CHAPTER VIII.

DIABETES.

Diabetes, being a disease which runs on the whole a steady course unaffected by anything but diet, does not afford a promising field for the use of drugs; but as drowning men catch at straws, patients who have been told that they are incurable are naturally disposed to try any remedy that holds out a prospect of cure or relief. Although there are a good many proprietary remedies for diabetes, few seem to have a large sale, but such as exist are pushed by the usual pretensions set forth in advertisements and circulars. Every one must admit that few things can be more cruel than to trade upon the hopes and fears of sick people or to sell them worthless remedies with the positive assurance of cure. Yet this is what is done by the sellers of quack remedies, and the Inland Revenue pockets the patent medicine duty without a blush. Some account is here given of two much advertised preparations—Vin Urané Pesqui and Dill’s Diabetic Mixture. It may be objected that Pesqui’s Uranium Wine is not a secret remedy because it is said to contain uranium nitrate, pepsin, and “other appropriate elements” added to “old Bordeaux wine”; but uranium nitrate is a drug well-known to the medical profession, and whatever may be its properties it is not a cure for diabetes. There is no trustworthy evidence that it has ever cured a single case, and the most that can be honestly said of it is that patients have improved in general health while taking it, although it has not influenced the amount of sugar. Yet we are told in this advertisement that Pesqui’s Uranium Wine “positively cures sugared diabetes provided it is resorted to at an early stage and used during a sufficient length of time.” Dill’s Diabetic Mixture appears to consist mainly of extract of hydrastis, a well-known drug, which amongst the many virtues claimed for it has never been shown to possess any influence over diabetes; yet the advertisement says that Dill’s Diabetic Mixture is the “only known remedy for this deadly disease”! There is another triple nostrum for diabetes which, on examination, was found to consist of tablets of aspirin, unsweetened lime-juice, and a pink powder composed of sodium sulphate flavoured with oil of peppermint and tinted with phenolphthalein. These simple remedies were solemnly vouched for by the vendors in the following words: “We have satisfied ourselves that the treatment is an absolute and permanent cure”! Apparently the law cannot reach those who publish deliberately untruthful statements with the object of selling their goods. The words of the judgment of the Lord Justice Clerk in a case with reference to Bile Beans, heard on appeal in the Court of Session at Edinburgh, should have aroused the Government to a sense of its duty to provide protection to the public. The Lord Justice Clerk exposed in plain language the procedure by which the vendors of this nostrum had worked up their business and palmed off their medicine on the public, yet the number of their advertisements does not appear to have diminished.

VIN URANÉ PESQUI.

This medicated wine is made in Bordeaux but is sold in this country from a depôt in London. The price charged for a bottle holding 24 fluid ounces is 8s.

A small booklet, entitled _Diabetes and its Cure by the Vin Urané Pesqui_, was enclosed with the bottle; a few extracts from this are here given:

It has been shown by medical statistics that there are in France every year 10,000 deaths or more, due to diabetes through a deficient treatment, whilst they could have been cured by taking the Vin Urané Pesqui....

Organic sugar enters the blood together with the alimentary sugar, the former being destroyed by the molecular changes that it undergoes for the nutrition of the different organs. If not sufficiently destroyed, it is productive of glycohemia, and as it passes into the urine it brings forth glycosuria; this pathological state determines, in course of time, particularly among persons suffering from obesity, some of the following diseases: polydipsy (excessive thirst), oedema in the legs, the enfeeblement of the physical and intellectual faculties, visionary troubles, amblyopia, cataract or gutta-opaca, headaches and anaemia, followed by dryness of the skin, successive furuncles, gatherings or boils, eczemas, itching on the skin provoking an irresistible desire to scratch one self, anthrax, urinary gravel, lumbago, sciatica, albuminuria, polyuria (insipid diabetes, without sugar, excessive emission of urine), rheumatism, dropsy, bulimia (insatiable appetite) or polyphagia, azoturia (large quantity of urine with a heavy percentage of uric acid), then fearful complications; pneumonia, prurience, either vulvar or prepucial; diabetic phimosis, gangrene in different parts of the body, particularly in the toes, the nails of which become black; consumption, etc. Great mental worries are also productive of glycosuria....

