Background
He was born on June 6, 1900 in the Jewish community of Nadvorna, Austria (now Nadvornaya, Ukraine), the son of Mayer Sakel and Judith Golde Friedman.
neurophysiologist psychiatrist
He was born on June 6, 1900 in the Jewish community of Nadvorna, Austria (now Nadvornaya, Ukraine), the son of Mayer Sakel and Judith Golde Friedman.
Little is known of Sakel's early life, except that he graduated from the First State College of Brno, Czechoslovakia, in 1920 and the medical faculty of the University of Vienna, where he received the M. D. , in 1925.
He continued as an associate physician at the Vienna Hospital until 1927, when he became a fellow at the Urban Hospital in Berlin. That year Sakel became psychiatrist in chief at the Lichterfelde Hospital in Berlin, which specialized in the abstinence treatment for morphinism. Around 1928, he began using insulin as a "vagotonic antagonist" to the observed "sympathotonic overactivity. " In the process he found that accidentally induced hypoglycemic shock actually seemed beneficial to his patients.
After the Nazis seized power in Germany, Sakel returned to Vienna in 1933 as a refugee and went to work as a volunteer assistant at the Vienna Psychiatric and Neurological Clinic.
Julius Wagner von Jauregg had a young female schizophrenic patient who had not responded after a year of treatment. Sakel suggested using full insulin shock treatment. After the second shock the girl seemed very coherent, and although she had a relapse after a few days, a few more insulin shock treatments led to a complete recovery. Results with a second patient confirmed their first impression, and Otto Potzl, director of the clinic, offered Sakel facilities for large-scale investigations.
Sakel reported his initial findings to the Vienna Medical Society on Nov. 3, 1933. A serialized article on his hypoglycemic method appeared in the Wiener medizinische Wochenschrift, November 1934-February 1935 and as a monograph entitled Neue Behandlung smethode der Schizophrenie (1935). In 1936 Sakel came to the United States to treat a private patient and was subsequently invited by the New York state commissioner of mental hygiene to conduct a training course on insulin coma therapy for physicians in the state hospital system.
A special supplement to the Schweizer Archiv fur Neurologie und Psychiatrie (1937), republished as a supplement to the American Journal of Psychiatry (1938), along with a republication of Sakel's earlier monograph as The Pharmacological Shock Treatment of Schizophrenia (1938), did much to spread his new views. Sakel refused academic posts, preferring private practice. A near-fatal heart attack in 1946 restricted his career, and his last two books, Schizophrenia (1958) and Epilepsy (1958), were both published posthumously.
He died of a heart attack in New York City.
(Schizophrenia by Manfred Sakel.)
(mental health)
He outlined four "phases" of treatment: (1) the introductory phase, during which increasing doses of insulin are given and the patient's personal reaction is evaluated; (2) the shock phase, which consists of provoking severe hypoglycemic shocks culminating in coma or convulsion as a result of the insulin dosage; (3) the rest and observation phase, when small or medium doses of insulin are administered; (4) the polarization phase, when preshock (similar to the introductory phase) doses of insulin are administered. Sakel also noted that the gravity of the disease (schizophrenia) and the hopelessness of expecting a cure from any known therapy has justified my use of an apparently dangerous treatment.
Around 1937 Sakel modified his theory of how insulin coma therapy worked; for while the assumption that insulin diminished the activity of the nerve cell was sufficient explanation of the sedative effect on excited states, it did not serve to explain the mental changes during and after hypoglycemia. Sakel now suggested that the hypoglycemia blockades the (newer and more aberrant) pathways which happen to be most active at a given time, so that the reactions to the same stimuli now come through (older neural) pathways which had previously been inactive.
Sakel never married, but his relationship with Mimi Englander lasted for almost thirty years.