Alexander Fleming: Penicillin’s Co-Finder

Like the X-ray machine, the humble post-it note, and even the pacemaker, penicillin goes down in history as one of the most life-changing ‘accidental discoveries’ ever made. Alexander Fleming himself remembered it similarly:

One sometimes finds, what one is not looking for. When I woke up just after dawn on September 28, 1928, I certainly didn’t plan to revolutionize all medicine by discovering the world’s first antibiotic, or bacteria killer. But I suppose that was exactly what I did.
— Alexander Fleming

The discovery of penicillin was to revolutionise medicine forever, curing countless diseases and saving millions of lives. As with many discoveries, however, Fleming’s unearthing of penicillin didn’t happen in a vacuum.

Although Fleming was the first to identify penicillin and its potential life-saving properties, the journey from discovering the first contaminated culture to the mass distribution of penicillin as we know it today was a collective effort. Fleming even described the fame he garnered following his discovery as the ‘Fleming Myth’. That hasn’t stopped him from being largely accredited with its discovery. Like most mythologies of a human nature, Fleming’s role in the penicillin story has some truth to it, but it would be false to say that he was solely responsible for its success.

The Discovery of Penicillin

The year is 1928, and bacteriologist Alexander Fleming, having just returned from a summer holiday, is sorting through his messy laboratory in London. On his return, he is dismayed to discover that one of his lab assistants has left a window open, resulting in the pile of petri dishes he left on the bench becoming contaminated by different microbes. Putting aside his annoyance, Fleming takes a closer look, only to discover that a bacteria-free circle has emerged on the culture dishes – being used to grow the bacterium staphylococcus.

Alexander Fleming hoped that his discovery could lead to therapeutic treatment for bacterial diseases – and a potential end to the suffering of millions of people. It had echoes of Fleming’s earlier discovery of the antimicrobial lysozyme in 1921. Lysozyme was another personal finding for Fleming. He uncovered it when he was suffering from a cold and a drop of his mucus dropped onto a plate of bacteria, resulting in some of the bacteria dissolving. Although lysozyme stands as one of the greatest achievements of Fleming’s career, it ultimately proved ineffective at combatting serious bacterial infections. For some time, indeed, it looked as though penicillin would follow a similar trajectory. Fortunately a group of scientists in Oxford had different plans…

A Tale of Two Cities

It’s now 1935 and the scene has moved from bustling London to leafy Oxford. Howard Florey, a talented pathologist, has just been appointed Professor of Pathology at Oxford University. Shortly after arriving, he assembles an impressive team including Ernest Chain, Norman Heatley, and Jim Kent. After Chain rediscovered Alexander Fleming’s paper on the remedial possibilities that penicillin offered, the team set about picking up where he had left off.

On Friday the 23rd of April 2020, Oxford was once again cast into the spotlight as human trials began on a vaccine hoped to suppress Covid-19. 1,100 healthy volunteers signed up to trial the vaccine and will be closely monitored over the coming weeks. Then and now, human trials play a pivotal role in the development of most scientific breakthroughs, and the discovery of penicillin was no exception.

The first patient to undergo human trials for penicillin was a policeman named Constable Albert Alexander. He had developed sepsis after working in a rose garden in Oxford and was gravely ill by the time he was treated with penicillin.

Initially, Alexander’s recovery was remarkable. However, since penicillin was not mass-produced at the time, his body excreted it faster than Florey and the team could replace it. Alexander’s story ultimately had a tragic ending, as penicillin was not able to save him, but his temporary reprieve gave the team hope that penicillin still had life-saving potential.

After securing wider production of the drug, the team’s hopes were realised and many of their patients began to recover. Following hundreds of hours in the laboratory and many trials and experiments, the use of penicillin to successfully treat human subjects had finally been achieved.

The results were monumental, with a myriad of diseases, including pneumonia, meningitis, scarlet fever, and syphilis all being successfully treated by the wonder drug. As the mass manufacturing of penicillin coincided with World War II, it was also utilised to treat wounded soldiers, saving many lives, whilst also allowing other soldiers to get back on the front line.

The development of penicillin was a joint effort, with Fleming laying the critical groundwork that led to victory. Why then, is Fleming the individual who is celebrated as the great pioneer of penicillin and its ground-breaking success? Did Fleming even deserve the accolades and heroic status bestowed on him by the media and public? The truth, as is often the case, probably lies somewhere in the middle.

Norman Heatley: the story’s unsung hero

Back in 2009, a BBC documentary called Breaking Mould: The Story of Penicillin threatened to rewrite the history books. The documentary suggested that other members of the Oxford group, most notably Norman Heatley, played a much larger role in the development of penicillin than they have previously been credited for. Heatley had devised a system for the production and purification of penicillin, with his scientific skill, combined with his imagination, enabling the team to overcome the frustrating limitations that Fleming himself had faced when researching penicillin.

The team’s development of penicillin changed the face of medicine irrevocably, and the efforts of those involved were recognised in 1945 when Fleming, Chain, and Florey were jointly awarded the Nobel Peace Prize in Physiology or Medicine. Surprisingly, Heatley did not share the prize and it was not until 1991 when he was awarded an honorary doctorate from Oxford University, that Heatley’s role received public recognition.

Heatley did, on all accounts, prefer a quiet life, and it’s thought that Fleming’s willingness to talk to the media, alongside his connections with St Mary’s hospital, resulted in him achieving a greater deal of recognition. It remains telling that almost one hundred years on, the name that is most closely associated with penicillin is not Florey, Heatley, or Chain, but Fleming.

Beyond Penicillin

Fleming remained modest about his discovery throughout his career, claiming that he didn’t ‘invent’ penicillin, as it already existed as part of nature.

Another way to look at the penicillin tale is to see that by associating Fleming exclusively with penicillin, we are also limiting and devaluing his many scientific achievements. Alexander Fleming was a phenomenal bacteriologist, having discovered the powerful effects of antiseptics on soldiers’ wounds, but he was also amongst the first to usher in warnings about antibiotic resistance, a finding that has shaped much of the medical and pharmaceutical industry since.

Rewriting History

As clinical trials continue in hopes of finding an effective vaccine against Covid-19, it is to be hoped that we can all benefit from Alexander Fleming’s tale. Great discoveries rarely occur thanks to one person and, as we’ve seen in the last few weeks, there is plenty of room for expressing gratitude to all those involved in this herculean mission, whether their role be big or small.

The history books cannot be re-written overnight, and nor should they be. But by uncovering the whole story, we not only get closer to the truth, but we also bring to light the forgotten heroes hidden in the shadows of our scientific landscape.