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Uncovering Diabetes Mellitus: Symptoms and Origin Explained
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Thomas Willis stared at the contents of his glass and pensively took a sip. It was sweet and slightly ... delicious. He was baffled. So baffled that he recorded his findings in his publication Pharmaceutice Rationalis:
But it seems more hard to unfold, wherefore the Urine of the sick is so wonderfully sweet, or hath an honied taste; when rather on the contrary if according to our Hypothesis the fusion of the Blood and (which therefore follows) the profusion of the Urine happens by reason of the combinations of Salts, the Liquor certainly impregnated with these should be rather salt then sweet. [...] But why that it is wonderfully sweet like Sugar or hony, this difficulty is worthy of explanation.¹
Yes. Willis consumed a diabetic patient's urine.
In the 17th century advanced laboratory tests and diagnostic instruments were unavailable. Sampling urine by taste or visual inspection was one of the closest forms of lab work available to physicians. Their senses were their best tools.
The discovery of the honey flavor prompted him to use the term "mellitus" which originates from the Latin word for "honey" or "sweet." This sugary taste results from elevated glucose levels in the urine and bloodstream, which leads to hyperglycemia. The connection between diabetes and the body’s inability to regulate glucose was never established until the late 19th century.
The treatise from the 2nd-century Greek physician, Areteaus of Cappadocia, would read:
The course is the common one, namely, the kidneys and bladder; for the patients never stop making water, but the flow is incessant, as if from the opening of aqueducts. The nature of the disease, then, is chronic, and it takes a long period to form; but the patient is short-lived, if the constitution of the disease be completely established; for the melting is rapid, the death speedy. Moreover, life is disgusting and painful; thirst, unquenchable; excessive drinking, which, however, is disproportionate to the large quantity of urine, for more urine is passed; and one cannot stop them either from drinking or making water.²
He provided an acutely accurate description of diabetes and its key symptoms. He observed excessive thirst (polydipsia), excessive urination (polyuria), and weight loss, and characterized diabetes as a condition in which fluids seemed to pass through the body without being properly absorbed.
Arteaus used the term "diabetes" from the Greek word "diabaínei," meaning "to siphon." This reflects the ancient observation that people with diabetes urinated excessively, as if fluids passed straight through their bodies without being absorbed.
The sweetness Willis discovered was a crucial clue for identifying diabetes mellitus. By tasting the urine, he and other physicians could confirm its presence, helping to differentiate diabetes mellitus from other conditions that also caused excessive urination, like diabetes insipidus.
It was unfortunate for the physicians who sampled diabetes insipidus; they missed out on the "wonderfully sweet" flavor of mellitus, the flavor Willis seemed to be so high on.
Did you catch any errors? Let me know in the comments.
Words we've learned
Diabetes: to siphon
Hyperglycemia: high blood sugar
Insipidus: without flavor
Mellitus: honey or sweet
Polydipsia: excessive thirst
Polyuria: excessive urination
Notes
¹ "Pharmaceutice rationalis: or, An exercitation of the operations of medicines in humane bodies. Shewing the signs, causes, and cures of most distempers incident thereunto. : In two parts. : As also a treatise of the scurvy and the several sorts thereof, with their symptoms, causes, and cure. / By Tho. Willis ..." In the digital collection Early English Books Online 2. https://name.umdl.umich.edu/A66509.0001.001. University of Michigan Library Digital Collections. Accessed September 3, 2024.
² "Of ARETÆUS, the CAPPADOCIAN, on the Causes and Symptoms of Chronic Disease" http://data.perseus.org/citations/urn:cts:greekLit:tlg0719.tlg002.perseus-eng1:2.2. Perseus Digital Library. Accessed September 5, 2024.