Salvarsan
As early as the beginning of XIX century the vast majority of medicines were created from compounds that exist in nature. Roughly speaking, those were only “folk remedies”, just purified and systemized. Nevertheless only the success of synthetic chemistry has given an opportunity to create directly substances that affect causative agents of diseases or tumour cells.
An Austrian physician and bacteriologist Paul Ehrlich (1854–1915) was searching for a remedy against sleeping sickness, caused by trypanosomes, but a drug on the basis of arsenical compounds called Salvarsan, which he proposed in 1910, appeared to be effective for other infectious diseases, syphilis in particular. Later Ehrlich modified Salvarsan and created Neosalvarsan. The new medicine became widespread, and it inventor — worldwide appreciated. It was the first directive synthesis of chemotherapeutical medicine in the world.
Ehrlich was dreaming of the “magic bullet”, which would selectively strike agents of one or another disease and at the same time would be harmless for an organism. To obtain the necessary medicine, Ehrlich synthesized 605 different compounds. And only the 606th one was a success (an alternative name of Salvarsan is “compound 606”). It worked because the arsenic-based compound is a bit more poisonous to bacteria than it is to humans. Most modern cancer drugs work in much the same way. They are poisonous, hard-to-take drugs dosed to kill a disease before they kill the patient.
Ehrlich, who shared the Nobel Prize for discovery of basics of immunity with Ilya Mechnikov (1845–1916), is considered a founder of chemotherapy — treatment with a help of medicines created to fight a certain disease. Thousands of new drugs were synthesized after Salvarsan.
With Salvarsan, Ehrlich began another modern tradition: the idea that drug makers have moral responsibilities. People threw rocks at his window. They said syphilis was God's punishment for fornicators and that Ehrlich was interfering.
Chemotherapy for malignancies was first used in 1941 by an American surgeon and oncologist Charles Huggins. The method of treating prostate cancer using drugs with oestrogenic activity (female sex hormones), suggested by him, was internationally acknowledged and became the start of hormonotherapy, one of the varieties of cancer chemotherapy. In1966, Huggins together with Peyton Rouse (1879–1970) was awarded the Nobel Prize.
90% of drugs, which are sold in pharmacies and used in clinics, are synthetic. As before, many of them are acquired with trial-and-error method— when one of thousands of synthesized substances is a real medicine.
Insulin
Diabetes mellitus type 1… It was diagnosed for about 10–15 million residents of the planet. Practically, their only salvation is insulin injections throughout the whole life. Without this drug every of them would be dead. Patients with advanced diabetes can't use the energy stored in their bodies. No matter how much they eat, they starve, because their bodies stop making insulin, needed to convert sugar into energy.
Diabetes used to be known as "the sugar sickness." The only treatment was to give patients a near-starvation diet. They got only as much food as they could metabolize. They soon wasted away and died.
In 1869, a German physiologist Paul Langerhans (1847–1888) was studying the structure of the pancreas under a microscope when he identified some previously unnoticed tissue clumps scattered throughout the bulk of the pancreas. The function of the “little heaps of cells”, later known as the islets of Langerhans, was unknown. In 1901, a Russian scientist Leonid Sobolev (1876–1919) experimentally found that the islet cells produce a hormone, which regulates blood glucose level, and suggested ways to obtain it. 20 years later, a Canadian surgeon and physiologist Frederick Banting (1891–1941) and a medical student Charles Best (1899–1978) after three-months long experiments managed to isolate an extract from these islets, producing what they called "isletin" (what we now know as insulin). Banting and Best were then able to keep a pancreatectomized dog named Marjorie alive for the rest of the summer by injecting her with the crude extract they had prepared.
A Scottish biochemist and physiologist John Macleod (1876–1935) and a Canadian biochemist James Collip (1892–1965) joined the study. By the end of 1921, the technology had been improved, and insulin has been obtained from extract of fetal calf pancreas. On January 11th, 1922, Leonard Thompson, a 14-year-old diabetic who lay dying at the Toronto General Hospital, was given the first injection of insulin.
Then followed clinical trials to determine insulin dosage, production and guidance for usage. Inspired by success, Banting decided to help his colleague Joseph Gilchrist, who suffered diabetes; he consented to experiment. After several subcutaneous injections blood glucose level of the patient reduced, and he felt much better. Thus, insulin became an effective measure against diabetes mellitus, one of a few medicines, which have given quick relief to many people.
In 1923, Banting and Macleod were awarded the Nobel Prize. Banting was in revolt at the fact that his assistant Charles Best, who was good at determining the level of glucose in urine, which played a clue role in the discovery, wasn’t among the awarded. Banting threatened to renounce the Prize at all. Finally, he was persuaded to receive the award, but a half of money he fairly gave to his assistant. The same way Macleod did, who shared the Prize with James Collip, the technology of insulin purification developer.
That wasn’t the only Nobel Prize awarded for insulin. In 1958, the highest scientific prize was given to an English biochemist Frederick Sanger for determination of amino acid sequence of insulin.
For some types of diabetes, insulin is the only way to survive. In Russia, about a quarter of people suffer this disease. Besides, the main amount of insulin is imported from abroad — for some reasons we can’t organize domestic insulin industry.