the agar, eliminated the germs within a radius of eleven millimetres. But the only reserve of pure penicillin then to be found in England, and a very small reserve at that, was at Oxford.

On the 6th he telephoned Florey and explained matters to him: Tf you could possibly spare a little penicillin, I should like to try it.' Florey gave him the penicillin with full instructions how to use it, on condition that his case formed one of the series of cases which were being treated in Oxford.

'He was good enough', wrote Fleming, 'to place his whole stock at my disposal. On the night of the 5/6 the patient was drowsy, comatose, with bouts of extreme restlessness, during which he was wandering and rambling: he had been suffering from uncontrollable hiccough for 10 days. On the evening of August 6, three-hourly intramuscular injections of penicillin (15,000 units) were begun. Some improvement was almost immediately manifest. In 24 hours the patient was mentally clearer, the 'hiccough had disappeared, and head-retraction was less marked. The temperature had fallen to 970 F. But when the spinal fluid was examined it was found that little or no penicillin was present.

'I consulted Florey on the telephone about the possibility of injecting penicillin into the spinal theca. He had never done it, but as the case was desperate, and from what I knew about the innocuity of penicillin to human cells, I injected 5000 units by lumbar puncture. Later in the day Florey rang me up on the telephone and told me he had injected penicillin into the spinal theca of a cat and that the cat had promptly died. However, the man did not die. The injection of penicillin into his spinal canal did not upset him at all and he made a rapid recovery. On Aug 28th he got up. His temperature had been normal for two weeks and he had no sign of meningitis. On Sept 9th he left the hospital, completely cured.

'Here was a man who seemed to be dying, but who, in a few days, with penicillin treatment, was out of danger. Such a case makes a great impression on one.'

This miraculous cure was tremendously talked about, both at St Mary's and in medical circles everywhere. On August 27th, 1942, The Timespublished a leading article entitled 'Penicillium', laying stress on the hopes which this substance, a hundred times more active than the sulphonamides, must arouse. At the moment, said the article, it was not easy to obtain a synthetic product, but that did not much matter, since the mould was easily accessible. 'There will', it went on, be general agreement with the plea of the Lancet that "in view of its potentialities" methods of producing penicillin on a large scale should be developed as quickly as possible.'

This was more than advice given to the British Government: it was tantamount to an order.

The article mentioned neither Fleming nor the research-workers at Oxford, but on August 31st, The Times printed a letter from Sir Almroth Wright:

TO THE EDITOR OF THE TIMES Sir,—In the leading article on penicillin in your issue yesterday, you refrained from putting the laurel-wreath for this discovery round anybody's brow. I would, with your permission, supplement your article by pointing out that, on the principle of palmam qui meruit ferat> it should be decreed to Professor Alexander Fleming of this research laboratory. For he is the discoverer of penicillin and was the author also of the original suggestion that this substance might prove to have important applications in medicine.

I am, Sir, yours faithfully,

ALMROTH WRIGHT

Inoculation Department, St Mary's Hospital,

Paddington, W.2 Aug. 28

Thus did the old master proclaim the merits of his disciple. It must have cost him a great effort of intellectual honesty — which he made with perfect loyalty — publicly to sing the praises of chemotherapy. He continued to believe, or at least to hope, that in the last analysis immunization would prevail — as wets only natural.

Wright, now 81, had left London and was living in the country (at Farnham Common). But he still came up, three times a week, to spend a few hours in the laboratory. His train was often delayed by air-raids. He might have made the journey by car, but that would have meant, he said, being driven by women (the only available chauffeurs in war-time) 'and they would have talked all the way.' He preferred the fatigue and danger of the railway.

About Wright and Fleming we have a good deal of first-hand evidence from a secretary, the first Fleming had ever had — Mrs Buckley. 'What struck me5, she says, 'was the extraordinary difference between the two men: between the great master and the great pupil: between Sir Almroth, a creature of intellect, urbane, academic; and Professor Fleming, also with a powerful brain, but much more like a child in his manner of dealing with everything, even with his work. He had an astonishing simplicity of approach, and it was this, I imagine, which so often led him to the right solution of a problem. Yes, they saw things with very different eyes, but the Professor was always the most loyal of disciples.'

