LETTER TO DR. ROBERT M. FARRIER FROM(Sanitized)

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP80R01731R000200100029-2
• Release Decision: RIPPUB
• Original Classification: K
• Document Page Count: 6
• Document Creation Date: December 14, 2016
• Document Release Date: March 25, 2003
• Sequence Number: 29
• Publication Date: July 7, 1959
• Content Type: LETTER

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Dr? Robert M, Farrier
Assistant Director
Clinical Center
al Institutes of Health
Bethesda 14.. Maryland
Dear Bob;
ER 11-5719/a
7
1959
The Boss read the attached with interest and
asked that I inquire of you to determine whether
you or any of your people know anything about it,
I can be reached on Agency extension
and would appreciate a call at your convenience.
With kindest regards.
Sincerely.
E
Distribution: .
Orig - Addressee (w/cy basic & encls)
1 ,-- ER (w/basic via JMC4
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For the Forgotten Sufferer:
The Manfred Sakel Foundation The Man or Woman
17 East 63rd St., New York 21, N.Y. TErnpleton 8-5634 who is unnecessarily confined
to a mental institution
._ ine=23, 1959
Dear Mr. Dulles:
Because you have shown such sympathy with the
problems of schizophrenia and such understanding of our
efforts to help continue and develop the work started
by Dr. Manfred Sakel, I am sure you will be more than
interested in the attached two reprints from The
New York Times.
The report by William L. Laurence of the recent
meeting of the American Psychiatric Association in
Philadelphia tells of the renewed scientific recognition
by the highest medical authorities of the Sakel insulin
shook method as the most effective treatment for schizophrenia
today. Then came Dr. H. Peter Laqueur's paper of his eight
year study. So encouraging was this report of advancement
in the fight against mental illness, that it merited a
rousing editorial by The Times three days later.
To all of us who support the Manfred Sakel Foundation,
these two reprints tell a story of progress and hope that
might not be possible without our contributions.
Now that research in this field is coming along so
fast, as Mr. Laurence's article testifies, now that the
Sakel treatment has been simplified, your contribution
counts more than ever, to help speed up this encouraging
research and aid in the training of more and more psychiatrists
in the modernized techniques of administering insulin therapy.
The check you mail in the enclosed envelope will, in
the words of The New York Times, help "open the way to the
eventual elimination of one of mankind's greatest scourges."
e 7 since r, ,9y,
Mrs. Louis S. Gimbel, Jr., Vice-President
The Manfrea Sakel Foundation
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(Cur
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THE NEW YORK TIMES, SUNDAY, MAY 3, 1959.
SCIENCE IN REVIEW
New Method of Administering Insulin
Shock for Schizophrenia Reported
Leaders In, psychiatry have gen-
!rally agreed that the best available
rpproach to the treatment of schizo-
phrenia is the method known as
~nsulin shock therapy. In this pro-
cedure a massive dose of insulin
produces a state of profound coma
by suddenly depriving the brain of
sugar, the brain's fuel. But the fact
that the method involved consider-
able danger and required great skill
had until now stood in the way of
its general acceptance.
A much simplified method that
promises greatly to reduce the dan-
ger, and thus to make the benefits
of insulin therapy generally avail-
able at last to the vast population of
schizophrenics in our mental hos.
pitals, was described last week at
the annual meeting of the American
Psychiatric Association of Phila.
delphia.
Schizophrenia, in which the vic-
tim withdraws from reality and lives,
in a world of hallucinations and de-
lusions, is the most serious of the
mental illnesses that afflict 16,000,-
000 Americans in some degree and
fill every second hospital bed. Its
cause is the greatest mystery con-
fronting medical science, greater
than the mystery of cancer, heart
dfgease and all other physical ills
of mankind.
Long Illness
Schizophrenia most often appears
in the age range of fifteen to forty.,
four years.'About 21 per cent df all
admissions to state mental hospitals
each year are schizophrenics. Be-
cause of the relative youth of schizo-
phrenic patients on admission to
hospitals and their relatively* lbw
death rate, those schizophrenic pa-
tients who are not discharged tend
to accumulate from year to year
and to make up a great part of the
mental hospital population. In 1955
they made up about 58 per cent of
the patient population in New York
State mental hospitals.
