Courtesy: Medical Miracles, from Readers Digest 1981.
November.
From the frontiers of science and the far horizons of
personal courage, these stories of medical triumphs and miracles will reaffirm
your faith in the awesome powers of the human spirit. Dramatic victories and
human triumphs.
Selected and edited by the editors of Readers Digest
The man who came into the laboratory the morning of May 16,
1921, didn’t look like a medical immortal.
Few do at age 29. Dr. Frederick
Banting looked more like a farmer—powerful, with slightly stooped shoulders,
blue-green eyes, big nose and jutting, stubborn chin. His voice, halting, quiet, betrayed an inborn
shyness.
“Let’s get started, Mr. Best,” he said. “We rally haven’t much time.” What an understatement! He had asked the University of Toronto for the
use of a laboratory for eight weeks, for ten dogs, and for the help of someone
who knew chemistry and physiology. The
money value of his modest request was $100.
With this he thought he could conquer a disease that had always baffled
medical men: the merciless killer, diabetes.
“You read French, don’t you?” Banting asked. I did.
“Let’s to the library then.” He said, “and look up how a Frenchman named
Hedon took a pancreas out of a dog.”
That was the beginning.
We both knew the horror of diabetes—described by a Greek
physician 2000 years earlier as “a disease in which the flesh melts away and is
siphoned off in the urine.” Somehow the
bodies of stricken people stopped burning sugar into energy. Instead their bodies turned cannibal,
consuming stored fats and proteins.
There was always unquenchable thirst—victims often drinking several
gallons of water a day while losing a like amount of sugary urine. And their appetite was ravenous. The only treatment was a rigid diet designed
for correct the patient’s disrupted chemical balance. Severely stricken victims were offered a grim
choice: eat well today ad die tomorrow, of cut down to a few hundred calories a
day and linger for a white in weary befuddlement.
Banting had seen diabetes convert a cicacious 15-year-old
girl classmate at Alliston, Ontario, into a pathetic child for whom death came
swiftly. At my home in West Pembroke,
Maine, I had seen the same happen to my Aunt Anna. A stout, vigorous woman in her early 30s, she
wasted to 80 pounds before she died.
The world would have considered us a most unlikely pair to
match wits with this killer. I was a
22-year-old graduate student, working for my master’s degree in physiology and
biochemistry. Banting’s experience in
research was virtually nil. At his
family’s urging he had started out to study for the Methodist ministry. But, a halting speaker, he changed to
medicine. He had been an average
student.
After serving as a surgeon in the Canadian army in World War
1, and winning the military Cross for bravery, he set up practice as an
orthopedic surgeon in London, Ontario.
He waited for patients who never came.
One month his income was four dollars.
His fiancée could see little future with such a man, and they parted.
Noël this man was staking all his meager resources on his hunch
that he could cure the sugar sickness.
He gave up his little practice, sold his office furniture, books,
instruments, everything. Banting
couldn’t afford another failure.
It was known that the pancreas—a pale-yellow, pollywog
shaped abdominal organ that produces digestive juices—was somehow involved in
the disease. In 1889 Oscar Minkowski in
Germany had removed a dog’s pancreas, mainly to see if the animal could get
along without it. Next day he noted
flies clustered around puddles of the dog’s urine. The urine was sugary; the dog, in normal
health the day before, now had diabetes.
Did pancreatic juices, then, contain a factor that normally
regulated the metabolism of sugars? To
test the idea, research men tied off the ducts that carry these juices to the
intestine. When dogs got this surgery,
their pancreases shriveled and generated—but they did not Ger. diabetes! The shriveled organs, unable to send
digestive secretions to the intestines, were still producing the anti-diabetic
factor.
But if it wasn’t in the pancreatic juices, where was it?
Attention shifted to the thousands of mysterious little
“islet” cells scattered through the pancreas and surrounded by tiny
capillaries. Did they secrete some “X”
stuff, perhaps a hormone that regulated the burning of sugar? And did they empty it, then, not into the
intestine but into the blood stream?
Several research men had suggested as much and had gone hunting for the
elusive hormone. But all had come home
with empty game bags.
Now it was our turn.
“Maybe it’s this way, Mr. Best.” Banting did not say—nor for
several days would we become Fred and Charley.
“Maybe when the researchers remove a healthy pancreas and grind it up to
extract this X stuff, enzymes in the digestive juice mix with the X stuff and
destroy it—just as they break down proteins in the intestine. Maybe that’s why no one has been able to find
it.”
Knowing that when the pancreatic ducts are tied off the
cells, which secrete digestive juices, degenerate faster than do the islet
cells, we would tie of these ducts in dogs and wait. “In seven to ten weeks the pancreas will
degenerate, stop making digestive juices—and there will be nothing to destroy
the X stuff. You extract it. Then we’ll give this extract to the diabetic
dog and see if it lower the sugar in blood and urine.”
I did my chemical work in our cubbyhole lab. Dog surgery was performed two flights up in
the sky lighted artic. Before summer was
over, that attic became steamy as any Turkish bath. To get some relief we wore little of nothing
under our white lab coats. Since money
was short, we ate in the lab. Eggs and
sausage fried over a Bunsen burner became diet staples.
One serious problem was a scarcity of dogs. When the situation became acute, Banting
said, “Crank up the Pancreas, Charley, and let’s go.” [This was our name for
hid Model T Ford.] We rattled through
the poorer parts of Toronto, hunting for dogs whose owners would part with them
for a dollar.
