Miracle Drug: The Discovery of Insulin

Georg Evers was an Egyptologist at Leipzig University sprat better known in his time as a novice because he tried to popularize Egyptology by writing period romances in 1873 he was in the city of Luxor Egypt looking for something in particular because there had been a rumor in the Egyptology community that someone had discovered a particularly important document he found the document and purchase it at an antiquities shop what he purchased was a papyrus scroll some 63 feet long that has since become known as the Evers papyrus and is thought to have been written around 1500 BC and to be actually copies of works that were even older than that and is among the most important of the Egyptian medical texts gives us an insight into the practice of medicine in ancient Egypt among the many interesting parts of the eber's papyrus is a prescription for the elimination of urine that is too plentiful which is thought to be the earliest known record of the identification of the disease that today we know as diabetes it affects some 450 million people worldwide and while the disease was recognized in antiquity the Evers papyrus of just treating it with a concoction that included elderberry milk and beer swill the most important discovery in the treatment of diabetes occurred in the 1920s November is Diabetes Awareness Month in the United States when communities work together to raise awareness of a disease among its victims include my father the discovery of the miracle drug insulin is history that deserves to be remembered the Egyptians were not the only ancient culture to recognize the disease Hindu physicians recognized the difference between type 1 and type 2 diabetes as early as 500 BC Chinese medical texts described the disease's early as the 5th century BC ancient Greek texts attribute the name of the disease to the first century BC physiologist Demetrius of apamea although no original works of Demetrius survived his work is mentioned in later Greek works the Greeks saw diabetes as a condition of the kidney described as the inability to retain fluid as any fluid drunk was assumed to pass through as if through a pipe diabetes is the ancient Greek word that means to pass through ancient physicians seem to have little response to the condition the first century AD Greek physician err tre us of Cappadocia described the condition as the melting down of flesh and limbs into urine and warned that if the constitution of the disease be completely established for the melting is rapid the death speedy and added moreover life with the disease is disgusting and painful air Trace gave us his prescription eating cereals and drinking milk and wine the prescription is strikingly similar to that in the Evers papyrus written 1,600 years previous the understanding of diabetes develops slowly the 17th century English anatomist Thomas Willis rediscovered the idea that diabetes was associated with sugar in the urine in fact described by Hindu in Chinese physicians 2,000 years before while realizing it's connection to urination he called the disease the pissing evil Willis whom some credit with the adding of the name mellitus drive from the Latin word for sweet to describe diabetes also recognized that rather than an illness of the kidney diabetes was related to blood he recognized the connection to diet have prescribed a thickening and moderately cooling diet and cordials in the 19th century several researchers realized that there were abnormalities in the pancreas of people who had died of diabetes but the role that the pancreas played in the disease was still not clear in 1868 German medical student Paul Langerhans identified two systems in the pancreas one set of cells produced the pancreatic enzymes used in digestion it was unable however to determine the function of the other set of cells in 1889 German physiologist Oskar Minkowski and Joseph armoring established the connection more clearly they performed a pancreatectomy on a dog and other that had developed symptoms of diabetes including a high sugar content in its urine the two were thus able to determine that the unknown cells produce a substance it's related to the regulation of blood sugar because the cells look like small clumps which floated like islands they were called islets of langerhans later the Latin word for Island insula would give the purified version of those cells its name insulin while the relationship between pancreatic cells and diabetes was becoming understood the method of isolating and purifying the substance as a treatment had not been developed several researchers made attempts to isolate the islets secretions in 1906 German physician George Salzer achieved some success using pancreatic extracts on diabetic dogs yes we had partial success with a patient in a diabetic coma using an extract from cow pancreas that was manufactured by a small company in Berlin the patient showed some improvement but developed side-effects and the supply of the extract ran out he was unable to produce a breakthrough and his laboratory was turned over to the German military during World War 1 professor Israel kleiner of New York's Rockefeller University had some success reducing symptoms using pancreatic extracts in 1915 but World War one interrupted his work and he did not return to it it seems that the potential breakthrough was interrupted by the war and the eventual solution came from a surgeon of that war Frederick Banting had his medical training rushed to serve the Great War with the Canadian Army Medical Corps wounded by shrapnel he returned to London Ontario Canada and opened a practice but his practice struggle so we also took on work as a demonstrator at the medical school at the University of Western Ontario he was assigned to do a lecture on the function of the pancreas and in October 1920 in the course of researching for his lecture saw an article in the Journal of surgery gynecology and obstetrics by University of Minnesota pathologist named Moses Barron the article was entitled the relation of islets of langerhans to diabetes who is special reference to cases with pancreatic Lithia says lathy osseous means essentially Stehly concretions in the body like gall stones or kidney stones in this case the article talked about stones in the pancreas the author talked about a patient where a stone in the pancreas blocked the duct that produced digestive enzymes in the case the pancreas atrophied except for the islet cells it occurred to Banting that he could simulate the same condition in dogs he jotted down a note the cake pancreatic ducts of the dog keep dogs alive till I see need to generate leaving islets tried to isolate internal secretion of these and relieve glycosuria his idea was to surgically tie off the same part of the dog's pancreas that had been blocked in Brown's patient and then identify and purify the islets of langerhans in brief he had a plan to isolate insulin but Banting was a local physician not a research physician he didn't have a lab he didn't have publishing experience he didn't have the means to test his hypothesis a colleague suggested that he talked to dr. John McLeod who was a lecturer at the University of Toronto Banting presented his idea to MacLeod in the spring of 1921 unlike Banting McLeod was an experienced research physician McLeod was born in Scotland and 1898 had gotten a PhD in medicine from the University of Aberdeen he'd been a lecturer in biochemistry at the London Hospital Medical School and earned a doctorate in public health