Pesqui’s Urané Wine positively cures sugared diabetes, provided it is resorted to at an early stage and used during a sufficient length of time.

As soon as the patient has made use of this wine, his thirst is allayed almost instantaneously; his strength reappears; all his functions are gradually restored; his breathing, which the absence of feculents had rendered difficult, becomes easier; he is no longer put out of breath, nor does he feel any lassitude; he can now walk about without undergoing any fatigue; his look improves and his temper assumes a more pleasant character....

The Vin Urané (Uranated Wine) prepared by Mr. Pesqui, of Bordeaux, has been qualitatively analysed at the Barral chemistry laboratory. The result of this analysis points to this medicine being a compound of old Bordeaux wine, in accordance with Bouchardat’s prescriptions, to which the following elements have been added: azotate of uranium, pepsine, and other appropriate elements.

The dose was given on the label as:

Three small sherry-glassfuls per day, with or without water, 5 minutes before, or immediately after meals, and at night before bedtime.

Analysis of the wine showed it to contain, in 100 parts by measure

Alcohol 8·75 parts. Glycerine 3·55 ” Total solids 2·92 ” Fixed acid, reckoned as tartaric 0·43 part. Volatile acid, reckoned as acetic 0·21 ” Reducing sugar 0·28 ” Cane sugar doubtful trace. Ash 0·30 part. Uranium, equivalent to crystalline uranium nitrate 0·02 ”

No digestive power whatever on egg-albumen could be detected, indicating the absence of unchanged pepsin. The amount of uranium found corresponds to one-twelfth of a grain of the nitrate in 1 fluid ounce, or half a grain in the daily dose, a sherry glass usually holding about 2 ounces.

The cost of the preparation depends, of course, on the cost of the original wine, and is scarcely affected by the added ingredients.

DILL’S DIABETIC MIXTURE.

This mixture is sold by a firm in Manchester at the price of 8s. 3d. for three bottles (not supplied singly), holding 2 fluid ounces each.

It was advertised in the following terms:

DIABETES.

Dill’s Diabetic Mixture is the only known remedy for this deadly disease. No dieting necessary. It also cures Yellow Jaundice, Gall Stones, Hepatic Asthma, and all Liver Complaints. It is also the very best remedy we know for Kidney Diseases.

In a leaflet enclosed in the package it is stated:

In Diabetes the Government returns of health show that 100 per cent. die of the disease—that is, all of them—66 out of every 100 die of Coma, and 34 of Pneumonia, so that in ordinary medicine there is no cure. But after 15 years’ experiment I discovered this remedy, by means of which hundreds have been restored to health and strength, the world and their families. It is the only known remedy for this deadly disease....

... all Liver complaints and Kidney complaints are cured by this remedy. And it is natural that it should be so, for when we know that the Liver is the workshop of the body; that it makes the Blood, and the Bile, and the Urine, and the Sugar which the kidneys only filter out, I say, when we know this, we may be quite sure that any remedy that cures the liver benefits the whole body. The nerves, the flesh, the skin, the blood, and tissues; even the special senses such as sight, hearing, and smell, with the sense of touch are all improved and benefited by it.

The Remedy, it is needless to say, will have to be persevered with. These are deadly diseases and must have time.

The dose was given on the label as:

One teaspoonful every four hours in a tablespoonful of water.

The mixture contained a considerable amount of sediment, partly of a heavy nature and partly very light; this caused some difficulty in dividing the contents of a bottle without altering the relative proportions of the ingredients, and increased the possible error in the quantitative results. Alcohol was present to the extent of 35 per cent.; the heavier sediment consisted of sodium bicarbonate, which is very little soluble in such a liquid; this constituent formed 7·4 per cent. of the mixture. Two alkaloids were present in approximately equal proportions, the total amounting to 0·25 per cent.; these proved to be hydrastine and berberine, and the general nature of the extractive, etc., present showed that they had been added in the form of extract, fluid extract, or tincture of hydrastis; there is no official standard for the alkaloidal strength of these, but, taking the usual proportion, the alkaloid found would represent 1·5 per cent. of extract of hydrastis. This left a portion of the total solids to be accounted for; a small amount of a resin was found which resembled scammony resin in its properties, and a larger proportion of a resinoid having general resemblance to caulophyllin (obtained from the blue cohosh or squaw-root), but the identity of the resin and resinoid could not be established owing to the absence of characteristic properties. The formula was thus found to be:

