104 AMERICAN DIABETES ASSOCIATION
of instruction for physicians were given in Toronto and
elsewhere to ensure more thorough understanding of the
properties of insulin and its application in treatment. The
number of "first cases to receive insulin" in various quar-
ters of the globe, which I have encountered, is very great.
It is, however, of the greatest significance that so many of
these early insulin patients are still living*.
With us, celebrating this day commemorating twenty-
five years of insulin, is a young girl of eleven years-at
least she was when first I knew her. A daughter of a
woman physician, she had been stricken with severe dia-
betes a year previously. She had received the best of care;
nevertheless, the condition had progressed. Fully familiar
with the immediate dread prospect, her mother wrote to us
and we decided that she was a case of considerable severity
and invited them to come to Toronto. The severe cases
were welcomed both because only such could provide un-
equivocal proof of the efficacy of treatment with insulin
and because the supply of pancreatic extract still was small
and the less severe could afford to wait. She came to us,
not with pigtails flying down the wind, as is the right of
childhood, but grave-faced and listless, tired and wan.
"Mother, what are they going to do to me?" she asked
without much interest. "They are going to make you bet-
ter, dear." The hope in the eyes of patients was a chal-
lenge to us all.
Well, Geneva helped us with our proofs and we helped
Geneva. Today she is attending our meeting, joyous, clear-
eyed and vibrant. She has outlived by a hundred times her
first prognosis and is now the busy and hard working audi-
tor for a large midwestern institution. Do you marvel
that we are proud? But let me say here that she illustrates
the first principle of treatment in diabetes, which is not
any particular type of diet or kind of insulin but Control
and Control and Control. Call it discipline if you like-
too many people hate that word-but it represents the
foundation of that morale which makes great soldiers and
is also the factor which makes the treatment of diabetes
*Our "first patient to receive insulin" died of bronchopneumonia in 1933, just
prior to the introduction of sulphonamides. While this patient never developed
any increase in carbohydrate tolerance, he was able to do his work acceptably
as an assistant in a drug and chemical factory.