When Fleming discovered penicillin and Spain fell at his feet

On Friday, March 10, 1944, the mother of little Amparito awaited the arrival of a “miraculous” medication. She would do so in anguish, because time was running out for the little girl, barely nine years old, affected by a bacterial infection in her bloodstream. The doctors had found nothing to abate her serious illness. Even less so in post-war Spain, where everything was lacking and ration cards were the norm.

The war in Europe was in its fifth year. “Snowstorm in Catalonia!” Along with this, that day The vanguard opened the cover with a photo of German soldiers caught in the same storm in Italy. On the inside pages, an avalanche of information about the progress of the war, which surely worried Amparito’s mother little.

The only thing that would matter to her at that moment was that her husband returned safely from the Brazilian embassy, ​​where he had gone for twelve bottles of penicillin. Protected by a thermos with ice, and thanks to a grace from the Brazilian Government, they had crossed the Atlantic expressly to save that life.

It was one of the first shipments of the drug – the first antibiotic in history – to reach the peninsula. That is why, the next day, the news opened the national information pages from the newspaper: “A full dose of penicillin arrives in Madrid to save the life of a girl”.

This contrasts with what was happening in the United States, where the product was already advertised on billboards as if it were a cure-all. “Cure gonorrhea in four hours”, read some posters. Curiously, if he began to arrive in Spain it was because of the war in Europe. Although in theory it was foreign to us, it was going to have an unexpected beneficial effect, at least for the rich: from North Africa, some doses from the US army were “sneaking” through Gibraltar.

A year earlier, the British Army had already established a committee to study the new cure. Too late, as the US had already launched into mass production. In fact, the financing of the armed forces of this country was key for a team from the University of Oxford to locate the mushrooms necessary for its production. As time showed, the best investment they could make.

If in the First World War (1914-1918) the death rate among soldiers infected with bacterial pneumonia was 18%, by the Second (1939-1945) it had already fallen below 1%! Aware that, in war, sometimes the infection kills as much as the bullets, the Allied high command made sure that the first wave of soldiers that landed in Normandy did so with half a million doses of the new drug.

What to say about syphilis, a disease that had been terrorizing the world for centuries and that in some European cities affected 15% of the population. After 1943, a treatment with antibiotics eliminated the agent Treponema pallidum in just a few hours. In Spain, where life expectancy increased by ten years between 1950 and 1970, it is impossible to underestimate the importance of penicillin.

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And it is that, before that, a badly healed scratch could kill anyone. The case of Albert Alexander (1896-1941) is very famous, a 45-year-old English policeman who was fond of gardening who, after a scratch on a rosebush, ended up with abscesses on his face, shoulders and lungs. Alexander would become famous for being the first person treated with antibiotics. But with little to celebrate.

Due to the lack of doses to continue the treatment – ​​all those that existed in the world were inoculated to him –, he ended up dying a few days later. Like the son of US President Calvin Coolidge, who fifteen years earlier had died from brand new tennis shoes that caused a wound that ended up becoming infected.

In almost every street in Spain there is a “Doctor Fleming”

Illustrious or not, microorganisms do not respect anyone. That is why the discovery of Alexander Fleming (1881-1955) changed the course of history. Beyond the Nobel Prize he received, how many streets, squares, avenues and avenues in Spain bear his name? In almost every street there is a “Doctor Fleming”. Popularly, we say to a braggart “you haven’t discovered penicillin either” when he thinks he has come to a unique conclusion that the rest of us don’t think is so great. The one who was not a friend of giving them anything was Fleming himself, who once said: “Nature makes penicillin, I only found it.”

For a man who was also rather shy, his visit to Spain in 1948 must have been impressive. Especially when, thanks to the front pages of the main newspapers, the country was already warned. As the microbiologist Eduardo Villalobo-Polo explains in an article on the case (“Alexander Fleming: 70 years of his visit to Spain”, 2018), in Barcelona he could not walk down the street without receiving ovations, applause and the affection of more than a passerby The Scotsman, unaccustomed to kisses and hugs, when leaving to continue his tour, said that in “no city” he had received so much love.

A few days later, the same thing happened to him in Seville, Córdoba or Madrid. In the latter, as if he were a bullfighter, the medical students carried him out of the conference room on their shoulders, walking him amidst the shouting to the official car. In Seville they shouted “You have saved my life!”, and more than one kissed his hand because his medication had relieved the infection of a child. In fact, Villalobo-Polo says that in that city many bars and brothels had a photo of the discoverer on the wall. According to popular legend, the prostitutes put candles on the “saint” who had cured his venereal disease.

