1923: After scientists discover insulin, mass production begins

In the decades leading up to 1923, patients diagnosed with diabetes didn't have any hope of recovery. If you went to the doctor to find that you had tested positive for the disease, it was less of a reassurance that you could proceed to a treatment plan than a death sentence. While patients could restrict their diets in the hope of extending their life spans, no medication existed that could counteract the damage that diabetes was wreaking on their bodies.

This being an age of remarkable technological advancement, in some ways the overall quality of care was improving. The rise of the automobile resulted in the first motor-based ambulances in 1899 and they soon became widespread, especially during World War I, which reduced the length of patients' trips to hospitals dramatically. The spread of radio meant that during the first World War, radios were being used to dispatch and communicate with ambulances directly from hospitals, a practice which spread to civilian hospitals in ensuing years. In 1920, X-rays were improved upon thanks to vacuum tubes, rendering them practical for medical purposes. But diabetes remained an unsolved problem.

In the 1889, Oscar Minkowski and Joseph von Mering discovered that the pancreas produced chemicals that digested glucose in addition to the known digestive juices, but they did not know what the substance was or from where it came.

The islets of Langerhans, some cells of which are used to produce insulin, are now named in honor of Paul Langerhans, who discovered that the pancreas produced glucose-digesting chemicals. It was eventually discovered that some of the islets produce insulin, the chemical whose presence Langerhans predicted in 1869.

In 1920, Dr. Frederick Banting began experiments at the University of Toronto in which he experimented on diabetic dogs (artificially induced diabetes, not natural; concerns about animal welfare in medical testing were only raised in the 1960s) by stopping the flow of nutrients to other dogs' pancreases, removing them, cutting them up, freezing them, grinding and filtering them and isolating one of the substances. Finding that this substance was effective in treating the symptoms of diabetes and actually returned diabetic dogs to health, they proceeded to replicate the process with pancreases of cattle (which were more readily available and practical) and expanded the experiments, discovering shortcuts and streamlining the process along the way before using it on human subjects. In 1923 they won a Nobel Prize in medicine for their efforts.

That year, the first commercial insulin product was released in a collaboration with Banting by Eli Lilly, an American company founded by the Civil War veteran after which it is named. Launched in Indianapolis a century after the signing of the Declaration of Independence, Eli Lilly earned decent profits through the early 20th century. But insulin brought them great success as well as the opportunity to form partnerships much like those they established with Banting with renowned researchers; two collaborations on liver products won another Nobel Prize in 1934.

Colonel Eli Lilly, who founded an eponymous corporation in 1876. What was a small player in medicine in his time grew to become an enormous corporation that grossed $19.6 billion in 2014 (and that was after a slight decline in profits.) The company's biggest legacy will likely remain the creation of Prozac, the first in a class of drugs called SSRIs that also includes Zoloft and Lexapro.

Insulin was like a goldmine for Lilly, paving the way to a partnership with the U.S. Government during the Second World War in which the company mass-produced penicillin, the world's first antibiotic. Throughout the decades, the company grew enormously; today, they're probably known for the manufacture of the enormously successful Prozac.

Even a century ago, life-changing medical discoveries were inextricable from the business that was required to manufacture and distribute the treatments. Debate rages today about the manner in which medications are marketed by pharmaceuticals corporations like Lilly, but science and business have been and will be more closely intertwined by necessity than we'd like to imagine.

Bibliography:

https://www.nobelprize.org/educational/medicine/insulin/discovery-insulin.html

https://www.drugwatch.com/manufacturer/eli-lilly/

https://www.verywell.com/most-common-antidepressants-1066939

Some information taken from Freedom from Fear