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To the Editor:—
Recent literature discussing the insulinhypoglycemic therapy of schizophrenia indicates some confusion as to what is understood by the term coma. It is of clinical importance to have some gage as to the onset of coma and its optimum depth. Dorland defines coma as a state of complete loss of consciousness from which the patient cannot be aroused even by the most powerful stimulation. Sakel states (Am. J. Psychiat.94:111 [July] 1937) that "coma should be associated with the absence of the corneal reflex or at least with presence of a Babinski." Cameron and Hoskins (The Journal, Oct. 16, 1937, p. 1246) differ. They say "We usually consider somewhat arbitrarily that coma is present when the patient can no longer swallow, when, if he is turned on his side, saliva tends to drool from the mouth, or when, on the eyelids being drawn up, the eyeball is
Brody MW, Hayman M. COMA IN INSULIN-HYPOGLYCEMIC THERAPY OF SCHIZOPHRENIA. JAMA. 1937;109(22):1833-1834. doi:10.1001/jama.1937.02780480065025