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insulin shock therapy : ウィキペディア英語版
insulin shock therapy

Insulin shock therapy or insulin coma therapy (ICT) was a form of psychiatric treatment in which patients were repeatedly injected with large doses of insulin in order to produce daily comas over several weeks.〔Neustatter WL (1948) ''Modern psychiatry in practice.'' London: 224.〕 It was introduced in 1927 by Austrian-American psychiatrist Manfred Sakel and used extensively in the 1940s and 1950s, mainly for schizophrenia, before falling out of favour and being replaced by neuroleptic drugs in the 1960s.
It was one of a number of physical treatments introduced into psychiatry in the first four decades of the twentieth century. These included the convulsive therapies (cardiazol/metrazol therapy and electroconvulsive therapy), deep sleep therapy and psychosurgery. Insulin coma therapy and the convulsive therapies are collectively known as the shock therapies.
==Origins==
In 1927 Sakel, who had recently qualified as a doctor in Vienna and was working in a psychiatric clinic in Berlin, began to use low (sub-coma) doses of insulin to treat drug addicts and psychopaths.〔MJ Sakel (1956) The classical Sakel shock treatment: a reappraisal. In F. Marti-Ibanez ''et al.'' (eds.) ''The great physiodynamic therapies in psychiatry: an historical reappraisal.'' New York: 13-75.〕 Having returned to Vienna, he treated schizophrenic patients with larger doses of insulin in order to produce coma and sometimes convulsions.〔 Sakel made public his results in 1933 and his methods were soon taken up by other psychiatrists.〔
Joseph Wortis, after seeing Sakel practice it in 1935, introduced it to the USA. British psychiatrists from the Board of Control visited Vienna in 1935 and 1936, and by 1938 thirty-one hospitals in England and Wales had insulin treatment units.〔 In 1936 Sakel moved to New York and promoted the use of insulin coma treatment in American psychiatric hospitals.〔 By the late 1940s the majority of psychiatric hospitals in the USA were using insulin coma treatment.〔GL Jones (1948) ''Psychiatric shock therapy: current uses and practices.'' Williamsburg: p17.〕

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