When Bill Frankland began practising in the 1940s, allergy medicine was barely a discipline. The allergist Adam Fox said: “To say Bill Frankland was the grandfather of allergy medicine doesn’t do it justice. He wasn’t the grandfather in the sense of being the oldest but in the sense of being the originator of the speciality. He did the original trials and founded the British society. He was still practising in his 90s and 100s, and remained the doctor people wanted to see.”
On his release from a Japanese prisoner of war camp in 1945, Frankland, who has died aged 108, returned to St Mary’s hospital, Paddington, in London, where he had trained. He had suffered with hay fever since he was nine, and when he saw an advertisement for a part-time assistant in the allergy department, he applied. In February 1946 he became full-time and for the next 70 years was gripped by allergy medicine, which he said was like a fascinating detective story.
Frankland worked at the allergy clinic at St Mary’s hospital for more than 30 years, and was its director from 1958 until he retired in 1977. A few years later it was renamed the Frankland Allergy Clinic. It was the busiest in the country, and it is estimated that Frankland oversaw the desensitisation treatment of around 30,000 hay fever patients. At the same time, he also ran the hospital’s pollen farm near Woking, Surrey, until it closed in 1970.
In 1948 the British Association of Allergists was formed with 30 members and Frankland as its secretary. It grew rapidly as it widened its scope to include immunology, becoming the British Society for Allergy and Clinical Immunology (BSACI) in 1973. Frankland was its president from 1963 to 1966 and remained at its heart all his life.
When he began his career in the late 1940s antihistamines had recently come on stream to treat allergies. Frankland was involved in several trials, demonstrating that two antihistamines reduced hay fever symptoms but were not effective for asthma.
Allergen desensitisation for hay fever had been used since 1911, but had not been properly evaluated. Frankland had read about double-blind placebo-controlled trials and wanted to apply them to his discipline. Patients at that time were injected with a grass-pollen extract called Pollaccine to desensitise them.
Frankland was concerned that it contained material that gave unwanted side-effects and wanted to determine exactly which part of the pollen extract was effective. In 1953 he recruited 200 hay fever patients and showed that a purified pollen protein worked just as well as Pollaccine. His paper, published in 1954, was a milestone: the first double-blind randomised clinical trial in immunotherapy; 65 years later, Frankland was gratified to see it celebrated on the 2018 cover of the journal Allergy.
In the 40s and 50s it was difficult for hay fever patients to control their symptoms without information on what type of pollen and how much of it was in the air. Frankland knew that atmospheric levels of pollen were being measured in Cardiff and wanted to do the same in London. In 1953 he installed a Hirst spore trap on the roof of the nurses’ home at St Mary’s and recruited a biologist (whose name he was amused to recount was Miss Hay) to provide daily pollen counts and analyse the prevalence of different pollens. Initially the information went out once a week to members of the British Association of Allergists, but, to disseminate it further, in 1963 Frankland persuaded the Times and the Daily Telegraph to print a daily pollen count. (It is now part of the weather forecast and coordinated by the Met Office.)
As well as his other duties at St Mary’s, in the 40s Frankland spent two years as Sir Alexander Fleming’s clinical assistant. He took care of Fleming’s patients, reporting on their progress every morning at 10am even though Fleming preferred to discuss other subjects.
Frankland said: “He just wasn’t interested in clinical medicine – once he looked down a microscope, he continued looking down a microscope”
In 1948 the publisher Butterworths asked for a new chapter on sensitivities in Fleming’s bestseller Penicillin: Its Practical Application, and Fleming tasked Frankland with writing it. Fleming himself did not accept that people could be allergic to penicillin, saying adverse reactions must be the result of drug impurities. When he read Frankland’s draft, he crossed out the last sentence: “With the increasing use of penicillin, it is to be expected that allergic reactions will become more common,” substituting: “With the increasing use of penicillin, reactions due to impurities will become less common.” Frankland disagreed, but did not feel he should argue with the Nobel prize winner.
