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Ernest Lyman Scott (Fig. 4) was born on August 18, 1877 in the small town of Kinsman in northeastern Ohio. He grew up on the farm of his parents – his great grandfather had been granted the equity soon after the Western Reserve was opened for settlement in 1802. Their farm was not running very well and, as a result, his father could not afford to pay for the Ernest’s education. Luckily a prosperous Kinsman citizen offered a free loan of USD 1,000 with no limit on the time to repay it. Ernest studied natural sciences at Ohio Wesleyan University, finishing his BA in 1902. His first job was working for the US Coast and Geodetic Survey (1902–1903). Later he worked as a teacher of natural science in West Bay City until 1909 [14]. One of his students, a 17-year-old boy, developed diabetes – he was told by the doctors that all he could do was die [14]. This sad experience led Scott to pursue a scientific career in physiological research. In spring 1909 he was employed as an instructor in the Department of Physiology in the Medical School in Chicago. His stipend was only USD 750 per year and tuition fees, laboratory fees, and living expenses for 2 had to be paid from this. He presented to his boss, Prof. Anton Julius Carlson, a topic for his MA thesis: to find a blood glucose-lowering substance in the pancreas. Carlson was not enthusiastic – this topic was not in his main research interests – but he agreed. The research had to be carried out in the department of chemistry. This laboratory had excellent equipment thanks to donations by the Rockefellers. The interim head of department was Prof. Waldemar Koch, who chaired the department of pharmacology. Koch was a nephew of the Noble Prize winner Robert Koch. Initially, Scott consulted carefully all the published literature on the topic. In contrast to Zülzer, Scott believed that the hormone was a protein. He ground pancreas with sand and alcohol made to 85%. This was also the method Banting and Best used following their initial extractions of insulin. After his work on the extraction of insulin Scott carried out experiments on pancreatectomized dogs in 1911. The results were quite positive and glucosuria decreased after the injection of the extract (Fig. 5). Sadly, the convincing synopsis of the experiments from the thesis was not included in the publication by Prof. Carlson. (Fig. 6).

Fig. 4. Ernest Lyman Scott serving in the US Army in France [14].

In summer 1911 Scott wrote his thesis and gave three copies to Prof. Carlson. Carlson offered Scott a renewal of his position with the same – very low – salary. But Scott needed more money as he and his wife were expecting their second child. Scott instead accepted a position at the University of Kansas and left Chicago at the end of September 1911.

Carlson submitted Scott’s work to the American Journal of Physiology [15] without any consultation with Scott. He never read the paper before it was printed [14] and it was published in the name of one single author: E.L. Scott! The thesis was changed substantially. The discussion of previous research was drastically shortened, half of the references were omitted (5 of 10, Zülzer and Forschbach were not quoted any more). In one of the citations a mistake was introduced: Cohnheim should not be referenced as 1904 but rather 1906, as mentioned correctly in the thesis. However, the worst was the summary of the article. Scott’s thesis ends with the following (reprint of the thesis in Scott [14]):

Conclusions

1st. There is an internal secretion from the pancreas controlling the sugar metabolism.

2nd. By proper methods this secretion may be extracted and still retain its activity.

Fig. 5. The “murdered manuscript” on Scott’s work, 1912 [15].

3rd. This secretion is easily destroyed by oxidation or by the action of the digestive enzymes of the pancreas.

4th. The secretion is insoluble or nearly so in strong alcohol but is readily soluble in acidulated water.

5th. The failure of previous workers to procure satisfactory results was due to their not preventing oxidation or the action of the digestive enzymes.

This formulation would have aroused interest in the scientific community. Today a journalist of the university would publish a press release adding that this research may soon provide a lifesaving treatment for diabetes – the paper would make the headline of The Times! In contrast Carlson’s summary was long-winded and dreary. Anyone who read this paper in the American Journal of Physiology may have thought: one more of these unsuccessful pancreatic extracts followed by some weird hypotheses – how boring! But judge for yourself, Carlson’s version ends as follows [15]:

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].