Sugar

From Arctic Memories there is this quote:

As Dionyse Settle, the Elizabethan chronicler of explorer Martin Frobisher's second expedition to Baffin Island, so shrewdly observed in 1577: "Those beastes, flesh, fishes, and fowles, which they kil, they are meate, drinke, apparel, houses, bedding, hose, shooes, thred, saile for their boates... and almost all their riches."

I looked up the full text of Settle's work and copied the following, since it was written in 1577, it seems like very broken English but I think it's not worth editing.

They are men of a large corpora∣ture, and good proportion: their colour is not much vnlike the Sunne burnte Countrie man, who laboureth daily in the Sunne for his liuing.

They weare their haire somethinge long, and cut before, either with stone or knife, very disorderly. Their women weare their haire long, and knit vp with two loupes, shewing forth on either side of their faces, and the rest foltred vp on a knot. Also, some of their women race their faces proportionally, as chinne, chéekes, and forehead, and the wristes of their handes, wherevpon they lay a co∣lour, which continueth darke azurine.

They eate their meate all rawe, both fleshe, fishe, and foule, or something per∣boyled with bloud & a little water, whi∣che they drinke. For lacke of water, they wil eate yce, that is hard frosen, as plea∣santly as we will doe Sugar Candie, or other Sugar.

If they, for necessities sake, stand in néede of the premisses, such grasse as the countrie yéeldeth they plucke vppe, and eate, not deintily, or salletwise, to allure their stomaches to appetite: but for ne∣cessities sake, without either salt, oyles, or washing, like brutish beasts deuoure the same. They neither vse table, stoole, or table cloth for comelinesse: but when they are imbrued with bloud, knuckle déepe, and their kniues in like sort, they vse their tongues as apt instruments to licke them cleane: in doeing whereof, they are assured to loose none of their victuals.

They franck or kéep certeine doggs, not much vnlike Wolues, whiche they yoke together, as we do oxen and horses, to a sled or traile: and so carrie their ne∣cessaries ouer the yce and snowe, from place to place: as the captiue, whom we haue, made perfecte signes. And when those Dogges are not apt for the same vse: or when with hunger they are con∣streyned, for lacke of other victuals, they eate them: so that they are as néedefull for them, in respect of their bignesse, as our oxen are for vs.

They apparell themselues in the skinnes of such beastes as they kill, se∣wed together with the sinewes of them. All the fowle which they kill, they skin, and make thereof one kinde of garment or other, to defend them from the cold.

They make their apparell with hoods and tailes, which tailes they giue, when they thinke to gratifie any friendshippe shewed vnto them: a great signe of friendshippe with them. The men haue them not so syde as the women.

The men and women weare their hose close to their legges, from the wast to the knée, without any open before, as well the one kinde as the other. Uppon their legges, they weare hose of lether, with the furre side inward, two or thrée paire on at once, and especially the wo∣men. In those hose, they put their kni∣ues, néedles, and other thinges néedefull to beare about. They put a bone with∣in their hose, whiche reacheth from the foote to the knée, wherevpon they drawe their said hose, and so in place of garters, they are holden from falling downe a∣bout their féete.

They dresse their skinnes very softe and souple with the haire on. In cold weather or Winter, they weare ye furre side inward: and in Summer outward. Other apparell they haue none, but the said skinnes.

Those beastes, flesh, fishes, and fow∣les, which they kil, they are both meate, drinke, apparel, houses, bedding, hose, shooes, thred, saile for their boates, with many other necessaries, whereof they stande in néede, and almost all their ri∣ches.

Their houses are tentes, made of Seale skinns, pitched with foure Firre quarters, foure square, méeting at the toppe, and the skinnes sewed together with sinowes, and layd therevppon: so pitched they are, that the entraunce in∣to them, is alwayes South, or against the Sunne.

