Ugo Cerletti
Encyclopedia
Ugo Cerletti was an Italian
neurologist
who discovered the method of electroconvulsive therapy
in psychiatry
. Electroconvulsive therapy (ECT) is a procedure in which electric currents are passed through the brain, deliberately triggering a brief seizure. Electroconvulsive therapy seems to cause changes in brain chemistry that can immediately reverse symptoms of certain mental illnesses. It often works when other treatments are unsuccessful.
, in the region of Veneto
, Italy
, on 26 September 1877. He studied Medicine
at Rome
and Turin
, later specializing in neurology
and neuropsychiatry
. He studied with the most eminent neurologists of his time, first in Paris
, France
, with Pierre Marie and Dupré, then in Munich
, Germany
, with Emil Kraepelin
(the "father" of modern scientific psychiatry
) and Alois Alzheimer
(the discoverer of the most common form of senile dementia
, which today bears his name); and in Heidelberg
, with Franz Nissl
, a neuropathologist.
After his studies, he was appointed head of the Neurobiological Institute, at the Mental Institute of Milan
. He remained the director of the Neurobiological Institute of the Psychiatric Hospital of Milan from 1919 to 1924. In 1924 he was given a lecturing post in Neuropsychiatry in Bari
; then, in 1928, he took over the post of Prof. Enrico Morselli, at the University of Genoa
. Finally, in 1935, he became the Chair of the Department of Mental and Neurological Diseases at the University of Rome La Sapienza
, where he developed electroconvulsive therapy
for the treatment of several kinds of mental disorders, a discovery which made him world-famous.
attacks. In Genoa, and later in Rome, he used an electroshock apparatus to provoke repeatable, reliable epileptic
fits in dogs and other animals.
The idea to use ECT in humans came first to him by watching pig
s being anesthetised
with electroshock before being butchered, in Rome. The story goes on his way home, he stopped at a butcher shop. The shop didn't have the cut he wanted, and was told to walk back to the slaughter house behind the shop to have the cut made for him. At that slaughter house, the technique used for butchering cattle was to shock their heads. The cattle would go into seizures and fall down. This made it easy to slit their throats, as the cattle couldn't resist or fight back. He reasoned that ECT might be useful, particularly for schizophrenia; in his time period, people believed that seizures were essential in preventing schizophrenia, since many found that those diagnosed with epilepsy were immune to the disorder. The reasoning was incorrect, but his findings were monumental, and EST therapies continue to be used to treat depression today.
Furthermore, since 1935, metrazol, an epileptogenic
drug, and insulin
, a hormone, were in wide use in many countries to treat schizophrenics
, with great success. This approach was based on Nobel winner Julius Wagner-Jauregg
's research on the use of malaria
-induced convulsions to treat some nervous and mental disorders, such as the general paresis of the insane
, caused by neural syphilis
, as well as on Ladislas J. Meduna
's theory that schizophrenia and epilepsy were antagonistic, which eventually led, in the same period, to institute insulin-coma therapy in psychiatry, by Manfred Sakel
, in 1933.
Cerletti first used ECT in a human patient, a diagnosed schizophrenic with delusion
s, hallucination
s and confusion, in April 1938, in collaboration with Lucio Bini
. A series of electroshocks were able to return the patient to a normal state of mind. Thereafter, in the succeeding years, Cerletti and his coworkers experimented with thousands of electroshocks in hundreds of animals and patients, and were able to determine its usefulness and safety in clinical practice, with several indications, such as in acute schizophrenia, manic-depressive illness, major depression
episodes, etc. His work was very influential, and ECT quickly spread out as a therapeutic procedure all over the world. Despite the fact that it does evoke a grand mal seizure marked by a stereotyped succession of events. EC work done later was deemed to be a safe and highly effective treatment, particularly for mood disorders . A tetanic muscular contraction, the "electric spasm, is followed after a latency of seconds by unconsciousness, a high voltage paroxysmal spike and sharp-wave discharge, and a clonic convulsion. Upon recovery of consciousness the subject is left with a transient acute brain syndrome. Acute brain syndrome can be defined as "A sudden state of severe confusion and rapid changes in brain function, sometimes associated with hallucinations and hyperactivity, in which the patient is inaccessible to normal contact. Symptoms may include inability to concentrate and disorganized thinking evidenced by rambling, irrelevant, or incoherent speech. There may be a reduced level of consciousness, sensory misperceptions and illusions, disturbances of sleep, drowsiness, disorientation to time, place, or person, and problems with memory," which is to be expected in people who suffer head injury, and contributes to the 'need' for compulsion to treatment under law, as people are unwilling to volunteer to such barbarism .
