A case of diabetes in which there was marked resistance to the action of insulin is descriptionbed. An interstitial cell tumour of the testis was found at autopsy and the possible relationship of this to the development of the insulin resistance is discussed. A working classification of the causes of resistance to insulin in diabetes is presented and the management of such cases is briefly discussed.
Forty-four patients, all but 2 male, were treated with 2 gm. of Terramycin given in 8 divided doses over 48 hours. Of 38 followed, the clinical progress of 27 (71 %) was without incident. In addition there were 4 re-infections and 4 patients with non-specific infections. It is considered that the latter should not be regarded as treatment failures but rather as concomitant infections with non-specific urethritis. There were only 3 definite failures (8 %). It is considered that the results of treatment with Terramycin in the dosage given are comparable with those obtained with Penicillin, and when given in this manner the antibiotic is also as free of adverse side-effects. No less than Penicillin, however, Terramycin may mask syphilis although with the accumulation of experience this risk may be considered to have been exaggerated. The dose of Terramycin given in this series is, as regards the serum levels obtained, probably comparable with a dose of 600,000 units of Procaine Penicillin and this aspect should therefore be borne in mind in later studies. When Terramycin is in more plentiful supply and its price compares more favourably with that of Penicillin its simple mode of administration may in the end result in it replacing Penicillin in the routine treatment of gonorrhoea.