0:00:02 > 0:00:09This programme contains scenes which some viewers may find upsetting.
0:00:09 > 0:00:12On Saturday, the 14th December 1799,
0:00:12 > 0:00:15George Washington, one of the founding fathers
0:00:15 > 0:00:18of the United States of America, lay dying.
0:00:21 > 0:00:22A couple of days earlier,
0:00:22 > 0:00:24he'd been out riding in cold and wet weather.
0:00:24 > 0:00:27He developed a sore throat.
0:00:27 > 0:00:30Early on the Saturday morning, he said to his wife,
0:00:30 > 0:00:31"I'm feeling very ill."
0:00:37 > 0:00:40Within hours, his personal physicians had arrived.
0:00:40 > 0:00:45The finest in the country, the best money could buy.
0:00:45 > 0:00:46They had all sorts of
0:00:46 > 0:00:49suggestions as to what was making him ill.
0:00:49 > 0:00:51His humours were unbalanced
0:00:51 > 0:00:55or perhaps he breathed in miasmas - foul air.
0:00:55 > 0:00:58His doctors gave him the standard medical treatment
0:00:58 > 0:01:02for someone who was as severely ill as he obviously was.
0:01:03 > 0:01:09They took a knife, found a vein and bled him repeatedly.
0:01:09 > 0:01:13They drained him of more than four pints of blood.
0:01:13 > 0:01:16By nightfall, Washington was fading fast.
0:01:16 > 0:01:20So his physicians applied even more scientific treatments.
0:01:21 > 0:01:25This Spanish fly, although it's actually a green beetle,
0:01:25 > 0:01:27they would have ground it up,
0:01:27 > 0:01:29and then applied the paste to his throat.
0:01:29 > 0:01:32But all that did was blister the skin.
0:01:32 > 0:01:34He said to his doctors,
0:01:34 > 0:01:37"I die hard, but I am not afraid to go."
0:01:37 > 0:01:38By late that evening,
0:01:38 > 0:01:42the first President of the United States was dead.
0:01:44 > 0:01:48Washington probably died from a simple infection.
0:01:48 > 0:01:50At the end of the 18th century,
0:01:50 > 0:01:54it made no difference if you were a pauper or the president.
0:01:54 > 0:01:57What you got was little more than quackery.
0:01:57 > 0:01:59But that was about to change.
0:01:59 > 0:02:02On the other side of the Atlantic, new ideas were
0:02:02 > 0:02:07beginning to prise open long-closed medieval minds.
0:02:07 > 0:02:12This series tells of the quest to find drugs that actually work.
0:02:12 > 0:02:15Drugs which could be harnessed to switch off pain.
0:02:16 > 0:02:19That's a very, very weird thing to do.
0:02:20 > 0:02:24Poisons from the natural world that we could turn to our advantage.
0:02:26 > 0:02:29All poisons should be considered as potential medicines.
0:02:29 > 0:02:33In this programme, I'll be telling the extraordinary stories of those
0:02:33 > 0:02:36who fought an enemy, armed with weapons
0:02:36 > 0:02:39more savage than anything we could dream of.
0:02:39 > 0:02:43People frequently died of infection and things like purple sepsis,
0:02:43 > 0:02:47women died after delivering their children.
0:02:47 > 0:02:49We know that during the First World War,
0:02:49 > 0:02:53more troops died because of wound infection
0:02:53 > 0:02:56than because of direct hits by enemy fire.
0:02:58 > 0:03:01This is the story of how we learnt to fight back,
0:03:01 > 0:03:04and by doing so, changed the course of human history.
0:03:23 > 0:03:26This place is a Category A prison.
0:03:29 > 0:03:33It houses the worst mass murderers in history.
0:03:36 > 0:03:39Serial killers who have been responsible
0:03:39 > 0:03:42for the fall of empires and the death of kings.
0:03:47 > 0:03:50I'm not going to be allowed to get too close to these inmates
0:03:50 > 0:03:53because they are extremely dangerous
0:03:53 > 0:03:58and are kept under constant 24-hour, state-of-the-art surveillance.
0:03:58 > 0:04:01If they escaped, the results would be disastrous.
0:04:08 > 0:04:11The Centers For Disease Control And Prevention, in Atlanta,
0:04:11 > 0:04:14is not for those of a nervous disposition.
0:04:14 > 0:04:18It holds some of the world's most deadly life forms.
0:04:18 > 0:04:23CDC has thousands of scientists who work 24/7
0:04:23 > 0:04:25figuring out what's making people sick and how to stop it.
0:04:27 > 0:04:30This facility contains some of the greatest evils
0:04:30 > 0:04:32ever collected in one place.
0:04:37 > 0:04:39This bacteria causes the plague.
0:04:40 > 0:04:44Your flesh dies and rots while you are still alive.
0:04:46 > 0:04:48The Black Death of the 14th century
0:04:48 > 0:04:50killed a quarter of Europe's population.
0:04:53 > 0:04:55And then, there's tuberculosis,
0:04:55 > 0:04:57a slow and deadly killer.
0:04:59 > 0:05:02The creator of oozing lung abscesses.
0:05:04 > 0:05:08The poet Keats, all three Bronte sisters
0:05:08 > 0:05:11and Chopin are a few of its more artistic victims.
0:05:12 > 0:05:14And this is gangrene,
0:05:14 > 0:05:17caused by any number of bacterial infections
0:05:17 > 0:05:21that lurk unseen in every dirty bullet, scalpel, and delivery ward.
0:05:24 > 0:05:27Some bacteria don't need a wound to get inside you,
0:05:27 > 0:05:30they're already there, waiting patiently.
0:05:32 > 0:05:36Patiently for our defences to drop, and then, they pounce.
0:05:37 > 0:05:40That's probably what did for George Washington.
0:05:42 > 0:05:47In 1790s America, sudden death was utterly common,
0:05:47 > 0:05:49and you clustered round people's bedside
0:05:49 > 0:05:52when they got cold and when they got chills because they could die.
0:05:52 > 0:05:55Washington's doctors would have laughed in your face
0:05:55 > 0:05:59if you had told them that microscopic life was killing him.
0:05:59 > 0:06:03They still clung to theories passed down from the Ancient Greeks.
0:06:04 > 0:06:08They believed that if you had a disease,
0:06:08 > 0:06:10the humours were out of balance.
0:06:10 > 0:06:11If you had a fever,
0:06:11 > 0:06:14you were considered to have an excess of the blood sugar,
0:06:14 > 0:06:16well, you were flushed, after all.
0:06:18 > 0:06:20So, why did it change?
0:06:20 > 0:06:25How did we track down, trap, destroy and isolate our enemies?
0:06:26 > 0:06:31Two bitter rivals would throw light on an invisible world of microbes,
0:06:31 > 0:06:34an idea called germ theory.
0:06:34 > 0:06:37But the starting point was not doctors, patients,
0:06:37 > 0:06:39any of the obvious.
0:06:39 > 0:06:40It began in the vineyards of France,
0:06:40 > 0:06:44and the problem of how to get a decent drink.
0:06:46 > 0:06:47In the mid-19th century,
0:06:47 > 0:06:51The French wine industry was undergoing something of a crisis.
0:06:51 > 0:06:57Now, this is what good wine is supposed to look like, smell like
0:06:57 > 0:07:01and, um...taste like.
0:07:01 > 0:07:05This wine looks fine, doesn't smell great...
0:07:07 > 0:07:10Ahh, it tastes absolutely vile.
0:07:11 > 0:07:15Now, the English were complaining a lot about the fact
0:07:15 > 0:07:17they were being sold this expensive vinegar,
0:07:17 > 0:07:21and the French were understandably keen to find out what was going on.
0:07:21 > 0:07:26What is it that makes some wine go off so spectacularly?
0:07:26 > 0:07:29It was a question of national pride,
0:07:29 > 0:07:32so the emperor Napoleon III
0:07:32 > 0:07:34asked a local chemist, Louis Pasteur,
0:07:34 > 0:07:37to find a solution, and quickly.
0:07:40 > 0:07:42When Pasteur looked down his microscope,
0:07:42 > 0:07:43at the off wine,
0:07:43 > 0:07:48he saw something there that was not present in normal wine.
