An analysis of the results of insulin administration to fifteen patients with bone and joint tuberculosis affords some evidence that, in selected [SEE FIG-2 FIG-3 IN SOURCE PDF] cases, may justify this therapy. The younger patients, who were given a well-balanced diet in an environment considered to be most conducive to the treatment of bone and joint tuberculosis, showed an average improvement in weight, which would not seem to be specifically affected by the injected insulin.
All of the patients did show greater interest in their food, so that no urging was necessary in order to persuade them to eat their regular meals. There was a simultaneous improvement in the general appearance of wellbeing, which those who were in immediate attendance attributed to the insulin therapy. The most definite evidence of a specific response with respect to gain in weight which attended and followed the insulin injections was in the cases of two older children, aged eleven and thirteen years, whose general course had not been at all satisfactory prior to beginning this treatment. While both of these children showed splendid gains, which continued after the therapy was stopped, we are not able to postulate ate conclusions from so short a series.
It seems wiser to conclude that insulin is not indicated as a routine procedure in the treatment of bone and joint tuberculosis. For patients who are finicky eaters and who, under the best of environmental conditions, do not gain, or who actually lose in weight, insulin injections should be tried. The results shown in Figure 5 may encourage the expectation of an appetite response and an increase in weight attendant upon an improved intake, digestion, and utilization of food.
(C) 1939 All Rights Reserved.The Journal of Bone and Joint Surgery, Inc.