A History of Diabetes, Pre Insulin, Part 1

To lead into discussing the discovery of insulin, today we have a history of diabetes and its treatment in the centuries before insulin was developed, including the starvation diets that were used in the years just before the discovery. 

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Episode Transcript

Speaker 1 (00:01):
Welcome to Stuff You Missed in History Class, a production
of I Heart Radio. Hello, and welcome to the podcast.
I'm Tracy B. Wilson and I'm Holly Fry. Before we
start on today's episode, I wanted to update folks. We
mentioned previously a couple episodes ago that we are going

(00:23):
to be doing a live show on July five at
Adams National Historical Park in Quincy, Massachusetts, and I just
wanted to let folks know that the park has information
about that show up on their website now. So you
can go to NPS dot gov slash Adam, which is
the Adams National Historical Park website. You can scroll down

(00:43):
to the calendar we're on there, or it's also on
their Facebook at facebook dot com slash Adams and PS
and that show. If you missed the announcement previously, it's
gonna be on July five. It is a daytime, outdoor show,
two pm. It was a fun time last time we
were there, so we're expecting another fun time. Yes, fingers
crossed whether or not we have any ghosts that get

(01:06):
in the machine and messed with recording. I plan to
have all kinds of fun me too, And now we
will get into today's episode. We have gotten a lot
of requests over the years to talk about the discovery
of insulin, and that's something that was so immediately and
dramatically life saving that it was hailed as a miracle.
And that discovery was also deeply contentious. In the words

(01:29):
of John McLeod, who was one of the two men
who was awarded the Nobel Prize for discovering insulin, in quote,
if every discovery entails as much squabbling over priority, et
cetera as this one has, it will put the job
of trying to make them out of fashion. Uh. It
is a high drama story when we get to the

(01:51):
actual discovery of insulin part But we're going to do
this in two parts. I feel like so many of
our scientific discovery stories go that way that it makes
me chuckle that he's like, this one is the most dramatic.
I'm like, are you sure? I think we've We've definitely
talked about a lot of of of fighting among the

(02:11):
discoverers of things. This is the first one I personally
recall in in the modern era that involved fisticuffs. So
we won't get to that part until part two. Because
this is a story that we're telling in two parts. Today,
we have a history of diabetes and its treatment in
the centuries before insulin was developed, and that is going

(02:32):
to include the starvation diets that were included in the
years just before insulin was discovered. And the next time
we will be talking about insulin, including all of that
squabbling and the fisticuffs, and we'll talk about how it
became a widely available treatment for diabetes, along with some
of the developments that have happened since then. And in
both parts of this we're going to be talking about

(02:53):
research that involved testing on animal subjects, and in part
two we'll also be talking about the use of byproducts
from animals that were slaughtered for food. Okay, So, hormones
are substances that help coordinate all kinds of complex processes
in your body, and insulin is one of the hormones
that helps regulate the amount of sugar or glucose in

(03:13):
your blood. Your body has to have glucose to live.
Most of your cells and especially your brain, use it
for fuel, but it's also really important to have the
right amount of glucose circulating in your blood. Having too
much or too little can lead to several complications. Some
of which are life threatening at a very basic level, because,

(03:35):
like Highie just said, these are complex processes. The body's
attempts to regulate blood glucose go this way. When your
blood sugar rises, your pancreas releases insulin, and that prompts
your body to store the extra sugar. Then, if your
blood glucose dips too low, your pancreas releases another hormone
called glucagon, and that prompts your body to release some

(03:56):
of that storage sugar. There are other systems of the
body involved with this, and there are other hormones besides
glucagon that can help raise your blood sugar, but insulin
is the only one that can really lower it. Diabetes melodis,
which you may have heard pronounced a different way I
certainly had up to this point, but that is correct,
is a group of conditions that affect the way your

(04:17):
body produces or works with insulin. In type one diabetes,
the pancreas either doesn't produce any insulin or it makes
very little, which means that the body does not have
a good way to lower blood glucose levels. Although type
one diabetes can develop in people of any age, it
is usually diagnosed in children and young people, which is
why it used to be called juvenile diabetes. It has