0:07:48 > 0:07:50Microbes.
0:07:50 > 0:07:52He reasoned they must be spoiling it.
0:08:00 > 0:08:02So true to his emperor's demands,
0:08:02 > 0:08:05he set out to destroy them.
0:08:06 > 0:08:09First, he tried boiling the wine,
0:08:09 > 0:08:14but after boiling, it tasted almost as bad as when it was off.
0:08:17 > 0:08:19It does not taste great.
0:08:19 > 0:08:21So what he had to do was,
0:08:21 > 0:08:23he had to get the temperature just right.
0:08:23 > 0:08:26It had to be hot enough to kill the bacteria,
0:08:26 > 0:08:30but not so hot that it would spoil the wine.
0:08:30 > 0:08:35And after much experimentation, he found the ideal temperature.
0:08:36 > 0:08:4055 degrees Celsius.
0:08:40 > 0:08:41So he was happy,
0:08:41 > 0:08:44the Emperor was happy, and this technique,
0:08:44 > 0:08:47pasteurisation, became widely used.
0:08:47 > 0:08:51But the really important thing about this whole wine demonstration
0:08:51 > 0:08:53is it got Pasteur thinking.
0:08:53 > 0:08:57If microbes can cause wine to go sour,
0:08:57 > 0:09:00what effect are they having on people?
0:09:00 > 0:09:04Now, before he could really develop these ideas much further,
0:09:04 > 0:09:07he was scooped, by an unknown, a younger man,
0:09:07 > 0:09:11and what was worse, he was German.
0:09:16 > 0:09:19Nationalism was fed by the Franco-Prussian War
0:09:19 > 0:09:21of the early 1870s,
0:09:21 > 0:09:24a short, bitter and brutal conflict.
0:09:24 > 0:09:26With the fighting over,
0:09:26 > 0:09:28the victorious German soldiers headed for home
0:09:28 > 0:09:30or started looking for new employment.
0:09:32 > 0:09:36In 1872, a young German doctor, Robert Koch,
0:09:36 > 0:09:39arrived here, in Wolsztyn.
0:09:39 > 0:09:44It's now Polish. Back then, it was a small rural town in a
0:09:44 > 0:09:46remote part of Prussia.
0:09:50 > 0:09:53Koch had served as a surgeon in the war,
0:09:53 > 0:09:54and before that,
0:09:54 > 0:09:57studied medicine at one of Germany's finest universities.
0:09:59 > 0:10:03He may have found himself a humble medic in the back of beyond,
0:10:03 > 0:10:05but he had ambitions.
0:10:07 > 0:10:13Robert Koch and Louis Pasteur were, at first, friendly rivals.
0:10:13 > 0:10:18But with the war between the new German Empire and the French,
0:10:18 > 0:10:21it became rather unfriendly.
0:10:21 > 0:10:24Koch was keen to go one better than Pasteur,
0:10:24 > 0:10:27Prove that microbes make people ill,
0:10:27 > 0:10:31but how was he to do that, stuck in the middle of nowhere?
0:10:31 > 0:10:34And then, on his birthday, he got a present from his wife,
0:10:34 > 0:10:37an expensive one, and that changed everything.
0:10:37 > 0:10:42Now, when I was ten, I got a microscope,
0:10:42 > 0:10:44I wasn't particularly thrilled,
0:10:44 > 0:10:47but for Robert Koch, this really opened up the world,
0:10:47 > 0:10:50albeit a microscopic one.
0:10:50 > 0:10:53Now, all he had to do was find something to look at.
0:10:57 > 0:11:01And that's where this rural location came into its own.
0:11:01 > 0:11:04Because the fields around Wolsztyn were filled with sheep
0:11:04 > 0:11:06suffering from anthrax.
0:11:06 > 0:11:10A disease which killed tens of thousands of them every year.
0:11:17 > 0:11:20But what was bad news for Prussian farmers
0:11:20 > 0:11:21was good news for Robert Koch,
0:11:21 > 0:11:23and with the help of a local butcher,
0:11:23 > 0:11:28he had an ample supply of infected tissue to take here, his home.
0:11:30 > 0:11:33So he's got the microscope from his wife
0:11:33 > 0:11:37and he's got some infected animal matter from his friend, the butcher.
0:11:37 > 0:11:40What he does is he takes a sample,
0:11:40 > 0:11:43and he smears it on a slide,
0:11:43 > 0:11:46and then, he looks at the slide
0:11:46 > 0:11:48under the microscope.
0:11:48 > 0:11:50And we know what he saw, because he drew them,
0:11:50 > 0:11:53and these are original sketches.
0:11:53 > 0:11:55These funny little grain-like particles here,
0:11:55 > 0:11:57these are anthrax bacteria.
0:11:58 > 0:11:59So far, so ingenious.
0:11:59 > 0:12:03But what he really needed to do was to prove it was the bacteria
0:12:03 > 0:12:06that had killed the animal. How was he going to do that?
0:12:06 > 0:12:11Well, what Koch did is he transferred bacteria from the
0:12:11 > 0:12:14infected spleen and meat into the animal's eyes,
0:12:14 > 0:12:18and there they grew in this sort of rich jelly medium.
0:12:18 > 0:12:24And when he had a lethal dose, what he did is he took a mouse and he
0:12:24 > 0:12:28deliberately infected the mouse with bacteria from the eye.
0:12:28 > 0:12:30And then he waited.
0:12:30 > 0:12:34Well, the mouse died, and with it died miasma theory,
0:12:34 > 0:12:39that age-old nonsense that it is bad air that causes infections.
0:12:39 > 0:12:44It clearly wasn't bad air that killed the mouse, it was bacteria.
0:12:47 > 0:12:51Miasma theory was replaced by germ theory,
0:12:51 > 0:12:54a new way of looking at disease.
0:12:55 > 0:12:58When hostile bacteria invade a living organism,
0:12:58 > 0:12:59they quickly multiply,
0:12:59 > 0:13:03producing toxins and enzymes which
0:13:03 > 0:13:05poison and destroy the tissue around them.
0:13:06 > 0:13:09If the body's natural defences are overrun,
0:13:09 > 0:13:11the result can be death.
0:13:13 > 0:13:18I think Robert Koch is rightly thought of, along with Louis Pasteur,
0:13:18 > 0:13:23as one of the founders of modern medical microbiology.
0:13:24 > 0:13:26Koch was important both for
0:13:26 > 0:13:29discovering the microorganisms that caused diseases,
0:13:29 > 0:13:33and also for generating an intense and very real
0:13:33 > 0:13:34sense of excitement that medicine
0:13:34 > 0:13:36was finally about to get to grips
0:13:36 > 0:13:40with problems that, really, humanity had been able to do nothing about
0:13:40 > 0:13:43since we first stepped onto the world.
0:13:45 > 0:13:46By the end of the 19th century,
0:13:46 > 0:13:49Pasteur and Koch had, between them,
0:13:49 > 0:13:53identified many of the microbes that cause the worst diseases.
0:13:53 > 0:13:58From anthrax to typhoid, cholera to TB.
0:13:58 > 0:13:59What we didn't yet have
0:13:59 > 0:14:04was a drug that could safely and reliably treat infection.
0:14:04 > 0:14:08When one came, it would be from a most unexpected source.
0:14:16 > 0:14:17The need was certainly there.
0:14:20 > 0:14:24At the start of the 20th century, diseases you might have associated
0:14:24 > 0:14:28with medieval times were still rampant.
0:14:29 > 0:14:31Syphilis, for example.
0:14:32 > 0:14:36Now, for centuries, doctors had used mercury to treat it,
0:14:36 > 0:14:39but being extremely toxic, it tended to kill the patients.
0:14:42 > 0:14:46So when, in this Frankfurt mansion, a scientist called Paul Ehrlich
0:14:46 > 0:14:50set out to find a safe and effective drug against syphilis,
0:14:50 > 0:14:51it was a major challenge.
0:14:53 > 0:14:57Fortunately, he was a real obsessive.
0:15:00 > 0:15:04Paul Ehrlich studied medicine in the early 1870s,
0:15:04 > 0:15:07but he spent an awful lot of time in the laboratory
0:15:07 > 0:15:11rather than the clinic, where he should have been.
