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Vol 38  No 7
December 15, 2005


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Bringing medical history to life

By Sharon Gray

Drs. Nigel Rusted (L) and Michael Bliss.

 

In a riveting talk to a packed audience, Canadian historian Dr. Michael Bliss gave the second annual Dr. Nigel Rusted Lectureship in the Humanities Nov. 30 at the medical school.

From Osler to Insulin: The Coming of the Age of Medical Miracles focused on the moment in time when modern medicine began and Canada made its greatest contribution to medicine. It all started with William Osler, born in Bond Head, Ontario, and a graduate of McGill University. In 1889 Osler moved to Johns Hopkins University, where he emerged as the most prominent physician of the day, becoming a role model and mentor for generations of doctors and a high priest of medicine.

“Osler, a preacher’s son, would increasingly look to medicine rather than religion for salvation ­ the prolonging of life,” said Dr. Bliss.

But at that time there were not many ways for doctors to save their patients. They could provide good nursing and accurate diagnoses, but had no cures. The first breakthrough came when thyroid extract was administered to treat cretinism. Osler considered the results a miracle and a sign of things to come.

The next breakthrough had an indirect connection to Osler. In July 1949 at Bond Head, Ontario, the baptismal record included the names of both William Osler and William Banting, father of Fred Banting.

It was Fred Banting who initiated the next medical miracle. The pancreas had proven maddeningly elusive to the medical profession. Dr. Bliss said it was known at that time that animals without a pancreas developed severe diabetes and died. But no one had been able to find the substance in the pancreas that was responsible.

On Oct. 31, 1921, Dr. Banting jotted down an idea about isolating the internal secretions in the pancreatic ducts of dogs. He was practising in London, Ont., and took his idea to J.J.R. MacLeod at the University of Toronto. The rest is history, if a rather embittered history. Dr. Bliss’ book The Discovery of Insulin and the movie based on it, Glory Enough For All, detail the infighting between the four people involved in the discovery of insulin - Banting, MacLeod, medical student Charles Best and biochemist James B. Collip. “Under pressure they behaved like Canadian hockey players,” said Dr. Bliss.

Eventually the Nobel Prize for the discovery of insulin was awarded to Banting and Macleod. Banting split his prize with Best; Macleod split his with Collip. Banting and Macleod never spoke to each other again.

Dr. Bliss finished his talk by illustrating the amazing progress of some of the earliest patients treated with insulin. He tracked down and interviewed Elizabeth Hughes, born in 1907 and treated with insulin in 1922 when she weighted just 45 pounds. Dr. Bliss met her and her family in 1980 and was thrilled to find an original patient alive. Unfortunately she died about six months later of heart problems complicated by her diabetes.

Dr. Bliss also had the good fortune to find Ted Ryder alive. He was one of the first patients treated with insulin and he survived until 1993, 70 years of his life on insulin. “Ted and Elizabeth were well controlled diabetics with good genetics who watched their diet and exercised,” said Dr. Bliss. “Today there are diabetics who have lived more than 80 years on insulin.”

William Osler’s dream came spectacularly true with the discovery of insulin, said Dr. Bliss. “Here was the coming of the age of medical miracles.”

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