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Fig. 6. Summary of Scott’s experiments in his thesis [14].
Summary: Intravenous injections of the pancreas extract, prepared as above, into dogs rendered diabetic by complete pancreatectomy diminish temporarily the sugar secretion and lower the D/N ratio in the urine. It does not follow that these effects are due to the internal secretion of the pancreas in the extract. The injections are usually followed by a temporary rise of the body temperature, and this may be a factor in the lower sugar output. Physiologists are not agreed as to whether the internal secretion acts by diminishing or retarding the passage of sugar from the tissue into the blood, or by increasing the oxidation of the sugar in the tissues. The pancreas extract may decrease the output of sugar from the tissues by a toxic or depressor action of the pancreas secretion. If this is the case, we ought to get the same results by extract of other tissues.
The position in Kansas was unpleasant and eventually Scott went to Columbia University in 1912. Probably in 1913, Scott tried to raise the interest of Prof. J.J.R. Macleod, already an important figure in research on glucose metabolism. However, Macleod, who was still working in the USA at the time, did not hire the young man who might have helped him to get the Noble Prize a decade earlier. Scott became Professor of Physiology at Columbia University, retired in 1942, and died in 1966.
Following the introduction of the insulin treatment of diabetes Scott wrote a letter to JAMA, explaining his scientific priority concerning the method to produce insulin from pancreas tissue, which was published in 1923 [16]. He did not, however, oppose the US patents granted to the Torontonians.
In December 1922, Dr. Roberts from Cambridge criticized the early studies by Banting and Best and pointed out the priority of Scott’s work in a letter to the British Medical Journal [17]. A reply appeared a week later in the BMJ written by Prof. Dale, who was awarded the Noble Prize in 1936 together with Otto Loewi: “He [Roberts] did not know that the work he attacks was the first, unaided attempt at research by two young enthusiasts; that one spent half the war as a combatant, and the rest, after being seriously wounded, as a medical officer in England, while the other had not even yet completed his student course. He had no conception of the personal sacrifice and the heroic labor in which their enterprise involved them. Working thus on their own initiative, without the invaluable help and cooperation, given later by the head of the laboratory, who, happened to be in Europe, when the earlier work was done, they may have wandered along a wrong trail for a time, though this has yet to be proved. It may be that they made an unnecessary detour, before finding themselves at the point where E.L. Scott had stopped” [18]. The fact that Scott stopped is the truth, but Banting’s service in the British Army has nothing to do with the scientific priority. Otherwise, to be fair, Dale should have mentioned that Scott volunteered to serve in the US Army and returned home from the war in France with tuberculosis.
Fig. 7. Book about Paulescu by Prof. Pavel [21].
Scott formally denied the authorship of the 1912 “Carlson” paper in 1964. It is quite unusual to deny authorship half a century after a publication [14]. His second wife published his biography in 1972. In the notes to his book on the discovery of insulin, Michael Bliss mentions that her “extreme claims are undercut by the published papers and by unpublished letters” without providing details [13, p. 250]. Reading Aleita Scott’s book, one gets the impression that the Torontonians were sadly unable to share a bit of their glory with their unhappy precursor – Banting and Macleod were too busy arguing aggressively about the value of their own contributions to the discovery of insulin – a bit more modesty would have suited both of them. They should have considered what the famous author (and medical doctor) Friedrich Schiller stated at the end of his inaugural lecture as a professor of history at the University of Jena: “To each merit is opened a path to immortality, to true immortality I mean where the work lives and continues, even if the name of its author should be left behind” [19].
Nicolai Paulescu: A Misquoted Discovery and Embarrassing Political Activities
Nicolai Paulescu (Fig. 7) was born in Bucharest in Romania on October 30, 1869 – the same year as Paul Langerhans published his thesis discovering the islets in the pancreas. Paulescu was the eldest of four children, one brother became a general in the Romanian Army. His parents were part of the very wealthy bourgeoisie in Bucharest and Nicolai received an exceptional education. He was fluent in ancient Greek and Latin and his French was perfect [20]. Romania’s intelligensia was closely related to France and therefore Paulescu took up his medical studies in Paris in the autumn of 1888 – the same year Oskar Minkowski moved from Königsberg to Strasbourg. In 1891 he passed, with honors, the exam to become intern at the Hôtel Dieu hospital, a renowned center for diabetes research and care since the time of Apollinaire Bouchardat. His thesis on the spleen was considered to be excellent and he graduated at the Sorbonne in Biochemistry and Physiology. Paulescu graduated in 1897 as an MD and worked in Paris at the Hôpital Notre-Dame du Perpétuel-Secours headed by Prof. Etienne Lanceraux, one of the most famous French physicians at this time. Both became friends and together published a textbook of medicine with nearly 4,000 pages [21]. Lanceraux believed in the pancreatic origin of diabetes. In several publications, starting in 1877, he argued for the existence of two forms of diabetes, one of them being pancreatic diabetes [22, 23]. Paulescu’s research activities covered many areas resulting in numerous publications. His greatest success was the development of a new method to remove the pituitary gland in animals by an intracranial subtemporal route. Harvey Cushing described Paulescu’s results as “by far the most important contribution to the subject” and Cushing used Paulescu’s method in neurosurgery which made him famous [20]. Motivated by Prof. Albert Dastre, Paulescu commenced work with the objective of isolating and studying the “active substance of the internal secretion of the pancreas,” but there are no publications about these experiments [24]. Dastre held the Chair of General Physiology at the Sorbonne, following Claude Bernard and Paul Bert.
In 1900, Paulescu returned to Romania where he had been appointed assistant professor of physiology. In 1904 he became Head of the Physiology Department of the Bucharest University Medical School. However, he needed the contact to clinical medicine and therefore served, in addition, as consulting physician at the St. Vincent de Paul Hospital.
In Bucharest Paulescu continued his research on the pituitary gland. However, inspired by the publications of Zülzer in 1908, he chose to return to diabetes research. In 1916, he observed that an extract he had produced from pancreas tissue improved metabolic control in pancreatectomized dogs. Alas, bad luck and political upheaval would intervene. In 1916 a new King was crowned in Romania and the country entered into the First World