0:15:11 > 0:15:13One of the things Ehrlich was doing
0:15:13 > 0:15:15was playing around with artificial dyes.
0:15:17 > 0:15:20The first had been discovered in 1856
0:15:20 > 0:15:23and soon, people went dye-crazy.
0:15:23 > 0:15:27His favourite colour was methylene blue,
0:15:27 > 0:15:30and with this, he made a remarkable discovery,
0:15:30 > 0:15:34one which would set him on the path to medical greatness.
0:15:37 > 0:15:40Ehrlich was wonderful in showing how
0:15:40 > 0:15:43you could use dyes to illuminate the hidden world.
0:15:43 > 0:15:46The world which, even down a microscope, you wouldn't be
0:15:46 > 0:15:48able to see unless you coloured it
0:15:48 > 0:15:52with these dyes that showed physical processes.
0:15:52 > 0:15:55He spent, wasted, whichever way you want to look at it,
0:15:55 > 0:16:00a lot of time playing around dying regions of biological tissue.
0:16:00 > 0:16:03When Ehrlich added a drop of methylene blue
0:16:03 > 0:16:05to tissue infected with bacteria,
0:16:05 > 0:16:07he noticed something astonishing -
0:16:07 > 0:16:10only the bacteria was stained by the dye,
0:16:10 > 0:16:13not the tissue around them.
0:16:13 > 0:16:17Often, what was needed to discover these bugs was the right stain.
0:16:17 > 0:16:19Get the right stain and in amazing colours,
0:16:19 > 0:16:21these bugs would appear before your very eyes.
0:16:24 > 0:16:28Now, the fact an artificial dye will selectively stain bacteria
0:16:28 > 0:16:31was remarkable, but it's what Ehrlich thought next
0:16:31 > 0:16:34that was truly revolutionary.
0:16:34 > 0:16:39What he did was he noted that some compounds were toxic
0:16:39 > 0:16:42and he said what if you create selective toxicity
0:16:42 > 0:16:46so that you can give somebody a compound that will kill off
0:16:46 > 0:16:49what's making them unwell and leave them unharmed?
0:16:49 > 0:16:53And he famously coined the phrase from a German folk story,
0:16:53 > 0:16:55you could create these "magic bullets",
0:16:55 > 0:16:57which is what we've been trying to do ever since.
0:17:00 > 0:17:04Now, many people thought Ehrlich was wasting his time.
0:17:04 > 0:17:07But he was convinced that magic bullets existed
0:17:07 > 0:17:08and he would discover them.
0:17:10 > 0:17:13Initially, he tried finding a cure for sleeping sickness.
0:17:14 > 0:17:18But with the help of his Japanese assistant, Sahachiro Hata,
0:17:18 > 0:17:21he switched his attention to a pathogen
0:17:21 > 0:17:24that was rather more common in Germany.
0:17:24 > 0:17:26Common, but horribly disfiguring.
0:17:28 > 0:17:30Syphilis.
0:17:33 > 0:17:36The end stage of syphilis was pitiful -
0:17:36 > 0:17:41paralysis, insanity and then, death.
0:17:42 > 0:17:45There were no cures and the only treatment, mercury,
0:17:45 > 0:17:47made your hair and teeth fall out,
0:17:47 > 0:17:50before eventually destroying your entire nervous system.
0:17:54 > 0:17:59Ehrlich hoped to find a magic bullet that would be more selective,
0:17:59 > 0:18:02poisoning the bacteria but not the rest of the body.
0:18:04 > 0:18:06Ehrlich thought that arsenic might
0:18:06 > 0:18:09be effective against syphilis.
0:18:09 > 0:18:12Arsenic is notoriously poisonous, but by this point,
0:18:12 > 0:18:17German chemists had made hundreds of different compounds of arsenic.
0:18:17 > 0:18:19So Ehrlich asked his assistant Hata
0:18:19 > 0:18:21to work his way systematically through them,
0:18:21 > 0:18:24hoping that, amongst them, there would be one
0:18:24 > 0:18:26that was safe and effective.
0:18:26 > 0:18:30Hata had found a way to infect rabbits with syphilis.
0:18:30 > 0:18:33He now set about the unenviable task
0:18:33 > 0:18:37of testing arsenic compounds on them, one after the other.
0:18:39 > 0:18:43Some compounds killed both bacteria and rabbit.
0:18:43 > 0:18:45Some killed neither.
0:18:47 > 0:18:51Hata went through hundreds and hundreds of compounds
0:18:51 > 0:18:56until, finally, he found one that was rather special.
0:18:56 > 0:19:02Compound 606, it killed the bacteria, but best of all,
0:19:02 > 0:19:07it left the dear old rabbit intact.
0:19:07 > 0:19:10This was the magic bullet they had been hoping for.
0:19:13 > 0:19:16Salvarsan 606 showed that Ehrlich was right,
0:19:16 > 0:19:18that these things were out there,
0:19:18 > 0:19:21all you had to do was methodically screen for them and you would find them.
0:19:21 > 0:19:25It showed the power of methodically screening lots of compounds.
0:19:25 > 0:19:29606, 606 compounds, to see what worked.
0:19:30 > 0:19:34I do think it's wonderful that it was in this building, 100 years ago,
0:19:34 > 0:19:39through a combination of luck, logic and sheer hard work,
0:19:39 > 0:19:41that they eventually found a cure for syphilis,
0:19:41 > 0:19:44a disease that had destroyed the lives of countless millions.
0:19:44 > 0:19:48Newspapers at the time carried it on the front pages.
0:19:48 > 0:19:50The medical profession were stunned.
0:19:50 > 0:19:54To be able to treat syphilis was miraculous, absolutely miraculous.
0:19:58 > 0:20:03By the 1920s, Salvarsan was the world's most popular drug,
0:20:03 > 0:20:05particularly with men.
0:20:05 > 0:20:08But Ehrlich's hope that it would be just the first
0:20:08 > 0:20:11of many magic bullets proved ill-founded.
0:20:11 > 0:20:14Infections caused by the most minor
0:20:14 > 0:20:16of injuries were still uncontrollable.
0:20:18 > 0:20:21People frequently died of infection
0:20:21 > 0:20:23and things like purple sepsis,
0:20:23 > 0:20:27women died after delivering their children.
0:20:27 > 0:20:29Septic wards were gruesome places,
0:20:29 > 0:20:34filled with the sick, the dying and the desperate.
0:20:34 > 0:20:39There were people with severe and chronic infections who tended to be
0:20:39 > 0:20:42there for sometimes weeks,
0:20:42 > 0:20:46with pots under their beds draining the pus
0:20:46 > 0:20:50from various abscesses or infected wounds.
0:20:50 > 0:20:53Cleaning of the wound of pus was the only way doctors,
0:20:53 > 0:20:56or more likely nurses, had of fighting infection.
0:20:58 > 0:21:00Pus is the debris left behind when
0:21:00 > 0:21:03the white blood cells of our immune system
0:21:03 > 0:21:04take on invading bacteria.
0:21:07 > 0:21:11But it can also become a nice cosy home for the bacteria,
0:21:11 > 0:21:13a constant source of reinfection.
0:21:15 > 0:21:17By draining pus,
0:21:17 > 0:21:20doctors hoped to prevent infections reaching the blood.
0:21:20 > 0:21:22Because once that happened,
0:21:22 > 0:21:25the prognosis becomes incredibly bleak.
0:21:28 > 0:21:30Half of those who went into a septic ward
0:21:30 > 0:21:32never came out alive.
0:21:35 > 0:21:39But that would change, thanks to the chance discovery, in 1928,
0:21:39 > 0:21:43of a mould with remarkable antibacterial properties.
0:21:43 > 0:21:45Penicillin.
0:21:47 > 0:21:50Most people learn at school that it was Alexander Fleming
0:21:50 > 0:21:53who was responsible for penicillin.
0:21:53 > 0:21:55Well, this is only partially true.
0:21:57 > 0:21:59Alexander Fleming, he'd hailed from Scotland,
0:21:59 > 0:22:02he was a very bright student.
