PROBLEM OF THERAPY AT THE PRESENT STATE OF DEVELOPMENT OF PSYCHIATRY IN SOVIET UNION

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP82-00039R000100230006-0
• Release Decision: RIPPUB
• Original Classification: R
• Document Page Count: 36
• Document Creation Date: December 22, 2016
• Document Release Date: May 10, 2012
• Sequence Number: 6
• Publication Date: February 29, 1952
• Content Type: REPORT

Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
PROBLEM OF THERAPY AT THE PRESENT STATE OF DEVELOPMENT
OF PSYCHIATRY IN SOVIET UNION
Nerropatologlya i Psikhiatriya, No 3, 19,0, pp 2L-28
Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
STAT
STAT
 Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
THE PROBLEM OF T1{1RAPY AT THE PRESENT STATE OF
DEVELOPMENT OF PSYCHIATRY IN THE'; SOVIET UNION
Professor V. A. Gilyarovskiy
Active Member of the Academy of Medical Sciences USSR
(Received by the Editors 10 March 1950)
(Inasmuch as the question concerning positive and
;^y `; 4x ? (~
negative di & concerning the use of leukotomy has not been
resolved, but has resulted in a nruniber of contradictory opinions,
the editors ask readers to give their opinions as based on personal
experience with respect to the problems dealing with positive
4
and negatives concerning the use of leultotomy. The Editors)
Soviet psychiatrists have always attached much significance to
problems of therapy not only from a practical point of view, but
also in relation to the working out of theoretical problems, clari-
fication of the mechanism of operation
determination opositive and negative
even during the Great Fatherland War,
of individual methods, and the
t r. c - , -.a
#'i"nd:ings. Such work continued
Our doctors, enriched by the
experience and stimulated by the successes of general medicine, are
trying to place therapy on a higher level. The possibility of
utilizing the achievements of the physiologists c I. P. Pavlov and
his school and new and exact data on heredity as dt r ..ned. by
biologists
I'.
of Michuri.n?s orientation, guarantees strict scientific
illumination of questions relating to pathogenesis, the structure
of psychosis and the conditions of remission. All these
factors open up extremely wide horizons for .therapy. Natur-
ally there is a desire to brim; out the most significant achieve-
Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R0001
00230006-0
 Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
rrents and indicate the direction for future effective work. Such
is the author' s purpose.
parting from fog' " .~ and w-i th striving to ct theoreti-
Our. science must be credited with having succeeded inn dew
cally various methods of therapy, This refers primarily to active
methods of therapy. The attempts of authors abroad to explain the
mechanisms of their operation have not been very convincing. This
includes the anesthesia of neural centers as the principal element
in sleep therapy and the hypothesis concerning the contrast of the
nature of schizophrenia and epilepsy as being basic in convulsion
therapy, Soviet investigators are in a position to propose an
explanation of the principles of shock and sleep therapy based on
the findings of our physiologists. Although psychosis has a
material basis, it cannot be considered to consist of merely de~
structive changes of the nervous system. The latter are permanent
only in organic psychoses and, moreover, can be explained princip
pally by symptoms of prolapsus. In toxic and infectional psychoses
such changes develop only after a prolonged period. The basis
of schi' onhrenia is to be found rooted in the brain process (moz-
in all, iprocesses of a pathophysiological character. In contra-
govoy protsess), but that results in destructive changes only in
e
P C. ' : (} erg .n
advanced stagges, `r\ is to be explained i the processes of stimu~
lation, inhibition, irradiation, positive and negative induction, all
Ld
tissue, they are reversible, and, to the degree that they are phy-
distinction to processes resulting from the destruction of brain
remission
siological, their
by physiological reaction. It is important to note that physio-
logical mechanism need not be specific in any way, What is import
k h, LI , V
-1
ant is ?-sue, that the -~me; If we consider
inhibition, then, in accordance with the findings of N. Ye Vvedenskiy,
5
N e ova +y ,
_
it may be b be -to various types of irritatio chemical, heat, and
Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
 Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
mechanical. With respect to this, clinical observation1 shows that
th eMt. affrr bra? n mechanisms may be rya d tt r various
but in therapeutic application they result in the rupture of patho~
are different from the point of view of their physiological nature'
types of factors. According to this the elimination of pathogenic
symptoms does not necessarily call for any specific reactions but
may be achieved by various rather intense irritations. This is
done by shock methods, Insulin shock therapy and convulsion methods
logical connections to more or less the same degree and make it
possible to rebuild the process through the reestablishment of
normal relations.
All applied active methods admit the great importance of
psychotherapeutic factors in the treatment of schizophrenia, In
this respect sleep therapy finds itself under the most favorable
conditions. This method was established theoretically by I. P.
Pavlov and sterns from his concept of protective inhibition. In
addition the beneficial power of sleep, in the sense of soothing,
rest, removal of the feeling of worry or anxiety brought on by
current cares, is so well known that the idea of therapy by prolonged
sleep finds ready acceptance.
