Grandfather of allergy: Dr. Bill Frankland, the ardent centenarian

John J. Turner
United Kingdom

 

Captain A. W. Frankland
Image credit Paul Watkins
Research for Far East Prisoners
of War History Group
Fepowhistory.com

“For your final choice?” Dr. William Frankland at one hundred and three, the oldest guest ever to appear in the London studio of the BBC’s Desert Island Discs, chose Elgar’s Nimrod in tribute to his fallen comrades while recalling his deliverance from Far East imprisonment.1 August 1945 and the Second World War finally ended in the atomic mushroom obliteration of Hiroshima and Nagasaki. Three months on, snaking lines of soldiers disembarked on Liverpool’s drizzly December dockside, good-humoredly waiting for a telephone kiosk. Captain A. W. Frankland of the Royal Army Medical Corps (RAMC) felt the swirl of emotion of three absent years squeezed into a brief call to his ecstatic wife, time rationed by the red-sashed sergeant major wielding his swagger stick of authority. Three rollercoaster minutes of reassurance, “Yes, I’m fine,” interwoven with practicalities. Not quite so fine, thought Pauline, as she contemplated her new skeletal Bill who now shared many of the tropical afflictions of Japanese prisoners of war. Swollen legs, feverish sweats, ulcerated skin, and irritating tingles from the peripheral neuropathy of Vitamin B deficiency.2 Together they pondered life beyond the cage.

Four severed sun-dried heads, impaled on the bridge to Singapore’s Changi gaol, imparted a chilling message from the Japanese Imperial Army, scornful of their captives, despised as soldiers without honor. In the service of the Emperor, death was preferred to surrender.3 Harsh to be a prisoner of war, doubly harsh as a raw young officer burdened with the medical care of two hundred Allied prisoners of war. Two days of tropical medicine training with the RAMC barely scratched the surface of what he really needed to know about malnutrition, malaria, dengue, beriberi, and strongyloides (parasitic intestinal roundworms) – let alone how to handle the psychological trauma of harsh punitive imprisonment.

Bill Frankland, Honorary Fellow
attending the annual Boar’s Head
Gaudy The Queen’s College Oxford,
2016. University of Oxford Alumni
ox.ac.uk

Medically fit for work? A simple test – to stand upright for one minute without fainting qualified prisoners to join the starving straggle in the forced labor gang on Hell Island.4 Infringements of rigorous camp discipline risked ritualized beatings from bamboo canes, hob-nailed boots, and rifle butts. Officers held responsible for the actions of their men might be punished along with the offender. In a life-threatening incident, his men restrained Frankland from an act of futile retaliation, saving him from what he believed would have been summary execution from the bayonet wielding guard.

Six months on at St. Mary’s Hospital London, he resumed work in the Inoculation Department. By 1947 he was housed in the Wright-Fleming Research Institute of Microbiology, a center of international standing headed by Nobel Prize winner Sir Alexander Fleming, discoverer of penicillin.5 Fleming’s interests concentrated on the laboratory and in vitro studies while Frankland explored allergic responses in vivo with patients.6 The Inoculation Department began with Sir Almoth Wright’s development of typhoid vaccines, attracting pivotal figures such as Leonard Noon. Under Frankland’s predecessor Dr. John Freeman, the Allergy Clinic became the largest in the world, creating the foundations for modern clinical immunotherapy.7 If Frankland became the “Grandfather of Allergy” then Freeman was a worthy Great Grandfather.8

Alexandra Medical School Campus
National University of Singapore
National Heritage Board of Singapore

Bill determined to commit himself to a career unravelling the medical mysteries of allergy. His twin brother Jack commented how odd it seemed not to share Bill’s history of hay fever and seasonal rhinitis. The twins, utterly identical in physiognomy, were intriguingly less so when it came to their immunology – a tantalizing conundrum that fired his research ambitions. To patients he likened the esoteric mechanisms as “immunity gone wrong” – maverick responses when antibodies trigger cellular damage instead of protecting as nature intended.

Frankland pioneered pollen vaccination, operating a pollen farm in rural Surrey producing key ingredients for vaccine production at the Wright-Fleming. After installing a Hirst pollen trap on the roof of the nurses’ home at St. Mary’s to measure spore levels, daily pollen counts were telephoned to The Times and The Telegraph, entering the public domain next to the weather reports.

