"ALLERGIC MANIFESTATION TO INSULIN"

To the Editor:  —In The Journal, Dec. 19, 1931, page 1885, there is an article by Dr. William H. Grishaw of Los Angeles entitled "Allergic Manifestation to Insulin," in which Dr. Grishaw concludes that such manifestations are due not to the insulin itself but to something in the particular brand used. This fact is known among those handling many diabetic patients and Joslin (1928 edition) mentions a patient in the early days of insulin therapy who could not stand insulin derived from pig pancreas but who could take without difficulties that derived from beef pancreas. Recently there was a patient at a New Jersey institution with which I was connected who developed large, wheal-like, indurated spots, lasting several days, only at the sites of injection, when one reputable brand of insulin was used, hut had no reaction at all when another was used. The local reactions were not materially influenced