Sir Neil Hamilton Fairley was bom in Melbourne, Australia and was educated at the Scotch College there and afterwards at Melbourne University. He early distinguished himself as a brilliant student and graduated with first class honours. He, however, did not limit himself to academic work for he played tennis excellently and did so for the State of Victoria.
Fairley was only 23 years old when the first world war broke out and he quickly enlisted with the Australian Army Medical Corps, serving in Egypt and Palestine from 1916 to 1918. He reached the rank of Lieutenant Colonel, was mentioned in despatches and in 1918 awarded the OBE. It was in Egypt that he encountered schistosomiasis, was struck by the many problems it presents and began to work especially on its pathology and diagnosis. He studied in great detail the evolution of the granulatoma it causes and used goats as experimental animals, showing that the infection led to cirrhosis of the liver. He was struck by the difficulty of diagnosing the disease in light infections and sought means of doing so immunologically. He found that complement fixing antibodies developed in the serum of infected persons and also showed that alcoholic extracts of heavily infected snails’ livers formed the most potent antigen then available for the test. It continued to be the antigen of choice for 40 years and was used at the Hospital for Tropical Diseases, London till the late 1950’s. He saw much malaria in the Middle East, and being drawn towards the immunological and haematological aspects of disease by his work on schistosomiasis, he was also impressed by the problems caused by anaemia in malaria.
During the 1920’s he was appointed Tata Professor of Tropical Medicine in the University of Bombay. He there worked on tropical sprue and was largely responsible for the introduction of high protein diets instead of the milk diet which till then had been the usual form of treatment. This change enormously improved the prognosis of the disease. He also made detailed studies of the anaemia encountered in sprue.
Fairley married first Violet Mary Phillips and had one son. This marriage was dissolved. It was in Bombay that Fairley met Mary Greaves who became his second wife and lifelong companion, whose help and support he frequently acknowledged to his friends. She was a welcome visitor at many of the meetings he attended. She was the daughter of H.R. Greaves who had a distinguished career as a merchant in India.
He was appointed to the consultant staff of the Hospital for Tropical Diseases, London, in 1929 and also became Director of Pathology there. At this time his principal research again centred on anaemia and he undertook a series of visits to Macedonia to investigate the anaemia associated with the then highly prevalent malaria in the region. It was these studies that led him to show that methaemalbumin is one of the disintegration products of haemoglobin which occurs when there is intravascular haemolysis. He was in great demand as a physician and built up a large consulting practice at this time.
At the outbreak of the war in 1939 he enlisted in the Australian Medical Force and shortly began to work on the chemotherapy and prophylaxis of malaria to which is ascribed the victory of the land forces in the East. Meticulous study of the effects of various antimalarials using human volunteers at Cairns, Australia, proved the efficacy of mepacrine and later of proguanil in preventing malarial attacks. It was this work which enabled troops to operate successfully in highly malarial areas of the Pacific, India and Burma. He had been appointed FRS in 1942 before this work in malaria prophylaxis had been done, but it has often been said that it alone would have deserved the honour.
After the war he returned to the Hospital for Tropical Diseases, London, and in 1946 was appointed the first Wellcome Professor of Clinical Tropical Medicine at the London School of Hygiene and Tropical Medicine. This was for him a period of intense administrative activity; he was a member of some 40 committees mostly concerned with the reestablishment of the Hospital and research after the war. In 1948 he suffered a severe illness which took its toll of his energy. He retired from his Chair but bravely continued his hospital and virtually all his other work. To the delight of students he continued to lecture on malaria and to let them hear at first hand of his researches, even though he found this taxed his strength. In this however, as in all his activities, he showed great resolution and courage.
Honours were showered upon him; he was knighted in 1950 and received honorary degrees at Adelaide in 1949, Melbourne in 1951 and Sydney in 1956. He was awarded the Richard Pierson Strong Medal of the American Foundation of Tropical Medicine in 1947; the Cameron Prize in Therapeutics of the University of Edinburgh in 1947; the Moxon Medal of the Royal College of Physicians of London in 1948; the Mary Kingsley Medal of the University of Liverpool in 1949; the Manson Medal of the Royal Society of Tropical Medicine and Hygiene in 1950; the James Cook Medal of the Royal Society of New South Wales in 1951 and the Buchanan Medal of the Royal Society, London in 1957.
One of his sons, the late Gordon Hamilton-Fairley (q.v.), had much of his father’s ability and was a Fellow of the College. A fitting memorial to Sir Neil was the inauguration at the College of the Neil Hamilton Fairley Medal for an outstanding contribution to medicine.
Sir Neil is remembered as an indefatigable investigator, a fine leader, administrator and physician. He was a thoughtful person and in company anything but an extrovert; he took his teaching activities very seriously and the contents of his lectures, always carefully prepared, were delivered unostentatiously. To those who came to know him personally he was recognised as the most loyal of friends with an extremely warm and generous personality.
AW Woodruff
[Brit.med.J., 1966, 1, 1117, 1178, 1366; Lancet, 1966, 1, 987, 1045; Times, 21 Apr 1966; J. Trop. Med. Hyg., 1973, Aug, 233; Nature, 18 Jun 1966; Aust. Newsletter, 5 May 1966; RACP Newsletter 1969, 2, 6; DNB]