The Nobel Prize in Physiology and MedicineSource: The Scientific Monthly, Vol. 39, No. 6 (Dec., 1934), pp. 565-567Published by: American Association for the Advancement of ScienceStable URL: http://www.jstor.org/stable/15843 .

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THE PROGRESS OF SCIENCE THE NOBEL PRIZE IN PHYSIOLOGY AND MEDICINE

THE Nobel prize in physiology and medicine has this year been divided into three parts and awarded to Dr. George H. Whipple, professor of pathology and dean of the School of Medicine and Den- tistry at the University of Rochester; Dr. George R. Minot, director of the Thorndike Memorial Laboratory of the Boston City Hospital and professor in medicine at the Harvard Medical School, and Dr. William P. Murphy, of the Peter Bent Brigham Hospital and the Harvard Medical School.

Prior to last year this prize-the world 's greatest scientific honor, with a value of about $40,000-had been awarded twenty-six times in physiology and medicine, but only twice in the United States, whereas it has been awarded five times in Germany, three and a half times in France and three times in Denmark. In 1912 it was given for the cultivation of tissues in vitro to Dr. Alexis Carrel, who a few years pre- viously had been called from France to the Rockefeller Institute for Medical Re- search, and in 1930 it was awarded for work on poliomyelitis, human blood groups and serological specificity to Dr. Karl Landsteiner, who came to the Rockefeller Institute from Austria in 1922.

The prize was, however, awarded in 1923 to Professor J. J. R. Macleod aAd Dr. F. G. Banting, of the University of Toronto. It is of interest that their work on the checking of diabetes by the administration of insulin following pre- liminary laboratory experiments is strik- ingly similar to the present award for the checking of pernicious anemia by the administration of liver and liver ex- tract by Dr. Minot and Dr. Murphy fol- lowing laboratory work by Dr. Whipple.

The prize has now been awarded in

the United States for two consecutive years. Last year it was given to Dr. Thomas Hunt Morgan, of the Califo-rnia Institute of Technology, not, however, for work that would ordinarily be classed under physiology or medicine, but for distinguished work in biology, especially for his study of mutations in the fruit fly Drosophila. The basis for the award this year is clearly de- scribed in statements prepared for Sci- ence Service by Dr. Whipple and Dr. Murphy. Dr. Whipple writes:

Unpredictable by-products of research in physiology are rarely brought to the attention of the layman. The studies which led to the appreciation of liver as a food to promote hemoglobin regen- eration were taken up with no idea of any clinical application. We wished to find out how the body built up hemo- globin and what materials could best be utilized by the body.

These studies are still being carried forward to determine what elements of food are most essential to make new hemoglobin. Dogs are best suited for these studies and all work has been done on these animals. They are frequently used to standardize liver fractions to be used in the treatment of human disease.

Future progress in the control of other diseases can not be predicted with any certainty but if history has any significance it points to future by-prod- ucts coming from investigations in the wide field of pure science which will enable the physician to bring under con- trol still other diseases which afflict hu- man kind.

It is never safe to state that any bit of accurate knowledge about body physi- ology is useless, for in the future some student may sense its application to the study of some particular disease state.

56.5

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566 THE SCIENTIFIC AMONTHLY

DR. GEORGE H. WHIPPLE

ProgIress is often miiade by -way o cle- touirs wh-1iiel look very n ifavorable at first.

Dr. Mu rplhy writes: It oives nme (reat pleasurie to lhave this

opportuinity to briefly commenit upon the -work in which Dr. Minot and I lhave cooperate(d dlring the past ten years, an(d for winch wN-e lhave received the high liest lhonor wlhiel it is possible for a p)hysician to receive-awarded by the Nobel Prize Coiiimlittee of the Caro- linie Instittite of Stocklholmii, Sweden.

Since otur initial work on the treat- nment of pernieiouis anenmia bY the use of liver, as carried ont in onIi office prac- tise and at the Peter Bent Briglham Hos- pital and( the Collis P. Huntington Hos- pital in Bostoni, muclh progress lhas been mlade in time dir ection of improvement and simplificationi of treatment of the unfortunate victinm of this disease.

