NOW HOPED THAT INSULIN
WILL BE PERMANENT CURE|
Professor MacLeod Emphasizes Possibility in Notable Address
Before Detroit Medical Convention "The Greatest
Thing of the Age." Says One Authority.
PATIENT TELLS HOW HE WAS BENEFITED
Detroit,Jan. 30. Medical Detroit
Last night paid tribute to the Toronto discoverer of insulin, the epoch-making treatment for diabetes. It welcomed Dr. F. G. Banting, and Prof. J. J. R. MacLeod with the heartiness for which it is noted over the continent. Toronto scarcely yet has begun to realize the international importance of the discovery made by this young Ontario man, worked out in the University laboratories with the aid of C. H. Best, and the supervision and co-operation of Prof. MacLeod and hi associates. Only from the perspective of such a welcome in a strange city, known for the high reputation of its medical men, does the full realization of insulins really stupendous possibilities strike home. It is no turtle serum charm for tuberculosis, no magic monkey gland grafting, but the genuine, established extract that transforms wasted sufferers from an agonizing scourge, back to a condition almost normal in every way in a few weeks and may possibly provide a permanent cure without life-long continuance of the injections.
Possibility of permanent Cure.
It was this very possibility of an ultimate permanent cure that was emphasized by Prof. MacLeod in his lecture last night before the Wayne County medical Society, in perhaps the strongest statement that has yet been made on the subject by any to the principals engaged in the experiments with insulin. At least, it seemed that way. In details, hitherto not disclosed, he outlined the reasons for this great hope. He indicated the fascinating conditions, already observed but almost untouched yet by concentrated research, upon which are based the instinctive belief of some research men that, given a complete rest by the administration of insulin, the pancreas will function normally again without further treatment.
All other scenes of the evening were secondary to that. It was near the end of Prof. MacLeods lecture. It had not the appearance of a rash statement. The professor was, if anything reserved. He was in reality, only giving the laboratory reasons for the tendency of a real cure, emphasized in the recent article by Dr. Banting and his two associated clinicians at the Toronto General hospital and noted form the standpoint of results observed on the physical condition of the patients there.
Basis of His Hope.
Professor MacLeod based this hope on the ductile system of the pancreas, which has shown strong evidence of being able to produce an islet of Langerhans tissue to replace what has already degenerated. This pancreas is resting as a result of the insulin injections. Since it is the isles of Langerhans tissue which produces the anti-diabetes agent, the newly manufactured tissue made by the ducts takes the natural place of the insulin, producing once again its own diabetic extract.
Above all, as modest a man as Dr. Banting, Prof. MacLeod, later on in an interview, tried to under-emphasize the statements he had made in his lecture, both by word and lantern slide, but there was no appreciable difference in the first and the second, as a verbatim account will show. In his lecture the professor, after describing the duct system and showing the new isles of Langerhans tissue it produced, by means of sections from specimens mounted on lantern slides, made the following summary: Does that mean to say that there may be a possibility in adults to have a regeneration of islet tissue, after most of the original islet tissue has been diseased? It would seem that way from the slides I have shown. Then there is the possibility of a cure. It means that, if the pancreas can have a rest, the islet will often spring from the outer duct cells. They often take their origin from outgrowths.
A Second Explanation.
Here is his second explanation: Isles of Langerhands tissue can be regenerated much more than is at present thought, and, if the pancreas is rested by giving insulin, it might be possible to a certain degree that a cure could be effected.
It was a night of thrills. Even a visitor from Toronto, who knew no medicine, could have understood the significance of most of the statements. Such a visitor might, by chance, have talked with one of the very people whom insulin is transforming, as if by magic, from emaciation and lethargy to former fullness of flesh and springy stride.
In this gathering of 700 doctors was one who is the outstanding specialist on diabetes in the city, I learned later on. Beside him was a tall young man, with dark hair and that characteristic American appendage tortoise-shell ones and have them good and dark. But his eyes were shining inside the dark rims, but no brighter than those of a young woman who sat by his side.
When they finally succeeded in shaking hands with Dr. Banting and Prof. MacLeod, it was a chance remark overheard that disclosed this drama of a few quiet words.