Wright had by no means lost his love of argument. 'I remember', says Professor Pulvertaft, 'one occasion in particular when I had gone to tea with him. We talked, or rather, he talked, about Shakespeare, of whom he had a somewhat poor opinion. He said that Shakespeare did not doubt enough, that no one could be an artist who was too certain. None of Shakespeare's characters had doubts. I murmured, rather treacherously: "To be or not to be; that is the question.55 He gave a loud sniff and changed the subject.'

During and after the miraculous cure of 1942, Fleming and Florey corresponded. Both of them thought that the time had come to start mass-production of a substance capable of achieving such marvels. In August, Fleming said to his host and friend, Dr Allison: 'Things look promising ... I am going to see Sir Andrew Duncan, the Minister of Supply. He is a Scot and a friend. Will you, on your side, make the Ministry of Health people get a move on and press for the industrial manufacture of penicillin?' He duly went to see Sir Andrew who, much impressed by the miraculous effects of the substance, replied: 'I am going to give you a committee, and a very active man who will get things moving.'

Sir Andrew sent for Sir Cecil Weir, the Director-General of Equipment, and a remarkable organizer. 'Fleming', said the Minister, 'has been talking to me about penicillin. He believes, and so do I, that it offers immense possibilities for the treatment of wounds and of numerous diseases. I want you to do everything you can to organize its production on a great scale.'

On September 25th, 1942, Sir Cecil Weir summoned to a conference at Portland House, Fleming, Florey, Raistrick, Arthur Mortimer (his assistant) and representatives of the chemical and pharmaceutical industries; in short, all those interested in the manufacture of penicillin.

Five big firms — May & Baker, Glaxo, Burroughs Wellcome, British Drug Houses, and Boots — had formed, in 1941, the 'Therapeutic Research Corporation', to which all had pledged themselves to communicate what they could find out on the subject of penicillin. Other large concerns, I.C.I, and Kemball, Bishop, were in direct contact with the Oxford team, and the latter had even made a free delivery of penicillin to Florey's Institute a few days before the committee met.

Sir Cecil Weir said that all information about the substance and its production must be shared. Research-workers and industrialists must keep one single goal before their eyes: rapid and abundant production. The reaction was unanimous, enthusiastic and favourable. All undertook to share their secrets and to enlist their knowledge and their talents in the service of the community. Florey told how he had passed on the results obtained at Oxford to the American concerns. He added that reciprocity ought to be complete and expressed some uneasiness about patents taken out by American research-workers to protect the manufacturing processes. The Therapeutic Research Corporation promised that all information received from America should be made available to the English scientists.

It was, however, agreed that the work of the different laboratories should not be centralized. A single research centre would, in view of air-raids, be too vulnerable. As to the quantities to be produced, it seemed premature to discuss that question there and then. Florey informed the conference that, though enormous doses had been necessary for the treatment of a single case of septicaemia or of meningitis, that would not be so in the treatment of local infections. Experiments made, for example, on burns showed that ten grams a month would suffice for all infected burns in the Middle East Forces. Dr Maxwell announced that the Therapeutic Research Corporation was thinking of putting up a factory capable of delivering a million litres every year. I.C.I, also had a plan. As to the distribution of the finished product,

Florey hoped that it would be made under the control of biologists, as a safeguard against the improper and harmful use so often made of new remedies.

At the end of the conference, Arthur Mortimer whispered in his chief's ear: T don't know whether you realize it, but this will rank as an historic meeting, not only in the annals of medicine, but probably in the history of the world. For the first time, all those concerned in the production of a remedy, are going to give their knowledge and their work without any ulterior motive of gain or ambition.'

Manufacture got under way very soon. A 'General Committee of Penicillin', at first presided over by Arthur Mortimer, and later by Sir Henry Dale, directed the operation. Professor Raistrick was its technical adviser and rendered immense services. He went to America, as did the engineers belonging to the great manufacturing chemists, to study the progress already made.

