DISCOVERY 



13 



Insulin and the Gland 

 Treatment of Diseases 



By R. J. V. Pulvertaft, B.A. 



There are fashions in medicine at least as transient, 

 as varied, and as emphatic as in feminine clothing. 

 We have passed through the age of " humours," when 

 the body was supposed to be at the mercy of vague 

 warring influences, which swayed it hither and thither ; 

 we are now in the hey-day of the gland theory ; the 

 old " humours " are to-day called " hormones," or 

 " excitants," and we are well content with the new 

 name. But behind the large amount of absurd 

 speculation which fills the advertising pages of medical 

 papers, there is a great deal of valuable truth. " Insu- 

 lin," the new substance which is used in the treatment 

 of that fatal disease, diabetes, is the latest production 

 of this age's medical fashion — untried, to any large 

 extent, as yet. And, while we bear in mind that 

 there is such a thing as transatlantic optimism, it 

 appears that much may be expected from it. 



A French scientist, Brown-Sequard, in 1891 , was 

 the first to use extracts of animal glands to treat 

 bodily ailments. He employed preparations of the sex 

 glands of dogs to ward off old age in men. Metschni- 

 koff, a Russian scientist, welcomed this notion as the 

 promise of eternal life, when combined with a wise 

 discretion in diet and a devotion to sour milk ! Per- 

 versely, we still die ; we " grow old as doth a gar- 

 ment." But Brown-Sequard grasped the idea that 

 the blood in flowing through an organ might be so 

 changed that it would affect other organs. The new 

 substance so produced was called in 1902 by Bayliss 

 and Starling, two contemporary English physiologists, 

 a "hormone." The field has widened ever since; 

 to-day we may, as a recent writer has ironically 

 pointed out, eat like Alice in Wonderland of one gland- 

 mushroom and be a giant, of another and be a dwarf. 



The pancreas, a digestive gland, is one organ capable 

 of so altering the blood that it produces far-reaching 

 effects on the chemistry of the body. We argue this 

 from the effect of disease of the pancreas in causing 

 diabetes ; and from the production of diabetes in dogs 

 on removing this gland or destroying certain parts of 

 it. But the argument that extract of pancreas would 

 cure this disease is not necessarily valid, for in a disease 

 which follows on destruction of another gland, the 

 suprarenal, glandular extracts have proved very dis- 

 appointing. 



However, there is one well-known case where gland- 

 extracts certainly improve conditions — a certain type of 

 dwarfish idiot known as a cretin is greatly improved 

 physically and mentally by being fed with thyroid 



gland from the neck of a sheep. And there are certainly 

 many abnormal conditions of growth which depend 

 on the workings of a small gland near the brain, called 

 the pituitary. Charles Byrne, the Irish giant, whose 

 skeleton is preserved in the museum of the Royal 

 College of Surgeons, was an extreme example of an 

 over-secretion of a part of this gland, associated with 

 a gigantic stature ; the fat boy of Peckham owed his 

 girth to its diminished activity ; and perhaps Hop o' 

 My Thumb of the fairy-tale was one of a group of 

 tiny miniature men, whose stunted growth is attri- 

 buted to destruction of the pituitary gland. 



The truth underlying the gland-treatment of diseases 

 would appear to be that our body must be considered 

 as a whole. There is a balance between the workings 

 of one organ and another ; by the blood-stream and 

 by the nervous machinery of the body a due propor- 

 tion is preserved. If a gland is for practical purposes 

 absent, as in the dwarfish idiot alluded to, gland- 

 extracts are of service. But when a disease attacks 

 the body, it is no simple matter to discover where 

 the real trouble is ; the changes in the pancreas may 

 be only a sign of the wider and more obscure changes 

 in diabetes. Up to the present, extracts of pancreas 

 have not brought more than transient relief ; it 

 remains to be seen whether the new and more stable 

 " Insulin " will prove to be efficient. 

 REFERENXES 



Glands in Health and Disease. By Dr. B. Harrow. (Xew 

 York, E. P. Button & Co., 1922.) 



Lancet, Saturday, November-i8, 1922. 



Principles of General Physiology. By W. M. Bayliss. (Long- 

 mans, Green & Co.) 



Between the Covers 



WATER-POWER IN THE BRITISH EMPIRE 



In November 1917 a Committee was formed by the 

 Conjoint Board of Scientific Studies to investigate the 

 resources of the British Empire for the production of 

 hydraulic power. Subsequently a Board of Trade 

 Committee considered the water-power of the United 

 Kingdom. The reports of both Committees have now 

 been published, and in his preface to Water-Power in 

 the British Empire, a collection of the reports of the 

 first-mentioned Committee (Constable & Co., Ltd., 

 js. 6d.), Sir Dugald Clerk, K.B.E., F.R.S., Chairman 

 of the Committee, and also a member of the second 

 Committee, is able to give a most interesting outline 

 of the present position. " The coal position of the 

 world must deteriorate from decade to decade," and 

 the obvious substitute for coal and oil is water-power. 

 "The world," writes Sir Dugald Clerk, "may be 



