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January 24, 1959, Vol 169, No. 4 >

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ARTICLE | January 24, 1959

POSTMORTEM DIAGNOSIS OF INSULIN SHOCK

Hans N. Naumann, M.D.
JAMA. 1959;169(4):408. doi:10.1001/jama.1959.03000210102017.
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ABSTRACT

To the Editor:—  In the article by Birkinshaw and co-workers (Investigations in a Case of Murder by Insulin Poisoning, Brit. M. J.2:463-468 [Aug. 23] 1958) discussed in the Foreign Letters section of The Journal (168:811 [Oct. 11] 1958) detection, identification, and quantitation of insulin were ingeniously achieved in tissue extracts from sites of needle marks in the victim's buttocks. However, in spite of large amounts of insulin in the body of the victim, paradoxically, not hypoglycemia but a hyperglycemia of 210 mg. per 100 ml. was demonstrated about six hours after death. Postmortem chemistry, so far, has been applied mainly as aid in autopsy diagnosis of diabetes mellitus (Hamilton-Patterson and Johnson, J. Path. & Bact. 50:473-482 [May] 1940; Tonge and Wannan, M. J. Australia1:439-447 [April 2] 1949; and Naumann, Am. J. Clin. Path. 20:314-324 [April] 1950) but rarely of insulin shock. Proof of

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