`11he Ministry of Health is endeavoring to raise the quality
of therapeutic aid. No doubt, this refers to the diffusion of
achievements in the field of therapy to the greatest possible
number of sick persons to be found in all hospitals, Moreover,
analysis of the existentr5& ti.on throughout the Soviet Union with
respect to the therapy of persons with psychic illnesses shows that
3
Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
 :'spucts. 11'hey are to be explained by the severance of the
periphery from the center, the breaking away in therapy of
practice from theory. e have made a study of the scientific
techniques of psychiatric institutions in the USSR and noticed
the absence from psychotherapy of hypnosis and work therapy, of
physical methods of therapy, and of psychoprophylaxas, while at
the same time plans are overloaded with studies on electric shock,
although it has been sufficiently studied, Electric shock can
be of use in schizophrenia and in presenile psychoses, but a number
of authors have shorn a tendency for applying it to neurotic
conditions. ' However, it has been established that it can lead to
a permanent psychic depression, in particular, to weakening of the
memory. Widespread interpretation of evidence concerning electric
shock shows that it can have most serious consequences for patients.
Weakening o the memory or a general slight psychic deterioration
would be a serious catastrophe in the lives of patients with neu-
S
rotic cofdltlofS or manic_depresslve psychosis. The widespread
distribution of electric shock therapy presents a danger to right
development of therapy. An overall picture of therapy in psy-
chiatric institutions shows that electric shock is used 10 tames
more than sleep therapy, but no one has proved that it is ten times
more effective. At a session of the Institute of Psychiatry of the
Ministry for I-Iealth USSR, V. Ye. Galenko communicated her findings
relating to the ca.tamnestic study of 110 schizophrenics who had
been clinically treated by prolonged sleep in which 1~0 percent of
the cases showed a permanent cure.
Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
vE, '? is G/
in spite of important achievements there are certain d&btu
 Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
broken sleep wne anent sleeps l6-l8 hours a day. It When the p c;
not only o
'th the researches of N. N.
parts of the same side. This agrees ~
the same time the researches of 14. N.
Dzidzishvili in Tb~ln.s~.? At that sleep ~ therapy leads to the eliminat~.ohl of
this Livanov pathology, while tha ctrical
the norri1alization of pictures of ele
'th clinical. improvement. This gives one
activity corresponds w~-
t'ne right ~ assume that this method should be given as mach at-
tentir~n as possible. There _ shcauld also be recol~nended the use Of
asynchronousness heres but o_
f ' ndividual hernisp s
ati on for this method of treatmer:~ has
The theoretical found
n in research on electrical activity.
fo?~.1d striking ver~.f~.cat~.o
hre1lia of
vanov has shown the presence in schizop
Professor M. N?ti asyrnrmetry and
the rupture of curves of electrical activity, the MI' f d' f f Brent
' ve but at the same tune quite helpful.
ewhat less effect
som
ProtopoPov even prefers this form of sleep therapy, 5ayin that
it yore closely approaches the natural.
~uxh ~ tal though it is closer to physio-
Sleep acni.eved thr.~ !, Y
obtained by K10e tt' s mixture neve rthele s s
logical sleep than can be
lee which is to a certain extent toxic,
is a pharmacolo},s p
im ortance of the principle of protective
The extraord~.nary p
inhibition of I. P. Pavlov should lead to working out of new methods
o on sleep in the full sense of the word of therapy which would bring ,
~' al sleep. We have tried to achieve asleep-
resemblin; pl-ryszol.o~,n.c
researches of I. I'. Pavlov on sleep and N.
inhibition based on the
stimulation, inhibition, and narcosis In our
Ye. Vvedenska.y on
relatively strong currents and achieved
first researches we applied
arcosis. While working on this method and
the state of electron
Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
 Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
trying to create a more suitable apparatus, I with N. i4. Liventsev
and S. A. Kirillova achieved a certain amount of success which was
made public at a meeting of the Learned Medical Council in October
1924.7 and in the magazine Klinicheskaya Meditsina in 19L.8. But
later we abandoned this method. The state that it creates is a
true narcosis, but it is accompanied by deafening, and thus is
distinctly different from sleep. For this reason we decided to
decrease the strength of the current and the duration of each imw
impulses)
pulse, By applying weak doses of electrical we were able
to use them as)ythmic irritations for evoking a diffused inner
inhibition, that is, physiological sleep. The reaction to the im-
pulses of current, which were given with a frequency varying from
applied to the occipital
1 to 10 per second, the electrodes being
lobes,
is successful with minimal doses of current and does
instead brings on a state of drowsiness, which under the right
not cause any special sensations nor any visual reactions, but
conditions (of quiet) passes over into physiological sleep.