The first and by far the most
important discovery in the treat-
ment of schizophrenia came in 1927,
when the late Dr. Manfred Sakel,
then a 27-year-old psychiatrist at
the University of Vienna hospital,
observed that the mind of a schizo-
phrenic patient, who was also a
diabetic, cleared up temporarily
after an accidental overdose of in-
sulin. Following up this clue, Dr.
Sake], at,the risk of his medical
career, deliberately administered
an overdose of insulin to another
schizophrenic patient and observed
a similar temporary Clearing up of
the patient's mind. For the first
time in medical history a pharmaco.
logical approach to the treatment
of schizophrenia had been discovered.
Step by step Dr, Sake] developed
the technique of insulin shock ther.
ally for schizophrenia. The heart of
the treatment is the production of
a state of profound coma by the
administration of an overdose of
insulin; the deeper the coma the
more pronounced the results. To
bring about lasting remissions, a
series of deep-coma insulin shocks
was found necessary, the number of
shocks as well as the dose varying
with each patient.
Deep Coma
Dr. Sakel found that to obtain
the best and most lasting results it
was necessary to bring the patient
as close as possible to the tenuous
borderline separating life from
death, and to keep the patient in
that twilight zone for as long a
period as possible. At the slightest
sign of danger the patient would
quickly be brought out of the coma
by the administration of sugar and
other medicaments. All this meant
that the technique was as much
an art as a science, keeping the
psychiatrist in attendance under a
great strain for many watchful and
anxious hours,
Because psychiatrists, including
at first Dr. Sake] himself, believed
that it was the convulsions pro-
duced by the insulin shock that
brought about the beneficial results,
less dangerous methods for.bring-
Ing about such convulsions were
sought. At first the drug metrazol
was used as a substitute for insu-
lin, but this also had its dangers.
This was soon followed by the de- reduce the quantities of insulin
velopment of the now widely u d ne rnededltopT~t~r3r10e c 003/04/02
r~ fY }IIY KP~P^ P
electroshock method, in which shock
and convulsions are produced by
applying a small electric current to
the brain.
These developments soon led to
one of the greatest controversies in
modern psychiatry. Dr. Sakel con-
tended that the convulsions were
merely incidental, that the beneficial
results were due-in a way not
understood-to the physiological and
pharmacological action of the insu-
lin on the central nervous system
in general and particularly on the
chemistry of the brain. He further
contended that while electroshock
yielded some superficially beneficial
results on some of the milder psy-
choses, it had no effect whatsoever
on schizophrenia.
Mixed Data
The situation was confused by
conflicting data on the results of
the insulin shock method from vari-
ous mental hospitals, some reporting
a much higher percentage of remis-
sions than others. 'Dr. Sakel con-
tended that those reporting poor
results were not using the method
properly.
The International Conference on
the Insulin Treatment in Psychiatry,
held at the New York Academy of
Medicine last October, concluded
that "the insulin treatment intro-
duced by Sakel thirty years ago is
still the best treatment for schizo.
phrenia." However, many modifies.
tions of the original method were
discussed, and the enhancement of
insulin therapy by using it in con-
junction with tranquilizers and elect,
tric.khock was considered.
The latest method was described
last week by Dr. H. Peter Laqueur,
supervising psychiatrist, and Dr.
Harry A. LaBurt, director, both
of the Creedmor State Hospital,
Queens Village, New York City. It
consists essentially of two parts:
(1) The administration of the insu-
lin in. multiple moderate doses, the
total of the multiple doses consist-
ing of'fewer units than the usual
large single dose in the older tech-
niques; (2) controlling the food
intake of the patients. This makes
it possible "to determine the doses
of insulin necessary to produce deep
coma with greater precision than
with the old methods, thereby
avoiding overdoses."
"Our method," Drs. Laqueur and
LaBurt reported, "is based on the
principle that insulin-unit for unit
-is more potent if administered
gradually over a certain time than
if given in one single dose all at
once. The reasons for this differ-
ence in potency are still not com-
pletely understood."
Smaller Doses
By the multiple dose method, they
reported, "we regularly obtain deep
coma in our patients with total
doses of 60 to 70 units of insulin,
usually administered in three injec-
tions of 20 units each, or of one
injection of 30 units and two of 20,
with intervals of 15 minutes be-
tween the individual injections." By
the single dose methods, doses as
high as 800 to more than 2,000
units were given.
