662 INSULIN IN HOSPITAL AND HOME
the percentage gains are highest in the younger patients. There
is no particular difference in the number of days which the old
and young have required to gain a pound of weight.
Diabetes in the first decade of life is considered to reach the
acme of severity.
Age of Patients at Beginning of Treatment with Insulin
Total Cases Avail- Av. Gain in Weight Average No.
Age by Decades No. of able for per Patient Days for Gain
Cases Statistics Lbs. Per Cent of 1 Lb.
0-10........... 14 10 4 10 13
11-20......... 19 18 7 8 10
21-30............ 9 4 8 7 7
31-40....... 13 7 5 5 13
41-50........... 11 8 6 7 15
51-0. ....... 8 3 5 4 7
61-70............ 7 3 4 5 12
71-80............ 2 0O
Age of youngest, 2 years.
Age of oldest, 77 years.
The youngest patient with diabetes, longest under our personal obser-
vation, who has been given insulin is Frederic G., Case No. 1616, who first
came for treatment September 1, 1919, showing 3.8 per cent. of sugar and
+- acidosis. Between that period and his return to the hospital on
November 3, 1922, he was free from glycosuria for about 6 months, but
during 1922 on account of taking food it has been impossible to keep him
sugar-free, and the glycosuria has varied between 1.4 per cent. and 4.4
per cent. The little boy was so hungry that he would burn his hands
taking food out of a hot oven, would get up at night when others were
asleep to secure food. On November 3, 1922, his parents brought him
back to the hospital saying, "Dr. Joslin, do anything you want with
Frederic, you can't make him any worse." At that time he was carried
in on a cushion, but about two weeks after his return home his mother
reported that he was carrying a gun on his shoulder while marching with
the other children and on January 26th again writes, "He is feeling fine
and would not touch a particle of food other than his diet. He walks
down town every afternoon and it is amusing to see the children on the
street look at him because he has not walked any for the last two years."
Nothing we can say based upon laboratory results can equal in importance
statements of this character.
Frederic G. had more reactions from insulin than any other patient,
but Frederic G. had derived from insulin unusually good results. Between
November 4, 1922, and January 18, 1923, he has taken approximateIy 1011
units of insulin and has gained 4.75 pounds or 17 per cent. body weight.
Dorothy Z., Case No. 2508, lives 114 miles from Boston, developed
diabetes July 7, 1921, has been under our observation since January 31,