New Issue of Medical History

The third issue of the Medical History for 2010 has been released online. Included in this issue is an article by Jesper Vaczy Kragh on Shock Therapy in Danish Psychiatry. The conclusion reads:

By the time the new plans for psychiatry were put into effect in the 1950s, Cardiazol shock therapy had been phased out. In most state hospitals it had been replaced by ECT in the late 1940s and early 1950s. ECT proved safer to use and, unlike Cardiazol therapy, it did not produce the same intense feelings of dread in patients. But before the late 1950s, Cardiazol shock therapy had, none the less, played a significant role in the development of Danish psychiatry. Although it was no magic bullet for schizophrenia, it did have beneficial results for other groups of patients, who would otherwise lead miserable lives in mental institutions. Furthermore, psychiatrists reported good results with patients who were suicidal, in a dangerous manic phase, or who suffered from postpartum psychosis. However, patient records of the state mental hospitals show that physicians found Cardiazol shock therapy useful for other purposes. In Vordingborg hospital the patients’ fear of Cardiazol therapy was sometimes exploited in order to control their behaviour. In general, patients who were characterized as destructive, hot-tempered, noisy, and aggressive often became candidates for shock treatment. This treatment was not used exclusively on these patients, however, and inmates who posed no problem for the hospital staff were also treated with Cardiazol. In sum, Danish psychiatrists found the treatment useful in dealing with very different types of disorders, and Cardiazol therapy was used on a wide scale to treat almost every diagnostic category. Side effects of the treatment such as vertebral fractures and death were perceived as inevitable. In addition, the press did not focus on this aspect but portrayed shock therapy as highly successful. A similar view was presented by psychiatrists, for whom Cardiazol shock therapy became an important tool in efforts to enhance the status of psychiatry and increase the funding of mental hospitals. Together with other somatic treatments of the 1930s and 1940s, Cardiazol therapy was successfully employed in campaigns for grants and for recognition of the psychiatric profession in Denmark.
The resolve to change the public image of psychiatry was not only restricted to Denmark; similar efforts were made by psychiatrists in several European countries and in the United States. As Pressman notes, somatic treatments were useful to American psychiatrists, “who were waging an ideological campaign to convince the public, the general medical community, and themselves that psychiatry did indeed have medical treatments, deployable in medical settings, that functioned according to medically understandable precepts”. Likewise, Cardiazol therapy and other somatic treatments were adopted in Germany, Switzerland, and Britain, where psychiatrists valued the therapies as a means of transforming psychiatry.
The Danish case, however, shows some differences when compared to that of other countries. In Denmark, Cardiazol therapy and ICT were used in every mental hospital and department, and there were no psychiatrists who opposed the wide use of these treatments. A similar spread of the two therapies cannot be found in many other countries, where Cardiazol therapy and ICT were criticized by internationally recognized psychiatrists. In Britain, for instance, Edward Mapother and Aubrey Lewis disapproved of somatic therapies; in France, Henri Baruk implored his colleagues to forsake Cardiazol shock therapy; and in Switzerland, Max Müller discarded the treatment because of the patients’ agonized fears of dying. In the United States, Philip Polatin and co-workers reported that vertebral fractures occurred in 43 per cent of patients, and these statistics were so compelling that a number of American hospitals abandoned Cardiazol. In the UK, the treatment’s reputation was also tarnished by published articles on the fractures it often produced, and it was discontinued in some British hospitals as a result. In Denmark, reports about side effects were published, but they did not affect the use of the therapy in any significant way.
Considering these diverse responses, it is possible that the use of Cardiazol therapy in Danish mental hospitals was in some respect different from the practice in other European countries. Yet it is difficult to draw conclusions regarding this, and an in-depth comparative analysis is beyond the reach of this article. In order to get a broader picture of the general use of Cardiazol shock therapy in Europe or worldwide, more studies of medical records and other primary sources are required. So far, studies of case notes have not been common in the historiography of somatic treatments, and Cardiazol shock therapy especially is in need of further historical scrutiny.
To read the whole article, click here.

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