Some results obtained by the treatment of nervous phenomena with glucose.

Abstract

Recently Edwards, Page and Brown 1 have described cardiovascular disturbances accompanying insulin hypoglycemia in dogs. They found that insulin brought about certain irregularities in heart action, a slight decline in mean blood pressure and a lowered CO₂ capacity of the blood. Similar results associated with nervousness have been observed following the injection of insulin in normal individuals or an overdose of insulin in diabetics, by Banting and his associates. 2 , 3 , 4 These results are apparently due to lowered blood sugar and may be relieved by the administration of glucose or of adrenalin. This action of adrenalin is attributed to its glycogenolytic effect on the liver.

We were impressed by the similarity of these findings in insulin hypoglycemia to those in some young patients with low blood sugar and low CO₂ capacity who were suffering from severe nervous manifestations. Experiments were conducted in the feeding of glucose to these children, with immediate and striking relief of their symptoms. This encouraged us to try glucose therapy in a number of other cases with similar but less severe symptoms with like success.

The symptoms in the cases referred to were either psychicasthenia, anorexia, phobias, etc.-or somatic symptoms such as tachycardia, palpitation and digestive disturbances, commonly thought to be psychogenic. These were associated with a blood sugar, which in most instances was within the limit generally considered normal, but below the average finding, a low CO₂ capacity of the blood and a high red cell count and hemoglobin, which latter findings were in contrast with the anemic appearance of the patients. The significance of the relatively low blood sugar is indicated by the fact that the patients' symptoms were promptly relieved by feeding glucose, and this relief in some instances was associated with a slight increase of blood sugar.