0:22:02 > 0:22:06Eventually, he won a scholarship to St Mary's Medical School
0:22:06 > 0:22:08and prospered there,
0:22:08 > 0:22:13and stayed on at St Mary's because he was a good sportsman
0:22:13 > 0:22:14and he particularly was a good shot,
0:22:14 > 0:22:16and they wanted him for their shooting team.
0:22:18 > 0:22:22When he wasn't shooting, Fleming spent much of his time in the lab,
0:22:22 > 0:22:26studying staphylococci, bacteria that are commonly found on skin.
0:22:28 > 0:22:32Then, in August 1928, Fleming went away on holiday.
0:22:32 > 0:22:33When he returned,
0:22:33 > 0:22:36he started to examine some Petri dishes
0:22:36 > 0:22:39which he'd previously seeded with bacteria.
0:22:39 > 0:22:41And he noticed something very odd.
0:22:43 > 0:22:45An uninvited fungal mould.
0:22:46 > 0:22:51Well, I want to show you the original cultivation, which I kept.
0:22:51 > 0:22:53Here's the mould and above,
0:22:53 > 0:22:56you've got the staphylococcal colonies,
0:22:56 > 0:22:57but closer on the mould,
0:22:57 > 0:23:00the colonies have disappeared.
0:23:02 > 0:23:06Normally, bacteria grow new cell walls before they divide.
0:23:08 > 0:23:10But the mould produced a substance
0:23:10 > 0:23:13that prevented new cell walls being made.
0:23:13 > 0:23:15The bacteria were unable to divide
0:23:15 > 0:23:18and eventually burst open, like a balloon.
0:23:21 > 0:23:25Fleming was lucky, it was likely the penicillin mould had
0:23:25 > 0:23:29blown in from a nearby lab, where they were studying fungi.
0:23:30 > 0:23:32But contrary to legend,
0:23:32 > 0:23:35he really didn't make the most of his remarkable break.
0:23:37 > 0:23:41He didn't really realise what he was on to.
0:23:41 > 0:23:47He made one very short comment in his first paper
0:23:47 > 0:23:52that said maybe this could be injected into the sites of infection,
0:23:52 > 0:23:56but he never did that himself and he never followed it up.
0:23:56 > 0:24:00So I have him down as an acute observer,
0:24:00 > 0:24:06but not the genius, as he's often been portrayed.
0:24:06 > 0:24:10It also didn't help that he was an absolutely terrible public speaker
0:24:10 > 0:24:13and was completely unable to enthuse others.
0:24:13 > 0:24:17For these reasons, the most powerful lifesaving fungus
0:24:17 > 0:24:19the world has ever known,
0:24:19 > 0:24:22well, for many years, it just languished in the dark.
0:24:28 > 0:24:30And there it would remain until 1938,
0:24:30 > 0:24:34when researchers here, at the Dunn School of Pathology, in Oxford,
0:24:34 > 0:24:36would rediscover penicillin,
0:24:36 > 0:24:38and turn it from a medical curiosity
0:24:38 > 0:24:42into the greatest lifesaving drug the world has ever known.
0:24:48 > 0:24:50The storm clouds of the Second World War
0:24:50 > 0:24:53were beginning to gather over Europe,
0:24:53 > 0:24:5520 years after the end of the First.
0:24:57 > 0:24:59We know that, during the First World War,
0:24:59 > 0:25:04more troops died because of wound infection
0:25:04 > 0:25:06than because of direct hits by enemy fire.
0:25:09 > 0:25:12In Germany, scientists had discovered the antibacterial
0:25:12 > 0:25:15properties of the sulphonamides.
0:25:15 > 0:25:17And with the prospect of more bloodshed on the horizon,
0:25:17 > 0:25:20a small team was assembled in Oxford
0:25:20 > 0:25:23to find a British germ-killing agent.
0:25:25 > 0:25:29The team had stumbled across Fleming's original penicillin paper
0:25:29 > 0:25:31and by remarkable chance,
0:25:31 > 0:25:34there also happened to be some penicillin mould in the building.
0:25:34 > 0:25:37The team consisted of three very different characters,
0:25:37 > 0:25:42led by an abrasive Australian doctor called Howard Florey.
0:25:42 > 0:25:43This was his office.
0:25:44 > 0:25:51Florey's talent was as a team leader and a designer of experiments,
0:25:51 > 0:25:54and he was the guy who'd organise the team
0:25:54 > 0:25:57and brought in the various specialities.
0:25:57 > 0:26:00He recruited two very different assistants.
0:26:00 > 0:26:05Ernst Chain, an excitable Jewish refugee who'd fled the Nazis.
0:26:05 > 0:26:10And Norman Heatley, a keen sailor from Suffolk.
0:26:10 > 0:26:16So Chain trained originally in Berlin and was generally regarded as
0:26:16 > 0:26:19a high-class biochemist.
0:26:19 > 0:26:23Heatley was an expert at micro techniques
0:26:23 > 0:26:26and he was very good at making equipment,
0:26:26 > 0:26:30producing things out of bits of wood and bits of rubber tubing.
0:26:32 > 0:26:36In 1939, war broke out in Europe.
0:26:38 > 0:26:41With wounded British troops dying in France,
0:26:41 > 0:26:46there was mounting pressure on the Oxford team to come up with answers.
0:26:46 > 0:26:48Trouble was, penicillin was proving hard to grow,
0:26:48 > 0:26:50and even harder to purify.
0:26:51 > 0:26:54Unlike Fleming, Florey's team had
0:26:54 > 0:26:57managed to extract the active chemical.
0:26:57 > 0:26:59And they had tested it on bacteria.
0:27:00 > 0:27:03Now, they needed to test it on a living creature.
0:27:05 > 0:27:07In this lab, in May 1940,
0:27:07 > 0:27:10they did the first really important experiment.
0:27:10 > 0:27:12They got eight mice
0:27:12 > 0:27:19and injected them with a lethal dose of streptococcus, a bacteria.
0:27:19 > 0:27:23And then, they injected four of the mice with penicillin
0:27:23 > 0:27:26and waited to see what would happen.
0:27:26 > 0:27:30Well, Norman Heatley kept a diary and this is what he wrote.
0:27:30 > 0:27:32"I stayed at the lab till 3:45,
0:27:32 > 0:27:36"by which time all four control animals were dead.
0:27:36 > 0:27:40"The ones given penicillin, however, were all still alive."
0:27:40 > 0:27:43Now, I'm sure Heatley recognised this was a massive moment,
0:27:43 > 0:27:46that what he wrote in his diary was,
0:27:46 > 0:27:49"I discovered I had put my pants on back to front -
0:27:49 > 0:27:51"a lucky omen."
0:27:53 > 0:27:55Florey was more obviously enthused,
0:27:55 > 0:27:58saying it looked like a miracle.
0:27:58 > 0:28:00And this was not hyperbole.
0:28:00 > 0:28:03Never before had anyone seen an effective germ killer
0:28:03 > 0:28:05with so few side effects.
0:28:06 > 0:28:09But the team now had to find ways to produce enough of it
0:28:09 > 0:28:11to test on a human.
0:28:12 > 0:28:16Florey made the comment that humans are 3,000 times bigger than mice,
0:28:16 > 0:28:20and so, we're going to need 3,000 times more penicillin
0:28:20 > 0:28:22than we had for these experiments.
0:28:23 > 0:28:27And so, during the summer of 1940, as France fell to the Germans,
0:28:27 > 0:28:30and Britain feared invasion, the entire staff
0:28:30 > 0:28:32of the Oxford School Of Pathology,
0:28:32 > 0:28:35was enlisted to help make penicillin.
0:28:35 > 0:28:38With, amongst other things, bedpans.
0:28:39 > 0:28:43Trying to make larger amounts of penicillin, in this building,
0:28:43 > 0:28:46with very little money and in the middle of a war,
0:28:46 > 0:28:48was an absolute nightmare.
0:28:48 > 0:28:50What were they going to do about equipment?
0:28:50 > 0:28:52Well, they had to improvise.
0:28:52 > 0:28:56They found they could grow the penicillin mould,
0:28:56 > 0:28:58in bedpans and then skim it off.
