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
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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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    struck by the parallelism which they found between the physio- logical events slowly occurring in the first two hours of insulin therapy and those which ran their gamut in a few seconds after cardiazol was given. Many of the changes mentioned were also described by von Meduna.* He stated that the leucocyte shift to the left was about twice as great in patients who remitted as in those who did not. The urinary findings he cites as much the same, after a convulsion, as in idiopathic epilepsy, i.e. increased acidity, increase of ammonia and phosphates and decrease of chlorides. Kennedy® draws attention to the curious fact that the well known wide gaping of the jaws which occurs with the fit appears to be peculiar to the cardiazol convulsion. Stief,!*? in a detailed paper, refers to the cerebral findings in epilepsy as well as in treat- ment by insulin and cardiazol and gives his view that cardiazol treatment leads to cerebral effects which are predominantly vascular and probably depend on vaso-constriction. Morsier and his co- workers! in a study of animals subjected to high doses of cardiazol were unable to find any cerebral changes except hyperemia. Von Meduna®’ himself said that he regarded cardiazol as a vaso- dilator. The absence of serious electrocardiagraphic change has been noted earlier,*? as has the cyanosis which is so obvious during treatment. (c) Changes during prolonged narcosis. These are outside the scope of this paper; but it may be said that they were described at the Miinsingen Congress in an article by Kulkow, Weiland and Kakusina,” and that treatment by prolonged narcosis was one of the basic subjects of that congress. THEORIES AS TO THE MECHANISM OF IMPROVEMENT. Most of the theories which have been put forward are closely related to each other, so much so that some of them may be looked on merely as different ways of stating the same fact or belief, but they are artificially separated here for the sake of clearness in discussion. We give first a list of theories, then a note upon each, and finally (and with diffidence) a few words as to the most promising views which seem to us to emerge from the available information. The list of theories. Improvement has been thought on various occasions to be due to one or more of the following :— 1. The elimination of diseased cells. 2. Changes in the vegetative system. 3. Hypoglycemia per se. 4. Some unknown effect of a convulsion. 5. Avitaminosis produced by high carbohydrate intake.
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