History of the History of the Discovery of Insulin
By Christopher J. Rutty, Ph.D
Lead Historian, Defining Moments Canada, “Insulin 100”.
There are a number of elements that make the discovery of insulin an especially compelling story for historians, as well as journalists, scientists, filmmakers and physicians. There was the unlikely figure of the country doctor-surgeon with a novel idea, who then somehow convinced a skeptical university professor to give him a chance to pursue it. Then there was the freshly graduated student, who assisted the would-be researcher through a hot summer of laboratory experiments to surprisingly succeed in isolating the elusive internal secretion and show it could control diabetes in dogs. Or there was the expert visiting biochemist who expedited the extract’s purification and successful testing in human diabetics.
More remarkably, this monumental discovery took place in Canada and not in the prominent universities of Europe, the United Kingdom, or the United States. But perhaps most compelling and dramatic — especially at a time when the power of medicine to effectively treat disease and prevent death remained quite limited — was that with discovery of insulin, diabetics on death’s doorstep were literally resurrected and restored to normal lives as long as they maintained their insulin injections several times each day. To historians of all stripes, this was, and remains, an irresistible story to tell.
The first to recount the history of the discovery of insulin was a Toronto Star newspaper reporter. Journalists are often the writers of the first drafts of histories and in first documenting the history of the discovery of insulin, Roy Greenaway was that first journalist-historian, as he later revealed in his memoir. Greenaway had been aware of what Dr. Frederick Banting had been working on through a friend of Banting’s, Dr. G.W. Ross, who was also Greenaway’s physician. In mid-January, 1922, a few days after the first human test of the pancreatic extract, Greenaway wrote, “All through the summer the work was rushed intensively in a little laboratory in the medical building, facing the west and overlooking the circular campus in from of the main building.” The story had begun “only last May” when “Dr. F.G. Banting and Mr. Best concentrated upon the new inspiration” in laboratories over which Professor J.J.R. Macleod had charge. Further historical details of the discovery and the discoverers, especially Banting, were recounted by Greenaway in more extensive newspaper coverage published on March 22nd. This article was based on interviews with Banting, Best and Macleod, and included details from the Canadian Medical Association Journal article about the first clinical tests of the extract.
This initial historical reconstruction of the discovery was quite balanced in recognizing the contributions of Banting, Best, Macleod and J.B. Collip, and was notably reflected in a syndicated photo “of the four Toronto medical men on the University staff who figure most prominently in the discovery of a pancreatic extract to be used in the clinical treatment of diabetes in human beings.” Through 1922, the focus of press attention shifted to Banting, particularly in the context of his well-publicized treatment of 14-year-old Elizabeth Hughes, daughter of the U.S. Secretary of State.
However, during the fall of 1922, as the discovery story spread beyond North America and to the U. K., medical and press attention shifted more to Macleod’s role in the discovery. This was prompted by news of Macleod, on behalf of the University of Toronto, offering U.K. insulin patent rights to the Medical Research Council. In early September, Prof. W.M. Bayliss, one of Britain’s leading physiologists, and a friend of Macleod’s, touched off public controversy, particularly in Toronto, when his letter to one of the London’s largest newspapers heightened Macleod’s role and downplayed Banting’s. Bayliss had been upset at Canadian news reports that seemed to give all the credit to Banting. Macleod was suddenly pressed by Banting and Best, and a Toronto Star reporter, Greenaway, to agree to a published statement refuting Bayliss’ view and give Banting full credit. However, Macleod’s statement did not satisfy Banting and Best, prompting a further public statement in which Banting highlighted Best’s role.
This public controversy prompted the preparation of what could be called the first official histories of the discovery of insulin. Hoping to resolve the tensions among Banting, Best and Macleod, as well as Collip, and more clearly establish their respective roles in the discovery, on September 16, 1922, the chairman of the University of Toronto Insulin Committee, Albert Gooderham, requested written statements from each, although Collip was no longer in Toronto. They were to describe their own understanding of the discovery events, and also outline how they viewed Collip’s role. Macleod later asked Collip for a list of his contributions. Gooderham received the three documents by the end of September, but nothing was done with them. Indeed, these histories were filed away and all but lost for the next 50-60 years.
