r VOLTM. 80 DIABETES MELLITUS-MAJOR 1597
THE TREATMENT OF DIABETES MEL- disappear from the blood and urine, and that the blood
sugar is lowered and maintained at a normal level. They
LITUS WITH INSULIN * found also that the alkali reserve returns to normal and
RALPH H. MAJOR, M.D. that the cardinal symptoms are relieved. Perhaps the
KALP A H.T MAJOR,MD. most interesting statement that they make is that insulin
KANSAS Cli¥, KAN.
KANÇS CTY, ;N is a specific in the treatment of diabetic coma.
The recent isolation by Banting and his co-workers
of an active glycolytic, nontoxic, pancreatic extract
opens up a new era in the treatment of diabetes mellitus.
Ever since the classical experiment of Mering and
Mil:kowsky proved the existence of pancreatic diabetes,
freluent attempts at specific pancreatic therapy have
been made. These attempts in the past have been uni-
formnly unsuccessful and now possess little but histor-
l'he isolation of insulin, which is described as the
ac;iie hormone of the islands of Langerhans, has
e xited unusual interest among both physiologists and
clh :icians. Allen' has written an excellent summary
ofi ial articles published on this subject up to August,
1'(2, and enables one to trace step by step the various
pli:~ses in the development of this important discovery.
Fig. 2.-Appearance of patient, Feb. 26, 1923.
The preparation of insulin (insulin-Lilly) which is
made in the United States has been used extensively in
this country during the last few months. We thought
it might prove of interest to record the results obtained
in this clinic with the use of this preparation. We have
used it in the treatment of thirty cases, and the results
obtained have confirmed the therapeutic value described
by Banting, Campbell and Fletcher. This group con-
sisted mainly of moderately severe cases, but also
included four cases of severe juvenile diabetes, four
patients on the verge of coma who could be aroused
only with great difficulty, and three patients in complete
coma. Since a detailed description of the cases is not
Fig. 1.-Boy with severe juvenile diabetes, Dec. 7, 1922. attempted in this report, a few typical results are
shown in the accompanying illustrations and charts.
A more recent article by Banting, Campbell and ,The boy shown in Figure 1 is an example of severe
Iletcher 2 describes the results obtained from the use juvenile diabetes. At the time the picture was taken,
of this preparation, in patients suffering from diabetes. Dec. 7, 1922, he had had diabetes for two years, and it
'They state that glycosuria is abolished, that ketones had been impossible to render him aglycosuric except
-- FmthDpatcon a diet of 5 per cent. vegetables, with days of com-
h From the Department of Internal Medicine, University of Kansas plete starvation. His weight at this time was 15 pounds
1. Allen, F. M.: Summary of Publications on Insulin to Date, (6.8 kg.). Treatment was begun at the St. Louis Chil-
J. Metabol. Res. 2: 125, 1922. en's "s' n
2. Banting, F. G.; Campbell, W. R., and Fletcher, A. A.: Furthe dren's Hospital uder the direction of Dr. W. McKim
Clinical Experience with Insulin, Brit. M. J. 1:8 (Jan. 6) 1923. Marriott, to whom I am indebted for this picture and