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March 5, 1938


Author Affiliations

Los Angeles.

JAMA. 1938;110(10):758. doi:10.1001/jama.1938.02790100056024

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To the Editor:—  Dr. H. M. Smith (The Journal, June 5, 1937, p. 1959), commenting on insulin therapy for schizophrenia, says "the coma results from the reaction to insulin rather than from the hypoglycemia." Sakel's own curves (Neue Behandlungsmethode der Schizophrenie) indicate blood sugar values which are moderately high (usually in the neighborhood of 60 mg. per hundred cubic centimeters) even though large enough doses to bring on coma were administered. Certainly the possibility is not excluded that an extrahypoglycemic factor may be producing the favorable results of this therapy. If the hypoglycemia were not an essential feature of the treatment, both the hazards and the great expense of insulin therapy might be largely overcome.The primary functions of insulin in the normal person have not been entirely established. It stores glycogen in the liver and in the muscles. There is some question as to an increased oxidation in the

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