John Rollo

Last updated March 18, 2023

John Rollo M.D. (d. December 23, 1809) was a Scottish military surgeon, now known for his work on a diabetic diet. Rollo was the first to suggest a low-carbohydrate diet as a treatment for diabetes.^[1]

Life

He was born in Scotland, and received his medical education at Edinburgh. He became a surgeon in the Royal Artillery in 1776, and then served in the West Indies. In 1778 the University of St Andrews made him M.D.^[2] He was stationed in St. Lucia in 1778–9 and in Barbados in 1781.^[3] His associates included Colin Chisholm on Grenada.^[4]

Rollo became surgeon-general of the Royal Artillery in 1794, and returned to the Royal Military Academy, Woolwich.^[3] There he oversaw the construction of the enlarged Royal Artillery Hospital: the Royal Ordnance Hospital dated from about 1780, and the enlargement was completed in 1806 (the building later became the Connaught Barracks).^[2]^[5] From 1804 he was inspector of hospitals for the Ordnance.^[2]

Rollo was frequently consulted about cases of diabetes, and in treatment had some success with the use of a nitrogenous diet. He died at Woolwich on 23 December 1809, and was buried at Plumstead in Greenwich.^[3]^[6]

Diabetes

In 1797 Rollo printed at Deptford Notes of a Diabetic Case, which described the improvement of an officer with diabetes who was placed on a meat diet.^[3] He was the first to take Matthew Dobson's discovery of glycosuria in diabetes mellitus and apply it to managing metabolism.^[7] By means of Dobson's testing procedure (for glucose in the urine) Rollo worked out a diet that had success for what is now called type 2 diabetes.^[8] The addition of the term "mellitus", distinguishing the condition from diabetes insipidus, has been attributed to Rollo.^[9]

Rollo's diet for diabetic patients consisted of "milk, lime water, bread and butter, blood pudding, meat, and rancid fat".^[10] He has been described as "the first one to recommend a diet low in carbohydrates as a treatment for diabetes."^[1]

Rollo collaborated with William Cruickshank, who was the chemistry assistant at Woolwich. In another edition of the work, An Account of Two Cases of the Diabetes Mellitus, published in 1798, other cases were added, and some of Cruikshank's research on urine and sugar in diabetics was included.^[11] A further edition appeared in 1806.^[3] John Latham supported Rollo's views on the treatment.^[12] In 1824 the Encyclopædia Britannica in its article "Dietetics" commented that the diet was successful in repressing the condition of the patients' urine, but that the patients often found the high fat content intolerable.^[13] This kind of dietary management continued to the 1920s, being more successful for adults, who might survive some years, than for young patients who typically had only some months of life on it.^[14] Other collaborations of Rollo and Cruikshank related to treatments for syphilis involving acids, and published with the work on diabetes;^[15]^[16] proteinuria; and strontium.^[17]

Other work

Rollo published Observations on the Diseases in the Army on St. Lucia, in 1781; and in 1785 Remarks on the Disease lately described by Dr. Hendy, on a form of elephantiasis known as "Barbados leg". In 1786 he published Observations on the Acute Dysentery.^[3]

Rollo published in 1801 a Short Account of the Royal Artillery Hospital at Woolwich. He had kept a record of his cases in Barbados, and the Account included a similar table for the Ordnance hospital.^[18]^[19] In 1804 a Medical Report on Cases of Inoculation supported the views of Edward Jenner.^[3]

Related Research Articles

<span class="mw-page-title-main">Diabetic ketoacidosis</span> Medical condition

Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of diabetes mellitus. Signs and symptoms may include vomiting, abdominal pain, deep gasping breathing, increased urination, weakness, confusion and occasionally loss of consciousness. A person's breath may develop a specific "fruity" smell. Onset of symptoms is usually rapid. People without a previous diagnosis of diabetes may develop DKA as the first obvious symptom.

