One hundred years ago, in the spring of 1921, Frederick Banting and Charles Best began experiments on dogs that led to the production of medically usable insulin. The diabetes had lost its horror.
Charles Best (left) and Frederick Banting (right) with an artificially diabetic dog they had treated with insulin taken from another dog. By Eli Lilly& Company manufactured insulin (Insulin Lilly) as it was sold in the USA in 1923.
Insulin was a big deal. Then as now. 100 years ago, in May 1921, the first experiments began. In 1923 the Nobel Prize followed. It was awarded to Frederick Banting (1841-1941), a hitherto rather unsuccessful Canadian physician, and John James Rickard Macleod (1876-1935), professor of physiology at the University of Toronto, Canada.
They received the award because Banting and his assistant, medical student Charles Best, and a few others succeeded in keeping a patient suffering from severe diabetes alive for an extended period of time. After only a few days of treatment with bovine insulin, Leonard Thompson, then 13 years old, had almost normal blood values again and did not die until 14 years later from pneumonia, not diabetes.
The Nobel Prize award already illustrates that the story was by no means simple. There was no question of "discovering insulin"; it had been known for some time that this was the substance that could cure diabetes. And why did the Scottish-born Professor Macleod get half the prize money?? Because he had given a laboratory and a few dogs to Banting and Best during the summer of 1921?
Apparently the laureates were not quite comfortable with it either. Banting especially. He immediately shared his half of the prize money with Best. Fiercely opposed Macleod almost simultaneously. He immediately shared his half of the prize money with Best. Almost at the same time fiercely opposed Macleod. And he immediately gave half of his prize money to the biochemist James Collip (1892-1965).
Insulin is still one of the most important weapons in medicine today.
"Discovered" insulin had actually been around for a long time
What had happened? The story is even more involved. The Romanian physiologist Nicolae Paulescu had already treated a dog in 1916 with a pancreatic extract he called pancrein. And he had published his results in the spring/summer of 1921. If anyone is entitled to bear the title "discoverer of insulin," it is he. However, the title itself is not without controversy, because "discovering" or "finding" was not really necessary anymore. It was rather a matter – to remain in the picture – of picking it up correctly.
Diabetes or diabetes is a metabolic disorder. The hormone insulin causes cells to absorb carbohydrates from food in the blood. Without insulin, blood sugar levels rise, and that damages the body. Until the 20. In the nineteenth century diabetes mellitus was a disease from which one died sooner or later. Doctors were helpless.
As therapy there were only extreme forms of diets. For this the American physician Frederick Allen (1879-1964) was known. He put his patients on extreme starvation diets of 1000 calories a day or even less (and one day of fasting a week). At least they remained alive for the time being.
A sleepless night and the birth of an idea
Frederick Banting was a farmer's son who had studied medicine but was sent to the front in Europe in 1917, practically in the middle of his studies. In Cambrai, he received a splinter in the arm, but continued to operate and care for the wounded without being moved. A certain stubbornness was already evident.
Frederick Banting
Physician and physiologist
After his return, he tried unsuccessfully to gain a foothold as a practicing physician. To earn some extra money, he helped a colleague train young physicians. On Sunday evening, 31. October 1920, he was working on a lecture on carbohydrate metabolism. He had little idea of the subject. Then he read an article in a journal by a certain Moses Barron. He reported on the rare case of a pancreatic stone. The stone was so large that it completely blocked the outflow of the pancreas, causing the organ to atrophy.
Banting was electrified. He now knew – and researchers had known for some time – that there were two kinds of cells in the pancreas. The "normal" ones, which produced digestive secretions, and the mysterious "islets of Langerhans," which were thought to make the diabetes-preventing hormone. So far it has not been possible to isolate this substance. Pancreatic extracts had been experimented with many times, even on humans, but without much success. Severe side effects with perceptible lowering of blood glucose levels indicated that the substance was contaminated.
Why not tie off the pancreatic outlet, wait, and obtain the substance from the pancreatic remnant? This was Banting's idea. And with that he marched to Macleod. He didn't exactly go for it. This had been tried many times before without success, but he finally gave in.
They died so that sick people survived
Banting and Best operated on dogs. In one they stopped the pancreatic outflow and waited until only the islets of Langerhans were working. In others, they removed the pancreas altogether to turn them into diabetics. It must be said that surgeon Banting had not improved much since Cambrai 1918. The dogs suffered and died.
But on Saturday 30. July 1921 – Macleod was by now on vacation in Scotland – Banting and Best removed "Dog 391's" atrophied pancreas, extracted it, and injected the solution into the artificially diabetic "Dog 410". His blood values improved almost instantly. Without the biochemistCollip and the expertise of Macleod, however, nothing would ever have come of it. Banting didn't know anything about biochemistry or blood glucose tests, and Best didn't know much else either. But the team was fast, and it wasn't far to medically usable insulin then.
From Eli Lilly& Company-produced insulin (Insulin Lilly) as sold in the U.S. in 1923.
Macleod went back to Scotland in a huff; surprisingly little was heard from Collip in the matter of insulin, but even more from Best. Both had long successful careers in scientific research. Banting crashed on 20. February 1941 on his way to England in a Hudson bomber. A mysterious death.