Abstract
The present report is concerned with further investigation on the insulin treatment of schizophrenia. This work was done at the Harlem Valley State Hospital, Wingdale, New York, where patients with schizophrenia are receiving Sakel's insulin treatment. Ten observations were made on 5 patients. An attempt was made to correlate the clinical, biochemical, and electrical changes occurring as a result of insulin. It was hoped that such studies would establish a physiological basis for this treatment.
Clinical observations were made before insulin was injected. Brain waves were recorded at this time and samples of blood, drawn from the internal jugular vein and femoral artery were analyzed for oxygen 1 and glucose 2 in order to estimate cerebral metabolism. All these observations were repeated during various stages of hypoglycemia and after sugar was administered to terminate the coma.
The typical results here published were obtained on E.B. during hypoglycemia caused by a dose of insulin adequate to produce coma. The symptoms exhibited by the patient are presented and divided in 4 groups; the first including somnolence, perspiration, and hypotonia developed during the first 2 hours after the injection of insulin. Loss of consciousness, primitive movements, and forced grasping formed the second group. The third group is characterized by tonic and torsion spasms and occurred chiefly during the fourth hour. The final group in the fifth hour includes deep coma with depressed tendon reflexes and respiratory disturbances which necessitated termination of the hypoglycemia with sugar. Table I contains the results of the arterial-venous oxygen differences of the cerebral blood and values for arterial blood sugar, alpha frequency and delta index, as well as the time after the injection of insulin that these observations were made.
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