from Cambridge University in 1903 he immigrated to the United States and taught at Western Reserve University in Cleveland Ohio for 15 years after the war he was employed at the University of Toronto was director of the physiology lab and faculty in the course of Medicine he had studied a number of important topics among them carbohydrate metabolism and diabetes Suffolk upon which he had published several papers it seemed a good fit McLeod shared an interest in the study of diabetes and had access to lab space but in many ways it was not a good fit MacLeod was unimpressed with Banting essentially a country physician and didn't think he had a good understanding of diabetes he was also not impressed with Banting's plan MacLeod was aware of the works of physicians like George soldier who had only found limited success treating diabetes with pancreatic extracts he thought it more likely that blood sugar was regulated somehow by the nervous system still Banting was passionate and convinced MacLeod to give him laboratory space to test his idea during a summer while MacLeod was going to be vacationing in while he was not convinced by the idea MacLeod assigned the young position and assistant Charles best who worked as a demonstrator at the school MacLeod also provided lab animals and gave advice on project planning and analytical techniques the research over the summer was difficult largely because the subjects dogs that had either had their pancreas removed or the Ducks ligated really lived long enough to experiment upon but while the cloud was in Scotland Banting and best managed a breakthrough using the method of ligation they had managed to isolate the pancreatic secretion of one dog and used that secretion to treat glycosuria in another animal that had had its pancreas removed the results were actually stunning the extract reduced the blood sugar of the dog with induced diabetes by 40 percent in one hour but upon return MacLeod was unconvinced pulling out flaws in the method of study he suggested the experiments be repeated with more dogs and better equipment while he moved Banting and best into a better laboratory and began paying Banting a salary from his research grants Banting took the criticisms as an attack on his integrity and apparently started to worry the macleod was trying to take credit for his work the tension grew more when they presented their findings at the conference of the American Physiological society at Yale University on December 30th Banting was nervous and an experienced and did a poor job presenting the findings when MacLeod stepped in to rescue the presentation Banting took it is more evidence that MacLeod was trying to steal credit for his work but then they had addressed the biggest difficulty the bottleneck that came from the time-consuming task of duct tying dogs and waiting weeks to be able to extract insulin or extracting insulin from kettle the work was so promising the MacLeod shut down all of the work at the lab to focus on the production of insulin in January they made the first trial on a human 14-year old Leonard Thompson Thompson was dying of type 1 diabetes in affliction that affects children were they're unable to produce insulin at the time a diagnosis of this type of diabetes was a death sentence but there was a problem Nansen was impure caused an allergic reaction the cloud brought in another researcher biochemist james collip to help purify the insulin a lecturer in the Department of physiology at the University of Alberta called at the University of Toronto on a travelling scholarship an expert on blood chemistry collip developed a method of purifying insulin using alcohol by then the tension between Banting and MacLeod was acute and collip only shared his discovery with MacLeod the drama aside the team had finally developed a successful process for producing usable insulin Banting best and Cullum shared the patent which they sold to the University of Toronto for $1 it is difficult to overstate the significance of this discovery it changed not just the treatment but the prognosis for the millions of people suffering from diabetes the results were so significant that people literally rose up from comas press at the time described the results as miraculous one of the many millions who benefited from this new treatment was Leonard Thompson who received his second dose of insulin about 12 weeks after the first dose which was impure had caused allergic reactions at the time his prognosis was death within weeks but because of insulin he went on to live another 13 years passing away in 1935 of pneumonia at the age of 27 bantington MacLeod shared the Nobel Prize for medicine in 1923 but the prize only increased the tension between the two Banting believed that MacLeod had not contributed enough to be included in the Nobel Prize and felt that Charles best had been slighted decided that he would share his part of the prize with Charles bast and MacLeod as a response decided to share his part of the prize with james collip painting spent the rest of his life arguing that the cloud had contributed little to the discovery but later analyses are kinder to MacLeod suggests that he had a larger role than Banting claimed and said that his management of the trials his interpretation of the data and his publication of the results were significant enough to include him on the Nobel Prize award but one of the results of this conflict between Banting and MacLeod is that the contributions of Charles best and james collip are kind of lost in the noise in 1972 the Nobel Foundation agreed that they had erred in not including Charles best in the Nobel Prize award there was a further controversy and that many other researchers had come close to the discovery of insulin notable among those was romanian physiologist nickel a police you who have been using pancreatic extract to treat diabetes and dogs prior to the toronto team however he was never able to successfully purify his formula it is certainly fair to say that the work of the Toronto team built upon the work of many other scientists many of whom came very close to making the discovery themselves there is a further controversy in that much of the work regarding the identification and purification of insulin involved surgery on living animals the practice called vivisection is still controversial today there are many different memorials buildings streets awards named after Banting MacLeod best and collip among them is the flame of hope in London Ontario which was kindled by the Queen Mother in 1989 it stands not just as a memorial to Frederick Banting but also as a reminder that insulin is a treatment but not a cure for diabetes and the flame is only to be extinguished when an actual cure is found I hope you enjoyed this episode of the history guy short snippets have forgotten history between 10 and 15 minutes long and if you did enjoy please go ahead and click that thumbs up button if you have any questions or comments or suggestions for future episodes please write those in the comment section I will be happy to personally respond be sure to follow the history guy on facebook instagram twitter and check out our merchandise on teespring com and if you'd like more episodes don't forgotten history all you need to do is subscribe [Music]

Channel: The History Guy: History Deserves to Be Remembered

Views: 137,366

Keywords: history, the history guy, medicine, canada, diabetes, insulin, history guy

Id: ro7h1a7ckZ4

Length: 15min 5sec (905 seconds)

Published: Fri Nov 15 2019