(04:40):
also been called insulin dependent diabetes and type two diabetes.
Either the pancreas isn't making enough an insulin although it
is making some, or the body resists the effects of insulin,
so it's also been called insulin resistant diabetes. Type two
diabetes has generally been more preval and adults, although it's

(05:01):
also becoming more common in younger people and because it's
tended to develop during adulthood, Type two diabetes also used
to be known as adult onset diabetes. There is also
gestational diabetes. The hormones involved with pregnancy make the body
more resistant to insulin. In most people, the pancreas increases
insulin production enough to make up for this when a

(05:23):
woman is pregnant, but in others it does not. Most
of the time, this resolves after the end of the pregnancy. Today,
treating every type of diabetes meloitists generally involves diet and
lifestyle modifications, along with regular blood sugar monitoring. There are
also some oral medications that can stimulate the pancreas to

(05:44):
produce more insulin or kind of just how the body
responds to insulin, and sometimes these steps are enough to
manage type two or gestational diabetes, but some people with
these conditions need insulin therapy as well, and this is
especially true the longer someone lives with type two diabetes.
On the other hand, insulin therapy is always necessary in

(06:06):
type one diabetes. Before insulin was developed, people with type
one diabetes typically lived only a few months or years
after they started showing symptoms, as the excess glucose in
their bloodstream ultimately led to coma and death. Although insulin
therapy has existed for less than a hundred years as
of when we're recording this, people have recognized diabetes for millennia.

(06:30):
Ancient and medieval documents have described a group of symptoms
that we still know today, including excessive thirst, excessive urination,
unexplained weight loss, fatigue, and urine that tastes or smells sweet.
And even though these earlier medical writers haven't known what
caused all of these symptoms, they've understood that they were
all connected to one condition. I don't think I have

(06:53):
ever heard the taste part before, and I'm like, gross,
how do we know? Um, yeah, that's used to be
a thing in diagnostic medicine was tasting people's urine. The
earliest known mention of diabetes is often cited as Ebers Papyrus.
This papyrus was written in ancient Egypt in fifteen fifty

(07:13):
two BC, but named for George Ebers, who bought it
and published it in English and Latin in the eighteen seventies.
This mention is a little bit vague, though The papyrus
includes a remedy quote to eliminate urine which is too plentiful,
and that could be referencing the frequent urination that accompany's diabetes,
but it could also be about something more common and

(07:35):
relatively benign, such as a urinary tract infection and what's
now India, the physician Sashruda and a surgeon Chikara both
described diabetes, with Sastruda noting the difference between what we
would describe today as types one and two. We also
have a whole episode on sastrrida back in the archive.
These texts date back to the Vedic period, which is

(07:57):
between one thousand and six hundred BC, and they used
terms that translate to honey urine or sweet urine diseased,
and they describe aunts being attracted to the patient's urine.
In about four hundred b CE, Hippocrates described diagnostic criteria
for diabetes, although that name had not been coined yet.

(08:17):
The criteria or that the person had a history of
excessive hunger, thirst, and urination, and that their urine was sweet,
and he described this condition as very rare. All of
this actually predates the first written descriptions of the pancreas, which,
as we mentioned earlier, is the organ that produces insulin.
That first description came from Greek physician Horophilis around the

(08:39):
third century b C, from terms that meant all flesh.
Horophilis did not know about insulin at this point, though,
he just described the organ that's the pancreas. Two different
people are credited with coining the term diabetes, both of
them living in about the second century. One was Demetrius
of epam Um and the other was Alreadius of capado Cha.

(09:01):
The word itself is from a Greek word meaning to
run through, or describing a thing that fluid runs through,
in other words, some kind of siphon. So this all
goes back to that excessive thirst and urination that are
characteristic of diabetes. Arete has described it this way quote
the course is the common one, namely the kidneys and
the bladder. For the patients never stopped making water, but

(09:24):
the flow is incessant, as if from the opening of aqueducts.
The nature of the disease then is chronic, and it
takes a long period to form, but the patient is
short lived if the constitution of the disease be completely established,
For the melting is rapid, the death speedy. And then
he went on with further description from there. The physician Galen,

(09:45):
living in the Roman Empire in the second and third centuries,
also described diabetes. He wrote, quote, I am of the
opinion that the kidneys too are affected in the rare disease,
which some people call chamber pot dropsy, other again diabetes
ease or violent thirst. For my own part, I have
seen the disease till now only twice, when the patients

