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Joseph Wortis, M.D.
JAMA. 1937;108(12):971. doi:10.1001/jama.1937.92780120003011b.
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A few months ago in the course of hypoglycemic insulin treatment of a psychotic boy according to Sakel's method,1 I was impressed by the rapid disappearance of the patient's facial acne lesions soon after the treatment started. The youth, aged 17, according to his father had been troubled by occasional skin eruptions of moderate severity since puberty. His skin condition had, however, grown definitely worse about six months prior to his admission to the hospital, at about the time that the psychosis first developed, so that many of his complaints and delusions involved his skin condition, and much of his tenseness and restlessness found expression in the constant fingering of the lesions. The lesions themselves were distributed over the entire face—cheeks, chin and forehead—and were either small, superficial and pustular or more deeply seated and papular or nodular. His complexion was otherwise pasty and


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