400 PHYSIOLOGY OF INDUCED HYPOTHERMIA 



chlorpromazine have to a certain extent similar actions, although there are differ- 

 ences. Phenergan for example is an antihistaminic. Diparcol is supposed to be a 

 bronchodilator and to inhibit bronchial secretion. Chlorpromazine is the most im- 

 portant of the phenothiazines in artificial hibernation. 



I am unable to assess the relative virtues and activities of the many drugs used. 

 It seems to be intuition that has guided the French. It is an approach that is widely 

 criticized in this country ; however, I think that we should reserve our judgment 

 in this instance until we have had more experience and when we want to see whether 

 "hibernation" has some virtue, why not follow their recommendations exactly? 



Nine patients, all of whom were considered beyond recovery by more conserva- 

 tive methods, were treated with artificial hibernation.^ Uncontrollable deterioration, 

 shock, spiking temperature, and restlessness were among the indications for hiberna- 

 tion. The technic of Laborit and Huguenard was followed as closely as possible. 

 In seven patients a rapidly downhill clinical course seemed to be arrested, at least 

 temporarily, and patients who seemed about to die lived 1 to 19 days during or 

 after hibernation. Eight of the nine patients were more comfortable during hiber- 

 nation. Such signs as spiking temperatures, ileus with distention, convulsions, ex- 

 treme restlessness, and cyanosis gave way to controlled temperature, less distention, 

 quiescence, and pink color. Two patients recovered temporarily but finally died 

 from the underlying disease. It is concluded that artificial hibernation deserves 

 further trial in patients with potentially curable disease who presently would suc- 

 cumb to overwhelming illness or during the struggle to overcome it. 



REFERENCES 



1. Laborit, H., Huguenard, P., and others : Pratique de rhibernotherapie en chirurgie et en 



medecine, Paris : Masson & Cie., Editeurs, 1954, p. 256. 



2. Huguenard, P. : Technique et resultats de I'hibernation artificielle : Sa place dans la pratique 



courante, Anesth. analg. 1: 16-53, 1953. 



3. Kolff, W. J. : Artificial hibernation : Teclmic, and observations on seriously ill patients, 



Cleveland Clin. Quart. 22: 109-123, 1955. 



Dr. E. Calkins: Since many of these extremely febrile cases are also in circulatory 

 difficulty, I wonder if you had any deaths which obviously followed intravenous 

 injection of chlorpromazine. which reduces the blood pressure rapidly in some 

 people. 



Dr. Lewis: Some of the patients who died had a fall in blood pressure even after 

 cooling. Of these eleven who had low blood pressure, some went on to die. Whether 

 it was due to chlorpromazine or to a continuation of their lethal disease process, 

 we really couldn't say. On the other hand, six of the eleven with serious vascular 

 collapse recovered their l)lood pressure after the cooling. I am afraid I can't answer 

 the cjuestion more definitely than that. We haven't felt that there was any clearly 

 detrimental effect from the technique in any of the cases. 



Dr. Henry Stvan: I would like to ask what your thought is on the effect of mild 

 hypothermia on the course of infection. Does the infective process seem to go 

 faster or slower? 



Dr. Lezins: This is a clinical study. A number of the patients had pneumonia. 

 Some of them were old men with pneumonia. Some of them who recovered did 