0:29:00 > 0:29:02It was a real Heath Robinson affair,
0:29:02 > 0:29:07made out of a bath, milk churns, an old book shelf,
0:29:07 > 0:29:10apparently from the Bodleian Library,
0:29:10 > 0:29:13and they made pretty rapid progress.
0:29:15 > 0:29:17But before seeing if it could cure,
0:29:17 > 0:29:19they needed to make sure it wouldn't kill.
0:29:19 > 0:29:21Just because it worked in mice
0:29:21 > 0:29:23didn't mean it would work in humans.
0:29:23 > 0:29:28They needed someone prepared to take a potentially fatal dose.
0:29:28 > 0:29:33Mrs Elva Akers, a 50-year-old housewife, was asked to help.
0:29:33 > 0:29:34She had terminal cancer,
0:29:34 > 0:29:38and she was told that the penicillin would do her absolutely no good.
0:29:38 > 0:29:40It might indeed push her over the edge.
0:29:40 > 0:29:44Nonetheless she volunteered, saying she was proud to help.
0:29:45 > 0:29:49The penicillin used was extremely impure.
0:29:49 > 0:29:53I think we now know that what went into the first patient
0:29:53 > 0:29:58was about 3% penicillin, 97% impurities.
0:30:00 > 0:30:03On the night of January 27th 1941,
0:30:03 > 0:30:07Elva became the first human to be injected with penicillin.
0:30:08 > 0:30:12After a few days, the team concluded it was safe.
0:30:12 > 0:30:16Now they needed to find a patient it could actually help.
0:30:16 > 0:30:19Just a few doors down from Elva, in the same hospital,
0:30:19 > 0:30:22a man was fighting a particularly hideous infection.
0:30:24 > 0:30:27It had started following a minor accident.
0:30:30 > 0:30:34Albert Alexander, a 43-year-old police constable,
0:30:34 > 0:30:37was out gardening one day when he got scratched
0:30:37 > 0:30:39on the side of his face by a rose thorn,
0:30:39 > 0:30:42or at least that's how the story goes.
0:30:44 > 0:30:48Whatever caused the tiny wound,
0:30:48 > 0:30:51it soon became horribly infected
0:30:51 > 0:30:53and Albert was consigned
0:30:53 > 0:30:56to one of the hospital's notorious septic wards.
0:31:01 > 0:31:04This is Albert, healthy, good-looking young man,
0:31:04 > 0:31:08and this is Albert in hospital.
0:31:08 > 0:31:09He's a complete wreck.
0:31:09 > 0:31:12His left eye has gone, he's covered in abscesses,
0:31:12 > 0:31:15and his lungs are full of purulent matter.
0:31:15 > 0:31:19This is draining pus from his right eye.
0:31:19 > 0:31:22He really only has one hope - penicillin.
0:31:27 > 0:31:32On February 11th, 1941, Albert was given the first dose.
0:31:34 > 0:31:36Over the next few days,
0:31:36 > 0:31:38Florey and his team constantly monitored
0:31:38 > 0:31:41him for any sign of improvement.
0:31:41 > 0:31:45He made what seemed to be a remarkable recovery.
0:31:45 > 0:31:48He was... His temperature came down,
0:31:48 > 0:31:49he started to eat,
0:31:49 > 0:31:52I think he even got out of bed. He was much better.
0:31:53 > 0:31:57The penicillin was clearly working, which was fantastic.
0:31:57 > 0:32:00Unfortunately, they didn't have enough of it.
0:32:00 > 0:32:03So in desperation, they collected his urine,
0:32:03 > 0:32:04and extracted from it
0:32:04 > 0:32:07the penicillin that his body hadn't used.
0:32:07 > 0:32:10But it was all too little, too late.
0:32:10 > 0:32:14A month after starting treatment, Albert Alexander died.
0:32:17 > 0:32:19Sad though the death of Albert was,
0:32:19 > 0:32:21his initial dramatic recovery suggested
0:32:21 > 0:32:25penicillin could be the miracle drug the country needed.
0:32:25 > 0:32:28And one of the fears now was that it might get into German hands.
0:32:30 > 0:32:32Penicillin was extraordinary stuff,
0:32:32 > 0:32:35but these were also extraordinary times.
0:32:35 > 0:32:38There was a serious fear that Britain would be invaded
0:32:38 > 0:32:41and if so, they would have to destroy all their work,
0:32:41 > 0:32:44rather than allow it to fall into enemy hands.
0:32:44 > 0:32:47So they smeared spores on the inside of their coats...
0:32:47 > 0:32:51So that if they were forced to escape from Oxford,
0:32:51 > 0:32:54they could actually take the mould with them
0:32:54 > 0:32:56and start the work again.
0:32:56 > 0:32:58So that gives some sense of the
0:32:58 > 0:33:01importance that they ascribed to this work.
0:33:02 > 0:33:05The conviction of the group
0:33:05 > 0:33:08was that their discovery was so important,
0:33:08 > 0:33:12it was a potentially capable of changing the course of World War II.
0:33:14 > 0:33:17But if the entire Dunn School working for months
0:33:17 > 0:33:20couldn't make enough of the stuff to save one man,
0:33:20 > 0:33:22then it wasn't going to help anyone.
0:33:23 > 0:33:28So that was why Florey realised the importance of upping production,
0:33:28 > 0:33:30but in fact, he couldn't get the
0:33:30 > 0:33:34British pharmaceutical industry to become involved.
0:33:34 > 0:33:38They were fully occupied doing things for the war effort.
0:33:38 > 0:33:41Um, and so, in a sort of frustration,
0:33:41 > 0:33:43he decided he'd have to go to America.
0:33:53 > 0:33:57In July 1941, Florey and Heatley arrived in New York,
0:33:57 > 0:34:01carrying the penicillin mould in a briefcase.
0:34:01 > 0:34:04They told immigration they were on medical business.
0:34:05 > 0:34:08With the help of the Rockefeller Institute,
0:34:08 > 0:34:10Florey and Heatley were introduced
0:34:10 > 0:34:13to the country's biggest chemical companies.
0:34:13 > 0:34:15Unlike their British counterparts,
0:34:15 > 0:34:17they quickly realised the drug's potential.
0:34:18 > 0:34:24The war was causing casualties that led to infections that led to death.
0:34:25 > 0:34:28Penicillin clearly was a winner,
0:34:28 > 0:34:30the question was, can we get it to the troops
0:34:30 > 0:34:32in sufficient quantity and in time?
0:34:35 > 0:34:39Now they were here, there were three problems they needed help solving.
0:34:39 > 0:34:43Firstly, find something the mould really liked growing in.
0:34:43 > 0:34:46Secondly, find a more powerful strain of the mould,
0:34:46 > 0:34:50and finally, improve the production process.
0:34:50 > 0:34:53Well, the first problem was soon solved because it
0:34:53 > 0:34:58turns out that penicillin mould really likes this stuff, corn syrup.
0:34:58 > 0:35:00Sweet, and sticky.
0:35:00 > 0:35:04They like it almost as much as we do.
0:35:04 > 0:35:08And fortunately, the Americans had lots and lots of it.
0:35:08 > 0:35:11The other two problems were rather harder to crack.
0:35:15 > 0:35:18The problem with the penicillin mould they were using
0:35:18 > 0:35:21was it was still based on Fleming's original mould.
0:35:22 > 0:35:25Maybe there were even more powerful moulds
0:35:25 > 0:35:27which could produce more penicillin?
0:35:29 > 0:35:32An international search was launched,
0:35:32 > 0:35:36and samples of mould found anywhere and everywhere in the world
0:35:36 > 0:35:39were flown to the US labs by military transport.
0:35:42 > 0:35:45Scientists worked around the clock testing them,
0:35:45 > 0:35:48but none gave the yields needed.
0:35:48 > 0:35:51Perhaps a more powerful strain simply didn't exist.
0:35:53 > 0:35:55And then, there was a wonderful twist.
0:35:55 > 0:35:58Now, the story goes that a woman called Mary Hunt,
0:35:58 > 0:36:01who worked for the US Department of Agriculture,
0:36:01 > 0:36:04was wandering through the fruit markets, as she often did,
0:36:04 > 0:36:08looking not so much for fresh fruit as for something really rotten.
