Insulin and Mrs. Barlow’s Bathtub | 胰岛素

• What was the price of insulin’s patent? | 胰岛素的专利卖了多少钱？

One Canadian dollar. | 一加元。

Insulin was discovered by Frederick Banting and Charles Best, but its first production also involved James Collip and John Macleod. Unfortunately the amazing story of insulin’s discovery was marred by scientific jealousy, intense business competition, and even fistfights in the laboratory. Despite all four scientists being involved in testing insulin, only Banting and Macleod were given the Nobel Prize for insulin’s discovery. Banting and Collip sold the patent for insulin to the University of Toronto for one Canadian dollar.

• Insulin shock therapy and “A Beautiful Mind” | 胰岛素休克疗法和《美丽心灵》

“When the patients were injected with insulin, it caused a dramatic drop in their blood glucose levels, depriving the brain of an essential component for normal physiological function. The patients began to sweat profusely, requiring repeated baths to wash away the sweat. As glucose levels fell further, patients became increasingly restless, followed by major convulsions that ended only when they entered into a coma, at which point the patients all had fixed, widely dilated pupils.”

“Although the symptoms of schizophrenia, including delusions, hallucinations, agitation, and inappropriate reactions, seemed to abate after insulin shock, no one knew whether the effect was due to the insulin itself or to the coma induced by the insulin.”

“Nobel Prize–winner and mathematician John Nash, who won the Nobel Prize for Economics in 1994, suffered from schizophrenia, and was subjected to insulin shock therapy to treat his illness. His life story, and his insulin therapy, were portrayed in the 2001 movie A Beautiful Mind.”

当时人们认为，给人注射大量胰岛素，让他/她们昏迷和休克，可以用来治疗精神疾病。诺贝尔奖获得者、数学家纳什就是该疗法的体验者之一。2001年的电影《美丽心灵》讲述了他的人生故事以及胰岛素疗法。

• Controversies in science community | 科学界关于胰岛素休克疗法的“撕”

In 1953 Dr. Harold Bourne, an experienced British psychiatrist, published a paper titled “The Insulin Myth,” arguing that there was no sound scientific basis for the validity of insulin coma therapy. He maintained that the initial psychiatric diagnoses were most likely flawed and based on unreliable and questionable tests. Bourne also claimed that the results of insulin coma therapy were biased by selecting particular patients and ignoring others. More alarmingly, it became apparent that no two hospitals were performing the coma therapy in the same way, with some clinics inducing a coma for one hour and others for an astounding four hours.

The immediate response to Bourne’s concerns was not a “thank you for showing us where we’ve gone wrong,” but rather a wave of condemnation from the medical community. Leading psychiatrists sent letters to medical journals criticizing Bourne, with one stating: “it is clinical experience that counts here, despite all [evidence] to the contrary.” It would be another five years before a carefully controlled study on insulin coma therapy would be published, a study that clearly showed, beyond any doubt, that insulin coma therapy was a sham.

1953年，经验丰富的英国精神病学家哈罗德-伯恩（Harold Bourne）博士发表了一篇题为《胰岛素的神话》的论文，认为胰岛素休克疗法的有效性没有合理的科学依据。医学界什么反应呢？一片谴责。其中一位指出： “尽管所有的[证据]都是相反的，但临床经验在这里才是最重要的。”

又过了五年，一项关于胰岛素休克疗法的精心设计严格实验的研究才得以发表，这项研究明确表明，胰岛素休克疗法是一个骗局。

• Uxoricide: husband killing wife | 胰岛素杀妻案

1957, England, Bradford. Kenneth Barlow used insulin to kill his wife Elizabeth Barlow.

Kenneth, a nurse, claimed to have given his wife Elizabeth an injection of ergometrine (a drug used in obstetrics to prevent heavy bleeding after childbirth by causing uterine contractions and also to induce abortions) with her informed consent, yet what was actually injected into her body was a lethal dose of insulin.

Elizabeth’s symptoms are the same as those of insulin shock: exhaustion, weakness, vomiting, profuse sweating, dilated pupils. She went to take a bath in the bathtub to feel better, only to fall into a coma and drown, or, after passing out, being pushed into the water by her husband.

身为护士的Kenneth声称在妻子Elizabeth知情同意的情况下，给她注射了麦角新碱（ergometrine，一种在产科使用的药物，通过引起子宫收缩来防止产后大出血，也可用于诱导堕胎），然而，真正注射到她体内的，却是致死剂量的胰岛素。

Elizabeth的症状和胰岛素休克的症状一样：疲惫，虚弱，燥热，呕吐，大汗淋漓，瞳孔散大，为了感觉好一点她去浴缸洗澡，结果却陷入昏迷，溺水而亡，或者，在昏迷后被丈夫推入水中而溺死。

“After a grueling five-day trial, the presiding judge instructed the jury that there was only one crime of which Kenneth Barlow could be convicted: “This is murder or nothing,” he told them. “If you are satisfied that he injected insulin into his wife, and knowingly injected it, you will probably find no difficulty in reaching the decision that he did so with intent to kill.” The jury took eighty-five minutes to find Barlow guilty. Sentencing him to life imprisonment, the judge described Barlow as “a cold, cruel premeditated murderer who, but for a high degree of detective ability, would not have been found out.” (The jury was also excused from further service for ten years, because they had listened to “a long and harrowing case.”)”

对Kenneth Barlow的案件审理长达五天。最后做出了有罪判决。该案的陪审团随后被免除了十年的服务，因为他们听了 “一个漫长而痛苦的案件”。

Kenneth Barlow的第一任妻子Nancy也死得很蹊跷，他们结婚十二年，在1956年突然“发病”，不到十二个小时就趋势了。在葬礼前曾有匿名电话打给警察让他们对Nancy进行尸检，但没有发现什么，只是脑部有轻微水肿。第一任妻子葬礼后两个月他就和第二任妻子Elizabeth结婚了，而她活了不到一年。

• Pharmaceutical insulin | 人造胰岛素

Although commercial insulin acts in the same way as the body’s natural insulin, small tweaks in the sequence of amino acids making up pharmaceutical insulin (to make it faster- or slower-acting) allow for easy confirmation that any excess insulin in a murder victim got there by nefarious means. In fact, murder by insulin poisoning is quite rare, with fewer than seventy documented cases worldwide, the vast majority occurring in the UK and the United States.

为Kenneth Barlow辩护的律师提出来的一个论点是，后来在Elizabeth体内检测到的大量胰岛素不是外来注射的，而是身体自己产生的。当然这很荒谬，我们的身体在正常条件下不会不受控制产生致死剂量的胰岛素。现在人造胰岛素的氨基酸序列和自然产生的胰岛素并不完全一样，所以如果再有辩护律师用这个理由，就可以轻易反驳了。不过，胰岛素下毒案比较少见，世界范围内有记录的不到七十例。

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