FIRST CLINICAL TRIAL OF INSULIN 105
successful. Some of these people can add, Geneva, and I
know it is not fair to give away a woman's age, but it is
important that physicians and parents and patients should
understand that the prognosis in juvenile diabetes has
utterly changed and we now see no reason why children
with diabetes should not live at least to a normal life expec-
tancy. And why not to old age? The bogey of the inevit-
able degradation of tolerance for carbohydrate that once
helped us to excuse our failures is now no more. Too many
diabetic people in the insulin era, as Joslin has called it,
have lived and disproved it. For those who fail, there is a
cause: perhaps the patient, relative or doctor, self-indul-
gence, neglect or infection. Let us face it squarely.
One of the most important developments of this inves-
tigation is the psychological one. Diabetes has been
changed from a metabolic disease, incapacitating and prog-
ressing slowly or more rapidly to an inevitable end, to a
metabolic defect and this metabolic defect is controllable
by suitable, though different, diet and the skilful applica-
tion of crutches called insulin, thus enabling the patient
and his family to live long, happy, and useful lives. The
physician who cannot use this weapon for the strengthen-
ing of his patient's morale, who cannot make his patient
see that science has discovered a.way to train him to win
the game is indeed to be pitied: he, and his patient also,
for hope well founded is the most precious thing that we
can offer to the suffering.
New problems await us and old problems remain yet
unsolved. Earlier diagnosis, earlier and better treatment
are important, but some of these problems are bound up
with insulin, in that insulin now enables the diabetic to live
long. I refer to the problems of ageing in the diabetic.
Perhaps, too, in their solution some of the problems of age-
ing in the population as a whole may be solved. The prob-
lems of the intermediary metabolism of man are-now
here, now there-yielding to the skill of men of vision and
dogged perseverence. It is not too much to hope that we
shall soon see the picture whole and in it the solutions we
seek. Like Franz Urbach's "phosphor," insulin has been
and still is converting the invisible infrared into visible
light for the searchers in this field.