<span class="mw-page-title-main">Hyperglycemia</span> Too much blood sugar, usually because of diabetes

Hyperglycemia is a condition in which an excessive amount of glucose circulates in the blood plasma. This is generally a blood sugar level higher than 11.1 mmol/L (200 mg/dL), but symptoms may not start to become noticeable until even higher values such as 13.9–16.7 mmol/L (~250–300 mg/dL). A subject with a consistent range between ~5.6 and ~7 mmol/L is considered slightly hyperglycemic, and above 7 mmol/L is generally held to have diabetes. For diabetics, glucose levels that are considered to be too hyperglycemic can vary from person to person, mainly due to the person's renal threshold of glucose and overall glucose tolerance. On average, however, chronic levels above 10–12 mmol/L (180–216 mg/dL) can produce noticeable organ damage over time.

Type 2 diabetes, formerly known as adult-onset diabetes, is a form of diabetes mellitus that is characterized by high blood sugar, insulin resistance, and relative lack of insulin. Common symptoms include increased thirst, frequent urination, and unexplained weight loss. Symptoms may also include increased hunger, feeling tired, and sores (wounds) that do not heal. Often symptoms come on slowly. Long-term complications from high blood sugar include heart disease, strokes, diabetic retinopathy which can result in blindness, kidney failure, and poor blood flow in the limbs which may lead to amputations. The sudden onset of hyperosmolar hyperglycemic state may occur; however, ketoacidosis is uncommon.

<span class="mw-page-title-main">Polyuria</span> Excess urination

Polyuria is excessive or an abnormally large production or passage of urine. Increased production and passage of urine may also be termed diuresis. Polyuria often appears in conjunction with polydipsia, though it is possible to have one without the other, and the latter may be a cause or an effect. Primary polydipsia may lead to polyuria. Polyuria is usually viewed as a symptom or sign of another disorder, but it can be classed as a disorder, at least when its underlying causes are not clear.

Diabetic nephropathy, also known as diabetic kidney disease, is the chronic loss of kidney function occurring in those with diabetes mellitus. Diabetic nephropathy is the leading causes of chronic kidney disease (CKD) and end-stage renal disease (ESRD) globally. The triad of protein leaking into the urine, rising blood pressure with hypertension and then falling renal function is common to many forms of CKD. Protein loss in the urine due to damage of the glomeruli may become massive, and cause a low serum albumin with resulting generalized body swelling (edema) so called nephrotic syndrome. Likewise, the estimated glomerular filtration rate (eGFR) may progressively fall from a normal of over 90 ml/min/1.73m² to less than 15, at which point the patient is said to have end-stage renal disease. It usually is slowly progressive over years.

Diabetes mellitus is a chronic disease in cats whereby either insufficient insulin response or insulin resistance leads to persistently high blood glucose concentrations. Diabetes affects up to 1 in 230 cats, and may be becoming increasingly common. Diabetes mellitus is less common in cats than in dogs. Eighty to ninety-five percent of diabetic cats experience something similar to type 2 diabetes but are generally severely insulin dependent by the time symptoms are diagnosed. The condition is treatable, and if treated properly the cat can experience a normal life expectancy. In type 2 cats, prompt effective treatment may lead to diabetic remission, in which the cat no longer needs injected insulin. Untreated, the condition leads to increasingly weak legs in cats and eventually to malnutrition, ketoacidosis and/or dehydration, and death.

Diabetic hypoglycemia is a low blood glucose level occurring in a person with diabetes mellitus. It is one of the most common types of hypoglycemia seen in emergency departments and hospitals. According to the National Electronic Injury Surveillance System-All Injury Program (NEISS-AIP), and based on a sample examined between 2004 and 2005, an estimated 55,819 cases involved insulin, and severe hypoglycemia is likely the single most common event.

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Matthew Dobson (1732–1784) was an English physician and experimental physiologist. He is now remembered for his work on diabetes.