(10:06):
suffered from an inextinguishable thirst, which forced them to drink
enormous quantities. The fluid was urinated swiftly with a urine
resembling the drink. He called the condition diarrhea urinoma, or
diarrhea of the urine. At about the same time in
Han dynasty China, jiang jong Jing also described the classic

(10:26):
symptoms of thirst and excessive urination, and then later Chinese
documents also described the phenomenon of sweet urine, with the
Chinese term for diabetes translating to wasting and thirsting. Written
references continue into the medieval period, including previous podcast subject
ibn Sina also known as Avicenna writing in eleventh century Persia.

(10:49):
Medieval Persian writing uses two different terms for diabetes, one
that's derived from the word diabetes and one that translates
to water wheel. Ibn Sina also scribed leaving a patient's
urine to evaporate and it leaving a sticky sweet residue behind. Overall,
these ancient and medieval writers described diabetes as a condition

(11:10):
more often than they described some kind of treatment for it.
That's possibly because and what we now know as type
one diabetes patients generally did not live very long after
being diagnosed. The treatments that did exist were mostly in
line with whatever system of medicine was being practiced that
had given place and time, including abstaining from or eating

(11:32):
more of certain foods, various herbal preparations and plant extracts,
so Shrewda, who observed a correlation between diabetes and a
person's weight, recommended a healthy, moderate diet and exercise as
a preventative measure, although type two diabetes can develop regardless
of a person's weight, and there were also recommendations of

(11:53):
things like opium to try to make patients be more comfortable.
But it wasn't until later that people started to understand
that diabetes did not just cause sugar in the urine,
but also caused sugar in the blood and tried to
formulate treatments based on that discovery. And we're going to
talk more about all of that after we pause for
a sponsor break. In the sevente century, people started making

(12:22):
some more concrete discoveries about diabetes beyond describing its outwardly
observable signs. One was Swiss anatomist Johann Conrad Bruner, who
partially removed the pancreases of dogs and then observed afterwards
that these dogs had an increased appetite, urination, and thirst.
He didn't really connect those symptoms back to diabetes, though

(12:45):
by that point the idea that diabetes caused sweet urine
had been forgotten, at least in Britain. Where the practice
of physicians tasting their patient's urine had fallen out of favor.
Who boy, am I glad that happened? But in six
seventy four Thomas will did taste a patient's urine while
working at Oxford University, and afterward he coined the term

(13:06):
diabetes melodis, with melodis coming from a Latin term for
sweet or honeyed, and this was to set the condition
apart from diabetes incipitus, which is also associated with excessive
thirst and urination, but is related to salt rather than sugar.
Diabetes insipitus is a whole separate thing that we are
not talking about in this episode at all beyond what

(13:29):
we just said. In seventeen seventy six, physician Matthew Dobson
of Liverpool confirmed something that probably seems really obvious at
this point. He evaporated a patient's urine and what was
left behind was a material that was indistinguishable from sugar.
So the reason that people were having sweet urine was
because there was literally sugar in there. But he made

(13:49):
another discovery as well, and that's that the person's blood
serum was also sweet. So he was the one that
started making that connection that diabetes was not just about
sugar in the urine, it was also about sugar in
the blood. In seventeen seventy eight, Thomas Coullie was doing
an autopsy on someone with diabetes and he noticed stones

(14:09):
and signs of damage to the pancreas, and he suggested
that these two things might be related, but that connection
didn't really become clear or more widely known until later.
In eighteen fifty six, French physiologist Claude Bernard discovered that
the body stores excess glucose in the liver, and he
coined the term glycogen for this form of stored sugar.

(14:32):
He also discovered that the nervous system played a role
in regulating blood sugar. He made these discoveries, as many
of these other researchers did, by experimenting on dogs. This
was something that really horrified his family. His wife, Marie Fransoise,
ultimately filed for divorce, took custody of their children, and
established an anti vivisection society in response to his work.