In the United States the large-scale production of penicillin had got off to a slow start.1 The chemists wanted fermentation in depth, but penicillium prefers to live on the surface. In addition, the struggle against contamination remained difficult. One of the firms which made a great effort was Charles Pfizer & Co., Inc. It was not a factory specializing in pharmaceutical products, but its staff had a great experience of fermentations. One of the directors, John L. Smith, a little man with grey hair and a poker face, who with his technical advisers, had tried, so far without success, to industrialize the production of penicillin, happened to witness the resurrection of a little girl smitten with an infection which every doctor had, so far, despaired of curing.

She was suffering from infective endocarditis and was going to die. In June 1943 one of the hospital doctors, a man from Brooklyn, Loewe by name, came to Smith and asked him for some penicillin with which to treat her. Smith objected on the ground that the National Research Council reserved to itself the allocation of this rare product, and was of the opinion that it had no effect on endocarditis. Loewe said that, provided it were used in conjunction with heparin, penicillin would be effective. Smith went to Paul de Kruif, Life Among the Doctors (Harcourt Brace, 1949). see the little girl — an action which, for the overworked head of a big firm, was both praiseworthy and surprising. He was deeply moved by what he saw, broke the regulations, and gave Loewe some penicillin. For three days the golden liquid flowed, drop by drop, into one of the young sufferer's veins. Every day, after long hours of work, Smith went to her bedside. When she was getting better, Loewe was satisfied with intra-muscular injections. One month later, the girl was out of danger.

Loewe then undertook the treatment of other obstinate cases and Smith continued to help him. The doctor was by that time administering up to 200,000 units a day. What did it matter, seeing that penicillin was non-toxic? But the National Research Council insisted on the regulations being observed. Endocarditis was still excluded since, according to the Council, the statistics were not 'convincing'. The patients, however, continued to take on a new lease of life, and Smith, in spite of the risk, went on supplying Loewe with penicillin. In October 1943 the Council sent a representative to Brooklyn to take a look at those sick folk who had walked out of their coffins. 'Take an eyeful of me,' said one old woman. 'I'm alive amn't I?' Her eyes were shining. 'All the same, statistically, I'm dead.'

After his visits to the hospital, Smith returned to the factory a changed man. 'You've saved another life,' he said to his engineers, bacteriologists and mycologists. All, thrilled by the grandeur of the struggle, spared neither time nor trouble. By sheer determination they succeeded, by sterilizing the air, in producing deep fermentation in huge vats. Bacteriology for giants. In all the rooms there were notices: 'Exercise scrupulous care ... contamination of penicillin may cause death ... Penicillin must be absolutely sterile. Are you doing everything you can to see that it is? The sick are relying upon your vigilance to protect them' In America this sort of appeal never fails. Very soon a torrent of penicillin was cleansing infected bodies.

Arthur Mortimer tells how certain persons in the United States suggested that they had a right to royalties on the new processes discovered by them. 'Our answer', says Mortimer, 'was that they were free to demand as high a sum in royalties as they liked. They began to wonder and asked us why we were being so generous. We replied that the moment they began to claim royalties, we should demand the like on the total production of penicillin, since the substance had been discovered in England, and that the amount would be exactly twice that asked by them for the use of their processes. After that, nothing further was heard about royalties.' Not unnaturally, when the war was over, patents were taken out — and respected — for the new processes. But penicillin itself remained unpatented and free of all royalties.

There were certain difficulties connected with the word 'penicillin', which a number of firms claimed they could use as their trade-mark. Fleming had to intervene in person. In 1929 he had made of 'penicillin' a scientific term which was common property. No one had a right to monopolize it. The governments of the different countries gave their support to this view and the question was settled without friction. It did, however, become necessary, even in England, to keep a sharp look-out on the way in which the word was used. As soon as it got about that a miraculous remedy had been discovered, the market was flooded with penicillin ointments, penicillin lotions for the eyes, penicillin pills and penicillin beauty preparations. Fleming, much amused, said to Arthur Mortimer: 'I wonder what they're going to invent next? I shouldn't wonder if somebody produces a penicillin lipstick.' 'That's more than possible,' answered Mortimer, 'and it wouldn't be difficult to float: Kiss whom you like, where you like how you like. You need fear no tiresome consequences (except marriage) if you use our Penicillin Rouge'  Fleming responded with a barely perceptible smile, and said it was a good idea, though it would be necessary to apply the Therapeutic Substances Act so as to make sure that no improper use was made of it.