They haue other sortes of houses, whiche wée found, not to be inhabited, which are raised with stones and What bones, and a skinne layd ouer them, to withstand the raine, or other weather: the entraunce of them béeing not much vnlike an Quens mouth, whereto, I thincke, they resort for a time, to fishe, hunt, and fowle, and so leaue them for the next time they come thether againe.

Their weapons are Bowes, Ar∣rowes, Dartes, and Slinges. Their Bowes are of a yard long of wood, si∣newed on the back with strong veines, not glued too, but fast girded and tyed on. Their Bowe stringes are likewise sinewes. Their arrowes are thrée pée∣ces, nocked with bone, and ended with bone, with those two ends, and the wood in the middst, they passe not in lengthe halfe a yard or little more. They are f•∣thered with two fethers, the penne end being cutte away, and the fethers layd vppon the arrowe with the broad side to the woode: in somuch that they séeme, when they are tyed on, to haue foure fe∣thers. They haue likewise thrée sortes of heades to those arrowes: one sort of stone or yron, proportioned like to a heart: the second sort of bone, much like vnto a stopte head, with a hooke on the same: the thirde sort of bone likewise, made sharpe at both sides, and sharpe pointed. They are not made very fast, but lightly tyed to, or else set in a nocke, that vppon small occasion, the arrowe leaueth these heades behinde them: and they are of small force, except they be ve∣ry néere, when they shoote.

Their Darts are made of two sorts: the one with many forkes of bone in the fore ende, and likewise in the mid∣dest: their proportions are not muche vnlike our toasting yrons, but longer: these they cast out of an instrument of wood, very readily. The other sorte is greater then the first aforesayde, with a long bone made sharp on both sides, not much vnlike a Rapier, which I take to be their most hurtfull weapon.

They haue two sorts of boates, made of Lether, set out on the inner side with quarters of wood, artificially tyed toge∣ther with thongs of the same: the grea∣ter sort are not much vnlike our Wher∣ries, wherein sixtéene or twentie men may fitte: they haue for a sayle, drest the guttes of such beastes as they kyll, very fine and thinne, which they sewe toge∣ther: the other boate is but for one man to sitte and rowe in, with one oare.

Their order of fishing, hunting, and fowling, are with these sayde weapons: but in what sort, or how they vse them, we haue no perfect knowledge as yet.

I can not suppose their abode or ha∣bitation to be here, for that neither their houses, or apparell, are of no such force to withstand the extremitie of colde, that the countrie séemeth to be infected with all: neyther doe I sée any signe likely to performe the same.

Those houses, or rather dennes, which stand there, haue no signe of foot∣way, or any thing else troden, whiche is one of the chiefest tokens of habitation. And those tents, which they bring with them, when they haue sufficiently hun∣ted and fished, they remoue to other places: and when they haue sufficient∣ly stored them of suche victuals, as the countrie yeldeth, or bringeth foorth, they returne to their Winter stations or ha∣bitations. This coniecture do I make, for the infertilitie, whiche I perceiue to be in that countrie.

They haue some yron, whereof they make arrowe heades, kniues, and other little instrumentes, to woorke their boa∣tes, bowes, arrowes, and dartes withal, whiche are very vnapt to doe any thing withall, but with great labour.

It seemeth, that they haue conuersa∣tion with some other people, of whome, for exchaunge, they should receiue the same. They are greatly delighted with any thinge that is brighte, or giueth a sound.

What knowledge they haue of God, or what Idol they adore, wée haue no perfect intelligence. I thincke them ra∣ther Anthropophagi, or deuourers of mans fleshe, then otherwise: for that there is no flesh or fishe, which they finde dead, (smell it neuer so filthily) but they will eate it, as they finde it, without any other dressing. A loathsome spectacle, ei∣ther to the beholders, or hearers.

There is no maner of créeping beast hurtful, except some Spiders (which, as many affirme, are signes of great store of Golde:) and also certeine stinging Gnattes, which bite so fiercely, that the place where they bite, shortly after swelleth, and itcheth very sore.

