Neil Hamilton Fairley - Between The Wars

Between The Wars

Fairley was one of a number of AIF officers granted leave "to visit various hospitals in the United Kingdom so that they become conversant with the latest developments in the medical sciences". For a time, he worked for Martin at the Lister Institute in London where he qualified for membership of the Royal College of Physicians of London. He also received a Diploma of Public Health from the University of Cambridge. He returned to Australia on the transport Orontes in February 1920, to become a research assistant to Sydney Patterson, director of the Walter and Eliza Hall Institute of Medical Research, where Fairley worked on developing a test for echinococcosis along the lines of the test that he had already developed for bilharzia.

Fairley remained for less than a year before resigning to take up a five-year appointment in Bombay as Chair of Clinical Tropical Medicine at a newly created School of Tropical Medicine, a post for which he had been nominated by the Royal Society. On arrival in India, he found that the scheme had been abandoned and that as his appointment could be terminated at six month's notice, he would no longer be required after October 1922. Fairley demanded and received an audience with the Governor of Bombay, Sir George Lloyd, the result of which was that the Secretary of State agreed to create a special five-year post of Medical Officer of the Bombay Bacteriological Laboratory and Honorary Consulting Physician to the Sir Jamshedjee Jeejebhoy Hospital and St George Hospital.

In India, Fairley continued his research into schistosomiasis. The disease was unknown in India but snails were abundant and there was danger that troops returning from Egypt might introduce it. In the absence of human schistosoma, Fairley investigated bovine schistosoma, which infected water buffalo and other domesticated animals in the Bombay area. Experiments with monkeys proved that daily intravenous doses of tartaric acid were an effective treatment. Fairley also carried out pioneering work on Guinea worm disease (dracunculiasis). However, his main interest was Tropical sprue. But he was unable to determine its cause or discover a cure; in spite of contracting the disease himself and making some advances in its treatment. He was invalided out of India, travelling to the United Kingdom to recuperate in 1925. While in India he had met Mary Evelyn Greaves, and they were married at the Presbyterian Church, Marylebone, on 28 October 1925.

Fairley returned to Australia in 1927 and rejoined the Walter and Eliza Hall Institute. He worked there for two years, collaborating with the new director, Charles Kellaway in studies of snake venoms and with Harold Dew on the development of diagnostic tests for echinococcosis. Fairley dedicated most of 1928 to the snake venom programme, coordinating an enormous body of epidemiological data – including a questionnaire to Australian clinicians – on the frequency and outcome of bites by Australian elapid snakes. This work involved numerous milkings to establish typical and maximal venom yields, innovative studies of snake dentition using wax moulds, and detailed dissections to describe each species' biting apparatus. Fairley furthermore undertook in vivo studies of envenomation in a range of large animal species, in order to determine the efficacy of prevailing first-aid measures. He concluded that at best, ligature and local venesection might slow time to death after a significant envenomation. This reinforced the need for effective antivenenes (antivenoms) for the more dangerous local species of snakes, notably the tiger snake (Notechis scutatus), death adder (Acanthophis antarcticus) and copperhead (Austrelaps superbus), although only the former was suitable for manufacture by the Commonwealth Serum Laboratories (now CSL Limited).

In 1928, Fairley received an appointment in London as Assistant Physician to the Hospital for Tropical Diseases and Lecturer at the London School of Hygiene and Tropical Medicine. Although he and Kellaway convinced the governors to delay Fairley's commencement until their major venom work was completed, he departed for London by the end of that year. He also opened a consulting practice in Harley Street. In London he encountered patients with filariasis and devised a test to diagnose the disease at an early stage; but when he went to write up his results he discovered that details of a similar test had already been published. In 1934, a sewer worker was referred to his ward with acute jaundice which Fairley diagnosed as caused by filariasis. The disease was revealed to be an occupational hazard of sewer workers, and steps were taken to protect the workers. Perhaps his most important work in this period was research into blackwater fever. Since malaria cases were uncommon in the United Kingdom, he made annual visits to the Malaria Research Laboratory of the League of Nations at the Refugee Hospital in Salonika. In the process, he described methaemalbumin, a previously unknown blood pigment. For his scientific accomplishments in London, Fairley was elected a Fellow of the Royal Society in 1942.