Without going into a description of the apparatus and details
pertaining to the manner of applying the current, we direct atten-
sleep, a fact which we consider to be most significant. This is
current, a sleep which almost in no way differs from physiological
Lion to the possibility of creating sleep with the help of electric
corroborated by a description by our patient Ye., a 20-year old
schizophrenic, in which he speaks of his experience while under"'
going therapy by this method,
ttJ)uring the first few days following my arrival at the
clinic, r was in a state of inner retirement, isolation, and
Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
 Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
indifference to everything. I felt dull and absent-rlinded. My
head ached. Moreover, I was frightened by my surroundings and
started at the slightest sound or noise. I was in agony because
of the moans of the patients, felt dread at the sight of a hypo-
dermic needle in the hands of a nurse, and was very depressed at
having to undergo injections. I talked neither to the patients
nor to members of the hospital staff and acted with distrust to-
ward the doctors. I feared my coming treatment although I did
not know what it was going to be and steeled myself for pain and
suffering. But my fears proved unfounded: except for a pleasant
sensation in the head during the treatment, there was no pain
whatsoever. In the next 2 - 3 treatments I began to notice that
my headaches and fear were decreasing, while at the same time my
apathy began to leave me. I began to feel alive. This period
increased with each day and each treatment. After 7 treatments
I succeeded in remaining in a good state f'or a whole day. I
felt the desire of wanting to mix with people, to work and live
at the collective. I should mention that during treatments I
entered a state of sleeps After the electrodes were attached,
I seemed to see flickering lights for 2 or 3 minutes and then
felt slightly dizzy as if slightly drunk. Throughout the body
my muscles started to relax, my breathing became deep, then a
certain forgetfulness, and finally, sleep. The condition of
sleep continued for 15 to 30 minutes after completion of a
treatment. Up to the present time I have had twelve such treat-
ments of electrical sleep. I want to emphasize once more my
desire to complete the entire tr..atment and return to my pro..
/r
fession.H
Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
 Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
The electrical activity of this patient was tested before
and after treatment. It gave results that were similar to those
obtained from prolonged amytal sleep with the exception that the
reduction in electrical activity observed during sleep was not
quite as significant. This is due to the fact that sleep in the
given instance is relatively lighter than in sleep caused by drugs,
Let us compare the oscillograms before and after therapy (Figure 1).
Without doubt we are on the way to developing a method of therapy
that would be in the full sense of the word Soviet and stemming
from T. P. Pavlov, By the character of its action on the patient
and its operation, it falls in line With the principles of solib
citude and humaneness of S. S. icorsakov.
The mission of therapy is the introduction into the net-
work of psychiatric institutions, primarily into the larger hos?
pitals, the most effective methods of therapy, with as few as
possible of those methods that show possible complications.
Among such methods rr1ay be included sleep and insulin therapy.
These should have first priority in scientific investigation for
the purpose of improving and simplifying the technique of their
application, thereby creating the possibility for their wide
application. At the same time electric shock in the practice
of therapy dominates all other methods; it occupies a central
place as a topic of study. This partiality should be considered
to be of a harmful nature.
Among certain investigators there is to be observed a
similar preoccupation with prefontal leu4'otomy. The theoretical
basis for it is to be round in the desire to exclude the possible
Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
 Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
onset in the lobal sections of irritations issuing from the thalamic
region, Technically the operation has been developed sufficiently
so that in the hands of such experienced neural surgeons as Pro-
fessor Babchin and Yegorov there are no bad afte of fects in most
cases. Actually in a nimiber of cases it brings about an end
to anxiety, a reestablishnent of contact with surroundings, and
an end to delirium with the possibility of at least a temporary
return of the patient to his family. However it is necessary to
distinguish between the initial and long-range effects. Thanks
to the courtesy of Doctors M. Ya. Grebliovskiy and. V. S. Ryaza-
nova of the First Rural Psychiatric Hospital we have been able
to obtain exact information concerning Lal patients of the course
of the disease subsequent to leukotomy. These patients were
transferred from Moscow psychiatric institutions because of the
non-effectiveness of the operation or deterioration taking place
after the initial favorable result from this method. We were
able to observe some of these patients ourselves in our clinic
where they were accepted for further study. We were able to
r
gather tha in a nurlber of instances there was a disruption of
delirium, depending no doubt upon the general deterioration of
the psyche, a disappearance of hallucinations, at the very least,
,n
a wearing of their effect upon behavior. There was observed in
some cases a derangement of speech of the organic type. All the
patients showed considerably lowered psychic activity which somew
tames presented a picture of complete apathy.
We consider this operation to be permissible only in
exceptional cases where patients are to be relieved of excitabil-
ity only after all other methods have been tried and where there
9
Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
 Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
is present a definite depression. Leukotomy must in no case
be considered an active method of therapy, Even if one does
not speak of its insignificant therapeutic effectiveness, one
still must remember that neither convulsion therapy, insulin
shock therapy, nor prolonged sleep ever bring on that picture
of total psychic depression which is to be observed resulting
from leukotorny.
Before Therapy
OD
Os
PD
Os
PD
rS
Figure l0
Before therapy OD and OS "- the electroencephalograms of the
right (upper) and left (lower) occipital zones of the cortex of
the brain, rihere is to be observed marked asyimnetrical variation
between the biocurrents of the right and left hemispheres. The
electrical activity of the left occipital region shows sharp,
lO -
Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
 Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
sudden variations expressed in modifications of the frequency
and amplitudes of the biocurrents, It is this that is respons-
ible for the "fragmentary character" of the curve.