(14:55):
She was one of the first of many people to
object to the use of experiments on animals that were
related to the study of diabetes or to the development
of insulin. Then, in the late eighteen sixties, while he
was still in medical school, Paul Langer Hans made a
big step in discovering the connection between diabetes and the pancreas. Today,

(15:16):
we know that the pancreas plays a role in both
the digestive and the endocrine systems. When it comes to digestion,
the pancreas excretes digestive enzymes that make their way through
ducts into the small intestine. As an endocrine gland, the
pancreas secretes several hormones, including insulin. But when Longer Hans
started his research, people knew very little about the microscopic

(15:39):
structures of the pancreas or what those structures did. His
work really started to change that. In his thesis on
the pancreas, he described nine different types of cells, and
at least two of them had not been described before.
One was a type of assent or cell which secretes
digestive enzymes, and he wasn't really sure what the other

(16:00):
our cells were four, but he observed that they were
clumped together in the pancreas in these little groups. Leger
Hans published his thesis in eighteen sixty nine. In eighteen
ninety three, a French history physiologist named Eduard la Guess
observed the same cells, and he named them for Leger Hans.
I Guess also theorized that these cells might secrete something

(16:20):
that removed glucose from the urine. At this point, people
hit theorized that some organs might secrete some kind of
chemicals that worked in the body somehow, but the word
hormone had not been coined yet. In between when Longer
Hans described these cells and when La Guests named them
the islets of Longer Hans, two French researchers made another discovery.

(16:42):
In eighteen eighty four, Louis val Yard and Charles Louis
Xavier Arnazan discovered that if you closed off the main
duct of a rabbit's pancreas, the pancreas itself would atrophy.
But it appeared that only the acid in our cells atrophied,
not the islets of longer huns, And then the rabbits
did not experience the increased appetite and urination and thirst

(17:04):
that Bruner had described two years before. After he partially
removed the pancreases of dogs. Five years later, in Germany,
Oscar Minkowski and Joseph vun Marrying totally removed the pancreas
of a dog, which immediately developed symptoms of severe diabetes,
including coma and death. Unlike Brunner, Minkowski and vun Marrying

(17:25):
were able to remove the whole pancreas, and they made
the connection between the pancreas and diabetes. So through all
of this, Western medicine had started to form a basic
understanding that diabetes caused elevated sugar, both in the blood
and in the urine, and it also seemed related to
the pancreas, specifically to these islets of longer hauns, and

(17:47):
it had some connections to the nervous system and to
the liver. Based on this growing knowledge, researchers speculated on
a number of potential treatments at this point. Although it
was known that diabetes caused sugar in both the blood
and the urine, it was much easier to test the urine.
Blood tests took a lot longer, and they required so
much blood that the tests themselves could be fatal for

(18:10):
research animals. So many of these initial studies were focused
on outward symptoms like thirst and urination as well as
how much glucose was in the urine, rather than specifically
testing blood. One idea was that diabetes root cause had
something to do with the liver's glycogen storage, and that
it might be possible to stimulate the nervous system to

(18:33):
activate that storage in the liver, or that maybe the
liver might be the key to the treatment for diabetes.
But a lot of researchers were focusing on the pancreas
and whether some kind of pancreatic extract could treat diabetes.
Most of these researchers followed the same basic process. They
would remove the pancreas of a dog or another animal,
which essentially caused it to develop diabetes, and then they

(18:56):
would try to treat that animal with an injected pancreatic extract,
sometimes from the same animals pancreas, and sometimes from the
pancreas of a different animal. This was not the first
time that people made extracts from endocrine glands and use
them as a treatment for patients who were not producing
enough of that particular hormone. The first use of thyroid

(19:17):
extract to treat hypothyroidism goes back to at least similar
use of adrenal extracts started in the late nineteenth century
as well, and Jocici Takaminae of Japan isolated and purified
adrenaline from cow glands in nineteen o one. The methods
for preparing this pancreatic extract varied, and for the most

(19:38):
part they were at least somewhat effective in reducing the
amount of sugar in a test subjects blood, as shown
by the corresponding reduction in sugar in their urine. That's
because if you make a pancreatic extract, it's very likely
to contain at least some insulin, but it's also hard
to separate the insulin from all the other tissues and
substances that are part of the pancreas. So overwhelmingly all

