It was the early 1920s and a small-town Canadian doctor was just starting out in practice. But he had so few patients that he couldn't afford to get married.
He couldn't even spell diabetes.
To supplement his meager income he decided to take a part-time job as an instructor in the Western University Medical School's department of physiology in Toronto. The job paid about $10 per week.
That doctor and that job changed the world. The doctor's name was Frederick Banting. He discovered insulin.
The Discovery of Insulin by Michael Bliss is the brilliant, definitive history of what is arguably the most significant and controversial medical event of modern times. It is certainly the most important medical discovery for every insulin-dependent diabetic on the planet.
When insulin was discovered at the University of Toronto in 1921-22, even hardened professionals marveled at its miraculous effect in bringing starved, sometimes comatose, people with diabetes back to life. One of the most sensational of all therapies in its impact, insulin symbolized and stimulated our century's commitment to medical research.
There have been few more fitting awards than that of the 1923 Nobel Prize in medicine for the discovery of insulin. But few awards have generated more controversy. Bliss tells this story exceptionally well from beginning to end.
Bliss tracks the genesis of the discovery back to October 1920. Banting's boss had asked him to prepare a lecture on carbohydrate metabolism. Fortunately, Banting knew almost nothing about the subject.
To bone up on it he went to the medical school's library and prepared his lecture on the afternoon of October 30. Unable to sleep that night, at 2 a.m. he jotted down 25 words that would lead him to his great discovery:
Ligate pancreatic ducts of dogs. Keep
dogs alive till acini degenerate
leaving Islets. Try to isolate the
internal secretion of these to relieve
He couldn't even spell diabetes or glycosuria. But he was on the right track.
Working with a medical student named Charles Best, Banting tied strings around the pancreatic ducts of several dogs. When they examined the pancreases of these dogs several weeks later, all of the pancreas digestive cells were gone and all that was left were thousands of pancreatic islets. They then isolated the protein from these islets. That protein is insulin.
It really wasn't as simply as that sounds. It took many trials and the lives of many dogs. Banting and Best became discouraged but never quit.
But they succeeded, and by 1923 Eli Lilly and Company was producing insulin in commercial quantities. And in that year Banting and J.J.R. Macleod were awarded the Nobel Prize for their discovery.
J.J.R. Macleod? He was an internationally known expert in carbohydrate metabolism who headed the laboratory in which Banting and Best worked. But why should he have shared in the prize for work done when he was out of the country on vacation?
Bliss's judgement and that of history is that Macleod didn't deserve it. Banting and Best are the ones remembered for their magnificent discovery.
The Discovery of Insulin is a worthy addition to anyone's library, whether you have diabetes or not. It is a careful, detailed study by a professional historian.
At the same time it is a page-turner and a highly emotional read. While I have diabetes, I haven't had to use insulin. But I still found myself in tears time and again as I read the moving stories of the first children who had been saved at literally the brink of death.
This article originally appeared in Diabetes Digest, May 1999.
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