PD and PS - - the electroencephalograms of the right
(upper.) arid left (lower) regions. There is to be seen the nor-
malization of electrical activity expressed in the disappearance of
the asyr>mletric fluctuations,
The essential problem in the field of therapy is its ac-
tivation and introduction of the most practicable methods into
the practice of psychiatric institutions, hospitals, and dis-
pensaries, There arises the ejuestiong To what extent has the
scientific-research work o? psychiatric institutes and clinics
been reflected in general psychiatric practice?
To determine this we made use of the data collected by
our Institute of Psychiatry. As an index of the activity of ther-
apy we determined the percentage of patients who had been treated
by insulin therapy, electric shock, sleep therapy, and blood trans-
fusions. In. this analysis there should first be noted the small
degree of application of active methods in therapy by the ma;jority
of psychiatric hospitals. Together with this it was noticed that
the existence of a connection between a hospital and a special
institute or clinic was responsible for most patients so treated,
It cannot be considered accidental that therapy is not carried
on intensively in those hospitals which have no connections with
special scientific institutions. There can be said to exist,
therefore, a gap between scientific-research institutions, institutes,
Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
 Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
and clinics and large psychiatric hospitals which is harmful to
the interests of therapy. The work of many hospitals in a number
of cases i~ not energized by clinics belonging to higher education-
al institutions in the same cities. Since there are 63 clinics
and 7 institutes it should be possible for every hospital to es-
tablish a connection with some scientific-research establishment
(institute or clinics) to serve as its guide. rihe benefit from
such a relationship would be mutual. The tone of the work would
be higher in the hospital, while institutes and clinics would ac-
0.
quire the possibility w-%h dealing with a lame body of material
therapy achieved during the war have been made little use of by
for their scientific work, This naturally refers to the new
methods of active therapy, these should include others besides
the ones already mentioned. Successes in blood-transfi.ision
lators and antibiotics. The results obtained from using peni-
psychiatrists. The same can be said for therapy using stimu-
should serve to direct attention in general to the role of anti-
cillin in treated syphilitic psychoses and progressive paralysis
biotics, The Institute of Psychiatry has been obtaining good
from schizophrenia caused by the toxic process in the intestines.
results in treating with penicillin complications resulting
Much profit could be gained in developing methods of physio-
therapy. lie have already referred to the little attention that
has been given to psychotherapy and work therapy.
The development of new, special methods of therapy,
especially those that can be classed among the active ones1 is
an important stage in therapeutic work. Insulin, sleep therapy
and other methods should not be paneeas but only one link in
Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
 Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
the general system of therapy carried on in institutions.
Active methods of therapy are used first of all in
schizophrenia, but there is also experience in treatment by
discontinuous sleep of manic-depressive psychosis. This
method may be used to advantage in the treatment of reactive
conditions and also in such sicknesses as ulcers and asthenic
condition following a trauma.
Psychiatrists now have sufficient experience in treating
psychic disorders following trauma to be able to successfully
carry on work in this field, A stimulus to this work should
be the knowledge of the fact that psychic depression of patients
of this kind is due not to destruction but to inhibition. This
fact, which we have noted, has been verified by A. S. Shmar~ yan.,
p
'
A most important problem is he therapy of e
ilepsy, No
doubt it should be included among those problems which are to
be studied in the immediate future. The use of electrical ac-
tivity has been very successful in the study of metabolism,
changes in the.physiological processes of the nervous system,
and the condition of chrona~de, But the same thing cannot be
said of therapy. It may be considered proven that the possi-
bility of cure exists when treatment begins at the very begin-'
ping. Drug treatment without doubt offers much in the sense
os suppressing attacks.
F?.eports read at the All-Union Congress and at special
conclaves on psychotherapy and logotherapy arm psychiatrists with
new data and assure the success of work in this field.
Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
 Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
Attention should be directed not only to special active
methods, but to activity in therapy in general, by applying to the
proper cases special methods, Successes in the field of patho-
physiology, and researches in metabolism may help the psychia~
trist select that system of treatment which best of all would
guarantee success, Symptomatic therapy also is very important.
At the present time it naturally should not be empi. ri- cal, For
it's foundation there should be clarified pathophysiological
mechanisms and changes in metabolisms
of exceptionally great importance is the creation of a
healthy atmosphere for therapy through a regime in which every-
thing relating to the case of a patient is planned out in ad-
vance of his arrivals
Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
 Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
CIA
FOREIGN DOCUMENTS DIVISION
4 February 192
STAT
STAT
TAT
COMBII\TED THERAPY OF PSYCHIATRIC PATIENTS WITH ELECTROSHOCK
AND SLEEP
author: M. Ya, Sereyskiy
Nerropatologiya i Psikhiatryia, No 3, 190, pp 28-3l
IMPORTANT NOTE: The content of this report is UNCLASSIFIED and may be
issemina e UNCLASSIFIED at the discretion of appropriate recipient
offices. If such dissemination is made, however, the RESTRICTED cover-?
sheet must be detached and neither the Central Intelligence Agency nor
the US Government be cited as the source of this work.
/This report has not been edited or
prepared for publication'
Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
 Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
COMBINED THERAPY OF PSYCHIATRIC PATIENTS HY ELECTROSHOCK AMID SLEEP
Professor M. Ya, Sereyskiy
Psychiatric 'Clinic of the Central Institute of Psychiatry of the
Ministry of Health RSFSR and the Central Institute for Advanced
Study by Doctor's of the Ministry of Health USSR.
