Bill Frankland, who died earlier this year – aged 108 and still writing papers – gave unstinting and unselfish commitment to allergy, to medicine and to humanity over a career spanning 85 years, including decades of work after his official retirement.
He was an inspiration to generations of allergists worldwide.
Bill was a twin. Born prematurely, weighing 1.4 kg, he was not expected to survive. However, both he and his brother Jack, who became a clergyman like their father, lived long lives. Aged nine, Bill caught tuberculosis; the doctor who treated him made rather a poor impression, leading Bill to try to do better in his own career as a doctor. He read natural sciences at Queen’s College, Oxford, before qualifying in medicine in 1938 at St Mary’s Hospital, London. At the beginning of the Second World War in 1939, he was mobilised, appointed as medical officer to the Warwickshire Regiment and sent to Singapore, where he became medical officer in charge of Tanglin Military Hospital.
When Singapore fell in February 1942, Bill was captured and spent 3 and half years as a prisoner of war, including some time in the infamous Changi Prison. While interned there, he tended the sick, regardless of their nationality: his patients included British, Australian, Indian and even Japanese service personnel. Such was his reputation, especially in the treatment of dysentery, diphtheria and malaria, that local civilians sought his opinion. Despite suffering appalling privation and being unable to talk about his experiences until he was over 100, Dr Frankland bore no malice towards his erstwhile captors. His father had once explained, after Bill had claimed to hate his brother Jack, that hate did nobody any good – least of all the hater. That childhood lesson set the tone of Bill’s subsequent life.
After the war, he returned to St Mary’s Allergy Department (now renamed the Frankland Clinic), having developed an interest because of his own hay fever. The detective work involved gripped him for the rest of his long life. His activity, in contrast to that of one of his consultants, Sir Alexander Fleming, was mainly clinical, rather than in the laboratory. Bill’s career spanned a time of great advances in allergy: immunoglobulin E (IgE) was unknown when he began, and non-sedating antihistamines and steroids were yet to be introduced. His prodigious memory for detail made him an excellent source of advice. His curiosity and willingness to learn about other fields, such as botany, entomology and psychology remained sharp until his death. Like all good allergists, he knew the importance of listening to the patient – and of clear explanation of the facts.
In the 1940s, allergen desensitisation (allergen-specific immunotherapy) was a mainstay in the treatment of respiratory allergies, having been introduced in 1911. In St Mary’s Inoculation Department the scale was prodigious: in 1945 under Dr John Freeman, some 6,000 patients were given pre-seasonal pollen vaccine, produced at a pollen farm in Woking, Surrey. The principle had earlier been extended to include animal dander and mould spores. It is now thought that the Inoculation Department was the source of the momentous contamination in the 1920s of a Petri dish in Fleming’s laboratory. Bill, having read about double-blind, placebo-controlled trials, proceeded to demonstrate the efficacy of grass pollen immunotherapy for seasonal allergic rhinitis in a landmark study. In a similar trial, to the dismay of some of his senior colleagues, he clearly demonstrated the lack of efficacy of bacterial vaccines in asthma treatment. Bill’s research on antihistamines demonstrated efficacy in allergic rhinitis, but not asthma, and found that 20% of subjects gave a placebo response.
Bill was also the first to identify what is now called local allergic rhinitis in subjects who are skin-prick test negative, but who respond positively to nasal allergen challenge. In the great tradition of self-experimentation, Bill used himself for an experiment on induction of allergy, using Rhodnius prolixus, a biting insect that can induce anaphylaxis. Repeated self-inflicted bites led to increasing local reactions, then to severe anaphylaxis. Fortunately, after two adrenalin injections, he survived. Unwisely, he then undertook exercise, necessitating more adrenalin and provoking an interest in late phase reactions. Bill also initiated a pollen trap on the roof of St Mary’s Hospital and made pollen counts available to fellow allergists and the press.
Bill was involved in the formation of the British Allergy Society, the forerunner of the British Society for Allergy and Clinical Immunology (BSACI), which now has almost 1,000 members. As the first secretary, he enrolled 30 founder members and helped to organise an initial meeting in 1948 at St Mary’s with Sir Henry Dale and John Freeman as speakers.
He was later BSACI president, president of the European Academy of Allergy and Clinical Immunology (EAACI), secretary general of the Asthma Research Council and vice president of the International Association for Aerobiology. BSACI has instituted the William Frankland award, which honours a distinguished clinician in the field of allergy each year.
On retiring from the NHS in 1977, Bill was asked by Maurice Lessof, professor of medicine at Guy’s Hospital, to help in their allergy clinic on a voluntary basis, which he did for 20 years. His fitness, memory and mental agility remained excellent, and Bill communicated easily with all generations, earning his nickname ‘the grandfather of allergy’. He remained active until his last years: reading journals, participating in medical meetings, giving medico-legal advice, offering clinical advice, making TV and radio appearances and writing papers.
Bill was made an MBE in 2015, one among many other honours. He delighted in his honorary fellowship of Queen’s College, Oxford, and particularly enjoyed their specially brewed Frankland Ale. The publication of his biography, From Hell Island to Hay Fever, won him a new audience of admirers.
His home life was very happy: in 1941 he had married Pauline Jackson, whose letters helped to sustain him during his incarceration. On his return from Singapore, Bill was asked if he wanted to see a psychiatrist and replied, ‘No. I want to see my wife’. Pauline died in 2002. Bill leaves four children, ten grandchildren and six great-grandchildren.
Glenis Scadding
[This obituary originally appeared in the Royal College of Physicians’ In tribute: Remembering RCP members and fellows who died from COVID-19 in 2020]