Edward Shorter’s comment on Herwig Czech, Gabor Ungvari, Kamila Uzarzzyk and Gabor Gazdag’s 2020 paper, “Electroconvulsive therapy in the  shadow of the gas chamber. Medical innovations and human experimentation in Auschwitz”

 

        The story told by Dr. Czech and collaborators is a horrifying one and the field can only be thankful that use of ECT in the Nazi death camps is starting to be investigated.  Less investigated, however, is the use of ECT and the other new “physical” therapies  (insulin coma, Cardiazol convulsion) in mental hospitals in the Nazi years.  Here, the story must be nuanced a bit.  In a study of patients in the Lower Austrian state asylum Kierling-Gugging, I found that in 1944 eight patients with “schizophrenia” were discharged as either “recovered” (geheilt) or “removed to home care” (in häusliche Pflege entlassen).  By contrast, a further eight schizophrenic patients died in the asylum or were transferred to a certain death in another institution.   What divided the two groups?  The schizophrenics who were not killed responded positively to insulin, Cardiazol or ECT (which came in around 1944).  Some of the eight who were killed had also received these new treatments but had failed to respond to them.  These results will be reported in due course.  But the point right now is that in an asylum such as Kierling-Gugging, not necessarily in a death camp, the Nazi psychiatrists evidently used these new physical treatments therapeutically on patients with diagnoses (“schizophrenia”) that in other settings might have been a death sentence. This is a small footnote to a paper that is otherwise very meritorious.

        On Feb 25, 2021, at 12:31 a.m., Tom Ban sent me an email: “Ned, In case you did not see this paper, published in Johns Hopkins Bulletin of the History of Medicine, please  find it in the attachment. They are referring to your work in it towards the end. Would you be interested in commenting/…”

Reference:

Czech H, Ungvari GS, Uzarczyk K, Weindling P, Gazdag G. Electroconvulsive Therapy in the Shadow of the Gas Chambers: Medical Innovation and Human Experimentation in Auschwitz. Bull Hist Med 2020;94(2):244-66.

 

June 10, 2021