The application of the insulin shock therapy in the treatment of dementia praecox by Sakel1 has brought forward anew the problem of the toxic effect of insulin on the central nervous system. The same problem before had interested the clinician and the pathologist when insulin was introduced for the treatment of diabetes mellitus. Over fifteen years of experience has shown that the average doses which are used to reduce the glycosuria seemingly do not produce marked deleterious effects on the central nervous system. However, there is a great difference between the treatment for diabetes mellitus and that for dementia praecox. In the latter case large, toxic doses, which produce convulsive states, are administered daily for as long as from two to three months.
Cases have rarely been reported in which the patient died in hypoglycemic shock after the treatment for diabetes mellitus. Sigwald2 had collected twenty-six cases up