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Friday, 15.12.2017

Lothar Kalinowsky and Paul Hoch

LOTHAR B. KALINOWSKY AND PAUL HOCH: SHOCK TREATMENTS AND OTHER SOMATIC PROCEDURES IN PSYCHIATRY

Grune & Stratton, New York, 1946. (1st edition; 294 pages)

Reviewed by Carlos Morra

CONTENT: This book is divided into eight chapters, preceded by Nolan DC Lewis’  “Introduction” and authors’ “Preface”. To set the stage for their review of the status of physical therapies, the  authors present an overview of ”Historical Development” of  organic treatments in psychiatry.  It includes bloodletting, emetics, purgatives, removal of the clitoris, turpentine oil produced abscess, sulfosin induced fever, etc.

The three central chapters of this book are devoted to physical therapies. In chapter two, the status of “Insulin Shock Treatment” is reviewed in terms of indications, contraindications, complications, and prognostic indicators. In chapter three, a similar review of “The Convulsive Therapies” are divided into pharmacologically induced (camphor, metrazol) and electrically induced convulsive treatments (ECT). And in chapter three, the status of “Combined Insulin-Convulsive Treatments” is presented.

In chapter five, the focus shifts from “physical therapies” to ”Other Somatic Nonsurgical Treatments and Their Relation to Shock Treatments”, such as Sodium Amytal, Benzedrine, Dilantin, Continuous Sleep, Fever Therapy, Nitrogen Inhalation, Vascular Shock, Faradic Shock, Refrigeration Therapy and Electric Narcosis.  These treatments are perceived as alternative therapies to ECT or modifiers of its effectiveness or safety. A special chapter (chapter six) is dedicated to “Prefrontal Lobotomy and Its Relationship to Shock Therapy,” in which authors argue that with the availability of effective physical therapies, surgical interventions, such as lobotomy, has no longer a place in the treatment of psychiatric disorders. Finally, in the concluding chapter (chapter seven), “Theoretical Considerations,” is a discussion of the mechanism of action of ECT, from psychological to biological. 

REVIEWER’S STATEMENT: The authors were particularly attracted by ECT. Yet they recognized in their conclusions that they are “treating empirically disorders whose etiology is unknown with shock treatments whose action is also shrouded in mystery”.     

 

Carlos Morra

December 25, 201