As a result of his experiments, which took him from the psychiatric hospital to the abbatoir and the zoologic gardens, Cerletti developed a theory that ECT caused the brain to produce vitalising substances, which he called "agro-agonines" (from the Greek for extreme struggle). He put his theory into practice by injecting patients with a suspension of electroshocked pig brain, with encouraging results. Although electroshocked pig brain therapy was used by a few psychiatrists in Italy, France and Brazil it did not become as popular as ECT, which soon replaced metrazol therapy all over the world because it was cheaper, less frightening and more convenient. Cerletti and Bini were nominated for a Nobel Prize
but didn't get one.
In his long activity as a psychiatrist and neurologist, Cerletti published 113 original papers, about the pathology of senile plaques
in Alzheimer's disease
, on the structure of neuroglia, the blood-brain barrier
, syphilis
, etc. In 1950 he received a honorary degree
by the Collège de Sorbonne
at the University of Paris
, in addition to a long list of other awards and degrees.
Away from his medical work, Cerletti is also credited with having designed winter camouflage suits for Italian military forces during the First World War, and also for the creation of a time delay fuse for artillery shells.
Cerletti died in Rome on 25 July 1963.
Italy
Italy , officially the Italian Republic languages]] under the European Charter for Regional or Minority Languages. In each of these, Italy's official name is as follows:;;;;;;;;), is a unitary parliamentary republic in South-Central Europe. To the north it borders France, Switzerland, Austria and...
neurologist
Neurology
Neurology is a medical specialty dealing with disorders of the nervous system. Specifically, it deals with the diagnosis and treatment of all categories of disease involving the central, peripheral, and autonomic nervous systems, including their coverings, blood vessels, and all effector tissue,...
who discovered the method of electroconvulsive therapy
Electroconvulsive therapy
Electroconvulsive therapy , formerly known as electroshock, is a psychiatric treatment in which seizures are electrically induced in anesthetized patients for therapeutic effect. Its mode of action is unknown...
in psychiatry
Psychiatry
Psychiatry is the medical specialty devoted to the study and treatment of mental disorders. These mental disorders include various affective, behavioural, cognitive and perceptual abnormalities...
. Electroconvulsive therapy (ECT) is a procedure in which electric currents are passed through the brain, deliberately triggering a brief seizure. Electroconvulsive therapy seems to cause changes in brain chemistry that can immediately reverse symptoms of certain mental illnesses. It often works when other treatments are unsuccessful.
Life
He was born in ConeglianoConegliano
Conegliano is a town and comune of the Veneto region, Italy, in the province of Treviso, about north by rail from the town of Treviso. The population of the city is of around 36,000 people. The remains of a castle that was built in the 10th century remain on a nearby hill...
, in the region of Veneto
Veneto
Veneto is one of the 20 regions of Italy. Its population is about 5 million, ranking 5th in Italy.Veneto had been for more than a millennium an independent state, the Republic of Venice, until it was eventually annexed by Italy in 1866 after brief Austrian and French rule...
, Italy
Italy
Italy , officially the Italian Republic languages]] under the European Charter for Regional or Minority Languages. In each of these, Italy's official name is as follows:;;;;;;;;), is a unitary parliamentary republic in South-Central Europe. To the north it borders France, Switzerland, Austria and...
