ABRAHAM JACOBI ON JUVENILE DIABETES MELLITUS-1896

Abraham Jacobi (1830-1919) was the first in the United States to specialize in the teaching of pediatrics. In 1862 he founded the first pediatric clinic in New York City. Probably no other pediatrician in America had a greater influence than Jacobi on the development of American pediatrics. This is how Jacobi treated juvenile diabetes mellitus 80 years ago and 26 years before Banting and Best had isolated insulin. ... The disease runs a more rapid course in infants and children than in adults, and terminates more readily in coma and death. Therefore the treatment must be enforced. Fortunately, the young, with very rare exceptions, are apt to live on milk mostly. Thus less difficulties are encountered in them than in adults. For these also milk, skimmed or not, forms a principal and beneficial part of their nutriment. The medicinal treatment of the young requires some modifications. The facility with which cerebral symptoms ("coma") are developed, renders the persistent use of alkalies advisable (mineral waters), and forbids the use of opium. lodoform, which I have seen to render fair service in adults, in daily doses of from ten to twenty grains internally, is seldom tolerated by the young, even in proportionately small doses. Arsenic may be given in increasing doses a long time, the bromide as well as other preparations, one drop and more of Fowler's solution [potassium arsenite], largely diluted, after meals, three times daily, the dose to be increased gradually until doses of from two to four drops are taken.