No one of the 700 knew but it was a situation of which drama is made. The discoverer of insulin was meeting the only benefited, so far, in Detroit. It was easily the discoverer who was most embarrassed, listening to these few quiet words of almost inexpressible gratitude.
A Patient Interviewed.
It was interesting talking to a patient, for hitherto no patent has been directly interviewed. What could a mean feel but inexpressible gratitude when he had gained fifteen
Pounds with five injections? He said he had been taking insulin only a week. He told of the terrible lassitude of diabetes having gone as I by magic.
You feel well?
He laughed for a reply, finding it difficult to describe the change by words.
And do you find no bad effects?
No; there have been absolutely no toxic effects.
But I mean a local reaction following the injections at the point where the needle went in?
The young lady smiled gratefully too. There wasnt any discomfort from the injection, he said, he took them under the skin on the arm.
Give all the credit to the Toronto doctors and Dr. Went, he continued. This is Dr. F. C. Went, who has an office here in the David Whitney Building, occupied entirely by physicians, of which the new building on Bloor street will be a Canadian example.
Had Been a Severe type.
Dr. Went coming up said he had been lucky enough to secure the insulin extract from the Eli-Lilly Co., of Indianapolis, the American producers to whom permission has been granted to manufacture by an arrangement for protection of public with the University of Toronto. His patient, he confirmed, had been a severe type. The transformation form the use of Insulin in one week with only five treatments was almost incredible. Its the biggest thing of the age, he declared without reservation.
Representatives from the whole of Michigan have gathered to hear Prof. MacLeod and Dr. Banting, who will remain for two days, the former speaking again this morning and the latter tonight.
Upon the invitation of the Wayne County Medical Association, as it is called from its origin in one of the oldest parts of the state, long ago incorporated in the city, the two Toronto doctors arrived on Monday afternoon after some adventures. The derailment of a coach at Windsor provided mild excitement and a delay in crossing through the tunnel to the Michigan station where two members of the medical associations entertainment committee took the two Toronto men in charge.
Woodward Avenue is the Yonge street of Detroit a very wide one, it must be confessed slicing the city from north to south. Up at about an imaginary Wellesley street, here in Detroit is east high street and a few doors east of the rushing main street on the north side, is the Wayne County Medical Association Wellesley street is a good comparison, for the association headquarters are situated in a big double mansion, like two of the high-ceilinged old houses on Wellesley street joined into one.
Why Speakers Were Chosen.
Here, last night, the light poured out of every window across a sheet of icy sidewalk and vacant lot. Here one hundred physicians from Detroit, the state of Michigan and the two guest counties this year of Lucas county, Ohio, and Essex county, Ontario, dined the guests. Later on they adjourned to the main auditorium in the basement, representing the little theatre of hear house on a smaller scale. Here a hundred blue twills floated up and spread out into a dense smoke screen before the president, Dr. D. Donaldson, introduced Professor MacLeod and explained the Beaumont foundation lectures and why the two guests had been chosen to speak this year. Toronto has a place in the medical firmament at present. We went over the field very thoroughly to cover the most marked advances in medical science, said Dr. Donaldson, and after looking closely we sent an embassy down to Toronto. Toronto is actually ringing with energy, the embassy reported upon its return. It is actually like a Ford factory.
Even the investigation of the university affairs by the special committee had been noted here, and was referred to by the president, The Toronto medical faculty is making its way over somewhat troubled waters, he explained, and at its head is a rather little man but with the head of a giant. Reference was made to Professor MacLeod as the master brain who was co-ordinating all the varied research work being done on insulin, and to his previous academic fame in Edinburgh and the western reserve university. In the work done in his laboratory we feel that the world is about to receive the supreme solution to something that has occupied its attention for centuries.
The Hungry Dog.
Professor MacLeods lecture was preparatory to the account of the experiments which led up to the discovery of insulin at the university which he will give today. He did not occupy the raised platform, but
HOPE M INSULIN
IS PERMANENT CURE
Continued from Page 17.
simply used a desk on the floor of
the auditorium for a few notes, and
Dr. Banting occupied a seat in the
audience. Both men received sustained applause.