, on 26 September 1877. He studied Medicine
Medicine
Medicine is the science and art of healing. It encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness....
at Rome
Rome
Rome is the capital of Italy and the country's largest and most populated city and comune, with over 2.7 million residents in . The city is located in the central-western portion of the Italian Peninsula, on the Tiber River within the Lazio region of Italy.Rome's history spans two and a half...
and Turin
Turin
Turin is a city and major business and cultural centre in northern Italy, capital of the Piedmont region, located mainly on the left bank of the Po River and surrounded by the Alpine arch. The population of the city proper is 909,193 while the population of the urban area is estimated by Eurostat...
, later specializing in neurology
Neurology
Neurology is a medical specialty dealing with disorders of the nervous system. Specifically, it deals with the diagnosis and treatment of all categories of disease involving the central, peripheral, and autonomic nervous systems, including their coverings, blood vessels, and all effector tissue,...
and neuropsychiatry
Neuropsychiatry
Neuropsychiatry is the branch of medicine dealing with mental disorders attributable to diseases of the nervous system. It preceded the current disciplines of psychiatry and neurology, in as much as psychiatrists and neurologists had a common training....
. He studied with the most eminent neurologists of his time, first in Paris
Paris
Paris is the capital and largest city in France, situated on the river Seine, in northern France, at the heart of the Île-de-France region...
, France
France
The French Republic , The French Republic , The French Republic , (commonly known as France , is a unitary semi-presidential republic in Western Europe with several overseas territories and islands located on other continents and in the Indian, Pacific, and Atlantic oceans. Metropolitan France...
, with Pierre Marie and Dupré, then in Munich
Munich
Munich The city's motto is "" . Before 2006, it was "Weltstadt mit Herz" . Its native name, , is derived from the Old High German Munichen, meaning "by the monks' place". The city's name derives from the monks of the Benedictine order who founded the city; hence the monk depicted on the city's coat...
, Germany
Germany
Germany , officially the Federal Republic of Germany , is a federal parliamentary republic in Europe. The country consists of 16 states while the capital and largest city is Berlin. Germany covers an area of 357,021 km2 and has a largely temperate seasonal climate...
, with Emil Kraepelin
Emil Kraepelin
Emil Kraepelin was a German psychiatrist. H.J. Eysenck's Encyclopedia of Psychology identifies him as the founder of modern scientific psychiatry, as well as of psychopharmacology and psychiatric genetics. Kraepelin believed the chief origin of psychiatric disease to be biological and genetic...
(the "father" of modern scientific psychiatry
Psychiatry
Psychiatry is the medical specialty devoted to the study and treatment of mental disorders. These mental disorders include various affective, behavioural, cognitive and perceptual abnormalities...
) and Alois Alzheimer
Alois Alzheimer
Aloysius "Alois" Alzheimer, was a German psychiatrist and neuropathologist and a colleague of Emil Kraepelin. Alzheimer is credited with identifying the first published case of "presenile dementia", which Kraepelin would later identify as Alzheimer's disease....
(the discoverer of the most common form of senile dementia
Alzheimer's disease
Alzheimer's disease also known in medical literature as Alzheimer disease is the most common form of dementia. There is no cure for the disease, which worsens as it progresses, and eventually leads to death...
, which today bears his name); and in Heidelberg
Heidelberg
-Early history:Between 600,000 and 200,000 years ago, "Heidelberg Man" died at nearby Mauer. His jaw bone was discovered in 1907; with scientific dating, his remains were determined to be the earliest evidence of human life in Europe. In the 5th century BC, a Celtic fortress of refuge and place of...
, with Franz Nissl
Franz Nissl
Franz Nissl was a German medical researcher. He was a noted neuropathologist.-Early life:...
, a neuropathologist.
After his studies, he was appointed head of the Neurobiological Institute, at the Mental Institute of Milan
Milan
Milan is the second-largest city in Italy and the capital city of the region of Lombardy and of the province of Milan. The city proper has a population of about 1.3 million, while its urban area, roughly coinciding with its administrative province and the bordering Province of Monza and Brianza ,...
