Brigitta Baran M.D.
Departamento de Psiquiatria e Psicoterapia da Faculdade de Medicina, Universidade de Semmelweis.
István Bitter, M.D., Ph.D., D.Sc.
Professor catedrático do Departamento de Psiquiatria e Psicoterapia da Faculdade de Medicina, Universidade de Semmelweis
Gábor S. Ungvári M.D., Ph.D.
Departamento de Psiquiatria da Universidade Chinesa de Hong Kong
Zoltán Nagy M.D., Ph.D., D.Sc.
Professor e chefe de Departamento do Instituto Nacional de Psiquiatria e Neurologia.
Gábor Gazdag M.D., Ph.D.
Serviço de Consultoria Psiquiátrica de Ligação

Abstract:

Convulsive therapy (COT) is a major European contribution to the psychiatric armamentarium and biological psychiatry. COT was introduced in psychiatry by László Meduna, a Hungarian neuropsychiatrist. All subsequent publications about the first patient treated with COT, Zoltán L (ZL), were based on Meduna’s papers and autobiography. After 4 years of catatonic stupor, ZL received camphor-induced COT which resulted in full remission and discharge from the institution. The aim of this paper is to reconstruct ZL’s case history from the original case notes-partly written by Meduna himself-which were recovered from the archives of the National Institute of Psychiatry and Neurology. The case notes show that ZL repeatedly received COT between 1934 and 1937, first with camphor and then with cardiazol induction. After the first course of COT the catatonic stupor was resolved and the psychotic symptoms subsided. However, the remission lasted for only a few months and was followed by a relapse. Despite repeated courses of COT, ZL never became symptom free again, was never discharged and died in the Institute in 1945. This historical case is discussed from both the diagnostic and therapeutic points of view, and an attempt is made to explain the possible reasons for the discrepancies found between Meduna’s account and ZL’s case notes.

Keywords:Convulsive treatment, camphor, cardiazol, László Meduna, history of psychiatry.