In 1943 the factories began to produce on a big scale, and relatively large quantities became available for the armies. Major-General Poole, Director of Pathology at the War Office, sent two specialists to North Africa. They arrived in Algiers immediately after the Allied victory at Cap Bon. They at once embarked on a whole series of treatments. The wounds in this campaign had been worse than ever and the Tunisian flies had done as much damage as the enemy. There was no end to them, and, proof even against D.D.T., they infected wounds with every type of bacillus, and laid their eggs in them, which produced worms. The treatment of such wounds required enormous quantities of penicillin.

It was not long before Florey arrived in Algeria. His experience enabled him to give much useful advice to the surgeons. The first results had made a tremendous impression on the medical world, and there was reason to fear that penicillin would be used for every kind of wound and every type of illness. Florey set himself energetically to point out that penicillin was not a universal panacea. Certain microbes are susceptible to it, others not. The first thing to be done in every case was to make a culture of the infecting germs and to carry out a test which would show the degree of their sensitivity to penicillin. Where the experiment showed that the germs were vulnerable, then penicillin could be administered and the wound stitched up. The surgeons had to reconsider much of their earlier knowledge and methods. Most of them took an objective view, but others grew indignant. There was still pus in some of the wounds, they said. Some bacteria, the pyocyaneus for instance, were not, it is true, affected by penicillin, but the phagocytes, freed from the other microbes, were strong enough to digest these ultimate assailants.

Meanwhile, small quantities of penicillin were finding their way into the war-factories. Dr Ethel Florey and her colleagues of the Birmingham Accident Hospital demonstrated the effectiveness of penicillin dressings for hand injuries, which were of such frequent occurrence in those surroundings. More than usually spectacular were the results obtained in the fight against gonorrhoea, which penicillin mastered in twelve hours. This was of capital importance in the armies, for the military hospitals were filled with venereal cases.

All of a sudden Glory, that goddess whose movements are unpredictable and violent, laid hold of the silent Scot. He was overwhelmed by a mounting tide of letters. His telephone rang from morning till night. Ministers, generals, newspapers of every country, were continually asking for him. He was a bit surprised, at times amused, but on the whole enjoyed it all, and made a point of insisting on the part played by Florey and Chain.

The public and the Press were fascinated by so original and modest a character. There was something romantic about the story of penicillin: the spore drifting in through a window and settling on a culture; the discovery brought to completion at the very height of the war just when it would be most useful; the marvellous reports pouring in from the armies — all these things helped to create a legend, most of which was true. Honours began to rain down on Fleming. In 1943 he was elected a Fellow of the Royal Society (F.R.S.), the oldest and most highly respected of all the scientific societies in Great Britain. It had emerged, in 1660, from an 'invisible Oxford College' where the philosophers held their meetings. Newton had been its President from 1703 to 1727. Wright belonged to it. To be made a member of it was for a scientist the highest honour which could be conferred upon him by his peers.

His friends at St Mary's, colleagues and students, gave him an eighteenth-century silver salver. Handfield-Jones, one of the hospital's most eminent surgeons, delivered the speech, which accompanied the presentation, in the presence of Sir Almroth Wright. 'There is no member of this community3, he said, 'whom it values more highly than Professor Fleming. He has always entered into the spirit of this house, even so whole-heartedly as, sometimes, to come down from the heights and drink a glass of beer at the Fountains.'

Fleming, in reply, said: 'In the course of my life I have had a few small successes which h^ve given me pleasure. But I can quite honestly say thai this is the greatest moment of my life, for you, my master, my contemporaries and my pupils, have come together to do me honour.' He confessed that he found it difficult to speak intelligently in his present profoundly emotional state. 'I could tell you a lot about staphylococci, spirochaetes, and, even, penicillin, but the situation is very different when I am, myself, the subject under discussion.'

He had, indeed, been terrified all that day at the prospect of having to reply to the eloquent Handfield-Jones. While lunching with MacLeod, he had told him how frightened he was, and MacLeod had reminded him of two famous lines by their compatriot, Robert Burns, which would give expression to the modesty appropriate to the occasion, and might well serve as a peroration.

