In his article on difficulties in the diagnosis of insulin coma, Sevringhaus1 discusses certain questions, the answers to which can be based on my own researches and observations.
Sevringhaus points out that the soft eyeball in diabetic coma is not present in other types of coma and emphasizes the importance of observing whether the eyeball is soft in cases of hyperactive insulin coma. Together with Fritz Koch, I2 have made a series of examinations with the object of ascertaining the degree of intra-ocular tension in cases of diabetic coma and of hypoglycemia after insulin injection. Of eight cases of diabetic coma, we found great reduction of the intra-ocular tension in six, while in two cases the tension was normal. Therefore when Heine3 says that "this great reduction in tension seems up to the present to have been observed only in cases of typical diabetic coma, and that
WIECHMANN E. DIFFICULTIES IN THE DIAGNOSIS OF INSULIN COMA. JAMA. 1929;92(18):1495–1496. doi:10.1001/jama.1929.02700440003002
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