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A COMBINATION THERAPY OF INDUCED NARCOSIS AND FEVER: ITS EFFECT ON THE AFFECTIVE SYNDROME A PRELIMINARY REPORT

A COMBINATION THERAPY OF INDUCED NARCOSIS AND FEVER: ITS EFFECT ON THE AFFECTIVE SYNDROME A... Abstract In a series of ten psychotic patients subjected to a combination therapy—prolonged narcosis and artificial induction of fever—the clinical results were specific in six patients presenting a decidedly affective symptom complex. The addition of this form of therapy to the neuropsychiatrist's armamentarium in the treatment of the affective states is deserving of further consideration and investigation. Since its introduction into the continental clinics by Kläsi1 in 1920, prolonged narcosis has been used considerably in the treatment of schizophrenia with variably reported results, but in only a few instances is it reported as effective in the affective states. Kohra2 and Beyerman3 reported favorably on the results obtained in the manic-depressive psychoses; Beyerman4 even advocated it as a specific remedy. The concept as to what constitutes schizophrenia and a manic-depressive psychosis, of course, varies in individual psychiatric clinics. Not only that, but the same patient on successive reentries References 1. Kläsi, J.: Ueber die therapeutische Anwendung des Dauerschlafmittels Somnifen bei Schizophrenen , Ztschr. f. d. ges. Neurol. u. Psychiat. 74:557, 1922Crossref 2. Eigenes über Schizophreniebehandlung , Kläsi Ztschr. f. d. ges. Neurol. u. Psychiat. 78:606, 1922.Crossref 3. Kohra, Takehisa: Die Dauerschlafbehandlung des manisch-depressiven Irreseins mit Sulfonal , Zentralbl. f. d. ges. Neurol. u. Psychiat. 53:638, 1929. 4. Beyerman, W.: Die Behandlung manisch-depressiven Zuständen mit Somnifen , Zentralbl. f. d. ges. Neurol. u. Psychiat. 51:848, 1929. 5. Beyerman, W.: Die Behandlung der manischer-depressiven Psychosen mit Somnifen , Zentralbl. f. d. ges. Neurol. u. Psychiat. 52:767, 1929. 6. Campbell, C. MacFie: Two Cases Illustrating the Combination of Schizophrenic and Affective Symptoms , Am. J. Psychiat. 6:243, 1926. 7. von Horànsky, Ferdinand: Ueber einige neuere Behandlungsmethoden der Schizophrenie , Arch. f. Psychiat. 84:181, 1928.Crossref 8. Lutz, Jakob: Ueber die Dauernarkosebehandlung in der Psychiatrie Ztschr. f. d. ges. Neurol. u. Psychiat. 123:91, 1929.Crossref 9. Pavlov, I. P.: Conditioned Reflexes , translated by G. V. Anrep, New York, Oxford University Press, 1927. 10. Menninger, Karl A.: The Amelioration of Mental Disease by Influenza , J. A. M. A. 94:630 ( (March 1) ) 1930.Crossref 11. Since this manuscript was submitted a slight modification of the technic, incorporating certain principles in use at the Heilanstalt Burghölzli, has been developed. The initial injections of typhoid vaccine are omitted. Instead, the patient is given a cleansing enema the preceding evening and again the next morning, followed by the administration of 1,500 cc. of weak tea. The patient is then narcotized, nourishment being given by protoclysis in the form of 2,500 cc. of from 5 to 7 per cent dextrose plus 500 cc. of physiologic solution of sodium chloride. From the second to the fourth day a slight rise in temperature may develop which responds favorably to the administration of from 0.1 to 0.2 Gm. of quinine added to the dextrose solution. Experience has shown that this initial rise may be disregarded, provided it responds to the quinine and no other signs of marked vegetative depression are in evidence. Otherwise the technic remains as described. This technic has an advantage in that the patient cannot aspirate vomited food and the narcosis remains uninterrupted. Its disadvantage is that loss in weight of from 4 to 6 Kg. is registered within the average ten day period of treatment, and patients already in a poor state of nourishment do not react well. 12. Pick, E. P.: Pharmacology of the Vegetative Nervous System , Arch. Neurol. & Psychiat. 23:582 ( (March) ) 1930. 13. Pavlov (footnote 8). 14. Cannon, Walter B.: Bodily Changes in Pain, Hunger, Fear and Rage , New York, D. Appleton and Company, 1929. 15. Farr, Clifford B., and Lueders, Charles W.: Gastric Secretory Functions in the Psychoses , Arch. Neurol. & Psychiat. 10:548 ( (Nov.) ) 1923. 16. Henry, George W.: Some Roentgenologic Observations of Gastro-Intestinal Conditions Associated with Mental Diseases , Am. J. Psychiat. 3:695, 1925. 17. Westburgh, Edward M.: Psychogalvanic Studies of Normal and of Abnormal Subjects , Arch. Neurol. & Psychiat. 22:453 ( (Sept.) ) 1929. 18. Reiman, Emil: Ztschr. f. Heilk. 23:1, 1902. 19. Folin, Otto, et al.: Some Observations on Emotional Glycosuria in Man , J. Biol. Chem. 17: 519, 1914. 20. Henry, George W., and Mangam, Elizabeth: Blood in Personality Disorders , Arch. Neurol. & Psychiat. 13:743 ( (June) ) 1925. 21. Westburgh, Edward M.: Psychogalvanic Studies on Affective Variations in the Mentally Diseased , Arch. Neurol. & Psychiat. 22:719 ( (Oct.) ) 1922. 22. Hackfield: Studies to be reported elsewhere. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology & Psychiatry American Medical Association

