1921: The Year the Nobel Prize Took a Break
In This Article, You Will Learn
Why the Nobel Prize was not awarded in this year, and how a world-changing idea in medical history was jotted down in a notebook in the early hours of the morning. Also, why 1921 was the last year a child could die of diabetes.
The Nobel Prize May Have Been Absent, but Ideas Were Born
The 1921 Nobel Prize in Physiology or Medicine was withheld. Why, even after the war had ended? There were several reasons, but fundamentally, the committee could not find a clear winner among that year's nominees.
However, in that year, an idea that would fundamentally change the world of medicine was born in Canada. Between the night of October 30 and the early morning of October 31, 1920, a young surgeon in London, Ontario, could not sleep. While preparing for a lecture the next day, he unexpectedly wrote the following sentence in his notebook:
"Tie off the pancreatic duct of dogs, wait for the acinar tissue to atrophy, and then extract the endocrine secretions from the remaining tissue."
The person who wrote this sentence was Frederick Banting. He took this idea to John Macleod at the University of Toronto in the summer of 1921. That summer, the experiment led to the discovery of insulin.
The Nobel Prize would be awarded to them in 1923. But the seed of the idea was planted in the sleepless night of 1921.
The Landscape of the Times: The Dawn of the Roaring Twenties
1921 was a year in which the post-war world was finding a new identity. Several symbolic events occurred:
- Anglo-Irish Treaty (December) β Ending most of the 800 years of British rule.
- New Economic Policy (NEP) of the Soviet Union (March) β Lenin partially adopted capitalist elements.
- Washington Naval Conference (November) β The first large-scale naval arms limitation agreement.
- Reorganization of the Nazi Party in Nuremberg (July) β The birth of an organization that would later shake the world.
In medical history, this period was the dawn of the Roaring Twenties. Penicillin not yet, DNA double helix not yet, MRI not yet, chemotherapy not yet. However, with insulin being born in this year, the coming of the era of hormone therapy was foreshadowed.
At the time, diabetes (type 1) was a death sentence for children. Most children diagnosed with the disease died within a few months to a year or two. The only treatment was the extremely low-carbohydrate diet of Elliott Joslin and Frederick Allen β essentially a starvation diet. Children lived by starving themselves until they were skin and bones, and eventually they died in that state. This was the world of diabetes until 1921.
When viewed in conjunction with Korean history, 1921 was a time when the cultural rule of the Japanese colonial government was being established. The Joseon Ilbo (1920) and the Dong-A Ilbo (1920) were founded, and Korean-language newspapers reappeared, and the activities of intellectuals were partially restored. However, the gap in medical infrastructure remained severe. Insulin was introduced in Korea 20 years later, in the 1940s, and even then, Korean children with diabetes continued to die under starvation diets while children in other parts of the world were already being saved by insulin.
Nevertheless, Science Did Not Stop
The Beginning of the Insulin Discovery Experiment
Between May and August 1921, Banting and his student assistant, Charles Best, began repeated experiments on dogs in a laboratory at the University of Toronto. Macleod was on vacation in Europe, and during that time, the two conducted the experiments on their own.
Key tasks:
- Tie off the pancreatic duct of dogs to cause atrophy of the acinar tissue (exocrine tissue).
- A few weeks later, remove the pancreas and extract the remaining tissue (islets of Langerhans).
- Inject this extract into dogs with diabetes.
- Observe whether blood sugar levels decrease.
On July 30, the first successful result was obtained. The blood sugar of the diabetic dog dropped dramatically. After several months of purification and improvement, the first human administration was performed on January 11, 1922, to 14-year-old Leonard Thompson at the Toronto General Hospital. The first attempt was stopped due to side effects, but the second attempt, after purification and improvement, normalized the boy's blood sugar. The boy lived another 13 years and died of pneumonia.
The background to this story is that Banting's original hypothesis was partially incorrect. He believed that atrophy of the acinar tissue was essential, but in later experiments, insulin was also obtained by using fetal pancreas or after freezing and extraction. Nevertheless, this is a case where a wrong hypothesis led to an accurate experimental design and the discovery of the truth. It is one of the interesting ironies of science.
First Human Vaccination with BCG Tuberculin Vaccine
In Paris, another decisive event took place in the same year. The tuberculosis vaccine BCG (Bacille Calmette-GuΓ©rin), developed by Albert Calmette and Camille GuΓ©rin, was administered to a newborn baby in Paris for the first time in 1921.
This vaccine would become one of the most widely administered vaccines in the world. Today, the mark on the left shoulder of a newborn in Korea is a remnant of BCG. Although the complete eradication of tuberculosis has not yet been achieved, it is certain that BCG has significantly reduced childhood mortality related to tuberculosis.
Einstein's Visit and the Internationalization of Academia
In 1921, Einstein made his first visit to the United States. He gave lectures at Columbia University, Princeton, and MIT, introducing the theory of relativity to the American academic community. What this visit symbolized was that European intellectuals began to recognize the United States as a serious academic partner. Einstein himself settled in Princeton, New Jersey, in 1932 to escape the Nazis. The seeds of that move were sown during his 1921 visit.
Connections
The events of 1921 led to the following:
- 1923 Nobel Prize in Physiology or Medicine to Banting and Macleod β Official recognition of the discovery of insulin. Banting was the youngest laureate at the time, at 41 years old.
- 1930 Nobel Prize in Physiology or Medicine to Landsteiner β ABO blood group system. Like BCG, its clinical value was proven as mass vaccination and blood transfusions became standard.
- 1932, the rise of anti-Semitism in Nuremberg β The result of the reorganization of the Nazi Party in 1921. This led to the exodus of Jewish scientists and reshaped the world's knowledge landscape.
If we use a CS analogy to summarize, 1921 was the year in which a decisive idea was born in an uncommitted branch. From a software perspective, Banting's notebook was a commit in a personal local branch that was not yet in the production repository (official academic publication). However, that commit was diligently refactored and reviewed over the next year and eventually deployed to the world of medicine.
The limitation of this analogy: Software ideas often start as individual ideas and develop through team collaboration, during which the contributions of the original author are clearly tracked. Banting's discovery of insulin was much more complex β the conflict between Banting and Macleod, the fact that Best was not awarded the Nobel Prize, and the fact that Collip's contribution to the purification was only belatedly recognized. Science is where people live, not an ideal collaborative tool.
Summary of the trajectory of the 1921 insulin idea: A single line in a notebook in the early hours of the morning led to a summer experiment, which in turn led to human administration in winter, and was finally recognized with a Nobel Prize the following year.
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