(Received by the Editors 1L July 1911.5)
In preceding years, like many other authors, we made wide
use of soporofics where convulsive attacks in electroconvulsive
therapy had brought on a marked post-attack excitement or an in-
tensification of procedural symptomatology (syrrptomatika), Which
~1 l/ c+"~ ``~ i^t 4: C, Y ''~ S; ~~ ~p ' ~} ?`~i 1'tel. h *''4. ~
seryed- & an additional o ad tLo.r the body (somatika) of the pa-
tient. There was created the impression that such a preliminary
introduction of soporofics neiit-rai.i ed excessive muscular con-
fractions, sharp increases of blood pressure, and, possibly to a
certain extent, the derangement of memory.
Then. giving soporifics prior to electrotherapy, patients
would wake up and not experience fear with regard to further ther-
apy. This, among other things, helped rake it unnecessary to hold
patients by force.
The introduction of 1'barbami1'~ (barbitol amyl?) orally
or intravenously prior to provoking the attack eased the post-
coi:ivulsion condition without, however, showing any marked effect
on sleep ensuing after the attack. Incidentally, we already have
indicated quite some time ago that prolonged post-attack sleep
was a favorable prognostic factor. We referred to this in detail
both at the session of the Central Institute of Psychiatry in
193 and in an article entitled "Problems of Clinics and Therapy
Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
 Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
yth respect to Psychic IinesSu in the symposium of the
r
Psychiatric Hospital imeni Kashchenko in 1916. Shekhanova
( Ryazan' ) confirmed and widened our observations. We were suc--
ccsfui in noting a definite correa_atiorl between the post
e~
sleep p and the prognosis. If prolonged absence of sleep,
attack generally observed in the post-attack condition of a patient without any improvement in the clinical condition was trans-
formed into an onset of sleep after the attack, tb s quite
frequently presaged the start of a remission. If, on the other
which was usually present in a patient,
hand, postattack sleep,
disappeared, this was a negative sign.
.It would be interesting to know what influence post-
attack sleep exerts on epileptics. Unfortunately we were not
to find data of such kind in literature, so that at the
able
present time it is necessary for us to try to determine this
on the basis of our own material.
According to the findings of Golarld (Vladimir) in
treating epilept' cs by electroshock and by our owrl method, the
~.
number of spontaneous convulsive
period of treatrnent(in the first
y :a~ rR,, "t ,fir ' 4 `~+ 1
troshoclMppM~, toe, with
attacks decreases during
the
type of treatment
ou'(method six times). How-
ever it is true that the frequency of attacks 2 to 3 months
after therapy both by the one and the other method reverts to
what it had been formerly. Sleep as a favorable factor is con.-
firmed d by y exCperiments we are carrying on at the present time
in treating epilepsy by the method of prolonged sleep.
?16-
Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
 Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
By what method is it possible to achieve prolonged post-
attack sleep?
Large doses tl~at ordinarily prolong sleep raised the
'tthreshold of disposition to convulsions" to such an extent
that an attack which is an essential and necessary element in
therapeutic reactions, would never take places
The method proposed by us has for its component a single
rectal dose of 0.5 to 0.8 of barbel (barbitol amyl?) immediately
following the end of the clonic phase oJ' the convulsion attack. The
action of soporifics when administered rectally is very close in
essence to the action of the preparation when administered intern
ally. In our case the soporific lodged in the lower part of the
rectum enters the 'Jena cava inferior by way of the lower hemorr
hoidal veins from where it goes straight to the heart. The rectal
introduction of sodium amytal causes patients to go into a deep
sleep lasting from lL to 20 hours, although they wake up usually for
a short period during the 5th to 8th hour, at which time it is
possible to feed them. During this interval patients show an
insignificant deafness.
It should be noted that in therapy with prolonged inter-
rupted sleep brought on by barbarnil ( barbitol amyl? ) it is nec-
essary to give a repeated dose of this soporific (on the whole
up to 1.5 to 2.0 per 2L. hours) to obtain a daily sleep lasting
from l~ to 22 hours (Tarasov, according to data from our clinic;
Y abl on skaya) .
How can one explain the surprising fact that bare
Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
 Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
(barbital amyl?) when administered rectally at the end of the sub-
silence of the convulsion attack produces a sleep lasting many
hours, while when administered prior to electroconvulsion therapy
it produces only a short sleep ('half-hour)?
We are inclined to explain this in the following manner. It
is essentially related to the tact that with our method barbiturates
(possibly G axii with bromine, about wha.ch more will be said be
low) fall on a soil which is favorable to narcotic action and act
in unison with the basic condition.. We have in mind the a;ggraw
vated hypoxemic condition (marked cyanosis, disturbance of breath-
ing, etc.) caused by the provoked convulsive attack0 This hypo-
xemia plays the part of protective inhibition (Sepp, Ravkin),
Moreover, barbamill (barbitol amyl?) is given at that phase of
the epileptic attack when it is passing into the state of deaf-
nets and sleep. Finally, one may suppose that an intensifica-
tion of inhibitive action prior to the onset of the deafness phase
results from the conjunction of the narcotic preparation with
the abating, but neverthelessstimulating, influence of the end
of the electroconvulsion attack. We can see this type of inten-
sified inhibitive action in the example of the combined use of
v' I
barbiturates with small doses of caf ane. ?u such a corn-
bination one can to some degree see a certain element of thera-
peutic action similar to the combined use of barbamil (barbitol
amyl?) with caffeine.
