In July 1922, fifty-seven year old Charlotte Clarke was referred to Banting by Dr. L.C. Palmer, a local surgeon who had been a fellow medical officer during the First World War in Cambrai, France. Palmer had a severely diabetic patient, Charlotte Clarke, who was also suffering from a badly infected gangrenous infection in her right ankle that needed to be amputated. Dr. Palmer, dubious about her chances of surviving the surgery, consulted Dr. Banting who advised amputation and prescribed treatment with insulin.
On July 10th, Charlotte Clarke, who was nearly comatose, was given her first dose of insulin.On the 11th, Clarke stabilized and Dr. Palmer amputated her right leg above the knee using a general anaesthetic which he thought she may have not been able to withstand without insulin.
Toronto General Hospital. Patient records for Mrs. Charlotte E. Clarke, showing her admission on July 9 and discharge on September 2, 1922.
These notes record the first operation on a diabetic utilizing the new insulin treatment. After the operation, in Dr. Palmer's opinion "it did not seem possible that she could get better." After receiving insulin for several days, however, her wound began to heal, but when the supply of insulin ran out, the wound reopened.
"The outlook was most discouraging for it did not seem possible to ever get the wound to heal again. Dr. Banting, on returning to the city, started the patient on a fresh supply of Insulin, the wound immediately started to heal and became a first hard scar. On August the 5th the patient was free of sugar for the first time in six years ... I may state that Mrs. Clarke is now in good health, she looks at least 40 years younger and gets around freely, does her own housework and cooked [sic] the meals for her family."
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