INFLUENCE OF THE ANTI-DIABETIC SUBSTANCE 69
1922. The urinary sugar at this time reached its lowest point,
9.17 gms. Acetone was reduced about one half the former quan-
tity and diacetic acid was absent on fourteen of the eighteen
The patient was transferred to his home July 31, 1922 and
kept at rest and on a diet consisting of carbohydrate 28.52 gms.,
protein 76.16, fat 127.04, and total calories 1,900. No treatment
was given from July 29, 1922 to August 13, 1922. During this
time the blood sugar rose somewhat but did not return ,to the level
before treatment was started. The urinary sugar averaged
from 39 to 52 grams. The acetone and diacetic acid 1+.
Forty-five injections were given subcutaneously during the
period from August 13, 1922 to October 13, 1922. From one to
three injections were given daily with occasional intermission.
Extracts secured by different methods were used. By means of
the subcutaneous method of injection, the blood and urine sugar,
acetone and diacetic acid were reduced to normal. The clinical
symptoms entirely disappeared. Marked reduction in blood
sugar was at times noted. On August 25, 1922 the blood sugar
was reduced from 0.320 to 0.200 six hours after a single in-
jection of the pancreatic extract. On September 9, 1922 the
blood sugar was reduced from 0.200 to 0.092, a reduction from
0.328 to 0.092 in twenty-three hours by four injections sub-
cutaneously. The blood sugar rose over night to 0.200. In six
hours by a single injection it was reduced to 0.070. The urinary
sugar, acetone and diacetic acid disappeared entirely. The diet
was increased to carbohydrate 50.52 gms., protein 119, fat 167,
arnd total calories 2,500. The urinary sugar, acetone and diacetic
acid remained absent. The blood sugar showed a slight rise.
Some of the earlier injections showed some pain, local edema
and occasionally temporary redness. Only three of the forty-
five injections showed definite local reaction. Later injections
were non-toxic and non-irritating. Pain is no greater than can
be accounted for by tissue distention.
Subcutaneous injections were discontinued October 4, 1922
and the extract given by mouth for two days. During the next
three days the extract was given in salol-coated capsules. Neither
method was plainly effective.
Subcutaneous injections were again given and the blood and
urinary sugar were reduced.