The first serious historical criticism of the discovery of insulin work emerged in December, 1922, although not in Canada, and was based on a close reassessment of the original medical journal publications by Banting and Best. This reassessment was by a physiological researcher in Cambridge, England, Dr. Ffrangcon Roberts, and published in the form of a long letter to the British Medical Journal of December 16, 1922. It was an especially critical, step-by-step, review of Banting and Best’s laboratory work as described in the publications. Roberts focused on the initial experiments that involved ligating the pancreatic duct and the degeneration of the pancreas to remove the powerful external secretion, before being able to extract the internal secretion. Roberts pointed out that this step was ultimately unnecessary, but Banting and Best did not say so, even through several experiments showed it. He also highlighted other problems in the experiments and Banting and Best’s misreading of them, which Roberts felt undermined their scientific credibility. “The production of insulin originated in a wrongly conceived, wrongly conducted, and wrongly interpreted series of experiments,” Roberts concluded. His critique prompted an immediate response by Sir Henry Dale, a prominent member of the U.K. Medical Research Council, in a letter published in the next issue of the British Medical Journal.
Of particular significance to the shaping of the history of the discovery of insulin was the fact that Dale, a close friend of Best’s, did not attempt to refute Robert’s points of criticism. Instead, he concluded his published letter by saying, “There is nothing to prevent Dr. Roberts from putting his own theories to the test of experiment. Nobody can deny that a discovery of first-rate importance has been made, and, if it proves to have resulted from a stumble into the right road, where it crossed the course laid down by a faulty conception, surely the case is not unique in the history of science. The world could afford to exchange a whole library of criticism for one such productive blunder, and it is a poor thing to attempt belittlement of a great achievement by scornful exposure of errors in its inception.” Dale’s conclusion that any critical discussion of Banting and Best’s work amounted to the belittling of what he saw as a great achievement helped establish a stubborn pattern within medical and historical circles in how those with personal connections to the discoverers, and the discoverers themselves, would approach and write about the history of insulin.
In 1927, Banting was awarded the prestigious Cameron Prize for Therapeutics from the University of Edinburgh, and on October 30, 1928, delivered as his Cameron Prize Lecture, “The History of Insulin.” Published in the Edinburgh Medical Journal in January 1928, Banting’s “History” lecture served to provide an authoritative recounting of the insulin story that few would question. Banting chose to emphasize the role of Best and the difficulties they encountered and overcame in their research work. “So much time has now elapsed since the original work on insulin was done,” he said, “that to me the subject is impersonal and dissociated entirely from my present existence.” During early 1940, a year before he died in a plane crash in Newfoundland, Banting wrote, but did not complete, an autobiographical manuscript he called “Story of Insulin.” It was certainly more personal and less dissociated than his 1928 “History.” However, like his September, 1922, statement to Gooderham, this manuscript remained in his personal papers and inaccessible.
By 1946, and the 25th anniversary of the discovery of insulin, little had changed in how the history of the discovery was depicted since Banting’s 1928 “History of Insulin” lecture. Yet much had changed in who had assumed leadership in telling the history. While there had been some popular books published about Banting and the discovery, the first serious biography of Banting appeared in 1946. Written by Lloyd Stevenson, a medical student/historian, the biography told the familiar story, although with some candor, particularly since Banting and Macleod were both dead; (Macleod, who left Toronto in 1928, died in 1935.) Best and Collip were still alive, but it was Best who assumed leadership in often telling the history of insulin story, emphasizing his role and partnership with Banting while limiting attention to the contributions of Macleod and Collip.
Into the 1950s, and despite Banting and Macleod’s absence, other direct and indirect participants in the insulin story were still alive and influential. Indeed, as Michael Bliss recognized while researching The Discovery of Insulin, the oral history about the discovery was more interesting than what had been written. There was gossip among many in the Toronto medical community, with discussions loosened by gatherings and drinks. It seemed that many who had been in and around the University of Toronto in 1921-22, whether professors, medical students, residents, nurses, and their friends, had stories about what had really happened and what Banting, Best, Macleod, and Collip had fought about. Much of the gossip could be traced back to the discoverers themselves, each of whom could be talkative at times. Collip was the most discreet, particularly as he had left Toronto in mid-1922 for Edmonton, then moved to McGill University in Montreal in 1928 and eventually settled at the University of Western Ontario in London as Dean of Medicine in 1947. Still, Collip was known on occasion to talk about the insulin days. There was an assumption among both insiders and outsiders that the historical truth would eventually come out, especially after all of the principals had passed away. Some also knew, or assumed, there were collections of significant unpublished documents hidden away in private papers or archives.
During the early 1950s, Best was quite active in telling his version of the history, and was supported by Sir Henry Dale, who nominated Best for the Nobel Prize in 1950. Dale was also asked to give an address at the opening of the Best Institute at the University of Toronto in 1953, erected next to the Banting Institute building. In his address about the discovery of insulin story, which focused on Banting and Best, Dale did not mention Collip, although, as Dale later learned, Collip had been in the audience. Embarrassed and curious, Dale wanted to learn more about Collip’s role, did some research, and then asked Best about it. Dale wanted to get the story right.