They make signes of certeine peo∣ple, that weare bright plates of Gold in their forheads, and other places of their bodies.

The Countries, on both sides the streightes, lye very highe with roughe stonie mounteynes, and great quantitie of snowe thereon. There is very little plaine ground, and no grasse, except a li∣tle, whiche is much like vnto mosse that groweth on soft ground, such as we gett Turfes in. There is no wood at all. To be briefe, there is nothing fitte, or profi∣table for ye vse of man, which that Coun∣trie with roote yéeldeth, or bringeth forth: Howbeit, there is great quantitie of Deere, whose skinnes are like vnto Asses, their heads or hornes doe farre ex∣ceed, as wel in length as also in breadth, any in these oure partes or Countrie: their féete likewise, are as great as oure oxens, whiche we measured to be seuen or eight ynches in breadth. There are also Hares, Wolues, fishing Beares, and Sea foule of sundrie sortes.

As the Countrie is barren and vn∣fertile, so are they rude and of no capa∣citie to culture the same, to any perfec∣tion: but are contented by their hun∣ting, fishing, and fowling, with rawe flesh and warme bloud, to satisfie their gréedie panches, whiche is their onely glorie.

Thomas Sydenham (1624-1689), hailed as a second Hippocrates in general medicine, contributed nothing of value in diabetes except a clearer definition as a disease of metabolism. Because the nutritive elements of the blood are not properly prepared for assimilation, they pour out through the kidneys, and the flesh and strength melt away. Later hypotheses of free versus combined sugar are here antipated.

Thomas Sydenham prescribed narcotics and theriak and said, “Let the patient eat food easy of digestion, such as veal, mutton, and the like, and abstain from all sorts of fruits and garden stuff” , but no effective dietetic treatment grew out of this advice. (6).

https://care.diabetesjournals.org/content/diacare/40/10/1302.full.pdf

Diabetes Its Medical and Cultural History

"From that period I had not met with a case of Diabetes, although I had observed an extensive range of disease in America, the West Indies, and in England, until 1796." "Captain Meredith, of the Royal Artillery, being an acquaintance. I had seen him very frequently, previous to his going on camp duty in 1794, but then he had no disease; however, he always had impressed me, from his being a large corpulent person, with the idea that he was not unlikely to fall into disease. (Editor: Another instance of Rollo's clinical acuteness.)" "On the 12th of June, 1796, he visited me, and though I was at once struck with the diminution of his size, yet, at the same time, the colour of his face being ruddy, I received no impression, otherwise than of his being in health: a moment's conversation, however, convinced me of the contrary ...... 

"He complained of great thirst and a keenness of appetite; his skin was hot, dry and parched; and his pulse small and quick. He told me his complaints had been attributed to an old disease, and a liver affection. The thirst, dry skin, and quick pulse, marking a febrile state, depending probably on some local circumstance, and connecting these with the keenness of appetite, Diabetes immediately suggested itself to me. I enquired into the state of his urine, which I found in quantity and colour to be characteristic of the disease; and was at the same time much surprised, that for the two or three months he had been under the care of a Physician and Surgeon, the circumstance of the increased urine had not been known to them. The patient told me, as he drank so much, the quantity of urine had appeared to him a necessary consequence; and of course never having been asked about it, he gave no information. I directed him to keep the urine he next passed, and, on examination, it was found to be sweet; in consequence of which the disease became sufficiently ascertained." 

At another point in the case history, Rollo states that Captain Meredith was 34 years of age and was 71 3/4 inches tall. At the time of beginning of the special treatment, the symptoms of diabetes had been present seven months or more and his weight had fallen from 232 to 162 pounds. A view held by some at that time was that diabetes was a primary affection of the kidneys. However, Rollo developed the idea that the disease was "a primary and peculiar affection" of the stomach in which, due to some morbid changes in "the natural powers of digestion and assimilation," sugar or saccharine material was formed in that organ, chiefly from vegetable matter. It was on this basis that he advocated the use of an animal diet together with certain medication designed to quiet the overactive stomach and to diminish the appetite. 