The history of the experiments
first by investigators in Europe, and
finally on this continent, which paved the way
for Banting's dicovery were outlined.
Brunner, a German, discovered as far back
as 1682 that removing the
pancreas of dogs caused all the
symptoms of the disease, that it
went back so often to its master to
steal bones, that he tried to persuade
the investigator to kill It.
Brunners experiments, however, led to nowhere in particular. He decided that the pancreas was not essential to digestion. The effect was that for over 100 years nobody sought to go on to find that organs functions.
It was Claude Bernard, the great master and founder of modern physiology, who discovered the function of the pancreas in digestion in 1856. Since his time opinion steadily gained ground that the derangement of the pancreas had something to do with causing diabetes. The champion of the importance of the use of animals for experimentary purposes and the necessity of laboratory investigation, Prof. MacLeod stressed that point.
Must Watch at Bedside.
Clinical observation and laboratory investigation must go together, he said. The notion is wrong that the laboratory man shuts himself up behind his doors and gets away from the patient. His doors are open. He must work hand in hand with the clinical investigator. He must watch the history at the beside. I think the history of diabetes has shown this fact more than anything else of which I know.
He trace the developments; how the islets of Langerhaus ad been discovered, a perculiar collection of cells in the pancreas; how the anatomists had done one important thing at least by suggesting that the removal of the islets of Langerhaus might cause diabetes. How the discovery of an internal secretion of the thyroid and the superarenal glands heightened this probability.
But this supposition could not be considered final until symptoms of the disease had been removed by administering an extract into human beings.
Up to that time, Professor MacLeod pointed out, the supposition was only experimental. Without such administration of an extract the condition could be ascribed to a local action in the blood which changed the blood. Banting caught the pancreatic hormone (or agent), which regulates the assimilation of carbohydrate or sugar forming foods. Two men, at least, almost caught that elusive agent before Banting; Zeugler, the German, in 1908; and Rennie and Fraser, Scotch, after that.
Zuezler really produced an extract but it caused overwhelming toxic or poisonous effects. This must be called an abandoned treatment, said the professor decidedly, although it was a touch-and-go thing.
Rennies and Frasers were abandoned, too, for the same reason, but it was almost a calamity they did not go on, added Professor MacLeod. They just about caught the elusive thing.
The search was really transferred to this continent by E. L. Scott, then working in Chicago. He prepared extracts of the pancreas with alcohol, but they changed to alkali. He made a mistake, in my judgement, of using the wrong medium, explained Professor MacLeod. Then in Chicago ligation of the ducts of the gland was successfully carried out. Two kinds of cells were discovered: acinal and the islet cells.
To R. R. Bensley, of Chicago, probably the greatest anatomist on this continent, said Professor MacLeod, belonged the honor of discovering in detail a great deal about the islets of Langerhands. How essential a dye may be to an anatomist was proved by Bensley, who by this means and the right medium discovered two kinds of cells in the islets, namely Beta and Alpha cells. There is a third kind also, the Gama cell, but it is of minor importance. Bensleys assistant, martin, went one better, and by an improved stain showed definitely that the internal secretion is the Alpha cells.
Bantings and Bests experiments depended upon a successful experiment by Professor McCallum, at Chicago, said Professor MacLeod. He it was how isolated the islets of Langerhaus and seven months afterwards took out the other part of the main gland. There were no symptoms of diabetes. This experiment showed that the islet tissue produces the anti-diabetic agent or hormone.
Banting suggested making extracts from the ligatured isle of Langerhaus. When his final extract was injected into dogs, made diabetic by being depancreatized, the symptoms were decreased.
MacLeods tribute to Associates.
A vast new field of metabolism (the assimilation of nutriment by the whole body) had been opened up then, said Professor MacLeod.
He explained a strange coincidence about the name of insulin, which he himself chose for Bantings extract. It was without ever having known that Sir Edward Schafer had suggested this as the proper name, sometime before in an article, when forecasting the day the extract would finally be discovered.
Banting and Best have blazed the trail that we others fortunate in being associated with them are following to make as substantial a road as possible into this new field of discovery which may apply to other metabolic diseases in many ways.
It was in this way that Professor MacLeod paid tribute to his two famous students.