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No. 3065:
Victor and Eva Saxl

by Chris Miller

Today, love, war and insulin. The University of Houston presents this series about the machines that make our civilization run, and the people whose ingenuity created them.

Victor and Eva Saxl married in 1940 in Prague. Barely newlyweds, this Jewish couple fled their homeland to escape the Nazi occupation of Czechoslovakia. They found asylum in Shanghai, China. But this was no Shangri-La. The Jewish ghetto in Shanghai housed 30,000 refugees who lived in overcrowded conditions with poor sanitation. 

Less than a year later, doctors diagnosed Eva with diabetes. Victor vowed to take care of her under any circumstances. He took an active role in her treatment by giving her daily insulin injections. Then World War II came to the Pacific as America declared war on Japan. Japan clamped down on its territories and cut off all medical supplies.

The people with diabetes in Shanghai searched for new sources of insulin as supplies dwindled. Black-market insulin was extremely expensive, of unknown quality, and sometimes poisoned. Victor begged the Japanese army to resume insulin shipments. But they rejected his pleas, because this was war, and casualties were expected.

Only one option remained for the Saxls: make the insulin themselves. Victor borrowed a medical text that described the process, and a food chemist provided lab space. Researchers took years to perfect the refining of insulin into a safe and effective form. Victor had only weeks.

His first batch looked like murky dishwater, not clear and colorless like pure insulin. Further, he had no idea of its potency or if it was contaminated with bacteria. Insulin is fragile; heating it to kill bacteria also breaks it down. So the medicine meant to help Eva, could also make her sick -- or worse.

Despite the risks, Eva volunteered to test the homemade insulin herself. Victor and a physician friend brought it to her. Victor injected Eva with a dose then left the room — he couldn't bear to watch if she had a bad reaction. Eva and the doctor waited while Victor prayed in the next room. One hour. Two hours. Miraculously, Eva felt the insulin working and experienced no side effects. The three rejoiced, but only briefly. Victor ran the remaining batch to a nearby hospital where two patients lay near death in diabetic comas. After receiving the insulin, both survived.

The Saxls produced insulin for over 400 people in Shanghai over the next five years. At war's end, they met with a US Army medical officer who brought them supplies of refined insulin. The Saxls cried when they saw the vials of the clear, pure liquid again.

Victor Saxl's love, dedication and perseverance saved not only his wife, but hundreds of other diabetic patients in Shanghai. But let's not forget Eva. She courageously volunteered to test the homemade insulin on herself, not knowing its possible effect on her — or if she'd even survive. These two heroes remind us that acts of bravery during wartime do not always happen near the front lines.

I'm Chris Miller, along with the University of Houston, where we're interested in the way inventive minds work.

(Theme music)

This episode is dedicated to my lovely wife, my extended family members, and everyone who fights their own battle with diabetes on a daily basis.

Diabetes (i.e., Diabetes Mellitus) is a disease where the body either does not produce enough insulin or cannot use the insulin it makes (CDC website). The hormone, insulin (produced in the pancreas), transforms sugars in the blood into a form that cells can use. Without it, sugars and fats build up in the blood. Chronic high blood glucose levels (hyperglycemia) may lead to organ damage. Conversely, a person with a mildly low blood sugar level (hypoglycemia) may experience unease, sweating and/or trembling. A severely low blood sugar level can lead to changes in behavior, confusion, unconsciousness, seizures or (if not treated immediately) death.

Frederick Banting and his medical student, Charles Best, were credited with being the first to extract insulin from the pancreata of dogs in 1921 (ironically the same year Eva Saxl was born). With the help of James B. Collip and J.J.R. Macleod, they developed the extract into a form safe for treating humans.

Victor Saxl extracted the insulin from water buffalo pancreata bought from a local slaughter house. They chose the water buffalo pancreas due to its large size, and therefore greater volume of insulin. After creating the first batch of insulin, Victor performed successful tests on rabbits before he tested the insulin on Eva. When the Saxls started producing insulin on a regular basis in Shanghai, local Japanese citizens often helped by bringing ice for the isolation process.

The Saxls stayed in Shanghai for two more years after the war, and then immigrated to the United States. Their story made them celebrities, and they became spokespersons for diabetes education. They corrected misinformation and stigmas about diabetes that were prevalent in the 1940's and 50's. 

The Saxls' story also appeared in this newspaper article (Kentucky New Era, November 6, 1951).

For more information on living with diabetes, visit the American Diabetes Association website.

A photo of Victor and Eva Saxl can be found here.

This episode was first aired on May 17, 2016