Medicine: Shocks for Sanity

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Two startling methods of shocking lunatics back to sanity were discussed by doctors at the American Psychiatric Association meeting in Richmond, Va. last week. Both types of treatment are mechanical, differ from chemical injections of insulin or metrazol, which are widely used in hospitals throughout the U.S.

Electric Current. Four years ago, two doctors in Rome named Ugo Cerletti and L. Bini passed an electric current through a dog's brain, gave him a mild convulsion without doing him any harm. They next attempted to faradize psychiatric patients back to normality. Dr. Lothar Kalinowsky of Berlin introduced the new technique to Paris and London, is now working in Manhattan's New York State Psychiatric Institute.

A patient with schizophrenia or manic-depressive psychosis (alternating fits of madness and despair) is placed on his back on a table. Two electrodes on a forceps-like spring are set firmly on his temples.

The electrodes are pads of soft rubber sponge covered with interlacing bands of thin copper strip, and are attached to a small electric transformer and timing device. A current of 70 to 100 volts is passed from one side of the patient's head to the other for about one-tenth of a second.

As soon as the electric circuit is closed, the patient becomes unconscious. Then his limbs begin to twitch and he falls into a fit closely resembling epilepsy. In a few minutes he awakens, with no recollection of the convulsion. Treatments are given about three times a week, for several weeks.

So far, over 10,000 convulsions have been given to patients abroad and in the U.S. The proportion of improvement depends upon the type and length of illness, is about the same as for insulin and metrazol—estimates range roughly from IS to 50%. But of course psychiatrists do not yet know how permanent any shock treatment is over a period of years.

Although electric shock may not replace the standard insulin treatment, most psychiatrists think it far superior to metrazol. Its advantages: 1) the convulsions are not usually as violent as those produced by metrazol; 2) since patients lose consciousness immediately, they do not remember the frightening "aura" that precedes a metrazol convulsion; 3) electric treatment is much cheaper than insulin or metrazol—a machine costs less than $300. But electric shock is safe only in the hands of a trained psychiatrist.

Famed Psychiatrist Abraham Myerson of Boston declared last week that he successfully used electric shocks for 40 cases of early depression. Dr. Lauren Howe Smith and colleagues of Philadelphia's Pennsylvania Hospital claimed that electric shock calmed noisy patients in the wards cut their length of stay in half.

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