In 1923 a Scottish doctor, John J.R. Macleod, and a Canadian colleague, Frederick Banting, jointly received the Nobel Prize for the discovery of insulin to treat type 1 diabetes [1]. This work was initially recognised throughout the scientific world and Macleod returned to Scotland in 1928 as Regius Professor of Physiology at the University of Aberdeen, a post he held until his death in 1935. However, through time John Macleod’s role in this medical breakthrough was diminished and overshadowed as a result of bitter personal rivalries amongst the co-discoverers of insulin. This led to a perceived decrease of Macleod’s role in the discovery of insulin by the medical establishment, initially in Canada and the USA, but subsequently in the UK and internationally, together with the suggestion that his Nobel Prize was undeserved.
In 1982 a leading Canadian medical historian, Prof Michael Bliss, published research which documented concerted campaigns by John Macleod’s former colleagues to blacken his reputation both before and after his death. Over the last 30 years, and as a result of this research, Macleod’s vital role in the discovery of insulin has gradually been accepted by the medical establishment and his reputation restored. This culminated in the formal acknowledgement of all four of the discoverers of insulin by the University of Toronto in 2012, some 90 years after its discovery. Now John Macleod’s role in this momentous medical discovery deserves to be much more widely known by the public in Scotland.
To raise wider awareness about Macleod’s contribution to medicine, the Royal College of Physicians of Edinburgh (RCPE) has invited Prof Michael Bliss to present a keynote lecture in Edinburgh today (6 November 2013) which will be open to the public [2] and webstreamed live to 8 international medical centres. In parallel, a paper documenting Macleod’s role in the discovery of insulin and the eclipse and rehabilitation of his reputation is published online in The Journal of the Royal College of Physicians of Edinburgh.
What is insulin and why is it so important?
Insulin is a naturally-secreted hormone produced in the pancreas which the body requires to regulate blood sugar. If sufficient insulin is not produced by the pancreas, high blood sugar levels occur and result in diabetes. Type 1 diabetes occurs mostly in children and young adults, when insulin is no longer made and insulin treatment is vital. Prior to the discovery of insulin, type 1 diabetes was rapidly fatal. Type 2 diabetes is common in middle-aged and older people in whom insulin does not work effectively and this is often associated with being overweight. While this type of diabetes can be treated with diet and tablets, many people progress over time to need treatment with insulin. Inadequately controlled diabetes is associated with a number of life-threatening conditions including heart disease, stroke and kidney failure in addition to causing nerve damage, foot disease and amputation, and blindness. It is estimated that there are currently almost 4 million people in the UK and 347 million people worldwide with diabetes.
Prof Michael Bliss, Professor Emeritus, University of Toronto, Canada, said,
“In discovering insulin, John J.R. Macleod and his colleagues were responsible for one of the most important medical discoveries of the 20th century. Despite receiving the Nobel Prize, he did not receive the recognition which he deserved from the medical establishment. As a consequence of academic rivalry his role in the discovery of insulin was diminished and discredited, and his reputation deeply tarnished. Almost all popular histories of the discovery either ignored or denigrated him. As a result of research by myself and others this version of history has been corrected and his reputation restored. Tragically, this did not happen within his lifetime, but it is not too late to raise wider awareness of John Macleod’s invaluable contribution to medicine and this could not be more deserving than in his native Scotland”.
Prof Brian Frier, Royal College of Physicians of Edinburgh, and an internationally-recognised specialist in diabetes, said,
“John Macleod directed and informed the research which led to the discovery of insulin. His expertise ensured that the laboratory findings of his team were rapidly translated into the clinical application of insulin to treat type 1 diabetes in 1922 – one of the therapeutic landmarks of 20th century medicine. Prior to the discovery of insulin, type 1 diabetes was fatal and without it many millions of people, many of them children, would subsequently have died. The discovery of insulin is frequently and inaccurately attributed to “Banting and Best”, and for decades Macleod was effectively airbrushed out of medical history. The importance of the research of this quiet and self-effacing Scottish scientist cannot be over-estimated and he deserves to be as well-known to the public as is Sir Alexander Fleming for his discovery of penicillin”.
“It is also interesting to note that the first insulin in the UK was given in the Royal Infirmary of Edinburgh in August 1922. Following publication of the early findings regarding insulin in March 1922, doctors in Edinburgh contacted John Macleod who provided them with detailed directions on how to make and administer insulin”.
Mr Iain Macintyre, History Editor, The Journal of the Royal College of Physicians of Edinburgh, said,
“We are delighted to publish Professor Bliss’s authoritative account of the background to the jealousies and rivalries which denied John Macleod his rightful recognition as a co-discoverer of insulin for so many years. Popular historical accounts may be corrupted by such emotions and we are fortunate in this instance to have had the true story revealed as a result of painstaking research by an eminent historian. In publishing this paper online and making it freely available to the public and researchers we hope this will lead to an improved and more accurate appreciation of the role of JJR Macleod, a pioneering Scottish doctor.”
Contact: Graeme McAlister on 0131-247-3693 or 07733-263453 / Lindsay Paterson on 0131-247-3673
ENDS
[1] On 8 November 1920 John J.R. Macleod, the Scottish-born and educated Professor of Physiology at the University of Toronto, met for the first time a young Canadian physician, Frederick Banting. Banting hoped Macleod would help him try out a research idea aimed at isolating the internal secretion of the pancreas. Macleod agreed to take Banting into his department, give him research animals and a student assistant, Charles Best, and advise on his plan of work. The research began on 17 May 1921; as it developed that summer and autumn, Macleod supervised a collaborative effort that eventually utilised the full resources of his laboratory.
In January 1922 extracts of animal pancreas, prepared by Banting, Best, and a biochemist, James B. Collip, following suggestions made by Macleod, proved spectacularly effective in relieving the symptoms of human type I diabetics. On 3 May 1922, Macleod read a paper to the American Association of Physicians. The audience, which included America's leading diabetologists, gave the Toronto group a standing ovation for the work they had done in isolating the pancreatic hormone that controlled metabolism, which they named "insulin". In October 1923 it was announced in Stockholm that Frederick Banting and John Macleod would share the 1923 Nobel Prize in Physiology or Medicine for the discovery of insulin.
[2] The Douglas Guthrie History of Medicine Lecture: ‘JJR Macleod, Scotland's Insulin Laureate, in shadow and sunshine’ will be presented by Prof Michael Bliss, University Professor Emeritus, University of Toronto, Canada, at the RCPE, 9 Queen Street, Edinburgh at 4.15pm (until 4.55pm) on Wednesday 6 November 2013. It is open to the public.
