29. THE INSULIN SHOCK THERAPY AT THE NEUROPSYCHIATRIC CLINIC IN ROME

Abstract

The treatment of schizophrenia by insulin coma has been practiced in the clinic for nervous and mental diseases of the Royal University of Rome since November, 1936. In the beginning this treatment, which is still poorly understood in its mechanism of action and in the modifications it produces in the organism of the patients subjected to it, we believe we have accomplished besides the clinical observations a series of technical and laboratory researches aimed at a more fundarilental understanding of the character and the mode of production of tile very impressing and varied symptomatology. The long duration and the technical difficulties of this therapy do not permit us at present to base our experience on a sufficient number of observations to formulate statistics or express definitive judgments. Nevertheless we believe it will be useful to report briefly the data gleaned from our incomplete studies, some of which appear to us riot without interest. With regard to the procedure, we wish only to recall that for the insulin shock the method used at present by Sakel was employed with the most recent modifications introduced by the author himself. The researches on the symptomatology of the coma carried out by Accornero permit us to report the following noteworthy data: i. Marked paralysis of tile ocular muscles was observed in a patient during some phases of the coma. 2. It is possible to demonstrate with the suitable technique, in almost all the patients signs of functional damage not only to the pyramidal but also to the extrapyramidal system. 3. Epileptic attacks may sometimes be induced with very small doses of insulin during the preliminary phase of the treatment. ihis was observed in a patient in whom there appeared after 35