Fleming decided to make use of the quotation, and to say: 'What do we really know about ourselves? I am a Scot from

Ayrshire. One hundred and fifty years ago, a famous Ayrshire man, Robert Burns, wrote:

O wad some Pow'r the giftie gie us
To see oursels as others see us!

If others see me as I have just been described by Handfield-Jones, then I must have seriously underestimated myself. But my Scottish upbringing has taught me prudence, and I know that on occasions like this, as in obituary notices, flattery is permitted.'

But when he came to speak he was so nervous that he used the Burns quotation at the wrong moment. While he was speaking, it occurred to him that there were three students of St Mary's who had become Fellows of the Royal Society, and he was one of them. He made an impromptu reference to this. 'Many years ago,' he said, 'there were three students here at St Mary's. All three are today Fellows of the Royal Society. Would you ever have thought such a thing possible?' He then immediately quoted Burns's lines, with the result that he appeared to be using the lines to imply that the others had not seen how clever he, and the other two Fellows, really were. However, those present could, for once, see on Fleming's face the emotion he was feeling, and this charming mix-up in his speech was received with affectionate laughter.

Alexander Fleming to Ronald Gray: They had their meeting at the hospital and presented me with a very beautiful silver salver. That was pleasant, but it was not so nice to have to sit on a platform and then have to make a speech. I hope I did not disgrace myself, but in that matter I am not a good judge.

The papers seem to have been busy with penicillin. I actually had a request from somebody in America for an autograph, and I had a letter of congratulations from the Council of my native village, Darvel. The provost of the town had read about penicillin when he was in Cairo. On Thursday week I am supposed to be broadcasting to Sweden ... Nothing startling happening here. We all just go on.

To another friend, the bacteriologist Compton, who at that time was director of a laboratory in Alexandria, he wrote on July 3rd, 1943:

I was naturally pleased at being elected to the Royal Society, and it is nice to think that my friends were pleased also ... I am very busy at present, trying out my chemotherapeutic baby. It seems to be extraordinarily powerful stuff and, when enough of it is available, some of the sulphonamides will have to take a back seat. In the last week or two we have had two staphylococcal septicaemias snatched from the jaws of death, a gonorrhea in which the infection disappeared in twenty-four hours, and some rather wonderful 'cures' by local application. I can see it keeping me very busy for the next six months or more.

We are all just waiting for something big to happen, but we know just as much or as little as you do about what is to happen. Maybe, before you get this, the whole Mediterranean business will be cleared up ...

The Missus is well and busy and Robert is at St Mary's as a student. We all send our best wishes to you and your family and look forward to seeing you when Hitler is finished.

Yours sincerely

ALEXANDER FLEMING

Meanwhile, in the United States, as in England, the spore carried by the wind'was giving birth to an industry which grew with every day that passed. In May 1943 the American Army had put in an order for twenty million units. England was preparing to spend three million pounds on the production of penicillin.

In 1944 Dr Coghill, of the Peoria laboratory, presented to the American Chemical Society a brilliant report which revealed the extraordinary rapidity with which the industrial production of penicillin in the United States had been developing:

Seldom within our memory has any topic so taken the interest of the scientific and lay world as has penicillin. For the past two years or more it has played Cinderella to the mycologists, chemists and engineers of the whole English-speaking world.

Product of the humble moulds, which until comparatively recent years have been something to control rather than to cultivate, it has miraculously been clothed with the raiment of $20,000,000 worth of plants, and is now attended upon by hundreds of footmen, and the party is proceeding with fanfares galore. Penicillin is very patently taking the limelight from its older sulfa sisters. Two years ago, those of us who were concerned with promoting the party used to wake up in the middle of the night and wonder whether at the stroke of 12.00 this lovely vision would flee, leaving us clutching at an empty glass slipper — the work and strife we had been through, and the plants we had built. However, the stroke of 12.00 is now upon us, and we find the two stories are digressing, for the few dozens of spectacular cases upon which we had originally built our hopes have now been augmented by hundreds more like them ...

This scientist wrote well, and the myth of Cinderella could be truly applied to Fleming's adventure.


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