LJ MEDUNA PAPERS PDF

Meduna was born to a well-to-do family in Budapest, Hungary, in He studied medicine in Budapest from to , his studies being interrupted by military service in the Italian front from to , during the First World War. He was interested in pursuing medical research in neurology, and soon got an appointment to the Hungarian Interacademic Institute for Brain Research, also in Budapest. There, he researched the structure and development of the pineal gland and of microglia , the neuropathology of lead poisoning , avitaminosis, and several other subjects. In he moved to the Psychiatric Institute and began clinical and research work in psychopathology. The reverse association also seemed true: of more than 6, patients with schizophrenia, only 20 had had epilepsy.

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The story of their differences and similarities invites us to consider the personal preconditions for scientific discovery. What common denominators led them to develop treatments, which represent the introduction of convulsive therapy, which remains today the most powerful treatment in psychiatry?

Despite the marked differences in their personalities, Sakel and Meduna shared intellectual quickness, drive, and a willingness to take risks, three qualities that, in the case of these individuals at least, came together to revolutionize the treatment of serious psychiatric illness. Keywords: insulin coma therapy, Laszlo Meduna, Metrazol convulsive therapy, Manfred Sakel, scientific discovery It is ironic that Laszlo Meduna and Manfred Sakel, within two years of each other, made epochal discoveries in psychiatry because otherwise, the two men were as different as chalk and cheese.

The story of their differences and similarities invites the question: What are the personal preconditions of scientific discovery? Sakel and Meduna made their discoveries only two years apart, in and Shorter and Healy offer a larger context of these events. What common denominators led them to creativity? Both were of Jewish origin, although religion seems to have played little role in the lives of either of them.

Sakel was born in as Menachen Sokol in the village of Nadvornaya in a part of Russian Poland then belonging to Austria. Fink, personal communication with William Karliner, January 27, After becoming wealthy in New York after his definitive migration in , Sakel was later said to favor Zionist causes.

Meduna by contrast came from a family of conservative Sephardic Jews of Mediterranean origin, in contrast to the Ashkenazic Jews of Eastern Europe such as Sakel. Born in , he spent his high school years in a Catholic boarding school. In their path to discovery, the two followed markedly different routes. Despite his subsequent statements of rigorously applying the scientific method, Sakel seems to have stumbled across insulin coma by accident.

Sakel graduated with a degree in medicine in Vienna in and went up to a psychiatric sanatorium in the Berlin suburb of Lichterfelde, the chief physician of which was Kurt Mendel. Sakel claimed to have begun his voyage of discovery with theoretically justified animal experiments, ending in May with the decision to move on to human subjects.

He got his idea when he was treating heroin addicts with insulin in Berlin to help them over their withdrawal symptoms. Once, one of his addicts who was also schizophrenic, accidentally slipped into a hypoglycemic coma. Sakel was scared but brought him out of the coma quickly with an injection of glucose. To his amazement, the patient showed a considerable improvement of his schizophrenic symptoms. Sakel then wanted to use hypoglycemic coma as a treatment for schizophrenia.

Sakel first published on the insulin treatment of morphine addiction, without mentioning coma or psychosis, in Heather Dichter kindly undertook a systematic search of the Viennese press for this period and found no mention of this event. When Sakel made the claim, during the World Congress of Psychiatry in Paris in , he seemed to have been in the grips of an almost manic fit of self-aggrandizement.

On stage, Meduna refused to shake his hand and did not subsequently submit the text of his own lecture for publication. He then read several epidemiological studies that demonstrated in asylum populations an absence of epilepsy, indeed in one institution, patients who had recovered from their schizophrenia after epileptic attacks.

Meduna formed the question: Could there be an antagonism between epilepsy and schizophrenia? After undertaking preclinical experiments to establish safety, he contemplated the big wager: human trials. Meduna thus established a testable hypothesis on the basis of biological findings and demonstrated it with a proper clinical trial that, although lacking a placebo control group, showed substantial efficacy for cardiazol.

Finally, one can note the difference in how the two investigators dealt with their triumphs. Both became world famous. For Meduna, there was a steady string of visitors to Budapest that challenged his pocketbook in taking them all to dinner. In , he emigrated to the United States, took a post in psychiatry first at Loyola University, then at the Illinois Psychiatric Institute of the University of Illinois, both in Chicago.

To keep body and soul together, he had a modest private practice. In fact, I made no money at all with the Metrazol treatment inasmuch as I never had any private patients to whom I gave Metrazol treatment. He was involved with such innovative therapies as carbon dioxide treatment and with pioneering diagnoses such as oneirophrenia dreamlike psychosis. Yet what is most interesting for our purposes is that as soon as a superior form of convulsive therapy came along, in the form of electroconvulsive treatment in , he lost interest in chemical convulsive therapy.

He saw it as inferior to initiating seizures electrically. I do not believe the original publications have much value anymore. Sakel shunned institutional affiliations in New York, or perhaps it was his famous arrogance that discouraged colleagues at places such as New York University from approaching him he did get a feeler from the New York State campus in Albany but apparently did not respond to this provincial quiver.

