"
Cerletti came to the first use of electroshock for therapeutic purposes
in human beings by way of his experiments with animals on the
neuropathological consequences of repeated epilepsy attacks. In Genoa,
and later in Rome, he used an electroshock apparatus to provoke
repeatable, reliable epileptic fits in dogs and other animals. The idea
to use ECT in humans came first to him by watching pigs being
anesthetised with electroshock before being butchered, in Rome.
Furthermore, since 1935, metrazol, an epileptogenic drug, and insulin, a
hormone, were in wide use in many countries to treat schizophrenics,
with great success. This approach was based on Nobel winner Julius
Wagner-Jauregg's research on the use of malaria-induced convulsions to
treat some nervous and mental disorders, such as the general paresis of
the insane, caused by neural syphilis, as well as on Ladislas J.
Meduna's theory that schizophrenia and epilepsy were antagonistic, which
eventually led, in the same period, to institute insulin-coma therapy in
psychiatry, by Manfred Sakel, in 1933.
Cerletti first used ECT in a human patient, a diagnosed schizophrenic
with delusions, hallucinations and confusion, in April 1938, in
collaboration with Lucio Bini. A series of electroshocks were able to
return the patient to a normal state of mind. Thereafter, in the
succeeding years, Cerletti and his coworkers experimented with thousands
of electroshocks in hundreds of animals and patients, and were able to
determine its usefulness and safety in clinical practice, with several
indications, such as in acute schizophrenia, manic-depressive illness,
major depression episodes, etc. His work was very influential, and ECT
quickly spread out as a therapeutic procedure all over the world.
Despite the fact that it does evoke a grand mal seizure marked by a
stereotyped succession of events. A tetanic muscular contraction, the
"electric spasm, is followed after a latency of seconds by
unconsciousness, a high voltage paroxysmal spike and sharp-wave
discharge, and a clonic convulsion. Upon recovery of consciousness the
subject is left with a transient acute brain syndrome. Acute brain
syndrome can be defined as "A sudden state of severe confusion and rapid
changes in brain function, sometimes associated with hallucinations and
hyperactivity, in which the patient is inaccessible to normal contact.
Symptoms may include inability to concentrate and disorganized thinking
evidenced by rambling, irrelevant, or incoherent speech. There may be a
reduced level of consciousness, sensory misperceptions and illusions,
disturbances of sleep, drowsiness, disorientation to time, place, or
person, and problems with memory," which is to be expected in people who
suffer head injury, and contributes to the 'need' for compulsion to
treatment under law, as people are unwilling to volunteer to such barbarism.
As a result of his experiments, which took him from the psychiatric
hospital to the abbatoir and the zoologic gardens, Cerletti developed a
theory that ECT caused the brain to produce vitalising substances, which
he called "agro-agonines" (from the Greek for extreme struggle). He put
his theory into practice by injecting patients with a suspension of
electroshocked pig brain, with encouraging results. Although
electroshocked pig brain therapy was used by a few psychiatrists in
Italy, France and Brazil it did not become as popular as ECT, which soon
replaced metrazol therapy all over the world because it was cheaper,
less frightening and more convenient.[1] Cerletti and Bini were
nominated for a Nobel Prize but didn't get one.
"
No comments:
Post a Comment