In an old and risky tradition of scientific medical self-experimentation, harking back to Jenner’s discovery of smallpox vaccination, he undertook a bold personal trial of treatment. He encouraged Rhodious Prolixus, a South American blood sucking insect, to feed on his blood at weekly intervals and observed escalating skin reactions. After seven weeks he deduced that the next bite might trigger a more severe allergic response and wisely removed himself from the laboratory to a research bed at St. Mary’s. The medical team stood ready as an alarmed nurse shouted, “I can’t get a blood pressure.” A potentially fatal anaphylaxis followed – with greying of consciousness, lips swelling, skin reddening, chest tightening, and an overwhelming sense of impending doom. The crisis was successfully terminated by three successive injections of adrenaline.

Hirst Pollen Counter
Researchgate.net and Burkard.co.uk

Bill considered himself to have had a charmed and lucky life, describing survival from anaphylaxis as one of a series of “near misses.” His posting to Tanglin instead of the Royal Alexander Military Hospital Singapore had been decided by the fortuitous toss of a coin. His unlucky fellow officer was destined to be bayoneted by the Japanese in the operating theatre along with the patient under anesthetic in a ferocious act of retaliation. Two hundred staff and patients lost their lives.9 The end-of-war liberation of the camp provided another harrowing “near miss” when the military guards reluctantly surrendered under orders from the Japanese High Command, but informed the prisoners that every one of them would have been shot if the anticipated US invasion of the Japanese homeland had gone ahead.10

After reputation-boosting publications and scientific conferences, he arrived as an international allergy specialist to see a VIP patient. The leather jacketed, moustachioed men in dark glasses at Baghdad airport escorted him through the studded door of the Royal Palace, past shiny booted armed guards, to the marbled throne room. Greeted by the President blowing circles of blue-grey tobacco smoke, they sat drinking green tea. Frankland extracted more precise details of the troublingly persistent presidential cough and enquired of Saddam Hussein how many cigarettes he smoked. In a tone of firm medical authority he stated decisively that the cough did not arise from the supposed fungal allergic asthma for which he had been treated with desensitizing injections, adding that cigarettes were the cause and he would not see him again unless he gave up cigarettes completely. A few months later, accompanied by his musically talented wife and equally musical daughter, Frankland received the medical update, while his nineteen-year-old daughter played Mozart on the palace grand piano. The President smilingly confirmed his non-smoking status, adding that the cough was almost gone.

By ninety his lifelong seasonal rhinitis had resolved. At a hundred he (reluctantly) ceased seeing patients but continued to keep up with journals, published four peer reviewed academic papers, and addressed the European Academy of Allergy at the age of 102.11

 

References:

  1. Interview, Kirsty Young and Dr Bill Frankland. Desert Island Discs, BBC Archive, 9 Aug, 2015.
  2. Meg Parkes and Geoff Gill, Captive Memories: Far East Prisoners of War and Liverpool School of Tropical Medicine Palatine Books, 2015.
  3. Oscar Craig and Alasdair Fraser, Letter from Capt, A.W. Frankland on conditions in Changi, in Doctors at War, The Memoir Club, Stanhope 2007.
  4. Lane, R, Bill Frankland: active allergist at 101, Lancet 382, 9894, P. 762, Aug 31, 2013.
  5. E. A. Heaman, ‘Pathology between the Wars: Wright and Fleming’, in St. Mary’s: The History of a London Teaching hospital, Liverpool University Press, 2003.
  6. Kevin Brown, Anabelle Slingerland, St. Mary’s Hospital, birthplace of Penicillin, hekint.org/famous-hospitals. Spring 2019.
  7. Freeman J. Toxic idiopathies: the relationship between hay and other pollen fevers, animal asthma, food idiosyncrasies, bronchial and spasmodic asthma, etc. Proc Royal Society of Medicine 1920;13:129-48. Personal communication, Dr Michael Freeman grandson of Dr John Freeman, (Beddgelert Wales 2018).
  8. https://www.imperial.ac.uk/…grandfather of Allergy, Dr William Frankland,5 July 2018.
  9. Paul Watkins, From Hell Island to Hay Fever: the Life of Dr Bill Frankland, Brown Dog Books 2018.
  10. Interview, Dr William Frankland and Michael de Swiet, Voices of Medicine Oral History Archive, Royal College of Physicians London, 2015.
  11. Calderon M, Coedona V, Demoly P, 100 Years of Allergen Immunotherapy, European Academy of Allergy and Clinical Immunology, Allergy 2012; 67: 462-476.

 


 

JOHN TURNER, MBBS, MA, FRCP, Physician, Aintree University Hospital Liverpool 1977-2017, Lecturer Liverpool School of Medicine. Held posts at St Mary’s Hospital [Imperial College London] St. Vincent’s University Hospital Dublin, the Radcliffe Infirmary and Nuffield Department of Medicine University of Oxford. Has a later life Masters in History and is a member of Voices of Medicine Royal College of Physicians London.

 

Spring 2019 | Hektorama | Physicians of Note