(20:02):
these experiments also caused side effects that made the work
simply too risky to try in human subjects. This included
things like abscesses and other infections and extreme fevers, and
also shock. The first person known to try this was
French physiologist Eugene Glay in the late nineteenth century. Glay
removed the pancreases of dogs and then treated them with

(20:25):
injections of a pancreas extract. The injections reduced the dogs
thirst and their urine output, and also lowered the amount
of sugar in the urine, but for reasons that are
not clear at all. He stopped his work on the
subject in eighteen ninety and then kept his findings sealed
until after the discovery of insulin was announced, which was
more than thirty years later. Meanwhile, in nineteen hundred, pathologists

(20:49):
Eugene Lindsay Opie of Johns Hopkins discovered that the islets
of Langerhans showed signs of atrophy and patients who had
died as a result of diabetes. In nineteen o five,
Ernest Henry Starling coined the word hormone, and people began
to suggest that the islets of Langerhunds were secreting some
kind of hormone that lowered blood sugar. Both of these

(21:10):
discoveries fed into the ongoing work on pancreatic extracts and animals.
George Ludwig Zuelzer of Berlin conducted his experiments on rabbits,
and he was successful enough that he did try to
inject his extract on a dying patient in nineteen o six,
Although this did seem to have some positive effect for
the patient, the patient's blood and urine weren't tested to

(21:34):
confirm it. They were really looking at outward symptoms, and
the patient died shortly after Zulzer ran out of his extract.
He went on to work with five other human patients,
but they all experienced high fevers, vomiting, convulsions, and other
serious side effects. As some other examples of this research,
Lydia Maria Adams DeWitt did her work with cats in

(21:55):
nineteen o six, legating the pancreatic ducks to try to
isolate just the islets of langerhounds when preparing her extract.
Romanian physician Nicolay Pulesque also worked with dogs in nineteen
fifteen in nineteen sixteen, developing an extract that he called
Pancrean before his work was disrupted by World War One.

(22:16):
Israel As Kleiner, whose parents had immigrated to the United
States from Bavaria, worked with pancreatic extracts and dogs in
nineteen nine. All of this work showed at least some promise,
but none of it was safe enough to use as
a treatment for diabetes. We'll talk about how people started
trying to manage diabetes through diet at about the same

(22:36):
time after a sponsor break. The idea that diabetes might
be controlled or prevented through diet goes back thousands of
years to shud azabetic medical text that we talked about earlier,
but in terms of what people were trying after the
medical community started to get a better sense of what

(22:58):
was happening inside of the body. One of the first
people to suggest a dietary approach was John Rolo of Scotland,
who became an English Army surgeon, and he was doing
his work in the earlier years of when people were
starting to make physiological discoveries about diabetes. Rollo concluded, incorrectly
the diabetes was a digestive problem in which some kind

(23:20):
of stomach issue was causing vegetable matter to break down
into excessive sugar. In s he worked with an Army
captain who had developed what we would know today as
type two diabetes. Rollo recommended a diet that was primarily meat,
along with some bread, milk, and lime water. The treatment
had other components as well, including rubbing the patient's body

(23:42):
with lard, producing an external ulceration over each kidney, and
wine and opium at bedtime. After a couple of weeks
on this regiment, the patient was, according to Rollo, producing
less urine, and servants said that his urine was no
longer sweet, so he was really not on the right
track in terms of diabetes cause. But the diet that

(24:04):
he was recommending was closer to correct. It was low
in sugar and other carbohydrates. But there were also physicians
who drew the opposite conclusion about how diet might be
used to treat diabetes. In Paris in the eighteen fifties,
Pierre Adolphe Puri recommended a high sugar, high calorie diet,

(24:25):
reasoning that patients were excreting so much sugar in their
urine that they would need to eat more of it
to replace it. Unfortunately, this approach was absolutely the opposite
of what needed to be done, and it contributed to
at least one patient's death, who is terrifying. Apollinaire Bouchard,
who was living in Paris at about the same time
as Puri, took a dietary approach that was closer to Ralows.

