Last updated: 2007-06-11 18:44 EET

Romanian medicine has given world science several personalities, such as Gheorghe Marinescu, Victor Babes, Ioan Cantacuzino, George Emil Palade or the Minovici Brothers. Also on the list is Nicolae Paulescu, a reputed physiologist, who became a leading scientific figure due to its decisive contribution to discovering the basic treatment for diabetes. Paulescu's grand discovery was the pancrein, the anti-diabetic hormone secreted by the pancreas, which was later called insulin.

Nicolae Constantin Paulescu was born on November 8th, 1869 in Bucharest and died on July 19th, 1931. He got a PhD degree in medicine and sciences in Paris and conducted a remarkable activity in physiological research, especially the study of glucide metabolism, diabetes pathogenesis, pancreas's role in nutritive intake, blood coagulation and the sudden death mechanism. In 1906 he developed an original method of hypophyseal excision in dogs, which would subsequently be applied to studies on humans. At the July 23rd session of the Biology Society held in 1921, Nicolae Paulescu presented the outcomes of four studies he had conducted on pancreas in diabetic subjects. Paulescu published his findings on the antidiabetic active principle in the pancreas, which he called pancrein, also in the Belgian magazine “Archives Internationales de Physiologie” in an article issued on August 31st, 1921.

These publications had come 8 months before the team made up of Canadian doctors Frederick Banting and Charles Best, Scottish doctor John James MacLeod and Canadian biochemist James Collip with the Toronto University announced their discovery of insulin. However, the Nobel prize for physiology and medicine was awarded to the Toronto team. Although he vehemently contested the practices of the Canadians, Paulescu failed to be credited with discovering insulin.

In the following minutes diabetics researcher Constantin Ionescu -Targoviste, a corresponding member of the Romanian academy and director with the Paulescu Institute in Bucharest explains Paulescu’s contribution to the discovery of insulin.

“Pancreine is the name of insulin, which is the pancreatic hormone extracted by Paulescu through his own method, first from a dog’s pancreas and later from the pancreas of other animals. This was the anti-diabetic hormone predictable starting from preliminary data provided by other researchers beginning with 1890, when the rush for discovering this hormone started. Paulescu himself, in 1899, while he was taking one of his three PhD degrees in Paris , explained in an activity report that he had conducted a study for the isolation of the pancreatic anti-diabetic principle. The scientific activity of identifying the characteristics of this hormone was conducted by Paulescu in an exemplary manner. He said that diabetes is a disease characterised not only by hyper-glycemia but also by an increased number of cetonic bodies in blood and urine, expressing the lipids metabolism and by an increased amount of urea in urine, which can be described as the catabolism of the protein metabolism. This overall view was weird for that time, when hyper-glycemia was everybody’s concern.“

Constantin Ionescu-Targoviste is also explaining the research conducted by the Canadians, Nobel prize winners in 1923.

“ Banting thought of a treatment for diabetes. According to Canadian historiography, Banting was one of the greatest liars of the time . He always claimed approximate things. As for instance, he provided three different variants about the same issue. He wanted to find a therapeutic solution for a disease which he did not know at all , he was a surgeon by profession He proposed an experimental model consisting in the complete removal of the pancreas which was what Paulescu had done earlier Banting and Best did not feel bound to quote the research made by Paulescu because they would have lost priority on that break through discovery. Unfortunately for them, in an article they however mentioned one of Paulescu ‘s works published in 1921. That is the proof that they knew about Paulescu ‘s work, although they denied that later. Paulescu said he had sent Banting his latest works, asking for his works in exchange, but Banting did not answer that letter. I only realised that much later when I found Paulescu ‘s letter in Banting’s personal archives, a letter in which the Romanian scientist had asked for clarifications. That was in 1922, before Banting was awarded the Nobel prize for medicine.”

Constatin Ionescu Targoviste gave us further details about the reasons why the Toronto university team got the Nobel prize:

“ Two arguments mattered in awarding the Nobel prize to the Toronto University team . The first was that James Collip succeeded in purifying the pancreatic extract which could be given successfully to humans. . This was a step ahead of what Paulescu had achieved. The second argument was the visit to Toronto of 1920 Nobel prize winner Danish August Krogh whose wife was suffering from diabetes. Visiting Mac Leod ‘s lab, they agreed for this hormone to be produced in a laboratory in Copenhagen as well. Krogh was the one who proposed the Canadians for the Nobel prize, although they had not published a single study on diabetes. One of the members of the Nobel Committee who refused to make the recommendation for that nomination , sent a letter to the director of the Nobel Committee writing he had often participated in the Nobel prize awarding formalities but had never been placed in such a situation , namely to have no works or publications to use for his documentation.”

We asked doctor Ionescu Targoviste about the difference between pancrein and insulin.

“There is no difference between the two. In other words, there is no difference between pancrein and isletin. The pancreatic extract used by the Canadians after Paulescu ‘s model was called isletin. I have recently got an article by Belgian physiologist Jean de Meyer who gave the name of insulin to that extract as far back as 1909 . De Meyer said that the anti-diabetes hormone which would be isolated from the pancreas should bear that name. Therefore, the Canadians had appropriated both Paulescu ‘s scientific work and the name given by De Meyer. “

In 1969, following the international campaign to restore the truth initiated by Scottish physiologist Ian Murray , the Nobel Committee acknowledged Paulescu ‘s merits and priority in discovering the anti-diabetic treatment. Paulescu’s case is but another example that although injustice can be done to a great scientist , the later moral reparation brings the much deserved glory.
(Steliu Lambru)
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