We had tied off the first pancreatic ducts in May, and in
early June we expected the pancreas to be shriveled, the X stuff
accessible. We opened one of the
animals—and found the pancreas blooming with health, no atrophy, no
shriveling. Banting and I had tied the
ducts incorrectly.
Our eight weeks were almost up. But Banting was a stubborn man. During the war he had gotten ugly shrapnel
wound in hi right arm. Doctors had
wanted to amputate. Banting refused—and
nursed the arm back to health. Now we
were going to nurse our sickly project back to health.
Professor John J.R. McLeod, head of the physiology
department, who had provided us with work facilities, was on vacation in
Europe. “He won’t know the difference if
we way on.” We decided.
We began reporting on dogs, tying off ducts, correctly this
time. On July 27 we got the beautifully
shriveled, degenerated pancreas we wanted.
It should contain the X stuff—if the X stuff existed.
Now we sliced the pancreas into a chilled motor containing
Ringer’s solution and froze the mixture.
We allowed it to thaw slowly, ground it up and filtered in through
paper. A dying diabetic dog was waiting;
too weak of lift his head. Fred injected
5c.c. Of the filtrate into a vein. The
dog looked a little better—but self-diffusion is easy such times. Blood tests were needed.
I drew a few droplets from the dog’s paw and began testing
for blood sugar. Banting hovered over
me. If sugar were heavily present the
reagent in the test tube would turn deep red; little sugar and it would be a
pale pink. There was a new test every
hour and the reagent was getting paler, paler.
Blood sugar was going down—form 0.20 percent, to 0.02 percent, to … it was headed for a normal 0.09 percent! This was the most exciting moment of
Banting’s life or my own.
Life now became a blurred nightmare of work. This thing had to be nailed down. Dogs had to be injected, blood had to be
drawn for testing, urine collected. It
was an hourly, round the-clock schedule.
We stretched out on lab benches to get what sleep we could.
But there was an ever-reviving miracle for us to behold:
dogs glassy-eyed with the sleep of death upon them; then, a few hours later,
they were up, tails wagging. Jolted back
to life, one dog lived 12 days, another 22 days.
Our pet was Marjorie—dog number 33. Black-and-white, vaguely collie, she learned
to jump up on a bench, hold out her paw to give us a blood sample and keep
still to get the shot on which her life depended. For 70 days she was alive, well. Then we ran out of the extract, isletin, as
we then called it. [Only later did McLeod persuade us to change the name of
insulin]
It took almost all the isletin we could extract from a
degenerated pancreas to keep one dog alive for one day. How far would this to toward keeping alive
millions of diabetics around the world?
Fred remembered reading that the pancreas of an unborn
animal was a mainle islet cell—since the digestive juice wasn’t needed in the
womb. As a farm boy, he also knew that
farmers frequently bred cows before sending them to the slaughterhouse, to
hoist weight. Wouldn’t pancreases from
the unborn calves be rich in isletin? We
cranked up The Pancreas and headed for a slaughterhouse. Later, back at the lab, we ground up the
salvaged pancreas, extracted, purified and reaped a rich harvest of isletin.
We could now keep dogs alive as long as we wanted. Eventually, of course, it was found that with
improved extraction methods any animal pancreas—sheep, hog, and cow—provided
insulin. There was going to be enough
for all needs.
By November 14 we were ready to share some of our experiment
with the world. Before the Journal Club
of the Department of Physiology, Banting and I gave our first paper—complete
with lanternslides showing blood-sugar charts.
But the crucial question we had to be answered. Would insulin work in human beings?
Across the street in Toronto General Hospital was the
14-year old Leonard Thompson. After two
years with diabetes, he was down to 65 pounds, had scarcely the strength of
lift his head from pillow. By the usual
criteria he would have, at most only a few weeks left.
We had established that insulin “cocktail” taken by mouth,
did not work. So now Banting and I
rolled up our sleeves. I injected him
with our extract and he injected me—we had to be sure it wasn’t too toxic to be
tolerated by human beings. Next day we
had slightly sore arms that were all.
So in January 1922, the wasted little arm of the dying boy
was injected. Testing began. All over again, it was the story of our
dogs. Blood sugar
dropped—dramatically. Leonard began to
eat normal meals. Sunken cheeks filled
out, new life came to weary muscles. Leonard was going to live! [He lived
another 13 years and died in 1935—of pneumonia following a motorcycle
accident]. He was the first of dozens,
then hundreds, thousands, and millions to get insulin.
Honors began to shower on us. For the best piece of research conducted at
the university that year we were awarded the Reeve Prize—a welcome $50. A grateful Parliament voted Banting a life
annuity of $7500. Then came a great
research institute named for him, and later one named for me. When Banting won the Nobel Prize in 1923 he
shared the money equally with me.
Both of us stayed on at the university, and through the
succeeding years concentrated on our individual research projects. But the excitement of the old days was
missing. Then on a wintry February day
in 1941, we were walking across the campus. “Charley,” said Banting, “let’s
start working together again. You handle
the chemistry, and I’ll….”
It was not to be.
Three days later Banting—now a Major Sir Frederick Banting, working on
problems of aviation medicine—was aboard a two-engine bomber bound for
England. The plane crashed in a
snowstorm in a forest near Margraves Harbor, Newfoundland. Banding, with a lung punctured by crushed ribs,
used his waning strength to bandage the wounds of the pilot, the only
survivor. Then he lay down on pine
burghs in the snow and went into the sleep from which he never awakens.
Of all eulogies, perhaps most moving was the one spoken five
years at a London gathering of the Diabetics association: “without Banting this
meeting could have been only a gathering of ghosts bemoaning their fate.”