. He remained the director of the Neurobiological Institute of the Psychiatric Hospital of Milan from 1919 to 1924. In 1924 he was given a lecturing post in Neuropsychiatry in Bari
Bari
Bari is the capital city of the province of Bari and of the Apulia region, on the Adriatic Sea, in Italy. It is the second most important economic centre of mainland Southern Italy after Naples, and is well known as a port and university city, as well as the city of Saint Nicholas...
; then, in 1928, he took over the post of Prof. Enrico Morselli, at the University of Genoa
University of Genoa
The University of Genoa is one of the largest universities in Italy.Located in Liguria on the Italian Riviera, the university was founded in 1471. It currently has about 40,000 students, 1,800 teaching and research staff and about 1,580 administrative staff.- Campus :The University of Genoa is...
. Finally, in 1935, he became the Chair of the Department of Mental and Neurological Diseases at the University of Rome La Sapienza
University of Rome La Sapienza
The Sapienza University of Rome, officially Sapienza – Università di Roma, formerly known as Università degli studi di Roma "La Sapienza", is a coeducational, autonomous state university in Rome, Italy...
, where he developed electroconvulsive therapy
Electroconvulsive therapy
Electroconvulsive therapy , formerly known as electroshock, is a psychiatric treatment in which seizures are electrically induced in anesthetized patients for therapeutic effect. Its mode of action is unknown...
for the treatment of several kinds of mental disorders, a discovery which made him world-famous.
Works
Cerletti came to the first use of electroshock for therapeutic purposes in human beings by way of his experiments with animals on the neuropathological consequences of repeated epilepsyEpilepsy
Epilepsy is a common chronic neurological disorder characterized by seizures. These seizures are transient signs and/or symptoms of abnormal, excessive or hypersynchronous neuronal activity in the brain.About 50 million people worldwide have epilepsy, and nearly two out of every three new cases...
attacks. In Genoa, and later in Rome, he used an electroshock apparatus to provoke repeatable, reliable epileptic
Epilepsy
Epilepsy is a common chronic neurological disorder characterized by seizures. These seizures are transient signs and/or symptoms of abnormal, excessive or hypersynchronous neuronal activity in the brain.About 50 million people worldwide have epilepsy, and nearly two out of every three new cases...
fits in dogs and other animals.
The idea to use ECT in humans came first to him by watching pig
Pig
A pig is any of the animals in the genus Sus, within the Suidae family of even-toed ungulates. Pigs include the domestic pig, its ancestor the wild boar, and several other wild relatives...
s being anesthetised
Anesthesia
Anesthesia, or anaesthesia , traditionally meant the condition of having sensation blocked or temporarily taken away...
with electroshock before being butchered, in Rome. The story goes on his way home, he stopped at a butcher shop. The shop didn't have the cut he wanted, and was told to walk back to the slaughter house behind the shop to have the cut made for him. At that slaughter house, the technique used for butchering cattle was to shock their heads. The cattle would go into seizures and fall down. This made it easy to slit their throats, as the cattle couldn't resist or fight back. He reasoned that ECT might be useful, particularly for schizophrenia; in his time period, people believed that seizures were essential in preventing schizophrenia, since many found that those diagnosed with epilepsy were immune to the disorder. The reasoning was incorrect, but his findings were monumental, and EST therapies continue to be used to treat depression today.
Furthermore, since 1935, metrazol, an epileptogenic
Epilepsy
Epilepsy is a common chronic neurological disorder characterized by seizures. These seizures are transient signs and/or symptoms of abnormal, excessive or hypersynchronous neuronal activity in the brain.About 50 million people worldwide have epilepsy, and nearly two out of every three new cases...
drug, and insulin
Insulin
Insulin is a hormone central to regulating carbohydrate and fat metabolism in the body. Insulin causes cells in the liver, muscle, and fat tissue to take up glucose from the blood, storing it as glycogen in the liver and muscle....
