| Abstrakt: |
Previous work has led us to believe that a common factor in the hypoglycemic and metrazol treatments for schizophrenia is a diminished cerebral metabolism. The mechanism for the production of the decreased metabolism is different for each treatment. During hypoglycemia the cerebral metabolism diminishes because the brain is deprived of its chief substrate, glucose.1After the injection of metrazol, on the other hand, the inhibition of cerebral metabolism is evidently due to an acute anoxemia induced by the severity of the convulsions and the temporary arrest of respiration.2If the beneficial results following metrazol therapy are dependent upon decreased cerebral metabolism resulting from acute anoxia, then anoxia of a similar degree, produced by any means should be equally effective. It occurred to us that acute anoxemia might be produced under safer and more controllable conditions by having the patients breathe for short periods an atmosphere in which the nitrogen was increased at the expense of oxygen. By this method it is possibe not only to control the degree of anoxemia produced but also to terminate the bout immediately in the event of untoward reaction.The production of acute anoxemia was under the direction of one of US, F.A.D.A., a trained anesthetist. The apparatus used included a tight fitting face mask with exhalation valve such as is used in anesthesia, a canister of soda lime and a 5-liter breathing bag connected in series. The apparatus was filled with pure oxygen, adjusted to the patient's face and after a few breaths, nitrogen was run into the mask gradually, displacing the oxygen. Unlike previous attempts of other workers the anoxia was intense. At the height of the bout the patient was respiring almost pure nitrogen. Carbon dioxide did not accumulate but was absorbed by soda lime, thus minimizing the patient's discomfort during the treatment. |
