England, 1918

After the war, Fleming went back home to England, and returned to the Inoculation Department at St. Mary’s Hospital. He was promoted and became the assistant director of the department. Ten years later, he became a professor of bacteriology.

Inoculation Department, St. Mary’s Hospital, England, September 3, 1928

“Good to have you back!”

“Good to be back, sir!”

“Fine to see you again!”

Alexander was back at work after a two-week vacation. He put on his lab coat and hummed a cheery little tune as he headed over to his culture plates (on which scientists grow bacteria in order to study them). “Botheration,” he muttered. He glanced around to make sure no one was watching; after all, he was known as a rather careless lab technician, and he was in no mood for his colleagues to discover yet another example of his sloppiness. How did that mold get there, anyway? And what kind of bacteriologist allows mold to grow on his laboratory culture plates? Feeling a bit hot under the collar, Alexander bent over to examine his contaminated culture plate. There it was, an unsightly green fungus growing on his staphylococcus culture. “There’s a fungus among us,” he muttered to himself (or he would have, if the term had been invented by then). But his natural curiosity overtook him, and before disposing of the contaminated plate, Alexander noticed something fascinating.

There was a clear ring around the mold, where the bacteria had stopped growing. It seemed that the mold had actually inhibited the growth of the bacteria staphylococcus, which causes disease — and might have even killed it.

“Look at that,” Alexander murmured, his heart beating faster. “Will you look at that!”

Just a few years before, in 1921, he’d had a similarly exciting discovery, when a drop of mucus from his runny nose (he had a cold, you see) dropped onto a different culture plate he was working on. His inborn curiosity had prompted him to mix his nasal mucus into the bacteria (why not, right?), and within a few weeks, he saw signs that the bacteria were dissolving. Alexander had discovered the enzyme lysozyme, which is present in our saliva, tears, and nasal mucus. Though his discovery did help the scientific and medical world learn significantly more about how our bodies fight infection, lysozyme didn’t really help kill most of the bacteria causing people to get sick and die. This time, however, Alexander was sure he had discovered an even more powerful enzyme. And he was right. Sort of.

It turned out that the mold, identified as Penicillium notatum, wasn’t an enzyme at all. In fact, it was an antibiotic — the first ever to be discovered. At first, Alexander called his miracle mold “mold (er, mould) juice.” Later, he renamed it “penicillin,” in honor of the mold itself. But Alexander just couldn’t figure out how to get penicillin to work the way he wanted it to. He quickly realized that the penicillin could be a huge help in the medical field, saving lives on both external wounds and internal infections, but he couldn’t get it right. His keen curiosity and his preference for working alone were great assets in actually making his discovery, but they weren’t as helpful when the task was extracting the beneficial potential medication from the fungus. To achieve that, more teamwork was required — multidisciplinary teamwork. (This means people working together, studying different aspects of the project at hand, particularly when there is more than one field of study needed to achieve results.)

After three years of trying, even with two young assistants, Alexander gave up on the study of penicillin. But he had shared his discovery with the scientific world in a publication in 1929, and the stage was set for the next players in the development of penicillin.

University of Oxford, Oxfordshire, England, 1939

On a beautiful, lush, green campus near the River Thames in England, in one of the oldest and most established universities in the world, the revolution quietly continued to unfold. Over ten years after Alexander Fleming first discovered the power of penicillin, two scientists, working together, managed to clearly show that penicillin could cure infections and save lives.

Australian-born pathologist Howard Walter Florey (1898–1968) and German-born (and reportedly Jewish) biochemist Ernst Boris Chain (1906–1979) prepared a crude preparation of penicillin, isolating and purifying the antibiotic from within the mold. They then tried treating laboratory mice infected with streptococcal infections (the same kind of infections that cause the common strep throat). It was thrilling to discover that, as they had hoped, their preparation had a dramatic effect on the mice and was able to cure the infections.

The next step was to try their penicillin on human patients suffering from similar infections. Here, too, the pair was able to demonstrate penicillin’s powerful curative properties.

Now the pair had two hurdles to overcome. First, they had to develop a method to produce large amounts of the purified, isolated mold extract, which was a challenge. Second, they had to continue researching the usefulness of penicillin by clinical trials, which required formal testing of their treatment, to see if it could really help lots of people with particular infections.

University of Oxford, Oxfordshire, England, 1941

Three years later, our researchers had collected enough penicillin to begin clinical trials. They recruited several patients suffering from terrible infections caused by staphylococcal and streptococcal infections, the kinds they had seen penicillin curing in the lab. These were patients other doctors couldn’t help; there was no good treatment for them, and they were going to die.

The effects of the study were extraordinary. Florey, Chain, and their colleagues were astounded by the success of their treatment. There was just one problem. They ran out of the medicine before they could save the lives of all the people in the trial!

Florey, Chain, and the other researchers could not get large amounts of penicillin using the facilities they had available in their lab. They were growing the Penicillium notatum mold in small containers, but they needed bigger containers to get enough of it and continue their lifesaving work. They realized they had to put their thinking caps on. How could they get sufficient amounts of the mold from which to extract their isolated, purified penicillin?

The answer lay in cooperation and joining forces. The scientists reached out to the United States Department of Agriculture’s Research Laboratories. There, researchers had access to large fermentation vats where they could grow large amounts of mold. Things were looking up!

Unfortunately, it seemed the time was not yet ripe. It became clear that the mold just wasn’t growing properly in bigger containers. But the scientists didn’t give up. Determined as ever, they decided to look for another strain of the Penicillium mold to see if they could isolate their antibiotic from there.

Eventually, the team found their answer in an overripe (rotting!) cantaloupe. The mold growing there was a strain of Penicillium chrysogenum, and the researchers managed to isolate their lifesaving medicine from that mold. As they had hoped, this new mold did grow very well in the deep fermentation vats at the USDA’s research lab. Now it was possible to grow large amounts of the mold and extract the lifesaving penicillin.

All this was going on in the relative peacetime of England and the US during World War II. Many soldiers were being wounded once again. But this time, penicillin became a major player on the scene, preventing many deaths and amputations.

The scientists in America worked hard to facilitate commercial production and joined forces with pharmaceutical firms to help them develop and distribute the new medication. It was very potent, effective, and safe. Within three years, penicillin was being produced in very large amounts to meet the tremendous demands of wartime.

Once the world discovered ways to produce large amounts of the medication — and wartime usage had proved beyond a doubt the effectiveness of it — the doors opened wide for extensive use of penicillin to treat infections everywhere in the world. In short order, the use of penicillin completely transformed medical care.

December 10, 1945

In early winter at the close of 1945, the Nobel Prize in Physiology or Medicine was divided into three and presented to Sir Alexander Fleming, Ernst Boris Chain, and Sir Howard Walter Florey “for the discovery of penicillin and its curative effect in various infectious diseases.” They, along with many others, had worked hard to achieve their goals, overcome obstacles, and kept their eyes on the real prize: saving and bettering lives the world over.

FUN FACT: In the beginning of 1943, there were only 400 million units of penicillin available; by 1945, US companies were making 650 billion units a month.

FUN FACT: Penicillin is the most widely used antibiotic in the world.

FUN FACT: Many additional lifesaving antibiotics discovered after penicillin were also derived from fungi.

QUOTE THAT!

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

–Sir Alexander Fleming

(Originally featured in Mishpacha Jr., Issue 834)