Following initial bloodlettings, Rollo's treatment of Captain Meredith was as follows: 

"1st. The diet to consist of animal food principally, and to be thus regulated: 

Breakfast. One and a half pint of milk and half a pint of lime-water, mixed together; and bread and butter. 

Noon. Plain blood-puddings, made of blood and suet only. 

Dinner. Game, or old meats, which have been long kept; and as far as the stomach may bear, fat and rancid old meats, as pork. To eat in moderation. 

Supper. The same as breakfast." 

"2dly. A drachm of kali sulphuratum to be dissolved in four quarts of water which has been boiled, and to be used for daily drink. No other article whatever, either eatable or drinkable, to be allowed, than what has been stated." 

"3dly. The skin to be annointed with hog's lard every morning. Flannel to be worn next the skin. The gentlest exercise to be only permitted; but confinement to be preferred." 

"4thly. A draught at bed-time of twenty drops of tartarized antimonial wine and twenty-five of tincture of opium; and the quantities to be gradually increased. In reserve, as substances diminishing action, tobacco and foxglove. " 

"5thly. An ulceration, about the size of half a crown, to be produced and maintained externally, and immediately opposite to each kidney. And, 

"6thly. A pill of equal parts aloes and soap, to keep the bowels regularly open."

Therapy 

A special diabetic diet was undoubtedly one of the foremost therapeutic measures, even before the age of insulin. Even before it was recognized that diabetes was a disorder of carbohydrate metabolism, various kinds of diet had been recommended. A change to a diet decided purely pragmatically, which was nevertheless very effective, did not come until JOHN ROLLO (d. 1809), a Scottish physician, who, in 1797, had achieved good results with a meat diet, made his recommendation (MARBLE; ANDERSON; BECKENDORF). He gave a particularly detailed account  The History of Diabetes mellitus 85 of the case of Captain MEREDITH of the Royal Artillery, who became diabetic at the age of 34, and who was very obviously overweight. His diet consisted of a breakfast and supper of milk mixed with lime-water and bread and butter, while his dinner consisted of pudding made of fat and blood and mature, preferably rank pork. In this way he had - without being conscious of it - excluded carbohydrates almost entirely from the diet. The patient of course lost a great deal of weight and felt extremely well. 

A second patient was less cooperative and therefore died at the age of 57, 19 months after treatment was begun, mainly - as ROLLO pointed out - because during his last three months he indulged in such things as apple pudding, sugar in his tea, and wine. 

The "meat diet" was used well into the 19th century, although gradually it was considered wiser not to cut out all carbohydrates, and patients had a certain amount of carbohydrate added to their diet, even though that caused some glycosuria. This kind of diet was initiated in the middle of the 19th century, mainly by ADOLF NIKOLAUS VON DURING (1820-1882) and RUDOLF EDUARD KULZ (1845-1895). The latter even distinguished between harmful and harmless carbohydrates and found that levulose, inulin, inosit, mannite, and lactose, as well as some root vegetables like celery, comfrey, etc. caused no deterioration of the metabolic condition. But it remains true that many specialists did recommend a carbohydrate-free diet with a lot of meat and fat (DICKINSON; PAVY; SEEGEN; R. SCHUMACHER, STEPP). 

SECT. II. - Cases and Communications

the first Edition of the Work. From Doctor Marcet. London, January 12, 1798

MY friend and countryman Doctor de la Rive, having informed me that Walker had been readmitted into the Infirmary at Edinburgh, and placed under the care of Doctor Gregory, I requested him to send me an account of the further progress and treatment of the case, which I now have the pleasure to transmit to you. 

Continuation of the Case of Walker. 

June 12th, 1797. 

