SPIEGEL, Wycis and their coworkers have adapted the Horsley-Clarke stereotaxic apparatus so that precisely localized lesions may be produced within the brain substance of humans. In this manner, they have been treating patients who have certain emotional disorders and intractable pain (1, 2). Consequently, a unique opportunity has been afforded the present authors to investigate the relationship of the thalamus and hypothalamus to the human metabolic economy. Patients so treated have been studied over a period of two years with a variety of tests, including those measuring the response of eosinophils to the stress produced by ACTH, epinephrine and insulin. This paper is limited to a report of changes observed with these latter procedures. Fifteen schizophrenic patients have been evaluated before and at intervals after bilateral lesions were produced in the thalamus and/or hypothalamus by Drs. Spiegel and Wycis. Several patients were operated on again and the lesions enlarged and/or second lesions placed in other areas. Fasting blood specimens were taken in balanced oxalate, and the test substance (25 mg. of ACTH intramuscularly, 0.3 mg. of epinephrine subcutaneously, or 0.1 unit per kilogram of body weight of crystalline insulin intravenously) administered. Four hours later, a second blood specimen was similarly drawn. True blood glucose levels (3) were determined fasting, and at 15, 30, 45, 60, 90 and 120 minutes after the injection of the test dose of insulin. The eosinophil counts of the oxalated blood specimens were made in Fuchs-Rosenthal counting chambers using the phloxine, propylene glycol-water stain of Randolph (4). Two pipettes were used for each blood specimen, and two chambers were filled from each pipette, the final count representing the average of four chambers.
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