Frederick Banting

Sir Frederick Grant Banting was a Canadian pharmacologist, orthopedist, and field surgeon. For his co-discovery of insulin and its therapeutic potential, Banting was awarded the Nobel Prize in Physiology or Medicine with John Macleod.
Banting and his student, Charles Best, isolated insulin at the University of Toronto in the lab of Scottish physiologist John Macleod. When he and Macleod received the 1923 Nobel Prize in Physiology or Medicine, Banting shared the honours and award money with Best. That same year, the Government of Canada granted Banting a lifetime annuity to continue his work. He is the youngest Nobel laureate for Physiology/Medicine, at 32.

Early life

Banting was born on November 14, 1891, in his family's farmhouse in Essa, Ontario, two miles from nearby Alliston. He was the youngest of five children of William Thompson Banting, a farmer in Tecumseh, and Margaret Grant, the daughter of a mill manager. The Bantings were a financially stable family of British and Northern Irish origin. Banting's distant relative, the London-based undertaker William Banting, popularised a weight-loss diet in 1864, and the word "Banting" entered the Oxford English Dictionary as its description. His mother's relatives, the Grants, were of Scottish descent.
With his family being located within a secure rural community, Banting was raised in prosperous circumstances. He was often called "Fred" or "Freddie." Farm life largely defined most of his boyhood. He felt excluded from his siblings, all multiple years his senior, and recalled that "my older brothers could not be bothered with me for the most part." When he began schooling at the age of seven in Alliston, Banting was a shy, asocial boy who tired of the attendance and was bullied frequently. Early difficulties with spelling ensured poor marks in exams: "I simply could not spell. Every word seemed to have about three ways of spelling. It was a guess and I invariably guessed wrong." He later attributed these experiences as being the product of an inferiority complex.
During his childhood, Banting devoted himself to farmwork, grew close with his mother, and sympathised with animals in the absence of other company. Marion Walwyn, a cousin who first met Banting in 1901, recalled that "we sat together in the swing in our yard. In an hour he didn't say one word." He continued to struggle in school and stubbornly resisted being disciplined there. After one incident, he resolved never to continue his education but was convinced otherwise by his father. Banting's grandfather, John Banting, had urged his own children to be educated; the philosophy had influenced William, who offered to provide a fund to his sons when they turned twenty-one. In contrast to his brothers, who spent the inheritance towards their own farms, Frederick would use it towards matriculation.
In his late teenage years, Banting grew into a tall man with engagements in school football and baseball teams. Both his mother and father hoped that he would find a vocation in the Methodist ministry. He passed physics and chemistry during junior matriculation examinations in 1909, but repeated English and was required to undertake French and Latin. The next year, he narrowly passed Latin but failed French and, for a second time, English composition. The principal later remembered his repeated efforts: "We would not have picked him for one on whom fame should settle. He was a white boy, a right boy."

