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The Treatment of Prolonged Insulin Coma^*

The Mental Hospitals Group Laboratory at West Park Hospital, Epsom, Surrey

^* Thesis approved for the Degree of Doctor of Medicine in the University of Manchester.

ABSTRACT

1. The types, treatment, aetiology and pathology of prolonged insulin comas are discussed.
   
2. The significance of fatigue of the anterior-pituitary-adrenocortical system and of the disturbance of the oxidative enzyme systems depending on B-vitamin co-enzymes in relation to prolonged insulin comas is indicated.
   
3. An account is given of experience of 62 cases of prolonged insulin coma, 55 of which were treated with cortisone and/or ACTH.
   
4. Twelve of these cases recovered in less than one hour after receiving hormone, and ten others within a few hours after. Four deaths occurred.
   
5. Initiation of recovery by both hormones appears to be an improvement on previous methods of treatment.
   
6. The rationale of the use of hormones in treating prolonged coma and some factors affecting results are discussed.
   
7. The method of treatment is stated together with an account of the laboratory investigations that should accompany it.