Insulin Marches On

Headliners on the program of the 117th annual meeting of the Medical Society of the State of New York, attended by 2,000 physicians, were Dr. Frederick G. Banting, the young Toronto investigator who discovered insulin (TiME, April 21), and Dr. J. J. R. MacLeod, his chief in the physiology department of the University of Toronto. They received an ovation and brought the cheering message that there is enough insulin in sight, in the pancreas glands of beeves and other food animals, to take care of all the diabetes in the world. Adequate doses for any patient can be secured at a cost of from 30 to 75 cents a day. This sets at rest fears that the commercial supply of the extract would be limited. Other sources proposed include green vegetables and roots, in which Dr. J. B. Collip, of Alberta, has found an insulin substitute called " gluekokinin," and the pancreas of sharks and other fishes, which are being investigated by the U. S. Bureau of Fisheries and the Public

Health Service. Dr. MacLeod said that insulin could never have been developed without animal experimentation.

Insulin is now thoroughly established as a therapeutic agent of un- questioned value, although the technique of its use has not been standardized, and warnings against false hopes have been sounded. From every side come reports of cured cases. Dr. Elliot P. Joslin, of Boston, used it successfully in 143 out of 150 cases.

A child, dying from diabetes when admitted a month ago, was shown to the visitors at St. Mark's Hospital as a clinical exhibit. Fifty cases have been alleviated at the Montefiore Hospital under Dr. A. I. Ringer. One of the most encouraging features is that insulin averts the condition known as diabetic coma, which is the last stage of many fatal cases. Patients have even been restored and cured from this unconscious condition by its use. It has been employed with success in maternity cases aggravated by diabetes, which have hitherto usually been fatal to the mother. It has also made it possible to anaesthetize diabetic patients for operations, and has enabled patients with tubercular complications to eat nourishing foods.

Another high spot in the New York meeting was the announcement by Dr. Rufus I. Cole, director of the Rockefeller Institute Hospital, that the anti-pneumococcus serum developed there for several years has shown almost complete effectiveness in the treatment of lobar pneumonia. Of 221 cases treated since 1914, there have been 24 deaths, but six of these were due to earlier complications. The actual mortality was thus but 7 1/2%. The treatment is for the " Type 1" pneumococcus, which is present in about 60% of all cases. The difficulties of administration are great for the general practitioner, but the State Board of Health gladly renders laboratory service, which is essential to the treatment, in determining the type of pneumococcus.