Althoughl the amount of liver neces-

sary for eaclh patienit's need's may vary g reatly it is necessary for lilm to take daily an average of froml onie fourtlh to one half pouin(l, O (luriig eaclh nloiitlh a total of eleven pouniids in or(ler to keel) well. If instead of takingp liver the pa- tient is advised to take a potent liver extract by nmouth it will be necessar.y to use daily three vials or (loses an(l in a nmonth eighty-four vials or (loses in or(der to replace the effect of the liver. The averag e cost of eleven pounlids of liver will be about $5.50, whereas the cost of the eighty-four dloses will be approxi- mately $17.00.

Contrast the difficulties ancd expense of such a reoinmen with that which is nowN possible tlhroughl the developmnenit at the Peter Bent Brighamn Hospital -with the cooperation of Dr. Guy W. Clark, of the Lederle Laboratories, of an extract of liver which may be inijected inlto the muscle and -which is so concentrate(l tlhat it is necessary to use only one inijeetion to replace the eleven pounids of liver or

DR. GEORGE R. MINOT

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THE PROGRESS OF SCIENCE 567

eighty-four doses of liver extract if taken by mouth. And this concentrated extract for intramuscular injection costs but $1.20.

Is not such a saving worth while at a time when each and every one of us feels the need for the greatest economy? If one is to realize that treatment by means of this material costs even less than does the liver, is more effective in controlling the disease and is so much more conve- nient to take, I am sure that we can all agree that progress in the direction of simplification of treatment for patients with this disease is being made.

Let us consider the evidence that progress is beingv made in the control of this disease as judged on another basis.

The Metropolitan Life Insurance Com- pany has recently compared the death rate from pernicious anemia for the period since 1926 when liver treatment came into general use with a like in- terval before 1926 when this treatment

was not available. They observed that the death rate in individuals with per- nicious anemia between the ages of 30 and 50 years has been only half so great since the use of liver as it was before. Above the age of 50 the death rate has not shown such a striking decrease, no doubt owing to complications which are more likely to occur during the older age period.

I feel sure that the death rate will be further reduced and that there need be no deaths from this disease if each pa- tient will continue to take regularly in some form an adequate amount of liver substance as prescribe(d by his physician. The amount of liver substanee necessary must be determined on the basis of regu- lar determinations of the number of red blood cells and the patient's physical condition. It is our hope that even fur- ther progrress in this direction will be made as others continue to take up the problem with us.

SANTIAGO RAMON Y CAJAL (I852-i934)

A VER-Y great loss to science occurred oh October 17 of this year when Santi- ago Ramon y Cajal, the great Spanish neurologist, died in Madrid. His death is a loss to the, whole world, for wherever modern methods and procedures are fol- lowed the work of Cajal is known and honored, and his methods of studying the finer structure of the nervous system are used.

Cajal was born on May 1, 1852, in the village of Petilla de Aragon, in the province of Zaragoza, where his father, Justo Ramon Carasu's, was physician and surgeon to the little community. Later, about 1870, the family moved to the university town of Zaragoza, where the son Santiago had already entered on the study of medicine. Here the father, in addition to his practise, gained the position of professor of dis-

section. He had a great enthusiasm for anatomy and he and his son dis- sected together for three years. At the end of his second year, on account of his industry and skilfulness, the young Cajal was given the position of ayyudante de disseccion. After he had finished his medical course in 1873 and obtained the title of Licenciado en Medicina, he had to undergo his military service. For this he entered the Cuerpo de Sanidad Militar, and in the following year, 1874, was sent to Cuba with an expeditionary force. Here he contracted malaria and was in poor health until his return home in June, 1875.

For the next two years he studied in- tensively anatomy and embryology and helped his father in his clinical work. He was aiming for the doctor's degree, and in due time went to Madrid for his

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