An exhibition by the College Library
for the 43rd St. Andrew's Day Festival Symposium

Diabetes and Endocrinology

Exhibition prepared by John Dallas, Rare Books Librarian

Aretaeus (81-138 A.D.)
De diabete
Paris, 1554

Diabetes is one of the world’s oldest known diseases. The phrase ‘the passing of too much urine’ appears in an Egyptian manuscript written around 1550 B.C. The great Indian physician, Susruta, described the disease around 500 B.C., noting a sweetness in the urine in certain cases.

The Greek physician Aretaeus, writing in the 1st century A.D., gave the first complete clinical description. He noted the excessive amount of urine which passed through the kidneys, and used the word diabetes - derived from the Greek meaning ‘siphon’ - to describe the condition.

Thomas Willis (1621-1675)
Practice of physick
London, 1684

Thomas Willis rediscovered what eastern physicians had observed a thousand years earlier – that in some forms of the “pissing evil”, the urine of patients was “wonderfully sweet”.

He used mellitus, the Latin word for honey, to distinguish between this condition and other causes of excessive urination.

Johann Brunner (1653-1727)
Experimenta nova circa pancreas
Leiden, 1709

Brunner came close to discovering pancreatic diabetes. He removed the pancreas from dogs and noted that they displayed extreme thirst and polyuria.

These are regarded as the first experiments on the internal secretion of the pancreas.

Matthew Dobson (1731?-1784)
Experiments and observations on the urine in diabetes (Medical Observations and Inquiries)
London, 1776

Matthew Dobson from Yorkshire graduated MD at Edinburgh in 1756. By evaporating the urine of a diabetic patient, Dobson was the first to prove the presence of sugar in urine.

He also made the crucial observation of the excess of sugar in blood, and demonstrated that diabetes is a systemic disorder rather than, as had been previously thought, a primary disease of the kidneys.

Thomas Cawley (fl. 1788)
A singular case of diabetes (London Medical Journal)
London, 1788

Thomas Cawley was the first to suggest a relationship between the pancreas and diabetes. He noted that the pancreas of a patient who had died of diabetes showed stones, and signs of tissue damage. The significance of this vital clue was not to be appreciated for another hundred years.

John Rollo (d. 1809)
An account of two cases of the diabetes mellitus
London, 1797

The Scots physician John Rollo was Surgeon General of the Royal Artillery. Considered an authority on diabetes, he pioneered the systematic treatment of the disease by a restricted diet.

Years of observation led him to the conclusion that a meat diet was the most effective. Rollo made many other original observations including diabetic cataract.

Frederick Pavy (1829-1911)
Researches on the nature and treatment of diabetes
London, 1862

Frederick Pavy had the largest number of diabetic patients in London. He spent many years studying the disease and concluded that there was a quantitative relationship between the degree of hyperglycaemia and glycosuria. Queen Victoria’s physician, Sir William Gull, is recorded as asking:

“What sin has Pavy committed, or his fathers before him, that he should be condemned to spend his life seeking a cure for an incurable disease?”

Oscar Minkowski (1858-1931)
Untersuchungen uber den Diabetes Mellitus nach Extirpation des Pankreas
Leipzig, 1893

Oscar Minkowski produced experimental diabetes by removing the pancreas of a dog.

This proof of the role of the pancreas in diabetes was of major importance in understanding the disease.

Eugene Lindsay Opie (1873-1971)
The relation of diabetes mellitus to lesions of the pancreas (Journal of Experimental Medicine)
New York, 1900-01

Minkowski and other researchers had focused attention on the pancreas as the seat of diabetes. Eugene Opie made a further important advance by establishing the association between failure of the islets of Langerhans and the occurrence of diabetes.

Sir Edward Sharpey-Schafer (1850-1935)
The endocrine organs
London, 1916

Schafer was Professor of Physiology at the University of Edinburgh from 1899 to 1933. He theorised that the islets of Langerhans must secrete a substance which governed carbohydrate metabolism.

For this suspected internal secretion of the pancreas Schafer suggested the name insuline.

Sir Frederick Banting (1891-1941)
Charles Herbert Best (1899-1978)
The internal secretions of the pancreas
(American Journal of Physiology)
Baltimore, 1922

At the University of Toronto Frederick Banting, assisted by a 2nd year medical student Charles Best, finally made the discovery which revolutionised the treatment of diabetes mellitus.

In 1922, only eight months after beginning their experiments, they announced the isolation of insulin from the pancreas of a dog. In 1923 Banting was awarded the Nobel Prize.

Sir Norman Purvis Walker (1862-1942)

One of the first people in Britain to benefit from the discovery of insulin was the Treasurer of the Royal College of Physicians of Edinburgh. Norman Purvis Walker became Treasurer of the College in 1908. A few years later he took ill and was found to be suffering from diabetes. By 1922 he was reduced to extreme emaciation and muscular weakness, and his colleagues held little hope for his survival. The discoverers of insulin heard of his condition and sent some over from Canada before it was generally available. Walker, however, insisted that these first batches be given to a boy of ten whose need he considered to be the greater. When Walker did eventually receive insulin the effect was immediate.

“This saved his life. The transformation was nothing short of marvellous and in a few weeks he had put on several stones in weight and looked as he had done before his illness.”

Walker went on to be awarded a knighthood in 1923, and to become President of both this College and of the General Medical Council.