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ECT was invented in 1938 by the Italian neurologist Ugo Cerletti and psychiatrist Lucio Bini.
The concept was that seizures, or convulsions, could be beneficial in treating psychiatric illness. In the 1930s, the drug metrazol was already being used to induce fits in patients with schizophrenia. It was mistakenly believed that people with epilepsy didn’t suffer from schizophrenia – the convulsions appeared to have some kind of therapeutic effect. An injection of a Metrazol, however, was slow to take effect, and produced violent seizures which were difficult to control.
Cerletti, searched for a safer alternative and discovered that electric shocks could be used in the same way to induce epileptic convulsions. He tested the treatment on dogs and then pigs observing some success.
In April 1938, Cerletti performed ECT on a patient, Enrico X, for the first time. Enrico was brought to Cerletti in a confused state by the police and received eleven treatments. It appeared to be a great success, and the next month Cerletti and Bini gave Enrico ECT in front of an audience at the Royal Academy of Medicine in Rome. Headlines the next day reported on this brilliant new method; what didn’t make the headlines, however, was that Enrico was readmitted to a psychiatric hospital two years later.
From then on ECT soon replaced Metrazol therapy all over the world. It arrived in the UK in 1939, where it was first performed at the Burden Neurological Institute in Bristol.
It is used today for people suffering from severe depression that has not responded to other treatment. The procedure involves passing an electrical current through the brain to induce an epileptic-like fit. To this day it is still not fully understood how ECT works: theories range from its role in releasing certain brain chemicals, to stimulating the growth of new brain cells in the brain. In 2018-2019, a report by the Royal College of Psychiatrists 2020, concluded around 68% of patients were “much-improved” or “very much improved” while some saw no change in their condition and 1% felt worse.
Specifications
The enamel box is fitted with carrying handles, and weighs 35lb. It is designed to ensure the safe administration of convulsive shocks of 200-250 volts and to guard against accidents. Operating instructions would accompany the apparatus and a 'Dummy Patient' to facilitate tests.
Grey Walter
In 1939, Professor Golla and his team, including Grey Walter, moved from London to Bristol to work at the newly opened Burden Neurological Institute (BNI). Here Grey Walter worked until 1970. He developed electrical methods to record the brain’s activity in the hope of better understanding and looked for physical treatments to help those who were mentally ill. The division in the 1930s between neurology and psychiatry was not as distinct as it is now.
At the Burden, Grey Walter perfected EEG (the electroencephalogram) which is still used today to help diagnose and monitor a number of conditions affecting the brain. It can help identify the cause of certain symptoms – such as seizures (fits) or memory problems.
Grey Walter developed two robot tortoises which helped to understand brain function called Elmer and Elsie in 1948/9. They were called tortoises after the teacher of the Mock Turtle in Lewis Carrol’s ‘Alice’, who was called Tortoise because he ‘taught us’ and also because they moved slowly. They had primitive neural pathways, which led to new insights into the function of the nervous system.
His pioneering role in neurological studies and the cybernetics movement contributed significantly to the transformation of those sciences in the early Cold War era. His book The Living Brain (1953) was a scientific bestseller.
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