As the work of Glasov and others have shown, electrical
current through a bitemporal application of electrodes, even
Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
 Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
if the bones of the skull remain intact, passes primarily through
the mezoenCephalic region. Thus Glazov investigated the paths
the brain in transcutaneous electrificaw
of the current through
Lion. He struck into the brain thin electrodes which were
insulated up to the tip and connected them to a sensitive gal-
ter He noticed. that when the electrodes only penetrated
vanome
to the cortex the mirro of the galvanometer remained still
after the current was turned. on, but when the electrodes were made
to penetrate further, it began to respond, On the basis of these
.
carne to the conclusion that most of the current
expera.rnents Glazov
res through the base of the brain and acts on the subcortical
pass
core. This was corroborated by G1azov' s experiments with ani-
mals where current was made to pass through the brain after the
cortical and subcortical layers had been administered a narcotic.
He concluded that electrical, currents intensify the effect only
with. "core narcotics't.
Aleksander disputes earlier beliefs that electrical cur-
rent passes in the animal organism through the length of the nerve
span and along the wider blood vessels. His experimental investi-
gations clearly show that electrical current passes, as it were,
along the structureless mass and always prefers the shortest
route without being deviated along anatomical- landmarks from
contact to contact.
In bitentporal application of electrodes, which is the usual
procedure in electroconvulsion therapy, the current while traveling
in the fora of a spincfe?shaped cluster between the electrodes passes
through the anterior polus n. tentatus. If the electrodes are
a
Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
 Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
gradually moved to the rear to the extent that they finally are in
a
a biparietal position, the current begins to pass through lamer
and larger masses belonging to the subcortical formation (in the
biparietal position for the electrodes the current passes d7rect~
ly through the visual mounds). In this connection, the observa~
Lions of our associates (Rotshteyn and Kononovich) have shown,
the more encompassing the mass of tissue comprising the subcorti-
ca/ nodes through which. the current passes, the smaller the mini-
mal dose of electricity required for convulsions (both from the
point of vc ew of amperage and the point of view of voltage).
A convulsion attack caused by electrical current is closer
C
in essen e to subcortical than to cortical epilepsy. ~i'here ex-
ists experimental. verification for this (Rizer and others). In
work carried on at the Brain Institute, I, together with S. A.
;arkisov and F. M. Lisits, was able to show that in experimental
epilepsy convulsion discharges of the brain quickly spend them-
selves, whereas they repeat for a long time in subcortical forma-
tions.
Attacks caused electrically are attacks of a complex mixed
type, primarily of a subcortical character, which are joined and
followed by attacks of a purely cortical character. Even in
electroconvulsion therapy electrical current, as we have already
shoran, directing itself primarily into the mesoencephalic re-
.ion acts directly on the core of the brain, and thus creates an
experimental It acute diencephalitis'~.
It is valid to admit that the creation of an attack by
Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
 Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
electrical current directed primarily at the region in the
vicinity of the hypophysis cavity, sensitizes that region
(in particular those parts of the brain which have a direct
connection with the regulation of sleep and the awakened state)
and makes it more susceptible to the action of narcotic poisons.
An indirect but altogether pertinent proof of the role of sub-
cortical soporific preparations is to he found in the fact that
when we substituted for barbiturates cortical poisons (pantopon,
morphine) we were not successful in obtaining prolonged sleep.
We should. pause to consider here several experiments
which, however, were carried out on animals. Electrical current
on being primarily directed in the direction of the region in
the vicinity of the hypophysis cavity, causes an irritation of the
hypophysis which leads, in accordance with the latest findings
of the Qrbeli school (Tonkikh, Moiseyev, and others) to an in-
tensified secretion into the bloodstream of hasopressine and a
bromine-Containing hormone. In this connection, it should be
noted that bromides have the faculty of entering into intimate
chemical processes which apply to the inhibition process and for
a time stabilize it. In bringing this data together we did not
forget to take into consideration that it refers to experiments
on animals and that it cannot serve as direct proof for acting
in the same way on man, A. V. Tonkikh in referring to the
participation of hypophysis in the genesis of lung ailments in
animals pointed out that analogical mechanisms should be considered
to e dst in hum. n pathology.