Sodium bicarbonate 7·4 parts. Extract of hydrastis 1·5 ” Resin, resinoid, and other extractive 2·2 ” Alcohol 35 ” Water to 100 ”

On the rather liberal assumption that the whole of the unidentified portion costs as much as caulophyllin, the estimated cost of the ingredients for 6 fluid ounces is 11d.

LANCASHIRE NOSTRUM

A treatment for diabetes was, and perhaps is still advertised by a firm of manufacturing chemists in Manchester. In a letter addressed to an enquirer the manufacturers wrote:

The treatment was recently discovered by a Lancashire doctor who had himself suffered from diabetes for a great number of years, and used all the recognized medical treatments without effect. His own discovery cured him entirely. The formulas have been entrusted to us, and we are manufacturing and offering the preparation to the suffering public. We have satisfied ourselves that the treatment is an absolute and permanent cure.... We have, therefore, every confidence in recommending it to you.

These statements are supported by a batch of testimonials which are not so strong as is usual in such cases. For example, one is headed in black type, “Completely cured a gentleman and his two friends,” and runs as follows:

Dear Sir,—I received the treatment yesterday. A friend of mine, a London gentleman, has told me your treatment and the Gluten Bread has (_sic_) completely cured him and two friends of his of sugar diabetes.

The medicines supplied consisted of (1) tablets, of which four were to be taken each morning, and (2) a mixture. A month’s supply was forwarded for 10s. 6d., from two to four months’ treatment being said to be sufficient. A booklet was also sent giving the usual directions for a diet free from carbohydrates, and enjoining the use of warm clothing, with occasional hot or Turkish baths. The tablets (1) contained 5 grains of aspirin; the mixture (2) was composed of unsweetened lime-juice containing 6 per cent. of free citric acid. A pink powder, described as an aperient, consisted of dried sodium sulphate, flavoured with oil of peppermint, and tinted with phenolphthalein. These remedies are not new, nor has their use been attended with any particular success in the treatment of diabetes. It is difficult to see why they should give better results when supplied as a nostrum than when ordered in the usual way by medical men, unless we attribute something to the suggestive power of bold assertions and public advertisement.

NOTE ON DIABETIC FOODS.

In the treatment of diabetes it is the rule, in order to diminish the amount of sugar passed, to decrease or altogether exclude starchy foods from the dietary, and to replace them by various substitutes, of which the most important are gluten bread and biscuits. Some of the so-called gluten flour and special foods sold as suitable for diabetic patients are impositions, inasmuch as they are found to contain either as much or nearly as much starch as ordinary flour. In one instance brought to notice at the end of 1905, a so-called gluten flour and special diabetic foods obtained from Messrs. H. H. Warner and Co., Ltd., who are also the vendors of Warner’s Safe Cure, but who in this instance acted as agents, it was found that the flour was practically ordinary wheaten flour. This is indicated in the following table, in which the result of the analysis of the special articles is placed side by side with the figures of the official analysis of wheaten flour published by the United States Department of Agriculture:

--------------------------+-------------------+-------------------- | Department of | The Special |Agriculture, U.S.A.| Materials. +---------+---------+---------+---------- | Spring | Winter | Gluten | Special | Wheat. | Wheat. | Flour. | Diabetic | | | | Food. +---------+---------+---------+---------- Water | 10·4 | 10·5 | 12·65 | 11·06 Proteid | 12·5 | 11·8 | 10·60 | 12·40 Fat | 2·2 | 2·1 | — | 3·00 Convertible carbohydrates | 71·2 | 72·0 | 70·30 | 71·06 Mineral matter | 1·9 | 1·8 | 0·44 | 1·52 Fibre | 1·8 | 1·8 | — | — --------------------------+---------+---------+---------+----------

It will be seen that the amount of starch and other convertible carbohydrates in spring wheat is 71·2, and in the so-called gluten flour 70·30.