By the mid-1950s, others were also suddenly interested in getting the insulin story right. An American doctor-historian, Joseph H. Pratt, with a long interest in diabetes and the pancreas, first broke the critical silence about the history of insulin in an article published in 1954 in the Journal of the History of Medicine. Entitled, “A Reappraisal of Researches Leading to the Discovery of Insulin,” the article condensed a longer manuscript he had circulated for several years. But, as Bliss discovered in his research, in order to publish, Pratt had been asked by the editors and reviewers to tone down his manuscript so as not to open up old wounds. Nevertheless, Pratt’s published article was a significant critical review of the insulin work that built on some of Robert’s criticisms of the original published articles by the Toronto group, while also highlighting Macleod and Collip’s contributions to refining Banting and Best’s experimental errors and their crude extract. Pratt concluded that all four men worked as a team and each made important contributions.
At about the same time, the Metropolitan Life Insurance Company was interested in sponsoring a production of a filmstrip about the discovery of insulin, while the National Film Board of Canada wanted to produce a feature film. Filmstrips, a series of still images projected like slides, but on a strip of 35 mm film, were an inexpensive alternative to 16 mm educational films. The producers of both projects approached Best for advice and also hired as consultant a close friend and colleague of Best’s, Dr. W.R. Feasby, who was an historian of medicine. The initial drafts for both projects were sent to Best and Feasby for comment. They emphasized Banting and Best’s work in 1921, pointing to the published and unpublished record that established there was convincing proof during that summer of the presence of insulin when they worked alone; there was no mention of Macleod or Collip.
However, the film’s scriptwriter, Leslie MacFarlane, complicated the history Best and Feasby presented after he gained access to Banting’s 1922 statement to Gooderham, as well as his 1940 manuscript, through Banting’s widow, Henrietta. MacFarlane was also able to study some of the original lab notebooks. While Best tried to explain the obvious historical discrepancies, Collip had also heard about the projects. With support from the president of the University of Western Ontario, Ed Hall, who had also been a colleague of Banting’s, Collip insisted that it would be inadvisable to resurrect the numerous issues around the discovery story while any of the principal figures were still alive. The sponsor of the filmstrip thus pulled its support, and after further discussions with Best and Feasby about what to include, the National Film Board decided to scale back the film project quite drastically. In the end, in 1958, the NFB released a short film entitled “The Quest,” which nevertheless simplified the story and glorified Banting and Best. At about the same time, Feasby wrote a harsh reply to Pratt’s 1954 article that was published as “The Discovery of Insulin” in the Journal of the History of Medicine. It attempted to reinforce the Banting and Best focused narrative, although with some credit of help given by others.
During the 1960s, Best’s control of the discovery of insulin narrative continued, particularly after both Pratt and Feasby died, and following the death of Collip in 1965. Feasby had left an unfinished biography of Best, and Henrietta Banting also passed away leaving an unfinished biography of her late husband. An effort to prepare a Collip biography also went nowhere. In addition, Banting’s earlier biographer, Lloyd Stephenson, had obtained Macleod’s 1922 statement to Gooderham, which he wanted to publish at the same time as Feasby’s article. Macleod’s statement had gone to Scotland with Macleod, but in 1949 had been sent to the President of the University of Western Ontario, and a copy sent to Stevenson, who later sent a copy to the president of the University of Toronto, Sidney Smith. But when Stevenson asked for permission to publish Macleod’s account of the discovery, Best advised Smith to deny the request on the grounds that all of the 1922 statements should be published together. However, Best was unable to locate his statement and Stevenson gave up.
By the late 1960s and early 1970s, as Best and his version of the history remained the focus of attention during the 50th anniversary celebrations of the insulin discovery, there had been a growing interest in the broader insulin story in Europe, led by the work of Ian Murray, a medical historian in Scotland. Murray’s interest was less on the Toronto story and more on the earlier pancreatic extract research, particularly by Nicolas Paulesco of Romania. In 1921, just as Banting and Best were getting started in the laboratory, Paulesco had published several significant papers that described his animal and human experiments with pancreatic extracts, the latter with limited effect. However, as the Toronto insulin team moved quickly into human testing and production, Paulesco was unable to begin serious clinical tests of a material he prepared called “pancréine.” Nevertheless, there were historians and others in Romania and elsewhere in Europe who supported a more prominent place for Paulesco’s work in the discovery of insulin story, some going so far as to suggest a conspiracy to cheat Paulesco out of his rightful share of honour and prizes, especially the Nobel Prize.
