Frederick Banting: A Life in Five Chapters

Chapter 1 · A Farm, a War and a Failing Practice

The least likely person to make a discovery

1891 – 1920 · Alliston, Ontario · Toronto · Cambrai · London, Ontario

Frederick Grant Banting was born in November 1891 on a farm near Alliston, Ontario, the youngest of five children. He was sent to university to study divinity, failed his first year, and switched to medicine.

He graduated early, in December 1916, because the war had accelerated the course, and went straight to France as a battalion medical officer. At Cambrai in September 1918 he was hit in the right forearm by shrapnel and went on treating wounded men for something like sixteen hours; a surgeon later wanted to amputate the arm and Banting refused. He was awarded the Military Cross.

He came home with a damaged arm and no money, and in 1920 set up as a general practitioner in London, Ontario. The practice failed. In his first month he took in four dollars. To fill the time and earn something he took a part-time post demonstrating anatomy and physiology at the University of Western Ontario.

This is worth holding on to. Banting had no research training, no laboratory, no publications, and no reputation. He was a country doctor with an empty waiting room who had been given some teaching to do.

On the evening of 30 October 1920 he was preparing a lecture on the pancreas, and read an article by Moses Barron describing a case in which a stone had blocked the pancreatic duct and the digestive portion of the gland had wasted away — while the small islands of tissue scattered through it survived.

“Insulin does not belong to me, it belongs to the world.”

— Attributed to Frederick Banting on the sale of the insulin patent

Why this matters

The insulin discovery was made by a man with no research training whose practice had failed, which is a useful corrective to assumptions about where discoveries come from.

You have the failed practice and the article read at midnight. What would you ask?

Ask Banting

• “What happened to your arm at Cambrai?”
• “What was it like taking four dollars in a month?”
• “What did Barron's article actually describe?”
• “Did having no research training help or hinder you?”
• “Why were you preparing a lecture on the pancreas at all?”

Chapter 2 · The Note at Two in the Morning

Twenty-five words, and an idea that was partly wrong

1920 – 1921 · London, Ontario · Toronto

Banting woke in the night and wrote down an idea. The note survives, and it is about twenty-five words: ligate the pancreatic ducts of a dog, keep the animal alive until the acini degenerate, then remove what remains and extract it.

The reasoning: the pancreas has two jobs. It makes digestive enzymes, secreted through a duct into the intestine. And it makes something that controls blood sugar — a substance nobody had isolated, because every attempt to extract it produced a preparation ruined by those same digestive enzymes, which destroy it during preparation.

So: tie off the duct. The enzyme-making tissue degenerates for want of an outlet. The islands of Langerhans, which secrete into the blood, survive. Now extract, with no enzymes present.

The idea is real and the reasoning is clear. It is also, in an important respect, wrong: later work showed the duct ligation is not necessary, and cold-acid extraction from an ordinary pancreas works perfectly well. Banting's premise was more elaborate than the problem required.

He took the idea to J. J. R. Macleod, professor of physiology at Toronto and a leading authority on carbohydrate metabolism. Macleod was unimpressed — the idea had essentially been tried before — but Banting was persistent, and Macleod eventually gave him what he had spare: a small laboratory for the summer of 1921 while he was away in Scotland, ten dogs, and one student assistant.

There were two students available. They tossed a coin. Charles Best won and took the summer.

Why this matters

Banting's founding idea rested on a premise that turned out to be unnecessary — which did not stop it leading to the right result.

You have twenty-five words and a coin toss. What is your question?

Ask Banting

• “Talk me through the reasoning in your midnight note.”
• “Why had earlier attempts to extract it failed?”
• “The duct ligation turned out to be unnecessary — does that matter?”
• “What did Macleod actually think of you?”
• “A coin decided your collaborator — what if it had landed the other way?”

Chapter 3 · The Summer of 1921

Ten dogs, no salary, and a hot laboratory

May – November 1921 · Toronto

Banting sold his car to live on. Neither he nor Best was paid.

The work was surgically demanding and it went badly at first. Duct ligation in a dog is difficult; several of the first animals died of infection or of the surgery itself. It was an exceptionally hot Toronto summer and the laboratory was on the top floor.

By late July they had an extract from a degenerated pancreas. They gave it to a dog whose pancreas had been removed entirely and which was therefore dying of diabetes. Its blood sugar fell. The dog rallied. Repeated injections kept it alive.

That was the result. They called the extract *isletin*; Macleod later renamed it *insulin*, from the Latin for island — a name that had in fact already been proposed by others.

Many dogs died in the course of this work, and it should be said plainly.

When Macleod returned he was persuaded, put more of the department behind it, and brought in James Collip, a skilled biochemist. This was the decisive addition. Banting and Best's extract was crude and impure; injected into a human it caused sterile abscesses and severe reactions. Collip developed a fractional alcohol precipitation that removed most of the contaminating protein and produced something fit to give a patient.

Relations collapsed almost immediately. At one point Banting and Collip came to blows in the laboratory over whether Collip would disclose his purification method.

Why this matters

Collip's purification was what made insulin usable in a human being, and it is routinely left out of the story.