College and service years

Banting finally passed examinations in July 1910. He stated on his application to university that he wished to be a teacher, although he also harbored aspirations of becoming a doctor. He toured the Canadian West for the summer, traveling to Winnipeg and Calgary, before enrolling at the University of Toronto, where he entered the General Arts course at Victoria College. Despite hard work, Banting failed his first year, but decided to become a doctor and returned to repeat the year. He petitioned to join the medical program in February 1912 and was accepted. In September, he dropped out of Victoria College to begin medical school at the University of Toronto.
Banting established himself in medical school by working diligently. His roommate, Sam Graham, remembered him for studying late into the night. Besides being a successful rugby player, however, he was otherwise undistinguished. His grades—now without the burden of language courses—saw a marked improvement, averaging approximately a B, an above-average score. Summers were spent returning to work at the farm. At Toronto's Faculty of Medicine, Banting specialised in surgery.
At the onset of World War I, Banting, along with most Canadian men, sought to enlist in the army. He attempted to enter the Canadian Expeditionary Force on August 16, 1914, the day after Canada's declaration of war, and then again in October, but was refused twice due to poor vision. In his third year of medical school Banting successfully joined the Royal Canadian Army Medical Corps in 1915 and was commissioned a private, then promoted to sergeant. He trained at a camp at Niagara Falls for the summer before his fourth year of school. The university accelerated the class by condensing the fifth year of medical school during the summer of 1916. The curriculum placed more emphasis on surgical procedure and trauma; a lecture dedicated to the treatment of diabetes derived itself from Frederick Madison Allen of the Rockefeller Institute, who recommended that diabetics be placed on a starvation diet for minimum metabolization.
Banting's fourth year was committed to clinical work at Toronto General Hospital. Under the guidance of Clarence L. Starr, the chief surgeon at the Hospital for Sick Children, Banting gained training as an undergraduate house surgeon. By 1915, he had definitively resolved to practice surgery, performing his first operation—the drainage of a soldier's abscess—next winter. On December 9, 1916, Banting graduated with his Bachelor of Medicine and reported for military duty the next day. After being promoted to lieutenant, he sailed from Halifax to Britain on March 26, 1917. Shortly before departing he became engaged to Edith Roach, whom he met in 1911. Starr, an orthopedist who enlisted in 1916, had been impressed by Banting's work as an undergraduate and requested that he join him at the Granville Canadian Special Hospital in Ramsgate, Kent. On May 2, 1917, Banting assumed a position as Starr's assistant.
For thirteen months, Banting assisted Starr, a pioneer of nerve suturing, at Granville Hospital. He oversaw 125 patients and refused to levy a fee for extra services: "it gives me a certain amount of pleasure to be able to help them which repays me in a way that money never could." After some study, he gained certification in obstetrics and gynaecology, and was transferred to serve in France, arriving in June 1918. Banting's first encounter with medical service came on August 8 at the Battle of Amiens. Several days were spent tending to and dressing the wounded on the front lines, in effect, as a general practitioner. In the lull between battles, Banting developed his knowledge of anatomy. Eager to see more active combat, he hoped to be deployed to Siberia with the Canadian Siberian Expeditionary Force.
The 44th Battalion, 4th Canadian Division, where Banting served, were engaged at the Battle of Cambrai in 1918. He witnessed much of the battle's brutality. When a German entered his aid post, Banting's life was saved by a patient, an amputee sergeant, who shot the soldier at the post's door. Later, Banting was struck by shrapnel from an exploding shell, ultimately ending his frontline duty. He wished to remain in battle to continue treating the wounded but his superior, Major L.C. Palmer, insisted otherwise. For his valour, Palmer would recommend Banting to be decorated. Banting was awarded the Military Cross owing to his "exceptional bravery while attending the wounded under fire."
Banting returned to Canada after the war and went to Toronto to complete his surgical training. In 1918, he was awarded the license to practise medicine, surgery, and midwifery by the Royal College of Physicians of London. He studied orthopedic medicine and, in 1919–1920, was Resident Surgeon at The Hospital for Sick Children. Banting was unable to gain a place on the hospital staff and so he decided to move to London, Ontario, to set up a medical practice. From July 1920 to May 1921, he continued his general practice, while teaching orthopedics and anthropology part-time at the University of Western Ontario in London because his medical practice had not been particularly successful. From 1921 to 1922 he lectured in pharmacology at the University of Toronto. He received his M.D. degree in 1922, and was also awarded a gold medal.

Medical research

Isolation of insulin

An article he read about the pancreas piqued Banting's interest in diabetes. Banting had to give a talk on the pancreas to one of his classes at the University of Western Ontario on November 1, 1920, and he was therefore reading reports that other scientists had written. Research by Naunyn, Minkowski, Opie, Sharpey-Schafer, and others suggested that diabetes resulted from a lack of a protein hormone secreted by the islets of Langerhans in the pancreas. Schafer had named this putative hormone "insulin". The hormone was thought to control the metabolism of sugar; its lack led to an increase of sugar in the blood which was then excreted in urine. Attempts to extract insulin from ground-up pancreas cells were unsuccessful, likely because of the destruction of the insulin by the proteolysis enzyme of the pancreas. The challenge was to find a way to extract insulin from the pancreas prior to its destruction.
Moses Barron published an article in 1920 which described experimental closure of the pancreatic duct by ligature; this further influenced Banting's thinking. The procedure caused deterioration of the cells of the pancreas that secrete trypsin which breaks down insulin, but it left the islets of Langerhans intact. Banting realized that this procedure would destroy the trypsin-secreting cells but not the insulin. Once the trypsin-secreting cells had died, insulin could be extracted from the islets of Langerhans. Banting discussed this approach with John Macleod, professor of physiology at the University of Toronto. Macleod provided experimental facilities and the assistance of one of his students, Charles Best. Banting and Best, with the assistance of biochemist James Collip, began the production of insulin by this means.
As the experiments proceeded, the required quantities could no longer be obtained by performing surgery on living dogs. In November 1921, Banting hit upon the idea of obtaining insulin from the fetal pancreas. He removed the pancreases from fetal calves at a William Davies slaughterhouse and found the extracts to be just as potent as those extracted from the dog pancreases. By December 1921, he had also succeeded in extracting insulin from the adult pancreas. Pork and beef would remain the primary commercial sources of insulin until they were replaced by genetically engineered bacteria in the late 20th century. On January 11, 1922, the first ever injection of insulin was given to 14-year-old Canadian Leonard Thompson at Toronto General Hospital. In spring of 1922, Banting established a private practice in Toronto and began to treat diabetic patients. His first American patient was Elizabeth Hughes Gossett, daughter of U.S. Secretary of State Charles Evans Hughes.
Banting and Macleod were jointly awarded the 1923 Nobel Prize in Physiology or Medicine. Banting split his half of the Prize money with Best, and Macleod split the other half of the Prize money with James Collip.