Report on cardiazol treatment and on the present application of hypoglycaemic shock treatment in schizophrenia / by W. Rees Thomas (medical senior commissioner of the Board of Control) and Isabel G.H. Wilson (medical commissioner of the Board of Control).
- Great Britain. Board of Control
- Date:
- 1938
Licence: Public Domain Mark
Credit: Report on cardiazol treatment and on the present application of hypoglycaemic shock treatment in schizophrenia / by W. Rees Thomas (medical senior commissioner of the Board of Control) and Isabel G.H. Wilson (medical commissioner of the Board of Control). Source: Wellcome Collection.
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![On somatic grounds. Neurological Extensor spasm. Epileptiform attack. Myocloniform attack. Circulatory Pulse over 140 or under 40; small, quick pulse. Definite arhythmia. Other sign of heart disturbance. Respiratory Kussmaul breathing (i.e. very deep slow breathing). Cheyne Stokes breathing. Cyanotic laryngospasm. Other signs of a clinical kind, e.g. severe tongue-bite. By various methods. (1) By tube, normally. (2) Intravenous. (a) Somatic indications—if not waking from tube feed. (6) Mental indications—cases of old catatonic stupor should be put in deep coma, and wakened suddenly. (3) Adrenalin should be reserved for (a) Peripheral vascular collapse. (b) In impending death, to be given intraventricularly. (c) To provoke excitement in the stuporose. MORTALITY. Kiippers’? in 1937 put this at 1-5 per cent. and noted that the period during which this figure was reached included the time of working out precautionary rules and discovering the scope of the method. Miiller!®? quotes 495 cases with two deaths (0-4 per cent. mortality), and Marzynsky °®’ 164 cases with no deaths. James says®> ‘We believe that the death rate will always prove to be in inverse ratio to the care with which a proved method of technique is adopted and applied.” We have as yet no full record of the number of cases treated in England. Two deaths have been reported, one being due to irreversible coma and the other to pulmonary edema in a patient found at autopsy to have had unsuspected chronic nephritis. DIFFICULTIES AND DANGERS IN THE LIGHT OF EXPERIENCE HITHERTO. These may conveniently be studied systematically. J]. NERVOUS SYSTEM. (a) Fatlure to wake. This may be diagnosed if the patient shows no real, definite signs of waking half an hour after the ordinary “ interruption ”’ glucose has been given. Occasionally, the glucose solution appears to remain in the stomach, and may later be vomited or discovered by tube; this retention may be favoured by giving too large amounts of glucose into the stomach. In this case intravenous glucose is indicated.](https://iiif.wellcomecollection.org/image/b32182648_0022.jp2/full/800%2C/0/default.jpg)
