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December 1953


Author Affiliations


From the Verdun Protestant Hospital.

AMA Arch NeurPsych. 1953;70(6):713-721. doi:10.1001/archneurpsyc.1953.02320360028003

THE DIFFICULTIES of ascertaining the depth of an insulin shock as currently used in the treatment of psychoses are well known. They are inherent in the hypoglycemic condition itself. After the insulin injection in a dosage high enough to produce hypoglycemic coma, the blood sugar level drops in the first two hours to from 20 to 30 mg. per 100 cc. No further drop occurs during the following hours, although the deepening coma and a number of neurological and vegetative signs indicate a continuous and progressive depression of brain activity. Himwich1 demonstrated this to be a result of a decrease in the oxygen metabolism of the brain. Accordingly, different clinical pictures may be present with the same blood sugar level.

Clinicians have tried to find practical methods by which to assess the depth of an insulin shock, since with increasing experience the dangers connected with too deep a shock

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