0:36:08 > 0:36:13And one wonderful day, she came across this.
0:36:14 > 0:36:15A mouldy melon.
0:36:17 > 0:36:19And they took this off to be tested
0:36:19 > 0:36:22and it turned out that the mould was
0:36:22 > 0:36:24a really powerful source of penicillin.
0:36:24 > 0:36:26So much so that, for a while,
0:36:26 > 0:36:30it became the source of almost all the world's penicillin.
0:36:33 > 0:36:35But despite these improvements,
0:36:35 > 0:36:38the inefficiency of the actual production process,
0:36:38 > 0:36:40meant that by 1943, there was still
0:36:40 > 0:36:43only enough penicillin to treat a lucky few.
0:36:47 > 0:36:52The standard techniques were large wide-bottomed flasks,
0:36:52 > 0:36:55because you had a single layer of mould producing,
0:36:55 > 0:36:58the yields from each flask were minimal.
0:36:59 > 0:37:03And the need for penicillin had never been more urgent.
0:37:03 > 0:37:06D-day, the greatest amphibious invasion in history,
0:37:06 > 0:37:08was only months away.
0:37:09 > 0:37:11Casualties were going to be horrific.
0:37:14 > 0:37:18Penicillin was the US military's second top research priority,
0:37:18 > 0:37:21after the Manhattan Project, after nuclear weapons.
0:37:25 > 0:37:27It was then that a small chemical company
0:37:27 > 0:37:32based in this building in Brooklyn, called Pfizer, got involved.
0:37:32 > 0:37:33Now, these days, Pfizer is better known
0:37:33 > 0:37:37for its anti-impotence drug, Viagra.
0:37:37 > 0:37:42But back then, they produced citric acid, used in fizzy drinks.
0:37:42 > 0:37:44Now, they realised, as everyone else had,
0:37:44 > 0:37:47that if you just grow penicillin on the surface of a liquid,
0:37:47 > 0:37:49then that is going to be really inefficient.
0:37:49 > 0:37:52What you want to do is grow it throughout the liquid.
0:37:52 > 0:37:56The problem is, that penicillin needs oxygen to grow,
0:37:56 > 0:38:00so they came up with a solution which they hoped would work.
0:38:00 > 0:38:05The oxygenation came with a tube introduced into the medium,
0:38:05 > 0:38:07into which oxygen was pumped.
0:38:07 > 0:38:10But you couldn't put too much and you couldn't put too little,
0:38:10 > 0:38:13so learning how much was right was key.
0:38:14 > 0:38:18There was absolutely no guarantee the technique would work.
0:38:18 > 0:38:20But the company took a gamble.
0:38:21 > 0:38:23Because of war-time shortages,
0:38:23 > 0:38:26they had to convert an old Brooklyn ice factory,
0:38:26 > 0:38:31scrounging a boiler from Indiana and a lift from Long Island.
0:38:36 > 0:38:39With just two months to go before D-day,
0:38:39 > 0:38:43they installed 14 giant fermentation tanks.
0:38:43 > 0:38:45Then, they added the corn syrup,
0:38:45 > 0:38:49and the cantaloupe mould before turning on the air.
0:38:54 > 0:38:56The results were spectacular,
0:38:56 > 0:38:58they soon began producing five times
0:38:58 > 0:39:01as much penicillin as originally planned.
0:39:01 > 0:39:04By June 1944, the D-day invasions,
0:39:04 > 0:39:07there was enough penicillin for every injured soldier,
0:39:07 > 0:39:10and most of it was produced right here,
0:39:10 > 0:39:12in the Pfizer plant in Brooklyn.
0:39:13 > 0:39:16Penicillin was successfully developed in time
0:39:16 > 0:39:19to hugely influence the outcome of World War II.
0:39:20 > 0:39:23Protracted hospitalisation from infected wounds
0:39:23 > 0:39:27was almost eliminated amongst Allied soldiers.
0:39:27 > 0:39:29Many could be back on the front line
0:39:29 > 0:39:32with a rifle in their hand within weeks.
0:39:32 > 0:39:35For others, it made once-lethal wounds survivable.
0:39:35 > 0:39:38NEWSREEL: 'Thousands of men, thanks to penicillin,
0:39:38 > 0:39:41'will come home to their thankful families.
0:39:41 > 0:39:44'Science has won another victory over death.'
0:39:51 > 0:39:53Hopes were high, and largely justified.
0:39:56 > 0:39:59These pictures show a little girl going from death's door
0:39:59 > 0:40:03to happy in just a few days.
0:40:03 > 0:40:07No longer would a scratch from a rose thorn or a minor cut
0:40:07 > 0:40:10lead to a hideous death.
0:40:10 > 0:40:13Now, it all started with Alexander Fleming and his chance observation,
0:40:13 > 0:40:15but without Florey and the Oxford team,
0:40:15 > 0:40:18who knows when the mould would have
0:40:18 > 0:40:21been made into a safe and effective drug?
0:40:21 > 0:40:25In summary, I would say that the work of Florey's team,
0:40:25 > 0:40:29particularly Florey, Chain, Heatley,
0:40:29 > 0:40:33resulted in the greatest medical advance of the 20th century
0:40:33 > 0:40:36and gave us a new way of looking at
0:40:36 > 0:40:38the treatment of infectious diseases.
0:40:40 > 0:40:44Penicillin heralded the dawn of the antibiotic age.
0:40:44 > 0:40:45And in the years that followed,
0:40:45 > 0:40:48further antibiotics were discovered and developed
0:40:48 > 0:40:49that made the incurable curable,
0:40:49 > 0:40:54and changed what was once fatal into no more than a minor illness.
0:40:54 > 0:40:57Prior to antibiotics, prior to penicillin,
0:40:57 > 0:40:59we really did live in a world where
0:40:59 > 0:41:01you could be young, fit and healthy one day,
0:41:01 > 0:41:05get a cold the next, and be dead by the end of the week.
0:41:05 > 0:41:07For the first time in human history,
0:41:07 > 0:41:09we seemed to have the germs on the run,
0:41:09 > 0:41:14but the battle against bacteria represents only a part of the story
0:41:14 > 0:41:17of our fight against infection.
0:41:17 > 0:41:20Because antibiotics, spectacular though they are,
0:41:20 > 0:41:22are useless against viruses.
0:41:22 > 0:41:26And viruses, in many ways, presented an even greater challenge.
0:41:34 > 0:41:37And that's why, along with all the deadly bacteria
0:41:37 > 0:41:40held here, at the Centers For Disease Control,
0:41:40 > 0:41:43there's also a wing for viruses.
0:41:43 > 0:41:46In fact, some of the tightest security is for them.
0:41:48 > 0:41:50Until just over a century ago,
0:41:50 > 0:41:53nobody knew that viruses actually existed.
0:41:53 > 0:41:55And it wasn't until the 1930s,
0:41:55 > 0:41:57with the invention of the electron microscope,
0:41:57 > 0:41:59it was actually possible to see them.
0:42:02 > 0:42:06Viruses are up to 100 times smaller than bacteria,
0:42:06 > 0:42:08and far, far simpler,
0:42:08 > 0:42:12essentially, no more than a tiny piece of genetic material
0:42:12 > 0:42:14surrounded by a protein coat.
0:42:14 > 0:42:17They're the most numerous biological entities on Earth,
0:42:17 > 0:42:21able to infect animals, plants and even bacteria.
0:42:21 > 0:42:23But they cannot exist on their own.
0:42:23 > 0:42:27They need to invade a living cell and reprogram it to replicate.
0:42:31 > 0:42:36Many scientists do not consider viruses to be living creatures,
0:42:36 > 0:42:38but that does not make them any less dangerous.
0:42:45 > 0:42:51This is an influenza virus, it is a master of disguise,
0:42:51 > 0:42:55able to evade the body's immune system by constantly mutating.
0:42:57 > 0:43:01This particular one is perhaps the worst spree killer in history,
0:43:01 > 0:43:03the Spanish flu virus.