You have the dogs, the heat and the fight in the laboratory. What would you ask?

Ask Banting

• “What happened when the first extract went into a diabetic dog?”
• “How many dogs died to get there?”
• “What did Collip do that you and Best could not?”
• “Did you really come to blows with Collip?”
• “How did you live with no salary all summer?”

Chapter 4 · Leonard Thompson

January 1922, and a ward of dying children

1922 – 1923 · Toronto General Hospital

Before insulin, type 1 diabetes in a child was a death sentence with a short interval. The only treatment was a starvation diet, which extended life by months at the cost of leaving the patient emaciated. Children were brought to hospital to die, and often did so within weeks.

On 11 January 1922 Leonard Thompson, fourteen years old and weighing about sixty-five pounds, was given the first injection at Toronto General Hospital. It was Banting and Best's crude extract, and it barely worked: his blood sugar fell slightly, and he developed an abscess at the site.

On 23 January he was given Collip's purified preparation. His blood sugar fell to near-normal, the sugar and ketones vanished from his urine, and he became visibly stronger. He lived another thirteen years.

What followed on the wards is the part people remember. Doctors went through the diabetic ward injecting comatose children one after another, and by the time they reached the last bed the first children were waking up. Parents who had come to watch a child die watched them sit up instead.

The patent was assigned to the University of Toronto. Banting, Best and Collip each sold their rights for one dollar. Banting's position was explicit: a doctor should not profit from a discovery that saves lives, and no company should be able to control the supply.

It is worth noting the outcome honestly. The dollar patent did not permanently keep insulin cheap — modern insulin analogues are patented separately and are expensive, and access remains a live problem. What the decision did was ensure that the original could be manufactured widely and quickly by anybody competent.

Why this matters

Assigning the patent for a dollar meant insulin could be manufactured immediately by anyone competent, which is why it reached patients worldwide within two years.

You have the ward and the dollar. What is your question?

Ask Banting

• “What happened on the diabetic ward that day?”
• “Why did the first injection fail?”
• “Why sell the patent for one dollar?”
• “Insulin is expensive now — what would you say about that?”
• “What was diabetes treatment before you?”

Chapter 5 · The Prize and the Quarrel

A Nobel divided in anger, and a crash in Newfoundland

1923 – 1941 · Stockholm · Toronto · Newfoundland

The 1923 Nobel Prize in Physiology or Medicine went to Banting and Macleod. Banting was the youngest laureate in the category and the first Canadian.

He was enraged. Best, who had worked beside him all summer for nothing, was omitted. Banting's first reaction was reportedly to refuse the prize; he was persuaded not to, and announced instead that he would share his half of the money with Best. Macleod then announced he would share his half with Collip.

The question of credit has been argued ever since, and there is a defensible answer: all four contributions were necessary. Banting had the idea and the persistence. Best did the work beside him. Macleod supplied the laboratory, the expertise, the interpretation and the departmental weight — and Banting's lifelong hostility to him is generally regarded by historians as unjust. Collip made it usable in a human. Remove any one and it does not happen in 1922.

Banting never accepted this. The feud with Macleod lasted until Macleod left Canada.

He was knighted in 1934, headed a research institute in Toronto, and spent the 1930s on work — cancer, silicosis, aviation medicine — that never approached the significance of the summer of 1921. He was involved in developing a flying suit to counteract the effects of high acceleration on pilots.

On 21 February 1941, on wartime service, his aircraft crashed in Newfoundland. He survived the crash with severe injuries and died the next day, aged forty-nine.

A flame lit in his memory at Alliston is to be extinguished when diabetes is cured. It is still burning.

Why this matters

The insulin discovery required four people and produced a lifelong feud, which is a fair illustration of how badly scientific credit maps onto scientific work.

You have the shared prize and the anger about it. What would you ask him?

Ask Banting

• “Was your anger at Macleod justified?”
• “Why split your prize money with Best?”
• “How should the credit have been divided?”
• “Why did nothing you did afterwards come close?”
• “The flame is still burning — what would you say to a child with diabetes now?”

What Banting changed

Insulin was the first hormone put to therapeutic use and turned a disease that killed children within months into a manageable condition. The one-dollar patent is still cited whenever the pricing of medicines is argued about. The animal insulin Banting extracted was replaced from 1982 by human insulin made in genetically modified bacteria — a technique that begins with Paul Berg's recombinant DNA and that Banting could not have imagined.

A debate that continues

The division of credit between Banting, Best, Macleod and Collip is still argued, and most historians now regard Banting's lifelong hostility to Macleod as unjust; his founding premise about duct ligation also turned out to be unnecessary.

Keep exploring — ask Banting

• “What should a discovery like this be worth to its finder?”
• “Who else in that laboratory should be remembered?”
• “What would you have needed to make it work sooner?”

Related lives

• Ernest Starling — The Man Who Named the Hormone
• Paul Berg — Who Joined Two Genomes, Then Called a Halt
• Claude Bernard — Father of Experimental Medicine
• Alexander Fleming — Discoverer of Penicillin

Related themes

Hormones and blood glucose · Diabetes · Discovery and credit