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.