(1). An historical introduction to the treatment of
insanity is outlined. The development of the
hypoglycaemic treatment is traced.
(2). The case material reviewed in this thesis consist
of 46 patients. Case summaries are included
and are divided into two groups - Group I
treated by Dr Strecker, and Group II treated by
the writer. Of these, 40 were diagnosed as
suffering from schizophrenia.
(3). An account of the treatment is given in detail.
The symptomatology is described at length, particular
reference being made to the definition
of coma. An account is given of the blood sugar
changes, together with a t able. A relationship
between coma and blood sugar was found, namely,
that for coma to be produced a mean fall of 80%
was necessary and. that the more rapid the fall
the deeper the coma. The onset of coma seemed
to coincide with an acceleration of the pulse
and a raised blood, pressure. This is recorded
(4). The management of hypoglycaemia has been d.iscusse
and certain points in technique have been emphasised.
The difficulties and dangers have
been enumerated, and their prophylaxis and treat
ment discussed. These undesirable phenomena
are rare and usually avoidable.
(5). The effects of hypoglycaemia upon the individual
have been reviewed. It is considered that there
is ample physiological foundation for this treatment
in schizophrenia. The mental effects have
been considered. Periods of lucidity are discussed
and related to the fugue states of
diabetics. The undoubted sedative effect of
treatment in many cases is made clear.
(6). Three types of remission are defined - complete,
incomplete and partial. Two Tables of results
(7). In the evaluation of results the two groups of
cases are dealt with separately. The poor
results in Group I are attributed to the unsatisfactory
case material, and to the inadequa
treatment in many of them. It is considered
that the results of treatment in Group II.
though perhaps not so satisfactory as might half
been hoped, are undoubtedly better than in spontaneous
(8). Insulin treatment is looked upon, not as a method
of treatment in itself, but as an important
psycho-biological factor which, used in conjunction
with other methods of treatment such a
psychotherapy and occupational therapy, seems to
accelerate the process of recovery - and make
this more complete - in essentially recoverable
(9). With the modified technique described, it is maintained
that treatment can be carried out in the
normal hospital routine with no great difficult
or undue expenditure of time and money.