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A notice on the title page says that Sakel's book is an "enlarged version of a series of articles from the Wiener medizinische Wochenschrift, 1934-35." It is to be regretted that the version is merely enlarged, perhaps also improved, but not materially revised. A suitable revision might have removed what is a decided weakness of the monograph: undue theorizing and dogmatic statement of opinion. Clinical experience of the past five years has conclusively shown that no rigid rules can be formulated concerning the technical manipulation of the patient with hypoglycemia and that the physiologic basis of the insulin effect is shrouded in obscurity. Nevertheless, Sakel continues to announce that "shock" must be discontinued when the patient with catatonic excitement passes into a state of somnolence and when the catatonic stupor gives way to excitement. The reason for the magisterial instruction is what it was five years ago: "that portion of
The Pharmacological Shock Treatment of Schizophrenia.. Arch NeurPsych. 1939;41(4):868. doi:10.1001/archneurpsyc.1939.02270160224022