A COMBINATION THERAPY OF INDUCED NARCOSIS AND FEVER: ITS EFFECT ON THE AFFECTIVE SYNDROME A PRELIMINARY REPORT

Archives of Neurology & Psychiatry , Volume 28 (5) – Nov 1, 1932

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Publisher
American Medical Association
Copyright
Copyright © 1932 American Medical Association. All Rights Reserved.
ISSN
0096-6754
DOI
10.1001/archneurpsyc.1932.02240050205014
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Abstract

Abstract In a series of ten psychotic patients subjected to a combination therapy—prolonged narcosis and artificial induction of fever—the clinical results were specific in six patients presenting a decidedly affective symptom complex. The addition of this form of therapy to the neuropsychiatrist's armamentarium in the treatment of the affective states is deserving of further consideration and investigation. Since its introduction into the continental clinics by Kläsi1 in 1920, prolonged narcosis has been used considerably in the treatment of schizophrenia with variably reported results, but in only a few instances is it reported as effective in the affective states. Kohra2 and Beyerman3 reported favorably on the results obtained in the manic-depressive psychoses; Beyerman4 even advocated it as a specific remedy. The concept as to what constitutes schizophrenia and a manic-depressive psychosis, of course, varies in individual psychiatric clinics. Not only that, but the same patient on successive reentries References 1. Kläsi, J.: Ueber die therapeutische Anwendung des Dauerschlafmittels Somnifen bei Schizophrenen , Ztschr. f. d. ges. Neurol. u. Psychiat. 74:557, 1922Crossref 2. Eigenes über Schizophreniebehandlung , Kläsi Ztschr. f. d. ges. Neurol. u. Psychiat. 78:606, 1922.Crossref 3. Kohra, Takehisa: Die Dauerschlafbehandlung des manisch-depressiven Irreseins mit Sulfonal , Zentralbl. f. d. ges. Neurol. u. Psychiat. 53:638, 1929. 4. Beyerman, W.: Die Behandlung manisch-depressiven Zuständen mit Somnifen , Zentralbl. f. d. ges. Neurol. u. Psychiat. 51:848, 1929. 5. Beyerman, W.: Die Behandlung der manischer-depressiven Psychosen mit Somnifen , Zentralbl. f. d. ges. Neurol. u. Psychiat. 52:767, 1929. 6. Campbell, C. MacFie: Two Cases Illustrating the Combination of Schizophrenic and Affective Symptoms , Am. J. Psychiat. 6:243, 1926. 7. von Horànsky, Ferdinand: Ueber einige neuere Behandlungsmethoden der Schizophrenie , Arch. f. Psychiat. 84:181, 1928.Crossref 8. Lutz, Jakob: Ueber die Dauernarkosebehandlung in der Psychiatrie Ztschr. f. d. ges. Neurol. u. Psychiat. 123:91, 1929.Crossref 9. Pavlov, I. P.: Conditioned Reflexes , translated by G. V. Anrep, New York, Oxford University Press, 1927. 10. Menninger, Karl A.: The Amelioration of Mental Disease by Influenza , J. A. M. A. 94:630 ( (March 1) ) 1930.Crossref 11. Since this manuscript was submitted a slight modification of the technic, incorporating certain principles in use at the Heilanstalt Burghölzli, has been developed. The initial injections of typhoid vaccine are omitted. Instead, the patient is given a cleansing enema the preceding evening and again the next morning, followed by the administration of 1,500 cc. of weak tea. The patient is then narcotized, nourishment being given by protoclysis in the form of 2,500 cc. of from 5 to 7 per cent dextrose plus 500 cc. of physiologic solution of sodium chloride. From the second to the fourth day a slight rise in temperature may develop which responds favorably to the administration of from 0.1 to 0.2 Gm. of quinine added to the dextrose solution. Experience has shown that this initial rise may be disregarded, provided it responds to the quinine and no other signs of marked vegetative depression are in evidence. Otherwise the technic remains as described. This technic has an advantage in that the patient cannot aspirate vomited food and the narcosis remains uninterrupted. Its disadvantage is that loss in weight of from 4 to 6 Kg. is registered within the average ten day period of treatment, and patients already in a poor state of nourishment do not react well. 12. Pick, E. P.: Pharmacology of the Vegetative Nervous System , Arch. Neurol. & Psychiat. 23:582 ( (March) ) 1930. 13. Pavlov (footnote 8). 14. Cannon, Walter B.: Bodily Changes in Pain, Hunger, Fear and Rage , New York, D. Appleton and Company, 1929. 15. Farr, Clifford B., and Lueders, Charles W.: Gastric Secretory Functions in the Psychoses , Arch. Neurol. & Psychiat. 10:548 ( (Nov.) ) 1923. 16. Henry, George W.: Some Roentgenologic Observations of Gastro-Intestinal Conditions Associated with Mental Diseases , Am. J. Psychiat. 3:695, 1925. 17. Westburgh, Edward M.: Psychogalvanic Studies of Normal and of Abnormal Subjects , Arch. Neurol. & Psychiat. 22:453 ( (Sept.) ) 1929. 18. Reiman, Emil: Ztschr. f. Heilk. 23:1, 1902. 19. Folin, Otto, et al.: Some Observations on Emotional Glycosuria in Man , J. Biol. Chem. 17: 519, 1914. 20. Henry, George W., and Mangam, Elizabeth: Blood in Personality Disorders , Arch. Neurol. & Psychiat. 13:743 ( (June) ) 1925. 21. Westburgh, Edward M.: Psychogalvanic Studies on Affective Variations in the Mentally Diseased , Arch. Neurol. & Psychiat. 22:719 ( (Oct.) ) 1922. 22. Hackfield: Studies to be reported elsewhere.

Journal

Archives of Neurology & PsychiatryAmerican Medical Association

Published: Nov 1, 1932

References