No abstract
FiPTy YEARS AGO, a research project was under way at the University of Toronto that would soon revolutionize the treatment of diabetes. The first public announcement was made on 14 November 1921. The reports that an extract of pancreas had demonstrated life-saving effects were at first received with scepticism, incredulity, and faint hope. But soon the miracle of insulin was everywhere acclaimed. THE STATUS OF A DIABETES TREATMENT BEFORE INSULIN After five decades, it may be difficult for those who were unacquainted with diabetes in the pre-insulin days, to realize how much of a miracle was this discovery that transformed a disease, so often hopeless, to a disorder now subject to control or alleviation. I find myself among the dwindling numbers of active physicians who can recall from direct observation what the management of diabetes was like in those days. Having been admitted to medical school as a teenager, I also had the good fortune to be an eyewitness of events at the University of Toronto. My own boyhood memories bring to mind three examples of diabetic disasters, then not uncommon. First, a neighbour, a man in his late fifties, began to have severe pain in one of his toes, causing constant suffering and loss of sleep. Then to his horror it began to turn black. His family doctor called it gangrene and confirmed the diagnosis of diabetes which he himself had feared, since a brother and several members of his family had been diabetic. A surgeon, consulted in the hope that the gangrenous toe could be amputated, was unwilling to operate. He stated that, with diabetes, healing would fail to occur. The man was bedridden for months as the gangrene extended into his foot. Finally death came to end his suffering. Second, this man's daughter was found, years later, to have diabetes and tuberculosis. She died from so-called galloping consumption. Third, a young sister of one of my schoolmates, with diabetes in an early stage, was treated with the Allen 'starvation diet' then in vogue. Introduced by Dr. Frederick M. Allen, and promoted by Dr. Elliott P. Joslin, dietary restriction of extreme degree was then the chief hope for juvenile diabetics. The results for this girl at first appeared successful, but suddenly diabetic coma developed and she was gone. Cases such as these were known in every community. When I became a medical student, I studied The Principles and Practice ofMedicine written by Osler and McCrae,1 a textbook universally used at that time by medical students in Toronto. I read with particular interest the section on diabetes. This book * Presented at the Annual Symposium of the
ONE of the problems most frequently encountered by the general practitioner and the internist is a complaint variously described as weakness, exhaustion, fatigue, loss of ambition, low vitality or weak spells. Weakness and fatigue, alone or dominating a group of other symptoms, cause thousands of people to suffer disability and a greatly lessened enjoyment of life. What can the physician do to investigate these complaints and how can he determine their cause? To present an answer to this question from our experience at the Lahey Clinic, data have been compiled on 300 consecutive cases in which weakness, fatigue or weak spells were the chief complaint.
No abstract
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.