During the late 1970s, the attention of historians to Paulesco and other early pancreatic extract research work pointed to both the limits in the existing historical scholarship and original documentation about the Toronto events of 1921-22, as well as to the unresolved historical controversies about Banting and Best’s laboratory research. The death of Charles Best, on March 31, 1978, finally opened the doors, particularly at the University of Toronto, to the release of at least some of the original documents related to the discovery of insulin, particularly Banting’s papers. Stevenson was also able to finally proceed with the publication of Macleod’s 1922 statement in the Bulletin of the History of Medicine in 1978.
Best’s death and the availability at the University of Toronto archives of a hitherto unexamined collection of primary documents related to the insulin, allowed Michael Bliss, University of Toronto history professor, to proceed with research that led to publication of The Discovery of Insulin. Bliss’ interest in the subject was sparked in early 1968 by his older brother, Jim Bliss, then a physiology professor at McGill, who had been told by a would-be biographer of Collip that all of the unpublished documents related to the discovery of insulin would become available after Best’s death. Indeed, Jim Bliss told his brother, then a graduate student, that “the Medical Research Council has a secret file of documents concerning the events surrounding the discovery of insulin – these to be released to historians when the last man involved dies – and Charlie Best is in poor health and is the last man. The true story is sure-fire for a popular but accurate book, not just for its scientific interest but for the violent clashes of personalities that accompanied the discovery. The combination of an historian and physiologist would seem the ideal team for the story.” Sadly, Jim Bliss died in 1969, leaving Michael to lament in the introduction of The Discovery of Insulin, “This would be a much better book if he had lived to help write it.”
Bliss was determined to recreate the discovery of insulin story from contemporary, or primary sources, and set aside the judgements of later writers, as well as the subjective recollections of the discoverers themselves, at least until he could learn from documents generated at the time what exactly had happened. U of T held Banting’s papers and was in the process of opening them to scholars when Bliss began his research. Bliss also sought original documents beyond Toronto. It seemed the more he looked and inquired, the more he found and was able to access, including the archives of the Nobel Committee in Sweden.
Bliss collected original correspondence, published articles, newspaper coverage, much of it pasted in Banting’s scrapbooks, and carefully studied and transcribed Banting and Best’s original laboratory notebooks to painstakingly trace each step and each experiment, day-by-day and dog-by-dog, they did during the summer and fall of 1921. Also significant were the extensive records of the U of T Insulin Committee, the papers of the Medical Research Council in the U.K., the archives of Eli Lilly in Indianapolis, records from Connaught Laboratories, and an extensive collection of letters written by Elizabeth Hughes before, during, and after her insulin treatment in 1922. After gathering as broad a collection of such primary documentation and conducting interviews with as many people as he could with a connection to the events related to the insulin story, Bliss could then “reflect on the fallibility of the participant’s memories and validity of the scientist’s claims and counter-claims.”
After the publication of The Discovery of Insulin in the fall of 1982, amidst the 60th anniversary celebrations, Bliss frequently said that he unearthed no further primary documentation of significance. However, soon after his book was published, Bliss discovered that one of the first diabetic patients treated by Banting in 1922, Teddy Ryder, was still alive and he was able to meet with him, as well as his mother. A Toronto Star reporter joined the meeting and wrote a feature article about it that was published on February 20, 1983. In October, 1990, Ryder was invited to Toronto for the opening of a discovery of insulin exhibit at the University of Toronto.
While Bliss was researching and writing The Discovery of Insulin, he was preparing to write Banting: A Biography, which was published in 1984. He also wrote many articles about various aspects of the insulin story, the most important of which was “Rewriting Medical History: Charles Best and the Banting and Best Myth,” published in the Journal of the History of Medicine in 1993.
Since the publication of The Discovery of Insulin and Banting: A Biography, other historians have written biographies of Collip, Best and Macleod, as well as a wealth of articles that explore a variety of other aspects of the insulin story. Research on the discovery of insulin has been made much easier since the 2002 launch of the comprehensive digital archives by U of T’s Thomas Fisher Rare Books Library; the archives is called “The Discovery and Early Development of Insulin,” and has been an indispensable resource for the Defining Moments Canada “Insulin 100” project. However, Bliss’ central argument of The Discovery of Insulin remains broadly accepted, which, as embodied in the title of a highly regarded 1988 CBC-TV mini-series, was that in the discovery of insulin, there was “glory enough for all.”
Sadly, Michael Bliss did not live to see the 100th anniversary of the events his book so vividly and painstakingly documents. Before his death on May 18, 2017, he had been revisiting original documents upon which he based his book, as well as some others collected since, in support of a 100th anniversary edition and additional writing about the insulin story. As significant as The Discovery of Insulin is as a foundational work, the history of the history of the discovery of insulin that led to Bliss’ book, and in the years since, reveals much about how the events, personalities, and vagaries of history can shape the understanding, telling, and doing of history.