0:43:04 > 0:43:07Between 1918 and 1920,
0:43:07 > 0:43:10it is estimated to have killed 50 million people,
0:43:10 > 0:43:13that's five times as many as the
0:43:13 > 0:43:15industrialised slaughter of World War I.
0:43:17 > 0:43:18And then, there's polio,
0:43:18 > 0:43:23which attacks the nervous system, preying particularly on the young.
0:43:23 > 0:43:25Iron lungs were needed because
0:43:25 > 0:43:28severely affected polio victims cannot breathe unaided.
0:43:35 > 0:43:40But there is one virus here that has killed more than any other,
0:43:40 > 0:43:42and in the most grisly manner.
0:43:44 > 0:43:47It has killed Japanese emperors, and European kings.
0:43:48 > 0:43:54It wiped out 90% of the Aztecs and brought down their empire.
0:43:54 > 0:43:59It was responsible for the deaths of at least 300 million people
0:43:59 > 0:44:01in the 20th century alone.
0:44:01 > 0:44:03It is, of course, smallpox.
0:44:07 > 0:44:09Smallpox, throughout all of history,
0:44:09 > 0:44:12going back at least 3,500 years,
0:44:12 > 0:44:18has been the most serious pestilence that man has endured.
0:44:18 > 0:44:22And the death rate was approximately 30%.
0:44:26 > 0:44:30The smallpox virus is held in a level-four containment lab,
0:44:30 > 0:44:33which is about as secure as it is possible to get.
0:44:34 > 0:44:38And this is as far as I am allowed to go.
0:44:38 > 0:44:40And granted, what a horrible disease it is,
0:44:40 > 0:44:43it's about as close as I feel I really want to get.
0:44:47 > 0:44:50Those unfortunate enough to catch this airborne disease,
0:44:50 > 0:44:55were often hideously disfigured and suffered excruciating pain.
0:44:55 > 0:44:58It develops first as little tiny pimples and
0:44:58 > 0:45:02then, the individual would be covered with these pustular lesions,
0:45:02 > 0:45:05particularly on the face, the arms and the legs,
0:45:05 > 0:45:08but over the whole body.
0:45:08 > 0:45:10It's in the inside of the mouth, on the tongue,
0:45:10 > 0:45:13so the individual has trouble drinking,
0:45:13 > 0:45:18and there's nothing really that you could do to ameliorate the pain.
0:45:20 > 0:45:24There is no cure, and antibiotics are useless against it.
0:45:24 > 0:45:26Smallpox is a monster.
0:45:28 > 0:45:31But a monster that no longer exists in the wild.
0:45:31 > 0:45:33Because smallpox is the first disease
0:45:33 > 0:45:37in human history that we have managed to eradicate.
0:45:37 > 0:45:40So how do you get rid of a monster that you cannot kill?
0:45:46 > 0:45:50The answer, as with Pasteur and Koch, came from a rural setting.
0:45:52 > 0:45:54It all began more than a century
0:45:54 > 0:45:57before anyone knew that viruses even existed.
0:46:00 > 0:46:04As a young man, 18th-century English doctor Edward Jenner
0:46:04 > 0:46:08had heard a milkmaid bragging that she would never get smallpox,
0:46:08 > 0:46:11because she had previously been infected by cowpox.
0:46:17 > 0:46:20Cowpox is like a very mild form of smallpox.
0:46:20 > 0:46:25Symptoms include pustules and blisters on the hands.
0:46:25 > 0:46:27Now, Jenner was not the first doctor
0:46:27 > 0:46:32to realise that cowpox could protect you against smallpox,
0:46:32 > 0:46:36but he gets the glory, because he did the critical experiment.
0:46:36 > 0:46:40One which these days would be regarded as so unethical
0:46:40 > 0:46:43that he would certainly be struck off
0:46:43 > 0:46:45and would probably end up in jail.
0:46:47 > 0:46:48What Jenner did is
0:46:48 > 0:46:50he got hold of an eight-year-old boy called James Phipps
0:46:50 > 0:46:55and he deliberately infected James with some cowpox.
0:46:55 > 0:47:00The boy developed a fever. Then what Jenner did is he got a scalpel,
0:47:00 > 0:47:03and he made a couple of slashes in the boy's arm,
0:47:03 > 0:47:07and then, he rubbed in puss from a smallpox victim.
0:47:07 > 0:47:11Now, I have no idea what he told the boy or the boy's father,
0:47:11 > 0:47:14but Jenner certainly knew that if the experiment went wrong,
0:47:14 > 0:47:19the boy would go blind and might die screaming in agony.
0:47:23 > 0:47:26Fortunately, the milkmaid had not lied.
0:47:26 > 0:47:28Cowpox did provide immunity to smallpox
0:47:28 > 0:47:32and, as far as we know, James lived happily ever after.
0:47:35 > 0:47:37Jenner called his discovery vaccination,
0:47:37 > 0:47:39after "vacca" - the cow,
0:47:39 > 0:47:43and it relied on one simple principle.
0:47:45 > 0:47:49The vaccine helps our body's immune system prepare for the
0:47:49 > 0:47:52invasion of a particular infectious agent.
0:47:52 > 0:47:54They give us, if you like, a preview of the invader,
0:47:54 > 0:47:57allowing the immune system to adapt its defences.
0:47:57 > 0:48:00A vaccine ensures that if the body is infected,
0:48:00 > 0:48:04it is ready to make as many antibodies as we need.
0:48:07 > 0:48:10It was a great addition to our medical armoury,
0:48:10 > 0:48:15but more than that, Jenner had kindled the dream.
0:48:15 > 0:48:19They knew that we might be able to transform the world
0:48:19 > 0:48:22where we were entirely vulnerable to disease,
0:48:22 > 0:48:24and change it into a world where we could fend them off,
0:48:24 > 0:48:27where we mastered them, we could keep them at bay.
0:48:29 > 0:48:31So Jenner would no doubt have been disappointed
0:48:31 > 0:48:36that more than 150 years after his original experiment,
0:48:36 > 0:48:39smallpox was still rampant,
0:48:39 > 0:48:42killing and mutilating in more than 60 countries.
0:48:45 > 0:48:49We were having, in the world, ten million cases a year,
0:48:49 > 0:48:51with two million deaths.
0:48:51 > 0:48:54So it was clearly a significant problem.
0:48:59 > 0:49:04In 1966, the World Health Organisation set up a special unit.
0:49:04 > 0:49:07Their mission, the complete eradication of smallpox
0:49:07 > 0:49:11within ten years, or as they called it, Target Zero.
0:49:11 > 0:49:12It was almost killed at birth.
0:49:14 > 0:49:18It just barely passed, it just barely passed by two votes.
0:49:20 > 0:49:24The team was headed by Donald Henderson, an epidemiologist.
0:49:24 > 0:49:26Even he had his doubts.
0:49:28 > 0:49:32In theory, I could say yes, you can stop the disease in
0:49:32 > 0:49:34any number of countries.
0:49:34 > 0:49:35We could do it worldwide.
0:49:38 > 0:49:43But could you really stop a disease that was so widespread?
0:49:43 > 0:49:46Could you really vaccinate every person on the planet?
0:49:48 > 0:49:51Many eminent scientists thought this was impossible,
0:49:51 > 0:49:54the practical problems were simply too great.
0:49:54 > 0:49:57This would be another wonderful '60s utopian dream
0:49:57 > 0:49:59that would end in failure.
0:50:00 > 0:50:03People think you have to vaccinate everybody,
0:50:03 > 0:50:05well, you don't.
0:50:05 > 0:50:07Because I think we have to bear in mind
0:50:07 > 0:50:10that smallpox has to go from person to person to person.
0:50:10 > 0:50:17So the idea was to have a team go to the area where the cases were,
0:50:17 > 0:50:21and vaccinate the people right around the cases.
0:50:21 > 0:50:26And this would put a barrier in smallpox being able to spread.
0:50:27 > 0:50:31Henderson's team travelled to some of the remotest places on Earth
0:50:31 > 0:50:35to find cases of smallpox before they were able to spread.
0:50:36 > 0:50:39NEWSREEL: 'Wanted - smallpox reports,
0:50:39 > 0:50:41'200 shilling reward.
