Until recent times, the treatment of madness was a kind of desperate punishment. In medieval madhouses patients were sometimes bound in whirling chairs and spun till blood ran out of their ears. Others were plunged down steep chimneys onto a pile of writhing snakes.
Today psychiatrists again apply with scientific refinements something very like medieval shock treatment to victims of schizophrenia (dementia praecox). Most common form of insanity, schizophrenia packs 200,000 patients in U. S. mental hospitals. Whether social, psychological or physical difficulties cause schizophrenia no one knows. A schizophrenic may believe that he is Napoleon, or that his children are trying to kill him. Or he may fall into rigid positions, lasting for hours. For many schizophrenics there are no more human emotions—only a slow retreat from life into deathlike stupor. Less than 6% are lucky enough to come back to sanity without treatment.
Until 1934, medical science could do very little for schizophrenia. Then Dr. Manfred Sakel of Vienna, now in Manhattan, announced that since 1928 he had been shocking schizophrenics back to sanity with large injections of insulin. In 1935, Dr. Laszlo von Meduna of Budapest successfully shocked schizophrenics with metrazol, a camphor-like drug. Psychiatrists the world over hailed this revival of the old medieval technique, enthusiastically set to work to confirm the results of their European colleagues.
After ten years of experimenting, physicians take a soberer view of shock treatment. Last week the American Journal of Psychiatry printed no less than ten painstaking articles, by topflight workers in U. S. hospitals and laboratories, on the value of this treatment.
Metrazol. Metrazol is a powerful stimulant of the centres which regulate blood pressure, heart action and respiration. Technique of metrazol injections is simple. A patient receives no food for four or five hours. Then about five cubic centimeters of the drug are injected into his veins. In about half-a-minute he coughs, casts terrified glances around the room, twitches violently, utters a hoarse wail, freezes into rigidity with his mouth wide open, arms and legs stiff as boards. Then he goes into convulsions. In one or two minutes the convulsion is over, and he gradually passes into a coma, which lasts about an hour. After a series of shocks, his mind may be swept clean of delusions.
Usual course is three convulsions a week for five or six weeks. A patient is seldom given more than 20 injections, and if no improvement is noted after ten treatments, he is usually given up as hopeless.
So horrible are the artificial epileptic fits forced by metrazol that practically no patients ever willingly submit. Common symptoms are a "flash of blinding light," an "aura of terror." One patient described the treatment as death "by the electric chair." Another asked piteously: "Doctor, is there any cure for this treatment?"
More serious than this subjective terror are dislocations of the jaw, tiny compression fractures of the spine, which occurred to metrazol patients in over 40% of one series of cases. During their violent convulsions, patients arch their backs with such force that sometimes they literally crush their vertebrae.