For years, he took pains to rebuke Meduna unfairly for plagiarizing his own work and to insist on the danger of inducing fits, as opposed to healing comas. He opposed ECT for the same reason. He made no mention of Meduna in advancing this claim.

He administered insulin coma therapy at the private Slocum clinic upriver in Beacon, New York, driven to and fro in the limousine of one of his private patients E.

Shorter and M. Fink, personal communication with William Karliner. Unlike Meduna, Sakel became very wealthy, acquiring a reputation among his contemporaries as driven by greed. He has found private practice better suited to him than the somewhat sour honey of research. Rather, it is that these were two totally different individuals, with psychological constitutions as diverse as could be.

These are three qualities that, in this pair of individuals at least, seem to have come together to produce innovation: Natural intellectual quickness, in the sense of an ability to make lateral connections. Natural energy. For Sakel, bestirring himself as a junior physician in an expensive private hospital conscious of its public image required drive.

Meduna invested large amounts of private time in microscopy, animal work, and clinical trials. Again, he was an individual full of energy. Willingness to take risks. Putting treatments of singular dangerousness into patients and inducing comas and convulsions therapeutically required courage, to say the least.

One can imagine the reactions of an institutional review board today. Today the work of these 2 pioneers would be inconceivable. Their work cost little, and, on the Central European academic model, they had few distractions in their lives save work.

There are lessons for our own time in the lives of Sakel and Meduna, but they are not necessarily encouraging ones. The world of endless research grant applications, of navigating the pitfalls of ethics review boards, and of balancing the demands of home life and office do not encourage us to imagine that similar figures might spring forth soon. James, NY. References 1. Shorter E, Healy D. Sakel M. Neue Behandlungsart Schizophreniker und verwirrter Erregter. Wien Klin Wochenschr.

Meduna L. Zeitschr Gesamte Neurolog Psychiatr. Kalinowsky LB. The various forms of shock therapy in mental disorders and their practical importance. New York State J Med. Linde OK, editor. Pharmakopsychiatrie im Wandel der Zeit: Erlebnisse und Ergebnisse.

Vienna obituary Lancet. New York Times. May 25, Free Palestine meeting: American League holds first sessions, lists aims; p. Fink M. Meduna and the origins of convulsive therapy. Am J Psychiatry. Dussik KT, Wortis J. Wortis Papers, Box 6. In: Urban HJ, editor. Festschrift zum Geburtstag von Prof. Innsbruck, Austria: Tirol Graphik; Lehmann H.

Pharmacotherapy interview In: Healy D, editor. The Psychopharmacologists. London, UK: Chapman and Hall; Wortis J. The history of insulin shock treatment. Insulin Treatment in Psychiatry. Neue Behandlung der Morphinsucht. Deutsche Medizin Wochenschr.

Schizophrenia: most disastrous disease of man: it destroys his mind though sparing his body.

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Ladislas J. Meduna

The story of their differences and similarities invites us to consider the personal preconditions for scientific discovery. What common denominators led them to develop treatments, which represent the introduction of convulsive therapy, which remains today the most powerful treatment in psychiatry? Despite the marked differences in their personalities, Sakel and Meduna shared intellectual quickness, drive, and a willingness to take risks, three qualities that, in the case of these individuals at least, came together to revolutionize the treatment of serious psychiatric illness. Keywords: insulin coma therapy, Laszlo Meduna, Metrazol convulsive therapy, Manfred Sakel, scientific discovery It is ironic that Laszlo Meduna and Manfred Sakel, within two years of each other, made epochal discoveries in psychiatry because otherwise, the two men were as different as chalk and cheese.

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LJ MEDUNA PAPERS PDF

Ladislas J. He studied medicine in Budapest from to , his studies being interrupted by military service in the Italian front from to , during the First World War. He was interested in pursuing medical research in neurology, and soon got an appointment to the Hungarian Interacademic Institute for Brain Research, also in Budapest. There, he researched the structure and development of the pineal gland and of microglia, the neuropathology of lead poisoning, avitaminosis and several other subjects. In he moved to the Psychiatric Institute and began clinical and research work in psychopathology. The reverse association also seemed true: of more than 6, patients with schizophrenia, only 20 had had epilepsy. There were anedoctal reports of cures of schizophrenia in patients who developed epileptic seizures.

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Kazrat Aprilpp. In the first half of the article, the circumstances regarding the foundation of the Institute and its first 60 years are reviewed. Zeitschr Gesamte Neurolog Psychiatr. American League holds first sessions, lists aims; p. Abood posted to meduna by filipmarcinowski on Notes provide important information to explain a concept or to complete a task. The treatment — while usually unpleasant or even terrifying — proved very useful for revealing previously unconscious fears. Hungarian neuroscientists Hungarian psychiatrists births deaths Medina subject research in psychiatry History of psychiatry People who emigrated to escape Nazism People from Budapest Hungarian emigrants to the United States Loyola University Chicago faculty Guggenheim Fellows.

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Sakel Versus Meduna

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