, a hormone, were in wide use in many countries to treat schizophrenics
Schizophrenia
Schizophrenia is a mental disorder characterized by a disintegration of thought processes and of emotional responsiveness. It most commonly manifests itself as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, and it is accompanied by significant social...
, with great success. This approach was based on Nobel winner Julius Wagner-Jauregg
Julius Wagner-Jauregg
Julius Wagner-Jauregg was an Austrian physician, Nobel Laureate, and Nazi supporter.-Early life:...
's research on the use of malaria
Malaria
Malaria is a mosquito-borne infectious disease of humans and other animals caused by eukaryotic protists of the genus Plasmodium. The disease results from the multiplication of Plasmodium parasites within red blood cells, causing symptoms that typically include fever and headache, in severe cases...
-induced convulsions to treat some nervous and mental disorders, such as the general paresis of the insane
General paresis of the insane
General paresis, also known as general paralysis of the insane or paralytic dementia, is a neuropsychiatric disorder affecting the brain and central nervous system, caused by syphilis infection...
, caused by neural syphilis
Syphilis
Syphilis is a sexually transmitted infection caused by the spirochete bacterium Treponema pallidum subspecies pallidum. The primary route of transmission is through sexual contact; however, it may also be transmitted from mother to fetus during pregnancy or at birth, resulting in congenital syphilis...
, as well as on Ladislas J. Meduna
Ladislas J. Meduna
Ladislas J. Meduna was a Hungarian neurologist and neuropathologist noted for his development of shock treatment for persons suffering from schizophrenia.Meduna was born to a well-to-do family in Budapest, Hungary, in 1896...
's theory that schizophrenia and epilepsy were antagonistic, which eventually led, in the same period, to institute insulin-coma therapy in psychiatry, by Manfred Sakel
Manfred Sakel
*Fink, M , "Meduna and the Origins of Convulsive Therapy", American Journal of Psychiatry, 141: 1034-1041 *Fink, M (1984), "Meduna and the Origins of Convulsive Therapy", American Journal of Psychiatry, 141(9): 1034-1041 *Fink, M (1984), "Meduna and the Origins of Convulsive Therapy", American...
, in 1933.
Cerletti first used ECT in a human patient, a diagnosed schizophrenic with delusion
Delusion
A delusion is a false belief held with absolute conviction despite superior evidence. Unlike hallucinations, delusions are always pathological...
s, hallucination
Hallucination
A hallucination, in the broadest sense of the word, is a perception in the absence of a stimulus. In a stricter sense, hallucinations are defined as perceptions in a conscious and awake state in the absence of external stimuli which have qualities of real perception, in that they are vivid,...
s and confusion, in April 1938, in collaboration with Lucio Bini
Lucio Bini
Lucio Bini was an Italian psychiatrist and professor at the University of Rome La Sapienza, Italy. Together with Ugo Cerletti, a neurophysiologist, he researched and discovered the method of electroconvulsive therapy, a kind of shock therapy for mental diseases.-References:*Kalinowsky, LB: Lucio...
. A series of electroshocks were able to return the patient to a normal state of mind. Thereafter, in the succeeding years, Cerletti and his coworkers experimented with thousands of electroshocks in hundreds of animals and patients, and were able to determine its usefulness and safety in clinical practice, with several indications, such as in acute schizophrenia, manic-depressive illness, major depression
Clinical depression
Major depressive disorder is a mental disorder characterized by an all-encompassing low mood accompanied by low self-esteem, and by loss of interest or pleasure in normally enjoyable activities...
