t
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.
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 Book
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.
The Lecture
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:
Diabetus
Ligate pancreatic ducts of dogs. Keep
dogs alive till acini degenerate
leaving Islets. Try to isolate the
internal secretion of these to relieve
glycosurea.
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.
The Prize
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.
Published in 1982, this remarkable book fortunately
remains in print. The University of Chicago Press lists a 1984
paperback reprint edition at $13.95. The original publisher in Canada,
McClelland & Stewart, reprinted a 304-page paperback edition in
1996 for $19.99.
This article originally appeared in Diabetes Digest, May 1999.
Last modified: January 16, 2001
[As of 14Oct2006, this book is available via
Amazon
for $22.00.]