Lives of the fellows

Charles Herbert Best

b.27 February 1899 d.30 March 1978
CC(1967) CH(1971) CBE(1944) BA Toronto(1921) MA(1922) MD(1925) DSc Lond(1928) FRCP Canada(1931) FRS Canada(1931) FRS(1938) FRCPE(1953) FRCP*(1961)†

Charles Herbert Best became one of the most distinguished of Canadian international figures and one of the most widely and favourably known of Canadian scientists. He was revered by diabetics throughout the world and spent much of his life working for their good.

Born of Canadian parents at West Pembroke, Maine, he spent the early part of his life in that region of the United States, near the New Brunswick border. His father, Herbert Huestis Best, also a physician, started his medical training at Dalhousie University in Nova Scotia and finished it in New York; after graduation, he took a locum tenens in Maine, thinking it would be a temporary position, but he stayed and did exemplary medical practice in that area for the next 45 years.

His wife, Charles Best’s mother, Luella Fisher, came also from King’s County, Nova Scotia. These Nova Scotian roots went far back to William Best and John Burbidge who in 1749 travelled from the Isle of Wight with Cornwallis to help found Halifax, Nova Scotia. They joined in building St Paul’s Church in Halifax, the first Protestant church in Canada, and assisted in the laying out of the public gardens as well as sitting in the first legislative assembly in 1758.

When Charles Best was sixteen he went to Toronto, Canada, to prepare for his university entrance examinations. Soon after entering University he volunteered for military service and went overseas with the Canadian Army as a sergeant in the 70th Horse Artillery.

After the war, he took up his studies again at the University of Toronto, transferring from a general Arts course to the more specialized course in physiology and biochemistry. In the fifth and final year of that course he studied advanced biochemical procedures and physiological techniques and was appointed a fellow in physiology in 1920. During that year he met Fredrick Grant Banting and became interested in his ideas concerning the pancreas and diabetes.

On May 17, 1921, one day after his final examinations were finished, he started to work with Banting on the experiments which culminated in the discovery of insulin. By November of that year they had 75 positive results, providing good evidence for an internal secretion of the pancreas, and on January 11, 1922, the first insulin was given successfully to a 14 year old diabetic at the Toronto General Hospital. During that year a series of papers was published by the Toronto group, which showed that the metabolic disorders of animals made diabetic by removal of the pancreas could be alleviated by their pancreatic extracts.

The improvement in insulin production developed by JB Collip was incorporated, but the large scale production of insulin required for clinical use brought many problems. Charles Best was made director of the insulin division of Connaught Laboratories, while at the same time continuing his course in medicine. With the cooperation of scientists from the Eli Lilly Company and others, methods for insulin production and purification were developed on a scale satisfactory for clinical use.

In 1925, following graduation in medicine, Charles Best went to Europe for postgraduate work. He spent a good part of that time in London in the laboratory of Sir Henry Dale, where he studied the actions of choline and histamine as well as the actions of insulin. He became interested in the disappearance of histamine under the action of a heat-labile agent, which at the time was called histaminase. Subsequently it was shown by others that histamine catabolism proceeded along several pathways and could result from the action of more than one enzyme.

Completing his degree work in London, he returned to Toronto and became head of the department of physiological hygiene in 1927. In 1929 he succeeded JJR MacLeod as professor and head of the department of physiology in the University of Toronto. In 1941, after the tragic death of Sir Frederick Banting, Best became head of the Banting and Best Department of Medical Research, giving up his position in physiological hygiene.

In their experiments, Banting and Best produced diabetes in animals by removal of the pancreas. They found that the administration of insulin could keep such animals alive, but subsequently it was discovered that when such animals were kept alive for long periods of time, signs of liver damage developed unless raw pancreas was added to the diet. It was reported by Hershey and Soskin that some component of crude lecithin could substitute for beef pancreas. This procedure took a long time and hence investigation was slow. A means of producing fatty livers in rats by using a high-fat low-protein diet was developed by Best, Hershey and Huntsman and the studies were accelerated. They found that the effect of crude lecithin was not due to impurities, and soon identified choline as the active constituent. There followed extensive work on the investigation of dietary choline and other lipotropic agents.

Charles Best recognized the need for a purer and more active anticoagulant, and organized a team to find sources and methods of purification of heparin (an anticoagulant discovered earlier by McLean and Howell). Heparin was successfully purified by his colleagues Arthur Charles and DA Scott and many experiments on the effects of this purified heparin on thrombosis were carried out in association with TS Perrett, LB Jaques, Gordon Murray and others. With the availability of a purified potent anticoagulant, it became possible to do various procedures such as exchange transfusions, and to attempt the use of artificial kidneys and artificial hearts. Later it became important in the development of cardiovascular surgery.

