# The Somatic Treatments · The Cult Dossier · The Atlas · The Congregation of Tomorrow

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The Cult Dossier · No. 157 · Psychiatry / The Asylum
The Somatic Treatments
Fever therapy; insulin coma; Metrazol convulsive therapy; unmodified ECT
1917 – c.1960 · Austria, Poland, Hungary, Italy; then worldwide
XV. THE ASYLUM — WHEN MEDICINE DECIDED WHOSE MIND WAS WRONG
None.
### Who led it
### What it worshipped and taught
### Who was in it
### How it ended, or where it stands
### The dead
### Of note
### Its timeline
- 1917 WAGNER-JAUREGG DELIBERATELY INFECTS PATIENTS WITH MALARIA to treat general paresis, the terminal neurological stage of syphilis. IT ACTUALLY WORKED — the induced fever attacked the organism — and it was, before penicillin, the only effective treatment for an otherwise fatal condition. IT WAS ALSO DANGEROUS: about 15 per cent of patients died of the treatment. He received the NOBEL PRIZE IN 1927.
- 1927 onward MANFRED SAKEL introduces INSULIN COMA THERAPY: large insulin doses drive the patient into hypoglycaemic coma, repeated daily over weeks. Estimates of the death rate run from about 1 to 4.9 per cent. It was in wide use for two decades. In 1953 HAROLD BOURNE publishes THE INSULIN MYTH in The Lancet, and in 1957 a controlled trial finds that barbiturate unconsciousness does just as well: INSULIN WAS NOT THE ACTIVE INGREDIENT.
- 1934 LADISLAS MEDUNA induces seizures chemically, first with camphor and then with METRAZOL (cardiazol), on a theory that epilepsy and schizophrenia were antagonistic — WHICH WAS WRONG. Patients reported overwhelming dread in the seconds before the seizure, and the convulsions were violent enough to cause SPINAL FRACTURES.
- 1938 UGO CERLETTI and LUCIO BINI administer the first ELECTROCONVULSIVE THERAPY to a human patient in Rome. Electricity replaces Metrazol because it is faster and the dread is removed by the immediate loss of consciousness.
- 1940s–50s UNMODIFIED ECT — no anaesthetic, no muscle relaxant — is given at enormous scale, causing fractures and terror, and is used in some institutions for compliance rather than for illness.
- 1950s onward Antipsychotic drugs arrive and the shock therapies collapse, except one. ECT, GIVEN UNDER ANAESTHETIC WITH MUSCLE RELAXANTS, REMAINS AN ESTABLISHED AND EFFECTIVE TREATMENT for severe depression and catatonia, and is not the procedure described above.
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