My friend Quinn Rossander wrote the following, excellent piece:

In his book, The Reign of Error, Dr. Lee Coleman, M.D. offers an explanation of psychiatric oppression that IMHO has never been surpassed. This book was written in 1984 and still marks the high water mark in many respects because it combines legal as well as medical issues. On page 116 the following dissertation begins:

Shock Treatment: As Damaging as Ever

Shock treatment started in 1933, with insulin being used to drop the patient's blood sugar low enough to cause a coma and sometimes a convulsion. This was the idea of Manfred Sakel, who had been treating his private patients at the Lichterfelder sanitarium, near Berlin, in this manner for several years. Sakel's reasoning was the following:

My supposition was that some noxious agent weakened the resilience and the metabolism of the nerve cells ... a reduction in the energy spending of the cell, that is in invoking a minor or greater hibernation in it, by blocking the cell off with insulin will force it to conserve functional energy and store it to be available for the re-enforcement of the cell.

In just a few years after Sakel published his new method insulin shock treatment was being used on thousands of the world's mental patients. Today it is rarely used.

Laszlo von Meduna had a different theory, one he developed during the early 1930's while working at the Interacademic Brain Research Institute in Budapest. Meduna used a chemical (Metrazol), rather than the hormone insulin, to produce the convulsions. Like insulin, Metrazol was given by intravenous injection. Before the patient started to convulse, he or she experienced a horrible period of panic and impending doom, lasting up to a minute. It was not a popular treatment.

Ugo Cerletti, professor of neuropsychiatry at the University of Rome, conceived the method by which shock treatment is given today - electric shock. Cerletti accepted the idea that convulsions were good for schizophrenics and in 1938 started using electric shock to produce the convulsions. Electric shock treatment quickly replaced insulin and Metrazol as the favorite form of shock treatment, and became the most effective method of controlling troublesome asylum inmates.

Today between one hundred thousand and two hundred thousand Americans receive Electroconvulsive treatment (ECT) each year. About 120 volts, the amount in ordinary house current, is applied to the brain for about a half-second. A course of treatment usually lasts two to three weeks, with shocks given perhaps ten to fifteen times. Some doctors give several shocks at a time, one right after the other. Many patients have received over the years several courses of treatment, and some patients are even "maintained" on shock treatments indefinitely. Many people believe that shock therapy is no longer dangerous. This is because psychiatry proudly proclaims that shock treatment today is administered differently from earlier practices.

I first witnessed shock treatment in 1963, when I visited the Illinois State Hospital at Manteno with three other University of Chicago medical students. After being shown around several of the wards, we were taken to observe patients receive "shock." Expecting to enter a treatment room with two or three patients waiting outside, we instead found ourselves inside a cavernous ward. About two dozen patients, lying on their backs and strapped to treatment tables, were lined up from one end of the room to the other. Most were women.

The treating psychiatrist greeted us and got to work. I had the impression, by the way the doctor readied her equipment, that administering shock treatment was routine. As the other patients watched, she rubbed conducting paste on the temples of the first patient, a woman who appeared to be in her forties. She passively accepted the rubber mouthpiece placed in her mouth, as though she had done this many times. We were told the mouthpiece was to prevent cuts during the seizure.

The doctor pressed a button on the small box she had been adjusting and the convulsion began. The woman went rigid and then began to convulse rhythmically. Her face became a ghastly blue as her convulsing muscles prevented her from breathing. It seemed like a long time before she started to breathe again, but it was probably only a few seconds. She made grunting and snorting sounds, as saliva mixed with a little blood, frothed at the corners of her mouth. Once it was clear that she would continue to breathe, perhaps thirty seconds to a minute after the shock had been given, the doctor went to the next patient. Most of the patients seemed prepared to accept the treatment without complaint, and a few told the doctor they were doing better and could skip a treatment today. Such pleas went unheeded.

We watched two or three more treatments, as the doctor made her way down the line of carts. We were told this was a typical day; Shock was given between ten and eleven o'clock each morning. We then moved on to other sights and sounds of the hospital.

Today fewer patients are given ECT. The practice is no longer common in state mental hospitals, but is still used widely in private mental hospitals. Psychiatrists who currently administer shock therapy claim it is a lifesaving treatment for those who are severely depressed and possibly suicidal. Furthermore, they insist that ECT no longer deserves its ugly reputation, because there have been several new medical developments in how the treatment is administered.

Today's patient is first injected with a barbiturate; thus the person is unconscious before the electric shock is administered. Second, he or (usually) she is given a nerve blocking agent (succinylcholine), which paralyzes the muscles of the body. As a result, the outward muscular convulsion is greatly reduced. In the past, patients sometimes suffered bone fractures or dislocations from muscular convulsions. Third, oxygen is given to the patient, to compensate for the patient's inability to breathe; thus the patient does not become cyanotic (blue).

Proponents of ECT claim these developments make shock treatment safe and effective. Psychiatrist Stuart Yudofsky of the New York State Psychiatric Institute for example, has said, "The only way you physically know a seizure is taking place is that sometimes you see a finger wiggling slightly."