The early days of insulin use in Edinburgh.

Abstract

BrMedJ 1990;301:1452-4 The Royal Infirmary of Edinburgh has long been associated with the treatment of diabetes mellitus, particularly with diet and insulin. This has been due more to the teams of workers who came together than to individual specialists, but even more so to the initial impetus when insulin was discovered. Before insulin was successfully isolated by B-anting the existence of an internal secretion of the pancreas that would influence carbohydrate metabolism had been postulated. In fact it had been named in 1916 by Sir Edward Sharpey-Schaffer, the professor of physiology in Edinburgh University. At the end of the first world war it was decided to establish a chair of therapeutics in Edinburgh, and the appointment went to Jonathan Campbell-Meakins, a Canadian who had been in London before the war with Sir Thomas Lewis and Sir James Mackenzie and again on war service. He showed a research instinct with a strong physiological bias in his clinical practice. With the appointment came an offer to establish a laboratory for biochemistry and for physiological investigation. When Meakins took up his duties in October 1919 the other members of the team were David Murray Lyon, assistant physician, and Charles George Lambie, clinical assistant. About this time Chas Harington (later Sir Charles) and William Robson, who were both working with Professor Barger (in medical chemistry), were added to the team as biochemists. Even before the arrival of insulin they were interested in diabetes and writing about it.12 Their main treatment was with the Allen regimen of controlled starvation. In November 1921 Meakins was granted leave of absence to join in experiments on respiratory physi? ology at high altitude in Peru. He wrote in his unpublished autobiography that on returning through Canada about February 1922 he heard rumours about a spectacular advance in the control of carbohydrate. It will be remembered that Banting and Best started their work together in May 1921 and treated their first patient in January 1922. Banting announced his