(24:48):
He recommended a diet that was high and fat but
low in sugar and other carbohydrates. He also recommended that
patients fast periodically and that they exercise. Did a lot
of other work in the field of diabetes research as well.
He is sometimes called the father of diabetology. Moving into
the twentieth century, two doctors built on Bouchardot's recommendations and

(25:11):
formulated the most well known and widely used diets for
people with diabetes in the years just before insulin was developed.
This was Frederick Madison Allen and Elliott Proctor Jocelyn, and
they started in about nineteen fifteen. Alan came to his
conclusions about diet by working with deep pancreatized dogs, and
he recommended a low calorie, low carb diet that included

(25:35):
intermittent fasting. These and similar diets were so restrictive that
they were often described as starvation diets. I have read
some articles that say they were derisively called starvation diets,
but no, that's literally what people called them as a
matter of course. And here is how it worked. From
the Starvation Treatment of Diabetes with a series of graduated

(25:56):
diets used at the Massachusetts General Hospital, which was published
in nine and then that The text includes quote for
forty eight hours after admission to the hospital, the patient
is kept on ordinary diet to determine the severity of
his diabetes. Then he is starved and no food allowed

(26:16):
save whiskey and black coffee. The whiskey is given in
the coffee one ounce of whiskey every two hours from
seven am until seven pm. This furnishes roughly about eight
hundred calories. The whiskey is not an essential part of
the treatment. It merely furnishes a few calories and keeps
the patient more comfortable while he is being starved. As

(26:40):
manual recommends bullion or a clear soup if whiskey isn't desirable,
and recommends that the patient be given by carbonate of
soda if they show signs of acidosis, and that's one
of the potential complications of diabetes in which acids start
to build up in the body. The starvation process continued
until the patient's yurine had no sugar in it. Then

(27:01):
food would be slowly reintroduced quote to the limit of tolerance.
In other words, doctors would gradually give patients more calories
and carbohydrates each day until sugar reappeared in the urine,
and then they would reduce that amount until it went
away again. This particular publication includes case studies for several
adults whose diets were adjusted over a period of roughly

(27:23):
one to two weeks as doctors figured out how many
grams of carbohydrates they could consume every day while still
not having any sugar in their urine. Most of the
patients wound up with diets that included between fifteen and
fifty grams of carbohydrates per day, between twenty five and
sixty grams of protein, and between a hundred and fifty

(27:43):
and two hundred grams of fat, and that added up
to a roughly two thousand calorie diet on average among
these adult patients. Type two diabetes is also associated with weight,
although as we said earlier, it can develop in people
regardless of their weight, and in general, with manual recommends
that adult patients lose weight. The approach in children was

(28:04):
a little different, though, reading from the same book quote,
Diabetes and Children is likely to be a good deal
more severe than it is in adults. Still, in a
few cases that have been treated with the starvation treatment
at the children's hospital, the results have been very satisfactory
as far as rendering the patients sugar free. Is concerned.
Most diabetic children, however, are thin and frail, and they

(28:28):
have no extra weight to lose, so it does not
seem so desirable to bring about any very great loss
of weight, which is quite an essential part of the
treatment for most adults. The few children that have been
treated have borne starvation remarkably well. It is too early,
and we have seen two few children treated by this
method to say what influence it may have on the

(28:49):
course of the disease, but it can certainly be said
that it is very efficacious in rendering them sugar free.
So here's the daily food intake of a twelve year
old girl who was admitted to the High Spittle in
nine after she went through this starvation process and then
was discharged with a new diet. Bacon four slices oatmeal,
four tablespoonfuls bread, one slice meat, one ounce, cabbage, five

(29:15):
tablespoonfuls spinach, five tablespoonfuls string beans, five tablespoonfuls butter two ounces.
This child's description of her diet ends with the note
quote a rather mild case which responded readily to treatment.
The question is can she grow and develop on a
diet which will keep her sugar free. A six year

(29:38):
old boy was also discharged on this diet string beans
three tablespoonfuls, spinach four tablespoonfuls, bacon, four slices, butter two ounces,
eggs three bread, one half slice cereal, two tablespoonfuls, meat
three ounces. This particular book was written about patients who

(30:02):
came to the hospital in nineteen fifteen, and the book
came out in nineteen sixteen, so it doesn't really include
anyone's long term results or prognosis in terms of the children,
though it does report one patient whose condition was critical
when they arrived at the hospital and who died during
the starvation period, as well as one who seemed to
be doing well but died suddenly a few months after