If it should prove possible to show by direct experiments
Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
 Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
an increase of bromine in the bloodstream of a human being while
undergoing electroconvulsion therapy, with which we are busy now and
which we consider to be quite probable, then, by introducing bro-
mines by the rectal method, we would be achieving a simultaneous
combined presence of barbiturates and bromine, This should re-
suit not in a simple arithmetic total but in a marked intensi-
fication of narcotic action. When carrying out experiments
(together with S. A, Khachaturyan) in 1930 on inducing artificial
sleep in monkeys through intracerebral administering of a mix-
ture of the so-called cortical and subcortical poisons, we were
able to learn that the individual introduction of cortical (bro-
,rdne) or subcortical (barbiturates) poisons into the diencephalon
region evoked a considerable smaller soporific effect than their
combined action,
The method we propose has special features which distin-
guish it, as will be noted below, from regular electrocanvulsion
therapy and from therapy by prolonged sleep. We were able to
prove in our initial work on prolonged sleep that the therapeu?
tic effect by the latter method does not merely result in the
single factor of sleep. Incidentally, we computed the average
length of sleep per twenty four hours for a group which had a
remission in therapy with barbarnil (barbital amyl ?) sleep and for
a group which did not have one. The number of hours for the latter
group proved to be somewhat higher, 16 hours as against 15
(according to the findings of Yablonskaya).
How can we prove theoretical the value of the combined
use of electroshock with soporifics?
22 M
Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
 Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
As is known, an increase in the number of convulsion
seizures increases all manner of changes in the organism.
Thus there are indications that the intensity and duration of
abnormalities to be seen on electroencephalograms is proportion-
ate to the number of attacks, According to our findings during
the course of electroconvulsion therapy there is disclosed a defin-
ite tendency in the direction of a dynamic modification in meta-
bolism from attack to attack, It is particularly interesting to
note the dynamic increase in the initial contents of albumin
in the blood stream,
Furthermore, there are indications that a connection exists
between the number of attacks after electroconvulsion therapy and
the growth of ''rnnestichenskiye" (mnemic ? ) disturbances. However,
this type of disturbance is sometimes to be observed even after
the first attack, while in other cases it does not occur even
after numerous attacks. This depends, as we have noted, on in-
dividual predisposition, the position of the electrodes, etc.
It has been asked whether or not it is possible to coun-
teract to any degree such or similar disturbances, We see such a
possibility to exist in our proposed method. We know that nar-
cotics stop the further development of seizures in experimental
epilepsy and stimulate the reestablishment of functions that had
been disrupted by the attacks, Thus Lf in the process of an at-
tack there is to be noticed a decrease in the contents of liquid
in peripheral blood, an application of ether narcotic at the same
time that the attack is provoked causes the contents of the water
to remain normal; the morphological character of the blood is
-23-..
Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
 Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
normalized. A lowered
tAJ 'ter content is to be noticed in the
i
brain during a seizure, while the application of a narcotic
brings it to normal; this applies particularly to the core
of the brain. Similar findings have come from a number of ex
pcrv -
rents carried out in Galkin Laboratory (Sakharova, Baranovskiy,
Fedorov, S edina) .
The researches of Asratyan and his associates (Sakhiu~
1,inaGlirova Romanovskaya, Ivanov) and of Dolin on traumas of
, ,
the brain are of much interest to the question on hand. The
f1zld se persons present the general conclusion that
~.ngs of the
soporifics as a rule speed up the restoration of disrupted func-
tions in the animal organism and increase the stability of the
restored functions.
Thee deserveiat'tention, in the light of what has been
said experiments (+::;I Geyl bx urn ants Beyl' ) indicating a way of
a
preventing nting hemorrhages in the brain whale provoking convu~siOn
seizures electrically. It was shown that a preliminary injection of atropin into rats, synthetic Vitamin K, and calcium
xluconate before provoking a seizure did not prevent this type
of hemorrhage, which prevention was successful only by simul-
taneous administering of ether narcosis. Incidentally the
findings of G. A. Rotshteyn and Kononovich proved this does not
correspond to the facts with respect to Vitamin K.
Assuming such an a priori opinion and such general patho-
ph,lysioloical and clinical considerations I, together with M. S.
Zeleva L. I. Lando, and M. A. Bunder, began to investigate and
w
2L
Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
la
rk
 Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
apply our proposed method. practice has confirmed our hypotheses.
'We carried out approximately 1~OC therapeutic treatments
on 5S2 patients. The majority of the patients were schizophrenics
tV ?-
( 38), while li were observed to have a typical manic-dePresst
a.
psychosis, although they had been sent to us diagnosed as schizo
brews. Almost all of the patients were chronic cases. The
p
clinical picture showed that the majority showed the presence of
a depressant componentemission of type J and B was observed
for 26 patients; a year's followip did not disclose any relapse
among them. Seventeen patients showed an intrahospital improve-
went but the condition of the patients neither changed nor de-
s
teriorated. Of course, we consider these findings to be pre-
li1Tjina . Its general etectiveness, as shown by the findings of
~Y
our clinic and that of the Psychiatric Hospital imeni Kashcheflso
Povolotskaya, Khokhulya, Che'oysheva, Yakovleva), seems to be
somewhat higher than for ordinary electroconvuls.on therapy, but
dy of material is not sufficiently great numerically for us
the body
to insist on this.
