Development of EST/ECT as a Psychiatric Treatment
The adoption of organic methods in psychiatry has been well documented. This approach was based on belief that conditions could be influenced by nonpsychological, physical methods. Historically there has been interest in organic methods such as bloodletting, emetics and purgatives. This focus on somatic therapies helped set the background conditions for adoption of shock treatments. Other organic treatments had included surgery, castration, removal of teeth, tonsillectomy, colonic excision, bacteriological and endocrinological agents, narcosis (e.g., carbon monoxide), fever-producing methods and sedatives ( Gayle & Campbell, 1951). Physical treatments also have included the use of water as "hydrotherapy," via continuous tubs. The psychiatric use of cold wet sheets as "therapy" had been extensive in the 1930s ( Ross et al., 1988).
The introduction of insulin treatments ( Sakel, 1933) also helped establish the background setting conditions for the subsequent acceptance of EST. Before the use of electricity, other clinicians had used insulin and camphor (metrazol/cardiozol) to induce convulsions. In the context of these extremely hazardous and unpleasant physical approaches, the promotion of electroshock in the 1950s was inevitably viewed as relatively "safe and effective" by many psychiatrists.
In Switzerland in 1937 Cerletti and Bini ( 1939) introduced the idea of an electric current as a convulsive stimulus for the treatment of schizophrenic behavior. The development of EST followed extensive work on electrically induced seizures. Since its introduction in Italy in 1938, the development of electroshock therapy in psychiatric services has been well-documented. In the original trials, electric shocks were given to animals, rather than people. Cerletti an Italian psychiatrist, was responsible for the extension of the original animal experiments to human populations. The application of the first experiment with a