When the second world war broke out, interest centred first on the effects of injury and blood loss, and one of the projects initiated was the preparation of dried human serum. A blood donor system was developed which ultimately provided over two million contributions of blood serum for the prevention and treatment of shock secondary to injury. With the cooperation of the Canadian Red Cross Society the blood donor project was extended across the country.

Once the blood serum project was established, Best joined the Royal Canadian Navy as director of the Royal Canadian Naval Medical Research Unit, achieving the rank of surgeon captain. Here he directed his energies and those of his colleagues to problems related to the war effort, including shock secondary to injury, motion sickness, protective clothing, immersion foot, nutrition, life-saving equipment, and auditory and visual problems. In connection with the latter, red lighting in naval units was important. The stimulus for the work on this problem and some of the basic information was provided by AV Hill. Best’s associate in the investigation was DY Solandt. This red lighting preserved night vision, a factor of importance in actions at night. It was subsequently used by all branches of the service and by the United States and Great Britain as well.

After Charles Best had taken over the responsibilities of the Banting and Best Department of Medical Research, following Banting’s death, CC Lucas of that department and Phillip Greey of the department of bacteriology, set up a pilot plant for the production of penicillin. This was transferred later to the Connaught Laboratories, where large scale production was continued.

When the war was over, Best returned to studies on insulin, heparin and choline. The choline studies were reviewed in his Croonian Lecture of 1955. The pathological changes resulting from choline deficiency and the effects of choline deficiency in early life were investigated in association with WS Hartroft.

Studies on pituitary factors were carried out with James Campbell, and on metaglucagon diabetes with John Logothetopoulos. Reports on these and other studies are included in a volume The Selected Papers of Charles H Best, published in 1963 by the University of Toronto Press. The 61 papers it contains give a good indication of the variety of his interests.

In 1953, the Charles H Best Institute, built in his honour, was opened by Sir Henry Dale. This Institute housed the department of physiology and part of the Banting and Best Department of Medical Research. Later, when the Medical Sciences Building was built at the University of Toronto, the department of physiology moved to the new building and the remainder of the Banting and Best Department of Medical Research moved into the Best Institute.

In collaboration with NB Taylor, Best wrote several textbooks of physiology, the best known being The Physiological Basis of Medical Practice, a most successful and popular text, first published in 1937. The other texts were The Living Body, an intermediate textbook and The Human Body, an introductory textbook of physiology. He was the author of many scientific papers and addresses and was a member of numerous commissions, committees and councils. He was a member of diabetic associations, medical and physiological societies in many different countries and was honorary president of the Canadian Diabetic Association, the British Diabetic Association, the American Diabetes Association and the International Diabetes Federation. Throughout his life he was interested in people, and especially in diabetics, and worked to promote their welfare. He received awards from all over the world and many civilian and military honours were bestowed on him by national and regional governments, cities and societies. In 1955 he was elected to the Pontifical Academy of Sciences, the first Canadian to receive this honour.

In 1924 Charles Best married Margaret Hooper Mahon, daughter of Alexander Wylie Mahon, BD, and Flora Cameron Macleod Mahon. Margaret was a strength and inspiration for him throughout his life. He had two sons, Charles Alexander Best, who died shortly before his own death, and Henry Bruce Macleod Best, who became president of Laurentian University at Sudbury, Ontario.

Charles Best - Charley, as he was known to his many friends -will be remembered as the co-discoverer of insulin and as an inspiring champion of diabetics around the world. He was a very popular speaker, greatly in demand, and did not spare himself in their cause. As a scientist he made major contributions, but he generously helped others, especially young scientists, to make their contributions too, encouraging them and inspiring them in their work. It was an honour and a great privilege to have known and worked with him.

RE Haist

* Elected under the special bye-law which provides for the election to the fellowship of "Persons holding a medical qualification, but not Members of the College, who have distinguished themselves in the practice of medicine, or in the pursuit of Medical or General Science or Literature.."

† The list of honorary degrees is too lengthy to include.

[Brit.med.J., 1978, 1, 927; Lancet, 1978, 1, 835; Canad, med. Ass. J., 118, 1167-8; Biogr.Mem.Roy.Soc., 1982, 28, 1-25]

(Volume VII, page 35)

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