After the investigators had completed the trials of the preparation in their own hospital, plans were made for extensive clinical investigation in other institutions in which there were men capable of conducting scientific studies on diabetes. More than 50 institutions were utilized in order to give the drug the most complete possible scientific trial before offering it to the medical profession in general; and when at last these trials were completed and the co-operating manufacturing concerns had fully developed the machinery for production of the drug on a large scale, it was released to the medical profession throughout the world.
Patients must do their part.—It should be understood that if the patient is to receive the greatest benefit from this new remedy, he must co-operate fully and intelligently with his physician. As soon as he discovers through competent examination that he is excreting sugar in his urine, he should consult his physician as to the use of the drug and a proper diet.
In many instances, the use of insulin is unnecessary because the patient is able to live satisfactorily without insulin on a diet with the proper amount of sugar or carbohydrate material. In other instances, the dosage of insulin may be very small, but this will depend on a careful and intelligent study of each case.
It is now rather generally known by the public that insulin is a preparation which is administered hypodermically, that is, injected with a needle under the skin. It cannot be taken by mouth, because the substance is digested before it can be absorbed into the blood. This does not mean that the patient must seek his physician for every treatment, because many competent specialists in the treatment of this disease have found that patients may be taught to regulate their diet and use the drug intelligently.
Recognition of the work.—As soon as it became known that this discovery was available, diabetics flocked to their physicians and began to inquire as to the possibilities of its use to “cure” the disease; but the drug is not in the usual sense of the word a “cure” for diabetes. Diabetes represents the absence from the body, probably as the result of disease, of certain substances which are responsible for the control of the digestion and use of sugar, and insulin cannot restore these tissues or substances any more than the injections of other glands can restore youth to the aged. It can only replace temporarily the substances that are absent; but in the case of a diabetic, this constitutes the difference between life and death.
Naturally Doctors Banting, Best, Collip and MacLeod have received great honors at the hands of their colleagues and of the world. The Canadian government has granted to Dr. Banting the sum of $7,500 per year for life; the Ontario government has provided $10,000 a year for a chair of medical research, now held for the first time by Dr. Banting; learned societies throughout the world have greeted him with the applause usually accorded only to military heroes.
The victor in the conflict of science with disease is certainly deserving of the wreath of the conqueror.
MORRIS FISHBEIN.
DIABETES: ITS CAUSE AND ITS TREATMENT WITH INSULIN
Insulin a welcome discovery.—The discovery of a method for obtaining insulin in a form suitable for use in treating diabetes is a cause for genuine rejoicing. The sensational newspaper and magazine articles that greeted the discovery were, in a sense, a public expression of such rejoicing, and their exaggerations may be forgiven if this is remembered. The effort to gain an understanding and a sure method of controlling diabetes has taken years, and while the scientist delved in his laboratory, the seemingly unconquerable disease continued to take an ever-increasing toll of young and aged victims. In New York City, for instance, where statistics collected by Dr. Emerson are most reliable, the deaths from diabetes in 1866 were only 1 for each 2,437 deaths from all causes. In 1923, one death in every fifty-one was due to diabetes. The diabetic death rate in New York City was trebled between 1880 and 1920 for ages up to forty-five years. For ages of forty-five and more, it was quintupled. There are probably more than a million patients with diabetes in the United States. No wonder then that mankind in general was overjoyed when the news came that the young Canadians, Banting and Best, had discovered insulin.