The Renal Unit of the Queen Elizabeth Hospital, Adelaide, South Australia, provides the only specialized renal service for the State's population of one million. Established two years ago, it has developed a programme of recurrent haemodialysis and has used recurrent peritoneal dialysis for a period. It is associated with a renal homotransplantation programme. The Unit staff consists of a full time Director, one Senior Medical Registrar, a Senior House Physician, nurses and technicians. There is a close liaison with the University of Adelaide Department of Surgery which has been responsible for establishing and running the homotransplantation programme with a staff of a Senior Lecturer and the assistance of two Honorary Assistant Surgeons. The psychiatrist works closely with the group and interviews all patients entering the programme. His role has been that of an observer and adviser on the management of patients in chronic renal failure, and in the psychological screening of potential kidney donors.
For nearly 20 years, from the mid-1930s until the mid-1950s, early cases of schizophrenia were treated, and surprisingly successfully treated, by deep insulin coma therapy. This paper is an attempt to explore what, if any, lessons there are to be gained for us 30 years later from a treatment regime that turned out to have nothing to do with insulin per se. Such lessons as there may be from our recent historical past may help us to foster our critical acumen and commonsense as we try in our daily practice to understand how we can best help our patients in safety.
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