The History of EST, the Lobotomy, and Mental Health

1. The History of EST, the Lobotomy, and Mental Health

2. History • “The early decades of the 20th century witnessed a major revolution in the understanding and treatment of mental diseases. Until then, people with psychoses were usually locked away in insane asylums, receiving only limited custodial care.”

3. History • “The knowledge that head trauma, convulsions and high fever could be good for improving mental disturbances is not new in Medicine.” • “In 1937, an Italian neurologist named Ugo Cerletti was convinced that metrazol-induced convulsions were useful for the treatment of schizophrenia, but far too dangerous and uncontrollable to be applied”

4. History: Benefits • “The idea to use ECT in humans came first to him by watching pigs being anesthetized with electroshock before being butchered, as a kind of anesthesia .” • “One of the unexpected benefits of transcranial electroshock was that it provoked retrograde amnesia, or a loss of all memory of events immediately anterior to the shock, including its perception. Therefore, the patients had no negative feelings towards the therapy.”

5. History: Negatives of ECT • “there were many examples of ECT being used to subdue and to control patients in psychiatric hospitals. Troublesome patients received several shocks a day, many times without proper restraint or sedation.” • “It is the effects of ECT on memory that give rise to much of the concern surrounding its use. In particular there is controversy about the long-term, rather than the acute, effects of ECT.”

6. History: The Lobotomy • “The idea of brain surgery as a means of improving mental health got started around 1890, when Friederich Golz, a German researcher, removed portions of his dogs’ temporal lobes, and found them to be calmer, less aggressive.  It was swiftly followed by Gottlieb Burkhardt, the head of a Swiss mental institution, who attempted similar surgeries on six of his schizophrenic patients.  Some were indeed calmer.  Two died.”

7. History: Lobotomy • “Antonio Egaz Moniz of the University of Lisbon Medical School really put the lobotomy on the map.” • “He devised a technique involving drilling two small holes on either side of the forehead, inserting a special surgical knife, and severing the prefrontal cortex from the rest of the brain.   He called it leucotomy, but it would come to be known as lobotomy.”

8. History: The Lobotomy • “He was awarded the Nobel Prize for his work on lobotomy in 1949.  He retired early after a former patient paralyzed him by shooting him in the back.” • “Between 1939 and 1951, over 18,000 lobotomies were performed in the US, and many more in other countries.”

9. History: Lobotomy • "these patients are not only no longer distressed by their mental conflicts but also seem to have little capacity for any emotional experiences - pleasurable or otherwise. They are described by the nurses and the doctors, over and over, as dull, apathetic, listless, without drive or initiative, flat, lethargic, placid and unconcerned, childlike, docile, needing pushing, passive, lacking in spontaneity, without aim or purpose, preoccupied and dependent."

10. Pics

11. Sources • http://www.cerebromente.org.br/n04/historia/shock_i.htm • http://webspace.ship.edu/cgboer/lobotomy.html