Andrew Almon Fletcher

Andrew Almon Fletcher (8 March 1889, Kingston, Ontario – 30 November 1964, Toronto) was a Canadian physician and pioneering diabetologist, known as one of the five co-authors of the famous 1922 paper Pancreatic Extracts in the Treatment of Diabetes Mellitus.^[1]

Biography

A. Almon Fletcher graduated in 1913 from the University of Toronto with an M.B. (qualifying him for the practice of medicine). From 1915 to 1918 he served overseas in the Canadian Army Medical Corps. After WW I, he became a staff member of the department of medicine of the University of Toronto and of the medical service of Toronto General Hospital. He qualified F.R.C.P.C. in 1930. He was an assistant professor in the department of medicine of the University of Toronto and a senior physician at Toronto General Hospital from 1922 to 1951 when he retired from Toronto General Hospital. In 1951 he was put in charge of the clinical investigation unit at Toronto's Sunnybrook Military Hospital,^[2] which in 1973 became Sunnybrook Medical Centre.

At Toronto General Hospital, in the diabetes ward under the direction of Duncan Archibald Graham, the physicians A. Almon Fletcher and Walter R. Campbell^[3] were responsible for the treatment of Leonard Thompson, a teenaged charity case with a severe case of type 1 diabetes, who had been transferred on 2 December 1921 from Toronto's Hospital for Sick Children.^[4] Dr. Campbell persuaded Leonard Thompson's father to consent to the experimental test on his son of the pancreatic extract supplied by Banting, Best, and Macleod. The historic injection of insulin took place on 11 January 1922.^[3]

The spring of 1922 was a period of consolidation. Visitors came from all countries of the western world. Especially memorable were

Petren from Oslo, Woodyatt from Chicago and Wilder from Mayo's—these men were largely instrumental in the development of the high-fat diets then in vogue—and Elliott Joslin and F. M. Allen, who were advocates of starvation and undernutrition. They made no effort to conceal their excitement and unbounded admiration. During this time further physiological papers appeared, describing the associated effects of insulin in addition to its influence on carbohydrate and fat metabolism. A method of pharmacological assay was devised and the unit defined.^[5]

Most of our patients went on to live normal, useful and happy lives. One writes me each Christmas; he now informs me tha he has reached the age when regretfully he must retire. Last Christmas, he sent me only a short note—"1922, remember."[6]

In 1953 Fletcher and Campbell were both awarded Banting Medals by the American Diabetes Association.^[7]

On 21 September 1921 in Toronto, A. Almon Fletcher married Helen Waterston Mowat (1895–1945). They had four daughters.

His burial took place at Mount Pleasant Cemetery, Toronto. He was a great-grandson of Sir Oliver Mowat.

Selected publications

Articles

• Brown, Alan; Fletcher, Almon (1915). "The etiology of tetany—metabolic and clinical studies". American Journal of Diseases of Children. 10 (5): 313–330.
  doi:10.1001/archpedi.1915.04110050002001
  .
• Banting, F. G.; Best, C. H.;
  PMID 20314060
  . 1922 (over 1250 citations)
• Fletcher, A. Almon (1922). "Dietetic Treatment of Chronic Arthritis and its Relationship to the Sugar Tolerance". Archives of Internal Medicine. 30: 106.
  doi:10.1001/archinte.1922.00110070109009
  .
• Banting, F.G.; Best, C.H.; Collip, J.B.; Campbell, W.R.; Fletcher, A.A.; Macleod, J.J.R.; Noble, E.C. (1923). The effect produced on diabetes by extracts of pancreas. University of Toronto Library: Published by the Librarian. (This paper was delivered on 3 May 1922 by Macleod at the Washington, D.C., meeting of the Association of American Physicians. See "The Discovery of Insulin". The Canadian Encyclopedia.)
• Banting, F. G.; Campbell, W. R.; Fletcher, A. A. (1923). "Further Clinical Experience with Insulin (Pancreatic Extracts) in the Treatment of Diabetes Mellitus". British Medical Journal. 1 (3236): 8–12.
  PMID 20770964
  .
• Fletcher, A. A. (1930). "Chronic Arthritis". Canadian Medical Association Journal. 22 (3): 320–323.
  PMID 20317726
  .
• Fletcher, A.A. (1931). "Diet and Nutrition in Chronic Arthritis". Journal of the American Dietetic Association. 7: 2–6.
  S2CID 244766397
  .
• Fletcher, A. A. (1933). "Value of Occupational Therapy in Chronic Arthritis". Canadian Journal of Occupational Therapy. 1: 20–23.
  S2CID 76194572
  .
• doi:10.7326/0003-4819-8-10-1315
  .
• Kerr, R. B.; Best, C. H.; Campbell, W. R.; Fletcher, A. A. (1936). "Protamine Insulin". Canadian Medical Association Journal. 34 (4): 400–401.
  PMID 20320225
  .
• Graham, J. W.; Fletcher, A. A. (1943). "Gold Therapy in Rheumatoid Arthritis". Canadian Medical Association Journal. 49 (6): 483–487.
  PMID 20322941
  .
• Volpé, Robert; Bruce-Robertson, Alan; Fletcher, A.Almon; Charles, W.Bruce (1956). "Essential cryoglobulinaemia". The American Journal of Medicine. 20 (4): 533–553.
  PMID 13302232
  . 1956
• Banting, F. G.; Best, C. H.; Collip, J. B.; Campbell, W. R.; Fletcher, A. A. (1956). "Pancreatic Extracts in the Treatment of Diabetes Mellitus". Diabetes. 5: 69–71.
  S2CID 22547673
  . (reprint of March 1922 article)