Microbes and Medicine

Reserve Police Constable Albert Alexander was in a very bad way. His face was horribly swollen and covered in abscesses, his breathing was short, and he was displaying all the symptoms of acute sepsis. The situation was so serious that surgeons at the Radcliffe Infirmary had been forced to remove one of his infected eyeballs.

Hearing of the case, Ethel Florey, researcher in clinical medicine and wife of Oxford’s Professor of Pathology, rushed to notify her husband. Without hesitation he summoned a meeting of his colleagues Ernst Chain and Norman Heatley.

The patient was clearly at death’s door. Drastic and immediate action was required. The decision was taken to administer a chemical which up to that point had only been examined under laboratory conditions and tested on mice.

On 12 February 1941 PC Albert Alexander became the first human being on earth to be injected with an intravenous infusion of penicillin – 160 milligrams: 200 units.

The results were almost instantaneous. The swelling decreased, breathing began to return to normal, the raging temperature was quelled. ‘It was the nearest thing I ever came to seeing a miracle,’ recalled Charles Fletcher, the doctor who had carried out the procedure. But it was not to be. The quantity of back-up penicillin was insufficient to sustain his progress and Albert relapsed. He passed away on 15 March.

Sir William Dunn School of PathologyUrged on by his wife, Florey and his team returned to their research laboratory with renewed determination. Together they set their sights on developing a way to isolate, cultivate, extract and purify penicillin in sufficient quantity to treat the entire population. Working day and night at the Sir William Dunn School of Pathology on South Parks Road (with significant funding from William Morris and the Nuffield Foundation) they eventually devised a scheme for harvesting antibiotic material of sufficient stability to be capable of mass production.

By the time Lord (Howard) Florey of Adelaide and Marston (Rhodes Scholar at Magdalen, Fellow of Lincoln, Provost of The Queen’s College) died in 1968, it was estimated that over 200 million lives had been saved. A stone memorial in the specially-planted rose garden opposite Magdalen College records the names of those who worked with him on the penicillin project – together with these words:

ALL MANKIND IS IN THEIR DEBT

Microbes and medicine go back a long way in Oxford. The periodic plagues of the seventeenth century killed people in their thousands (Michaelmas Term had to be cancelled in 1603); but these levels of mortality were as nothing compared with the pandemic known as the Black Death which swept through Europe in the years 1347-49.

The symptoms of the contagion were hideous to behold – black boils or buboes (hence the term bubonic plague) clustered around the lymph nodes in the neck, armpit and groin. A terrible fever, sweating, sickness and diarrhoea ensued. Death followed swiftly and almost inevitably.

Conditions soon became appalling. Many communities ran out of people to dig pits and bury the bodies, leaving piles of blackened corpses to fester, rot and in turn promote more plague. Whole swathes of the country were ravaged to vanishing point. Modern Ordnance Survey maps are still peppered with signs for ‘deserted villages’ dating from this period.

Medieval Oxford, low-lying and surrounded by water-meadows and swamps, already had a reputation as a hotbed of ‘foul Disease … contracted almost in an Epidemical Manner’ as a result of prostitution and undergraduate excess, poor sanitation and cramped living conditions. The Black Death brought sickness of an altogether different order. Between a quarter and a half of the entire population of Europe was eradicated: Oxford was no exception.

In later centuries the town was further afflicted by waves of cholera, smallpox, typhoid fever and tuberculosis. Victorian cemeteries at the then edge of town (Holywell, Osney, St Sepulchre’s) bear witness to the persistent ravages of contagion and the fact that the graveyards of the city centre churches were already full to bursting point.

One virulent outbreak brought Oxford especial notoriety: the so-called Black Assize of 1577. Over 300 of its citizens, including the Lord High Sheriff, were smitten by a foul-smelling and deadly disease following the trial of Rowland Jenkes, a bookseller accused of ‘popish’ sympathies, who was rumoured to have put a curse on everyone in the courtroom. All three judges who tried his case were among those who died.

Cometh the disease, cometh the response: the medieval treatises of ‘doctor mirabilis’ Roger Bacon; the establishment in 1621 of Britain’s first Physick (later Botanical) Garden for the collection and propagation of efficacious plants and herbs; the work on blood circulation, transfusion and respiratory disease carried out in the seventeenth century by an extraordinarily brilliant collection of Oxford scientists (including William Harvey, Thomas Willis, Robert Boyle and Robert Hooke); the eighteenth-century contribution of John Radcliffe (personal physician to the king and a major patron of medical research); the nineteenth-century advocacy of Sir Henry Acland, whose Memoir on the Cholera at Oxford in the year 1854 with considerations suggested by the epidemic laid the basis for a Diploma in Preventive Medicine and Public Health. Oxford has always been at the centre of attempts to combat disease and keep the nation healthy.

It was a contemporary of Florey, Dorothy Hodgkin (Somerville College) who confirmed the precise chemical structure of penicillin in 1945 using ground-breaking X-ray crystallography for which she eventually won the Nobel Prize. (Of equal, remarkable importance was her revelation of the biomolecular structure of insulin in 1969, after 35 years of research.)

Another distinguished female scientist, Professor Sarah Gilbert at Oxford’s Jenner Institute, is leading the UK’s current response to the coronavirus. At this very moment more than twenty departments of the university and over 500 researchers are energetically engaged in efforts to understand different aspects of COVID-19.

Oxford’s Medical School has been ranked first in the world for pre-clinical, clinical and health studies every year for the past decade. Oxford is also home to researchers working on different forms of health equipment. Teams of graduate engineering students are engaged, for example, in OxVent, ‘a collaborative project to develop a simple but effective ventilator that can be produced in its thousands every week’.

It is in Oxford that hundreds of volunteers are being recruited to participate in an antibody test that is quick (yielding results in just half an hour – three times faster than the current best method) and accurate (with built-in checks to prevent false positives or negatives).

And it will be citizens of Oxford who are first in line, when the time arrives (soon, we hear) to trial the breakthrough vaccine that will assuredly transform life as we know it.