In his long career Frankland treated many patients including, in 1979, Saddam Hussein, whose symptoms were caused by cigarettes rather than asthma. He told him: “If you’re not eating, sleeping or praying, you’re smoking. If you carry on, you won’t be president in two years’ time.” Saddam heeded the advice and later flew Frankland out to Baghdad for a celebratory lunch.
As well as asthma and hay fever, Frankland was interested in many different allergies, and, in the now no longer permissible tradition of self-experimentation, in 1955 allowed the South American insect Rhodnius prolixus to bite him weekly so he could observe the reaction. He got the insect from the London School of Hygiene and Tropical Medicine and kept it in the glove compartment of his car. After eight weeks, he had a severe anaphylactic reaction and was saved by two injections of adrenaline. Three hours later, he helped a nurse push her car. The strenuous exercise brought on anaphylaxis again, requiring a third shot of adrenaline. This experience led to his interest in the delay that is possible in allergic reactions.
Frankland was born near Bexhill-on-Sea, East Sussex. His father, Henry, was a vicar and his mother, Rose (nee West), a musician. He was an identical twin and nearly didn’t survive because he was born prematurely and was tiny, weighing just over 3lb (1.4kg). The family moved to Cumberland (now Cumbria), in north-west England, and Frankland remembered getting postcards from his father who was away during the first world war.
When he was nine he caught tuberculosis, and was unimpressed with the doctor treating him, deciding he could do a better job and should study medicine. He went to St Bees school in the county and then to Queen’s College, Oxford, to study natural sciences. His studies were interrupted for six months when he returned home to care for his elder sister Ella, who had scarlet fever. She died in October 1933 and he returned to Oxford before moving to St Mary’s hospital, qualifying as a doctor in 1938.
Two days before the second world war was declared in September 1939, Frankland volunteered as a civilian medical practitioner in the army. He was shipped out to Singapore, where his life was saved a second time. “Another doctor and I decided to spin a coin to determine our assignments,” he said. “I called heads and won. The man who lost went to [the] Alexandra hospital where he was brutally murdered by Japanese forces in 1942.”
Frankland, however, was captured and became a Japanese PoW. In 1943 he was moved to Pulau Blakang Mati (now Sentosa Island), off Singapore’s southern coast, where his two days of tropical medicine training were scant preparation for the array of malnutrition, malaria, dengue and beri-beri he faced. He was nearly bayoneted to death during a punishment “bashing” from Japanese soldiers, and his life was saved yet again when the Americans dropped atomic bombs on Hiroshima and Nagasaki in 1945, ending the war and preventing mass shooting of PoWs.
Frankland returned home in October of that year. He had married Pauline Jackson, an optometrist, in 1941, and had treasured her letters. When he arrived in Liverpool, he was asked if he wanted to see a psychiatrist and replied: “No. I want to see my wife.”
Frankland decided not to talk about his experiences to Pauline or to his family. He said: “When I got back, I thought I’m alive and this is marvellous. I’m going to forget everything I’ve gone through.” When he was nearly 100, he told a colleague he watched a TV programme about VE Day and had his first flashback. Thereafter he was amenable to talking about his experiences.
When Frankland left St Mary’s in 1977, he became an honorary consultant at Guy’s hospital in London, where he saw patients into his 90s. He also worked as an expert witness in court cases, and continued to write papers and attend conferences. Each year he presented the BSACI William Frankland award. He had a wide circle of friends and a great zest for life, remembered by one colleague as enjoying tea at the Ritz and riding a dodgem car aged 103.
Pauline died in 2002, and two years ago Frankland moved from his flat in Marylebone to accommodation in the Charterhouse, central London. When asked about his life, Frankland said: “I have been very lucky.”
He is survived by two sons and two daughters, 10 grandchildren and six great-grandchildren.
• Alfred William Frankland, immunologist, born 19 March 1912; died 2 April 2020