Did he do it by himself? The myth of the serendipitous invention, an English neologism that alludes to what is discovered unexpectedly, fits the Fleming case well. The story begins on September 3, 1928, when, on the way back from vacation, he discovered something strange in one of the bacteria cultures Staphylococcus aureus (the causative agent of various diseases) that he had prepared before leaving. One of the cultures was contaminated by a greenish mold that had killed the staph bacteria around it.

The next thing was to make cultures with that fungus to obtain more of its antibacterial component. To his amazement, with the juice he obtained, he was able to annihilate bacteria that cause diphtheria, tonsillitis, and pneumonia, among other ailments. Why did you name it “penicillin”? As he explained, because “mould broth filtrate” did not sound too good, and because the miraculous mold came from fungi of the genus Penicilliumalready known to science.

In fact, for most of us, since the Penicillium they are abundant. They proliferate on floors, skins and all kinds of surfaces. For example, in mandarins that, when spoiled, are covered with a whitish mold. Roquefort cheese lovers may know that this delicacy is made by the action of a species of this fungus on milk.

Fleming himself made the mistake of seeing his discovery as a laboratory bactericide, but not as a drug.

Once this milestone was achieved, the product still needed to be isolated in a concentrate that could be administered to humans, something for which Fleming had neither funding nor knowledge. In fact, during the first years, the discovery sailed through the scientific publications without transcending. In part, because they saw it as a good bactericide for laboratory cultures, but not as a drug. A mistake that Fleming himself also made.

So until a subordinate of the Australian pharmacologist Howard Florey (1898-1968) sent him one of the Scotsman’s works. Convinced of its potential, in 1939 Florey assembled a team of scientists from the University of Oxford. With the luck that the group received 25,000 dollars from the Rockefeller Foundation, interested in antibiotics.

Thus they achieved the first concentrate, which, with the participation of the US Government, they were able to start producing at a plant in Peoria (Ilinois). They did so without a patent for their discoverer. As Fleming later said: “I found penicillin and have given it free for the benefit of mankind.”

This is how he explained it to journalists during his tour of Spain, where he paraded like a profane saint. But, although the ladies who in Córdoba endorsed him “Long live the mother who gave birth to you!” Unbeknownst to them, more than a providential find, penicillin was the last stop in a long series of discoveries.

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Before him, in 1871 the English physiologist John Scott Burdon-Sanderson (1828-1905) had already observed that cultures contaminated with some kind of Penicillium did not develop bacteria. Similarly, it would be inexcusable not to mention the German physician Robert Koch (1843-1910), the first to find a concrete example that demonstrated the germ theory of disease. And this is the core of this whole mess.

This is why Louis Pasteur (1822-1895) is famous, for stating that microorganisms (microbes) are the cause of diseases. Although today it seems like an obvious statement, until the 19th century medicine was still governed by erroneous postulates, from the theory of the four humors traceable to Hippocrates (c. 460-c. 370 BC) to the hypothesis of miasms or spontaneous generation.

These postulates became obsolete when Koch discovered that the Bacillus anthracis was the pathogen causing anthrax. There was no longer any doubt: every living thing comes from another living thing and the germ theory of disease was valid. Now scientists could set out to discover a method to selectively kill those germs.

Paul Ehrlich (1854-1915) had some success, a German Nobel Prize winner who synthesized a chemical compound that he called a “magic bullet” because it managed to kill undesirable germs without damaging the patient’s cells. A finding with which he inaugurated chemotherapy.

Fleming was aware of and drew on the work of his predecessors. He never had a problem remembering it, even when he received the Swedish Academy Award. In his acceptance speech he did not forget to issue a warning: “The day will come when penicillin can be purchased by anyone in stores. With the danger that the ignorant man will often underdose and, by exposing his microbes to non-lethal amounts of the drug, render them resistant”.

Some scientists believe that by 2050 antibiotic resistance will cause more deaths than cancer

Indeed, the body learns, and natural selection proved Fleming right. Today, antibiotic resistance is a problem that is growing every year, and some scientists believe that by 2050 it will cause more deaths than cancer.

A problem that is of this generation. For that Amparito who headed our article, the urgent thing was to refer his infection. As soon as her father arrived, a practitioner administered the first dose to the little girl. It was already after two in the afternoon, and she was getting dark without the fever or the infections receding. Neither with the second dose, until she had to accept the inevitable. Although it had been quite a feat to bring the vials to that little house in the Madrid neighborhood of Argüelles, it was too late. The girl died a few days later.