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References

1 2 Veves, Aristidis; Malik, Rayaz A. (2007). Diabetic Neuropathy: Clinical Management. Humana Press. p. 3. ISBN 978-1-59745-311-0
1 2 3 Herrick, Claire E. J. "Rollo, John". Oxford Dictionary of National Biography (online ed.). Oxford University Press. doi:10.1093/ref:odnb/24028.(Subscription or UK public library membership required.)
1 2 3 4 5 6 7 Lee, Sidney, ed. (1897). "Rollo, John" . Dictionary of National Biography . Vol. 49. London: Smith, Elder & Co.
↑ The American Journal of the Medical Sciences. J.B. Lippincott, Company. 1829. p. 395. Retrieved 20 June 2013.
↑ Bridget Cherry; Sir Nikolaus Pevsner (2002). London: South. 2. YALE University Press ACADEMIC. p. 290. ISBN 978-0-300-09651-4 . Retrieved 20 June 2013.
↑ Daniel Lysons; Samuel Lysons (1811). The Environs of London: Being an Historical Account of the Towns, Villages, and Hamlets, Within Twelve Miles of that Capital : Interspersed with Biographical Anecdotes. T. Cadell and W. Davies. p. 577. Retrieved 20 June 2013.
↑ Elliott Proctor Joslin (2005). Joslin's Diabetes Mellitus:] ... [et Al.]. Lippincott Williams & Wilkins. p. 3. ISBN 978-0-7817-2796-9 . Retrieved 20 June 2013. Edited by C. Ronald Kahn
↑ Laurence D. Chalem (5 September 2009). Essential Diabetes Leadership. Laurence Chalem. p. 39. ISBN 978-1-4392-4566-8 . Retrieved 20 June 2013.
↑ Leonid Poretsky (1 January 2002). Principles of Diabetes Mellitus. Springer. p. 22. ISBN 978-1-4020-7114-0 . Retrieved 20 June 2013.
↑ White, Priscilla.(1932). Diabetes in Childhood and Adolescence. p. 21
↑ Watson, K. D. "Cruickshank, William". Oxford Dictionary of National Biography (online ed.). Oxford University Press. doi:10.1093/ref:odnb/57592.(Subscription or UK public library membership required.)
↑ Lee, Sidney, ed. (1892). "Latham, John (1761-1843)" . Dictionary of National Biography . Vol. 32. London: Smith, Elder & Co.
↑ Encyclopædia Britannica: Or, A Dictionary of Arts, Sciences, and Miscellaneous Literature, Enlarged and Improved. A. Constable. 1824. p. 565. Retrieved 20 June 2013.
↑ Marylou Ambrose (1 September 2010). Investigating Diabetes: Real Facts for Real Lives . Enslow Publishers, Inc. pp. 46–7. ISBN 978-0-7660-3338-2 . Retrieved 20 June 2013.
↑ John Hennen (1830). Principles of military surgery: comprising, observations on the arrangement, police, and practice of hospitals, and on the history, treatment, and anomalies of variola and syphilis. Illustrated with cases and dissections. Carey & Lea. p. 386 . Retrieved 20 June 2013.
↑ Samuel Cooper; William Anderson (1823). A Dictionary of Practical Surgery. Collins and Hannay. p. 280 . Retrieved 20 June 2013.
↑ Guillermo A. Herrera (2007). The Kidney in Plasma Cell Dyscrasias: 13 Tables. Karger Publishers. pp. 16–7. ISBN 978-3-8055-8178-3 . Retrieved 20 June 2013.
↑ John Rollo (1801). A short account of the Royal Artillery Hospital at Woolwich: with some observations on the management of artillery soldiers, respecting the preservation of health. Addressed to the officers of the regiment, and dedicated to the Master-General and Board of Ordinance. Mawman. Retrieved 20 June 2013.
↑ jameslindlibrary.org, Tröhler U (2010). The introduction of numerical methods to assess the effects of medical interventions during the 18th century: a brief history.