Oskar Minkowski

Oskar Minkowski introduced the concept that diabetes results from suppression of pancreatic substances - later found to be the hormone insulin.

He studied in Königsberg, Freiburg, and Strassburg, mainly as a student of Bernhard Naunyn (1839-1935). After receiving his medical doctorate at Königsberg in 1881, he was a pupil, assistant and collaborator of Naunyn in the medical clinic in Königsberg from 1882 to 1892. He was habilitated as Privatdozent in Königsberg in 1885; in Strassburg 1888, where Naunyn became professor of clinical medicine that year. Minkowski was appointed ausserordentlicher professor at Strassburg in 1891.

Minkowski taught medicine at the universities of Strassburg from 1882 to 1904, and from 1904 to 1905 was professor at the academy of practical medicine in Cologne, where he had headed the department of internal medicine from 1900. He was ordinarius and director of the medical clinic at Greifswald 1905-1909, and in Breslau 1909-1926.

At Strassburg Minkowski investigated the chemical basis of diabetes and found, in 1884, that ß-hydroxybuturic acid with a concomitant decrease in blood bicarbonate is the cause of diabetic acidosis; he also proved that diabetic coma is accompanied by a decrease in the amount of carbon dioxide dissolved in the blood, and he introduced alkali therapy to counteract it.

In 1889 Minkowski, with the German physiologist Joseph von Mering (1849-1908), discovered that dogs subjected to removal of their pancreas develop the symptoms of diabetes, leading Minkowski to postulate that the pancreas is the site of secretion of an «antidiabetic» substance, now known to be insulin. In 1885, by removing the liver from birds, he demonstrated that the organ is responsible for the manufacture of bile pigments and is the site of uric acid formation.

In 1886 Minkowski and Naunyn propounded the theory that bile pigment formation is a function of the liver cells alone. This was disproved by Sir John William McNee (1887-1984) in 1913.

Minkowski was a sound teacher and a well liked clinician. The noted French neurosurgeon Clovis Vincent (1879-1947) trained with him.

Für die Lehre vom Diabetes brach eine neue Epoche an, als von Mering und Minkowski 1889 zeigten, daß durch die Exstirpation des Pankreas jederzeit ein echter Diabetes hervorgerufen werden konnte.
Paul Diepgen (1878-1966).

• Ueber das Vorkommen von Oxybuttersäure im Harne bei Diabetes mellitus.
  Centralblatt für die medicinischen Wissenschaften, 1884, 22: 242-243.
  Discovery of ß-oxybuturic acid in diabetic urine.
• Ueber einen Fall von Akromegalie.
  Berliner klinische Wochenschrift, 1887, 24: 371-374.
  Minkowski called attention to the constancy of pituitary enlargement on acromegaly; he was the first definitely to note this relationship.
• Joseph von Mering, Oskar Minkowski:
  Diabetes mellitus nach Pankreasextirpation.
  Centralblatt für klinische Medicin, Leipzig, 1889, 10 (23): 393-394.
  Archiv für experimentelle Patholgie und Pharmakologie, Leipzig, 1890, 26: 37.
  Beginnt mit den Sätzen "Nach Exstirpation des Pankreas tritt bei Hunden Diabetes mellitus auf. Derselbe beginnt einige Zeit nach der Operation und dauert wochenlang ohne Unterbrechung bis zum Tode der Thiere. Außer dem Zuckergehalt im Harn beobachtet man Polyurie".
• Sir John William McNee:
  Experiments on haemolytic icterus.
  Journal of Pathology and Bacteriology, Chichester, 1913-1914, 18: 325-342.
  Disproving Bernhard Naunyn’s theory that bile pigment formation is a function of the liver cells alone.