He had continued perfectly well till within this fortnight, though his urine, which amounted to 5.5 lb. when he left the Hospital, increased gradually to 16 lb. His thirst is at present urgent; his tongue is dry, as well as his skin, which is also hot; says that he sweats frequently ; pulse 108. He complains of a burning pain in the palms of his hands and soles of his feet; of confiderable weakness) and occasional sourness in his stomach, with pain and flatulence. His fleep is disturbed ; his ankles often swell at night. 

June 14th. In the last 24 hours he has passed 17 lb. of urine, which is of the common diabetic appearance. Su.aj. pulv. alum. comp. jfs. 4. in die; libat aquae calcis 2 lb. in die. Full diet, with meat for dinner. 

June 17th. Urine l6 lb. The dose of the compound powder of alum to be increafed to a drachm. 

June 19th. Urine 14 lb. and rather more limpid. The alum powder to be omitted, the lime water continued, and an entire diet of animal food to be adopted, confining of the following articles ; three eggs for breakfaft, four ounces of cheese for fupper, two pounds of meat for dinner, with three pounds of beef-tea in the day. 

June 21st. Urine 8 lb, ftill pale, though less so than before.

June 29th. Urine 5 lb. yellower than it has yet been and of a more natural smell.

July 7th. Urine 5 lb. To be allowed 4 ounces of bread daily, in addition to his diet. 

July 9th. Urine 5.5 lb. He has drank two cups of tea with sugar

July 11th. Urine 5.5 lb.; a portion of yesterday's was evaporated, and the residuum evidently contained saccharine matter.

July l6th. The bread to be omitted, and the animal diet strictly adhered to.

July 27th. Urine 5 lb. Within these few days his strength has been recruited. He is to be discharged. This Patient was detected in following his habits of irregularity and intemperance; indeed he could not be depended upon.

My other Patient, Elizabeth Francis, aged 36, is a married woman. She miscarried near 12 years ago, but never had a live child. Eighteen months after that, she became dropfical, and had 17 quarts of water drawn off by the operation of paracentesis. She recovered of this, and enjoyed tolerable good health for near five years ; but she has been complaining these four years past, and became diabetic about June 1797.

 She was admitted into the Infirmary on the 28th of September following, at which time Mary Jackfon was using the carbonated ammonia, and apparently with advantage. Francis was therefore ordered to take it in the same manner, and to pursue the animal diet; I believe she did so rigidly, and with so good an effect, that on the 12th of November she was discharged at her own request, in consequence of feeling herself better than she had been for four years before, and indeed, to her own thinking, well; her strength being much improved, her thirst and appetite very moderate, and her water reduced to four, and sometimes to three pints in the- 24 hours, and free from sweetness, though for a week before she left us, she had been allowed two ounces of bread per day, and for the week preceding that, one ounce per day. On her going home, however, she increased it to a penny loaf per day, and at the same time took less animal food, owing to her inability to procure it ; the consequence was, that in a few weeks she became somewhat weaker, her urine increased a little, and she was frightened. She was therefore re-admitted on the 1 3th of February, and put again upon the animal diet, which she adhered to strictly till the 29th of March, when she was discharged again, to all appearance cured of the disease, though not restored to the strength and vigour of full health. 

She still keeps to the plan of eating animal food, and avoiding all vegetable matter, but lives a good deal upon milk; and when I called upon her yesterday, she said she had certainly gained strength lately. I then learned, for the first time, that she had also been affected two different times with an itching about the meatus urinarius, which was exceedingly troublesome to her; the water was increased in quantity each time, and was hot and acrimonious ; but she has had no return of it since she left the Infirmary. 

I shall now conclude this account with remarking, that the effects of the animal diet have been so obvious in all the three cases under my care, notwithstanding two of them occasionally deviated very largely, that I perfectly agree with you, in suspecting a deviation from the plan, wherever they are wanting, though the patient should strenuously deny it; for I have experienced the same propensity to deviate, and the same reluctance to acknowledge it, that you have done; and so averse are the other patients to betray the secret, that I believe the truth will seldom be obtained in an Hospital, while the patient remains there.