- Case #8: 

Dr. Joslin's Mother 

The first was 73 years old and was Dr. Joslin's mother. The second was 16 years old and the youngest daughter of Dr. James Jackson Putnam, who had been Dr. Joslin's principal mentor in the first year of his practice and his teacher in the medical school. Dr. Putnam was the austere, brilliant and path-finding neurologist whose name is now inscribed on the chair in Neurology at the Harvard Medical School. 

It is said that Dr. Joslin specialized in diabetes to help his mother with her disease. While this is not correct, he certainly remained highly interested in her progress as well as in her type of diabetes, hee proudly noted in his later writing that a remission or two occurred in her diabetes when she carefully followed the restraints of a good meal plan. In the first edition of his textbook on diabetes, published in 1916, EPJ described his mother's case, thinly disguised under the topic "Is the tendency of the diabetic glycosuria to increase?" 

A woman showed the first symptoms of diabetes in the spring of 1899 at 60 years of age and 5% of sugar was found in June. She had gradually lost during the preceding fifteen years, twenty pounds and weighed 165 pounds when the diagnosis was made. Under rigid diet, the urine promptly became sugar-free, the tolerance rose to 130 grams and safe for very brief intervals and remained so for nine years until 1908. In 1909, a carbuncle appeared. With prompt surgical care, vaccines, the restriction of carbohydrates and the temporary utilization of an oatmeal diet, the sugar disappeared and the carbuncle healed promptly, but the urine did not remain permanently sugar-free, although only about 30 grams of sugar was excreted. Residence in the hospital for a few days in September of 1912, in order to have a few teeth removed, lowered the sugar to 0.8%. 

Except for brief periods of illness due to the carbuncle and pneumonia, the patient remained well during all these years and was unusually strong and vigorous for a woman of 73 until she finally succumbed to a lingering illness subsequent to a hemiplegia and death finally occurred due to a terminal pneumonia in 1913. 

With his mother's case. Dr. Joslin described the most common presentation of diabetes. When she was diagnosed with diabetes, she was overweight and probably inactive. Had she been born a decade later, Mrs. Joslin might have enjoyed a life lengthened by the use of insulin in the 1920s and antibiotics in the 1930s. 

As an aside: Dr. Joslin's inheritance from his mother, Sara Proctor Joslin, left Dr. Joslin a millionaire several times over by today's standards. Sara Proctor, her sisters and one brother were the heirs to a very large fortune derived from their father Abel's leather tanning trade. Sara Proctor became the second wife of Dr. Joslin's father Allen, who was a shoe manufacturer in the town of Oxford. This connection with the Proctor leather tanning business guaranteed the success of the Joslin shoe factory. EPJ was fond of noting that he was a direct descendant of John Proctor of Salem, who had been hanged for defending his principles in the witch trials of 1692.

EPJ's lifestyle, in line with his upbringing and religion, always understated his affluence. However, it afforded him the means to aid family and associates with education and travel, as well as the ability to acquire the property needed to gradually expand his clinic. He underwrote Priscilla White's training in 1928 at the leading pediatric center in Vienna, a typical act of generosity to his co-workers.