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In this paper, which I regard as a framework, I shall describe the psychical experiences of patients undergoing shock treatment and shall attempt to estimate their significance; and I shall note certain facts to be observed in all the patients whom I examined. I shall try to relate the psychical experiences with the organic changes and to show that the bodily functions are reflected—like a mirror image—in the psyche, where they leave a lasting impression in contrast to the seemingly reversible organic events.
The paper deals with the use of insulin and triazol for the purposes of shock therapy; and I should like to make it clear from the outset that, according to my observations, they appear to belong to the same group as regards the effects which they produce. It seems to me that the distinction between them is that insulin is milder, less vehement and perhaps less profoundly effective, whereas triazol acts like a violent thunderstorm bursting suddenly and gives a far more vehement shock.
It would probably be best to begin my report with the history of a young schizophrenic. A young woman aged twenty (Case 1) came into this hospital in a stuporous condition with marked features of anxiety. She lay in bed for a long time without movements or any reactions. I will not give the whole very interesting history of this patient in detail, nor am I able to add the still more interesting account of the case given by the patient herself. I am hoping to make use of this material in a subsequent publication. She was from her childhood onwards very much attached to her father who died when she was a child; she did not like either her mother or her elder sister, who was