0:50:41 > 0:50:44'News of the reward spreads quickly and it helps the searchers.'
0:50:47 > 0:50:49To be successful, Henderson knew the
0:50:49 > 0:50:52project would need to work closely with locals.
0:50:53 > 0:50:55There was a tremendous camaraderie
0:50:55 > 0:50:58that developed among all of the people.
0:50:58 > 0:51:04We had, in all, nearly 800 people working at one time or another
0:51:04 > 0:51:08from different countries, who dropped everything,
0:51:08 > 0:51:13gave up family and worked in the field in the worst possible places.
0:51:15 > 0:51:19I feel like one who was privileged
0:51:19 > 0:51:23to be had of a...an army
0:51:23 > 0:51:26who were, themselves, the real heroes.
0:51:29 > 0:51:32By the mid 1970s, victory was tantalisingly close.
0:51:32 > 0:51:37Smallpox now only existed in a few isolated pockets.
0:51:37 > 0:51:38But the team also knew if
0:51:38 > 0:51:42there was a major outbreak, then all their good work could be undone.
0:51:45 > 0:51:50In October 1977, the team responded to reports of a smallpox case in the
0:51:50 > 0:51:52Somalian port city of Merca.
0:51:52 > 0:51:55When they arrived, they found a 23-year-old,
0:51:55 > 0:51:58Ali Maalin, in the grips of the disease.
0:52:00 > 0:52:01He was immediately isolated,
0:52:01 > 0:52:05and everyone who had come in contact with him since developing smallpox
0:52:05 > 0:52:07was tracked down and vaccinated.
0:52:09 > 0:52:13They waited anxiously for news of other outbreaks.
0:52:13 > 0:52:14But there were none.
0:52:15 > 0:52:16Ali Maalin was the last
0:52:16 > 0:52:20naturally-occurring smallpox victim in the world.
0:52:20 > 0:52:21And he survived.
0:52:25 > 0:52:28In just over ten years, and against extraordinary odds,
0:52:28 > 0:52:32Henderson and his team had achieved Target Zero.
0:52:32 > 0:52:37The eradication of smallpox has been hailed as a tremendous triumph.
0:52:37 > 0:52:43Suddenly, there were awards and special recognitions and so forth.
0:52:43 > 0:52:48It was a watershed event, in terms of an international programme,
0:52:48 > 0:52:52which set us a goal, a time frame and succeeded.
0:52:54 > 0:52:57I do think that the eradication of smallpox
0:52:57 > 0:53:01is one of our greatest ever human achievements.
0:53:01 > 0:53:03Far more significant than putting a man on the moon
0:53:03 > 0:53:05or splitting the atom.
0:53:05 > 0:53:10It is an absolute triumph of science and international cooperation.
0:53:18 > 0:53:22But although the disease has been eradicated, the virus has not.
0:53:26 > 0:53:29The CDC and Russia are the only two laboratories in the world
0:53:29 > 0:53:31authorised by the World Health Organisation
0:53:31 > 0:53:34to continue to hold the smallpox virus.
0:53:34 > 0:53:38We do that so that if it were to come back, we would be fully prepared.
0:53:39 > 0:53:42The fear is that a rogue state or terrorist
0:53:42 > 0:53:46might somehow acquire the virus and use it as a biological weapon.
0:53:50 > 0:53:54But Henderson is convinced we've already extracted everything useful
0:53:54 > 0:53:58from the virus' DNA to fight any potential outbreak.
0:53:58 > 0:54:01And the risks of us keeping something so lethal
0:54:01 > 0:54:02are simply too great.
0:54:05 > 0:54:09I've been very clear on this since 1995 - we should destroy the virus.
0:54:10 > 0:54:13Regardless of the ongoing debate,
0:54:13 > 0:54:17the eradication of smallpox was the catalyst for something much larger.
0:54:20 > 0:54:24It opened up the potential for massive immunisation
0:54:24 > 0:54:28using other vaccines which has resulted in,
0:54:28 > 0:54:34what many call, the era of vaccines.
0:54:34 > 0:54:38Prevention is the best buy, and vaccines are a powerful tool.
0:54:38 > 0:54:42We're continuing to create new and better vaccines,
0:54:42 > 0:54:44that can reduce illnesses,
0:54:44 > 0:54:47whether it's hepatitis C or human papilloma virus,
0:54:47 > 0:54:49or measles or polio.
0:54:49 > 0:54:53In Victorian times, before vaccines were generally available,
0:54:53 > 0:54:55infant mortality was horrific.
0:54:55 > 0:54:57And a lot of that was due to infections,
0:54:57 > 0:55:01which today we just struck off because babies are immunised.
0:55:01 > 0:55:06Life expectancy has increased, infectious diseases are on the run,
0:55:06 > 0:55:08but if we let down our guard, we'll be in trouble.
0:55:16 > 0:55:19When George Washington died in 1799,
0:55:19 > 0:55:25life expectancy in many Western cities was about 35 years.
0:55:25 > 0:55:26It's now more than doubled.
0:55:29 > 0:55:30Over the last 200 years,
0:55:30 > 0:55:33a combination of astute observations,
0:55:33 > 0:55:36dogged perseverance and sheer good luck
0:55:36 > 0:55:40has seen science, firstly, identify the microbes that cause infections,
0:55:40 > 0:55:44and then develop antibiotics and vaccines to fight them.
0:55:45 > 0:55:48Bacteria and viruses are on the back foot.
0:55:50 > 0:55:51For now.
0:55:53 > 0:55:56It is unusual, very, very unusual now
0:55:56 > 0:55:58for any of us to die when we're very young.
0:55:59 > 0:56:04But talk of victory over disease is premature.
0:56:04 > 0:56:07Our increasingly populated, mobile world means we are
0:56:07 > 0:56:09more vulnerable to pandemics than ever before.
0:56:12 > 0:56:15We do have a threat
0:56:15 > 0:56:19of agents emerging from what is tropical rain forest
0:56:19 > 0:56:21or haemorrhagic viruses,
0:56:21 > 0:56:24like ebola and marburg from Africa,
0:56:24 > 0:56:28which could spread and really be very destructive.
0:56:30 > 0:56:33And there is a very real danger of a flu virus
0:56:33 > 0:56:36mutating into something more lethal.
0:56:38 > 0:56:40Pathogens are evolving, but they're
0:56:40 > 0:56:43swapping genes between swine and bird and people,
0:56:43 > 0:56:46so that we may have something as deadly as the 1918 pandemic.
0:56:50 > 0:56:52While the rise of antibiotic resistant bacteria
0:56:52 > 0:56:56risks turning our magic bullets into magic duds.
0:56:58 > 0:57:04It is one of the biggest issues facing us in medicine today, I think.
0:57:06 > 0:57:08Now, some people believe that, unchecked,
0:57:08 > 0:57:11it could hurl us back into a medieval world,
0:57:11 > 0:57:15where operations, childbirth and even minor injuries,
0:57:15 > 0:57:17once again, lead to agonising death.
0:57:18 > 0:57:20I do not believe that.
0:57:20 > 0:57:24We know too much and we are learning more all the time.
0:57:24 > 0:57:25In labs around the world,
0:57:25 > 0:57:27scientists are sequencing pathogens,
0:57:27 > 0:57:29tracking outbreaks and searching for new ways
0:57:29 > 0:57:32to fight infectious disease.
0:57:32 > 0:57:35I am optimistic.
0:57:35 > 0:57:38I think that what we've learnt over the last 200 years
0:57:38 > 0:57:40has put us in a good position
0:57:40 > 0:57:43to combat whatever the microbes throw at us.
0:57:48 > 0:57:50And in the next programme,
0:57:50 > 0:57:53I'm going to find out how we turn
0:57:53 > 0:57:55some of the world's most dangerous poisons
0:57:55 > 0:58:00into some of our most effective medicines.
0:58:00 > 0:58:02If you'd like to take part in a quiz on pain,
0:58:02 > 0:58:06or perhaps find out something more about pus and poison,
0:58:06 > 0:58:08then go to the website below and
0:58:08 > 0:58:11follow links to the Open University.
0:58:40 > 0:58:43Subtitles by Red Bee Media Ltd