(30:24):
being discharged. These two children's diets that we just gave
as examples totaled one thousand, five hundred ten calories for
the first and one thousand, four hundred two calories for
the second. But as we said at the top of
the show, diet alone is not enough to control glucose
levels and type one diabetes. These children's bodies needed insulin

(30:44):
but could not make it so. Over time, a lot
of children who were on one of Alan's or Joscelyn's
diets were given fewer and fewer calories every day as
they inevitably showed signs of sugar in their urine. Sometimes
they would have like a full day of fasting to
try to reset their bodies. Patients were routinely on diets
of eight hundred calories a day or less, with a

(31:06):
day of total or near total fasting if any glucose
appeared in their urine. This breaks my heart seeing all
of this limited calorie diet for kids who need all
of the nutrients that they can possibly get to grow
and finish their bodies forming um. Because these were so restrictive,
these diets were very hard for patients to maintain, even

(31:27):
if they could and their urine stay free of glucose.
The children's bodies in particular were experiencing other negative effects
as a result of just not having enough nourishment. Basically,
children were described as wasting away on these diets, which
may have at best prolonged their lives by a few
months to a couple of years. They were often emaciated

(31:48):
and weak and prone to infections, while their growth was
delayed because they just weren't getting enough nourishment to simply survive,
and whether these diets actually did prolong their lives is
not entirely clear. There are just so many variables involved
in type one diabetes it's hard to say whether this
worked or not, and many doctors views these diets were

(32:10):
a desperate effort to prolong children's lives just a little
bit longer, with the hope that they would hang on
long enough to see and benefit from the discovery of
a more effective treatment. And Joscelyn's words quote, we literally
starved the child an adult with the faint hope that
something new in treatment would appear. It was no fun

(32:30):
to starve a child to let him live. That better treatment, though,
was finally found in nine two, and we're going to
talk about that on the next episode. So that is
sort of a cliffhanger, but also that means it's time
for listener mail. It is time for listener mail. This
is from Dan, and Dan wrote in to say I

(32:51):
love the recent six Impossible Episodes podcast on civil actions.
I actually gassed when you mentioned Julius Is. I'm a
journalist and frequently right about LGBTQ history. Stonewall was a
pivotal moment but it's so important to understand how much
work was done before then, and the sip in is
one of those key moments leading to the removal of

(33:11):
the New York liquor Boards ban on serving alcohol to homosexuals.
But I'm writing because I wanted your readers to know
that not only is Julius is still open, but it's
a wonderful bar that welcomes everyone. It opened in the
eighteen sixties, and by the nineteen fifties it was widely
known as a gay hangout, popular with Truman Capote, Tennessee
Williams and Rudolph Neriev. There's a press clipping from Walter

(33:33):
Winchell on the wall. It's largely the same as it
was when the Sippin happened, with photos and memorabilia from
that era. They have a monthly party machine named after
the Historic Machine Society. Unlike the Woolworth lunch counters and
other venues, Julius is one of the few places involved
in America's civil rights struggle that still exists in its
original form, not as a museum or a monument, but

(33:55):
as a living, breathing space for community celebration and joy.
I urge anyone coming to New York to hop down
to the village to visit this one of a kind
watering hole. Their burgers are to die for. Thanks for
all you do, sincerely, Dan. Thank you so much Dan
for writing I of course did not have all of
this detail in the outline ever, um but I did

(34:16):
at one point half that like the Julius is still
open and it welcomes everyone now um as opposed to
sort of what happened on the day with the manaching
Society sippen. But that six impossible episodes felt like it
was getting quite long, and I made some cuts for length,
and that was one of the details that was sadly
cut out. So thank you so much Dan for writing
in and giving me the chance to add that Today.

(34:39):
If you would like to write to us about this
or any other podcast, we're at History podcast that I
Heart radio dot com. And then you'll also find us
all over social media at miss in History. That's where
you will find our Facebook, Twitter, Pinterest, and Instagram. You
can subscribe to our show on Apple podcast, the I
Heart Radio app, and anywhere else to get your podcasts. MMMM.

(35:04):
Stuff you Missed in History Class is a production of
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