episodes, etc. His work was very influential, and ECT quickly spread out as a therapeutic procedure all over the world. Despite the fact that it does evoke a grand mal seizure marked by a stereotyped succession of events. EC work done later was deemed to be a safe and highly effective treatment, particularly for mood disorders . A tetanic muscular contraction, the "electric spasm, is followed after a latency of seconds by unconsciousness, a high voltage paroxysmal spike and sharp-wave discharge, and a clonic convulsion. Upon recovery of consciousness the subject is left with a transient acute brain syndrome. Acute brain syndrome can be defined as "A sudden state of severe confusion and rapid changes in brain function, sometimes associated with hallucinations and hyperactivity, in which the patient is inaccessible to normal contact. Symptoms may include inability to concentrate and disorganized thinking evidenced by rambling, irrelevant, or incoherent speech. There may be a reduced level of consciousness, sensory misperceptions and illusions, disturbances of sleep, drowsiness, disorientation to time, place, or person, and problems with memory," which is to be expected in people who suffer head injury, and contributes to the 'need' for compulsion to treatment under law, as people are unwilling to volunteer to such barbarism .
As a result of his experiments, which took him from the psychiatric hospital to the abbatoir and the zoologic gardens, Cerletti developed a theory that ECT caused the brain to produce vitalising substances, which he called "agro-agonines" (from the Greek for extreme struggle). He put his theory into practice by injecting patients with a suspension of electroshocked pig brain, with encouraging results. Although electroshocked pig brain therapy was used by a few psychiatrists in Italy, France and Brazil it did not become as popular as ECT, which soon replaced metrazol therapy all over the world because it was cheaper, less frightening and more convenient. Cerletti and Bini were nominated for a Nobel Prize
Nobel Prize
The Nobel Prizes are annual international awards bestowed by Scandinavian committees in recognition of cultural and scientific advances. The will of the Swedish chemist Alfred Nobel, the inventor of dynamite, established the prizes in 1895...
but didn't get one.
In his long activity as a psychiatrist and neurologist, Cerletti published 113 original papers, about the pathology of senile plaques
Senile plaques
Senile plaques are extracellular deposits of amyloid in the gray matter of the brain. The deposits are associated with degenerative neural structures and an abundance of microglia and astrocytes...
in Alzheimer's disease
Alzheimer's disease
Alzheimer's disease also known in medical literature as Alzheimer disease is the most common form of dementia. There is no cure for the disease, which worsens as it progresses, and eventually leads to death...
, on the structure of neuroglia, the blood-brain barrier
Blood-brain barrier
The blood–brain barrier is a separation of circulating blood and the brain extracellular fluid in the central nervous system . It occurs along all capillaries and consists of tight junctions around the capillaries that do not exist in normal circulation. Endothelial cells restrict the diffusion...
, syphilis
Syphilis
Syphilis is a sexually transmitted infection caused by the spirochete bacterium Treponema pallidum subspecies pallidum. The primary route of transmission is through sexual contact; however, it may also be transmitted from mother to fetus during pregnancy or at birth, resulting in congenital syphilis...
, etc. In 1950 he received a honorary degree
Honorary degree
An honorary degree or a degree honoris causa is an academic degree for which a university has waived the usual requirements, such as matriculation, residence, study, and the passing of examinations...
by the Collège de Sorbonne
Collège de Sorbonne
The Collège de Sorbonne was a theological college of the University of Paris, founded in 1257 by Robert de Sorbon, after whom it is named. With the rest of the Paris colleges, it was suppressed during the French Revolution. It was restored in 1808 but finally closed in 1882. The name Sorbonne...
at the University of Paris
University of Paris
The University of Paris was a university located in Paris, France and one of the earliest to be established in Europe. It was founded in the mid 12th century, and officially recognized as a university probably between 1160 and 1250...
, in addition to a long list of other awards and degrees.
Away from his medical work, Cerletti is also credited with having designed winter camouflage suits for Italian military forces during the First World War, and also for the creation of a time delay fuse for artillery shells.
Cerletti died in Rome on 25 July 1963.
External links
- Ugo Cerletti. WhoNamedIt.
- Psichiatria Biologica e terapie da shock - Ugo Cerletti. Storia delle Neuroscienze in Italia (In Italian).