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patient’s urine. He concurred with
Aretaeus that there were two forms
of the disease. He also described diabetic gangrene and treated the disease
with a mixture of lupine, trigonella
(fenugreek) and zedoary seed. This
mix considerably reduced the excretion of sugar and is still prescribed
today. Avicenna also described diabetes
insipidus quite clearly for the first time.
The term mellitus, or “from honey,” was
added by Thomas Willis in his 1674
Pharmaceutice rationalis to separate
the condition from diabetes insipidus,
which is also associated with frequent
urination. But the distinction between
type 1 and type 2 diabetes wasn’t made
clear until January 1936 by Sir Harold
Percival (Harry) Himsworth.
Treatment
Diabetes Through The Ages
From ancient Egypt to today, diabetes has had
an impact on humanity
By Angela S. Hoover, Staff Writer
Diabetes is a condition that has
afflicted human beings for thousands
of years.
Discovery and
Diagnosis
The first described cases of diabetes
are believed to be of type 1 diabetes.
The first written account of diabetes
symptoms is from 1552 B.C.E. by
an Egyptian physician, Hesy-Ra. He
documented frequent urination as a
symptom of a mysterious disease that
also caused emaciation. His exact words
were: “Too great emptying of the urine.”
Around the same time, Indian physicians identified the disease and called
it madhumeha – honey urine – noting
that the patient’s urine attracted ants.
The term diabetes, which means
“to pass through,” was first used in
250 B.C.E. by the Greek Apollonius of
Memphis. In 150 C.E. the Greek physician Aretaeus of Cappadocia described
diabetes as “the melting down of flesh
and limbs into urine.” His is the first
complete clinical description of diabetes. Aretaeus also noted the excessive
amount of urine that passed through
the kidneys. According to his chronicles, it seems diabetes mellitus was a
death sentence at that time. Although
he tried in vain to treat it, he wrote that
“life (with diabetes) is short, disgusting
and painful.” Interestingly, the famous
physician Hippocrates made no mention of diabetes, which could mean he
believed it to be incurable. It is suspected diabetes was rare during the days of
the Roman Empire; Galen of Pergamon
commented he had only seen two cases
during his career.
Diabetes was diagnosed by “water
tasters” – people who tasted the urine
of those suspected to have diabetes. If
the urine tasted sweet, the patient was
diagnosed with diabetes. It wouldn’t be
until the 1800s that scientists developed
chemical tests to detect the presence of
sugar in the urine.
Type 1 and type 2 diabetes were
identified as separate conditions for
the first time by the Indian physicians
Sushruta and Charaka in 400-500 C.E.
Type 1 was associated with youth and
type 2 with obesity.
Avicenna, who lived in medieval
Persia from 980-1037 C.E., gave a
detailed account of diabetes mellitus in
The Canon of Medicine. He described
the symptoms of “abnormal appetite
and the collapse of sexual functions”
and also noted the sweet taste of the
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The first known diabetes treatments
were exercise, especially horseback riding, which was thought to relieve excessive urination.
During the 1700s and 1800s, physicians noticed dietary changes could
help manage diabetes. Patients were
advised to eat only the fat and meat
of animals and not to consume large
amounts of sugar.
During the Franco-Prussian War
of the early 1870s, French physician
Apollinaire Bouchardat noticed that his
diabetic patients’ symptoms improved
with war-related food rationing. He created individualized diets for his patients
with diabetes. Bouchardat’s methods
led to the fad diets of the early 1900s,
which included the “oat cure,” “potato
therapy” and the “starvation diet.”
Boston scientist Elliott Joslin became
the world’s leading expert in diabetes
with his 1916 book The Treatment of
Diabetes Mellitus. Joslin recommended
a fasting diet and regular exercise to
reduce the risk of death from diabetes.
His advice is still used today to educate
patients about lifestyle changes for
the management of diabetes. But it
wasn’t until 1922 that insulin was first
used as an effective treatment, thanks
to Canadians Frederick Banting and
Charles Best.
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