The new technique, the report
states, resulted in the recovery of
78.5 per cent of the 255 treated
patients "to such a degree that they
can live and work again in the
community,
One of the newer developments
in insulin therapy was outlined at
a roundtable at the A.P.A. meeting,
moderated by Dr. Max Rinkel of
the Massachusetts Mental Health
Center's Research Division, Boston.
The newer development, Dr.
Rinkel stated, has come about as
the result of the isolation from the
pancreas of glucagon, the substance
that increases the level of sugar in
the blood, thus producing a reaction
opposite to that of insulin.
Glucagon in minute doses has re-
cently been used experimentally in
the termination of insulin coma. It
is believed that insulin prepared
from pancreas extracts contained
small doses of this blood sugar-
elevating substance, thus necessi-
tating larger doses of insulin to
overcome its anti-coma effect. Its
discovery and purification. Dr.
The New goxk Qllzmo.
ADOLPH S. OCHS, Publisher 1896-1935
PUBLISHED EVERYDAY IN THE YEAR BY THE NEW YORK TIMES COMPANY
ARTHUR HAYS SULZBERGER
Publisher - Chairman of the Board
ORVIL E. DRYFOOS, President AMnRV H. BRADFORD. arse
ia....t
res
THE NEW YORK TIMES, WEDNESDAY,. MAY 6, 1959.
Progress on Schizophrenia
By far the most tre.,ic form of all the afflic.
tions of the mind auu the emotions is schizo-
phrenia, a dreadful state in which the victim
withdraws from reality into a world of hallu-
cinations and delusions. About 21 per cent of
all admissions to state mental hospitals are
schizophrenics and because of their relative
youth on admission and their relatively low
death rate their numbers tend to accumulate
from year to year, so that they make up a great
part of the mental hospital population.
The underlying cause or causes of schizo.
phrenla constitute a mystery as great as the
mystery of the mind itself. And while nature
has on occasion brought about the spontaneous
clearing tip of a victim's mind, it was not until
1927 that the late Dr. Manfred Sakel, then a
young psychiatrist on the staff of the Univer-
sity of Vienna Hospital, accidentally came upon
the important discovery that a state of shock
and coma produced by an overdose of insulin,
repeated a number of times, led to a clearing
up of the schizophrenic's mind in a large number
of cases. This discovery revealed that diseases
of the mind may be alleviated, and in many
cases even healed, by chemical means, thus
offering the first hint that so-called mental dis-
ease may not be mental after all.
Though simpler methods of producing shock,
particularly electroshock, had been introduced
in the past quarter century, an international
conference held in New York last October con-
cluded that "the insulin treatment is still the
best treatment for schizophrenia." Unfortu-
nately, however, the method developed by Sakel
required, for best results, the bringing of the
patient as closely as 'possible to that tenuous
borderlinb separating life from death. The fact
that the method involved -considerable danger
and required great Skill therefore presented a
formidable roadblock to its general acceptance.
Now comes, the report from Creedmoor State
Hospital, at Queens Village, New York, present-
ed at the meeting of the American Psychiatric
Association at Philadelphia by Drs. H, Peter
Laqueur and Harry A. LaBurt, that they have
developed a modified method for administering
insulin coma that "considerably reduces the
dangers and cost of the treatment while the
benefits are fully sustained," This is, indeed,
news of the greatest significance. :It removes
the greatest obstacle that has stood in the way
of the general application of what is now uni-
versally accepted as the best method for return-
ing the victim of schizophrenia back to the
world of reality. What is more, it promises to
lead to a better understanding of the chemical
and physiological causes responsible for the
condition and thus to open the way to the.even-
tual elimination of one of mankind's greatest
scourges.
 Approved For Release 2003/04/02 : CIA-RDP80R01731 R000200100029-2
THE MANFRED SAKEL FOUNDATION
163 EAST 78th STREET
NEW YORK 21, N. Y.
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 Approved For Release 2003/04/02 : CIA-RDP80R01731 R000200100029-2
I am enclosing my check for $............... .... ..........to support the
Research and Training Program of he Manfred Sakel
foundation.
Name ............................................... _................. ........... ..........................................
Address ................................................................._.................................................
City........ ....................................................Zone...............State...........................
'lease make checks payable to:
THE MANFRED SAKEL FOUN)ATION
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