Let us begin by stating the fact that with the first treat-
vent there is established good sleep at night which continues to
hold true in the intervals between treatments; the same cannot be
said for single daily doses of soporifics which quite frequently
disrupt sleep at night. It should be pointed out that the "con-
vulsion dose" for bringing on a seizure remained constant throughout
the entire period of treatment. Furthermore, there is observed in
oconvulsion therapy a certain pattern for the unfolding of the
electr
Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
 Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
seizure and for the concomitant complications (such as a psy~
chomotor excitement); with our method this pattern either
completely or partially disappears - aggravated somato-vege-
tative manifestations taking place during the firstreatment
generally begin to fade out gradually while later attacks take
place without any manifestation of disturbance of the vascular
system or respiration. A dynamic study of the pulse, breathing,
blood pressure, temperature, etc., disclosed a smaller ampli-
tude in the scope of their fluctuations than either for electro~
c-onvulsion therapj or pharmacological convulsion therapy.
Our method proved applicable for a number of cases with
vital somatic indications connected to a psychotic condition
(a
e fusal to eat, marked emaciation). All the patients who had
been refusing to eat began to eat of their own volition after
the first treatment, while later, in contradistinction to what
observed in electroconvulsion therapy, refusal to eat was not
to be observed. regardless of the psychic condition. A number
of investigators (T'arasov, Yablonskaya, etc.) point out that
under sleep therapy patients eagerly accept food and gain in
weight.
is
In complete agreement with the special features indi-
cated above for general somatic changes showing smaller ampli-
tude of fluctuation in combined e:Lectroshock and sleep therapy
are our own biocherrrical findings for 26 patients, of whom 9
had an atypical form of circular psychosis, 9 with a circular
form of schizophrenia, and Q with various forms of schizophrenia
( catatonia, etc.). The majority of these were chronic cases.
w
., 26
Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
 Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
The first attack does not show any marked Jiff erence from that
of electroconvulsion therapy, for here there were also to be
cM.ZY
noticed sharp responding metabolic reactions (an increase of
albumin in blood-serum, a decrease in the coefficients of "A/G"
andttK/S&t, and an increase of sugar and lactic acid).
Later the cornbination of convulsion seizure and sleep
bring on a reconstruction of the chemical nature tissues;
treatments, as they succeed one another, take place on a modi-
fled soil and give a changed expression for metabolism. The
amplitude of fluctuation of these two coefficients is definitely
,y
smaller than in the case of eiect,roconvu.lsion therapy. It should
bears evidence of~ the instability ofalbumin
W considerable instability of albumin portions' a
be noted that the
manifestation which is characteristic for aggravated somatic ill-
I, Y
~d also for acute rc ehizophrenia (Yablonslcaya and Ignatov)
nesses ,
al
4Je observe this instability among schizophrenics with a remission
onset in electroconvulsion therapy. Among the majority of pa-
tients who had remissions there was a certain increase of the
A /G coefficient after the seizure which began as a rule with the
thirty-fifth treatment because of the increase of albumins. In
patients who had no remissions, as well as in cases showing a
deteriorated condition (both somatic as well as psychic), there
was to be observed a large variation in biochemical indexes and a dep
crease in the A/G coefficient, In contradistinction to electro-
convulsion therapy, but most pertinent and characteristic, there was
to be observed the condition where the expression of the general
albumin from attack to attack did not disclose any tendency toward
increase and was observed throughout the entire period of treat-
'~mw'^'-
... -."--.---..
Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
 Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
merit to have only slight fluctuations to one side or the other.
What is the mechanism of these changes?
Parallel experiments carried out one time jointly with G. A.
Rotshteyn on dry residues from the blood gave no basis to attri-
bute this increase to thickening of the blood, inasmuch as there
had occurred an absolute increase of albumin, A considerable in-
crease of sugar and chlorides in the blood after a convulsion
seizure lead to the surmise that this might have been caused
(while applying the refractonletric method) by increased ref rae-
tion of chlorides and sugar. A specially prepared solution con
tai.ning chlorides and glucose according to their contents in the
blood during the period of emerging from a convulsion disclosed
an insignificant refraction which could not have been signifi-
cantly influential in the results for determining the albumin,
There was considerable basis for relating the increase of albumin
to a change in the functions of the liver,
In our report at the Third All-Union Congress of Neuropatholo-
gists and psychiatrists CNevropatologiya i Psikhiatriya~ 17, 6, l9L.8)
concerned with the achievements and prospects of active therapy of
psychoses we indicated that an increase of albumins .~ such a progres-
sive fraction should be thought of as a favorable factor which as-
sisted in the restoration of disrupted functions, particularly
disrupted hydremia. As is known, electroconvulsion therapy brings
on an accumulation of water in the brain, while an increase of
the albumin fraction assists in the transfer of water surplus to the
blood and increases the electric potential of the blood,
M2g,.
Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
 Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
In my work together with L. I. Lando ('Nevropatoloyiya
i Psikhiatriya, , 6, 19L6: Byulleten1 Eksperirnental' noy
Biologii i Meditsiny, 221k, 1, 19L~7 and 2L, J, 19 7; Sborr4
Irudov Tsentral' nogo Instituta Psikhiatr% N, 19L~8) concerned
with permanent results of electroconvulsiOn therapy, we point
out that an increase in the sugar content in the blood during the
process of therapy may be considered to be a favorable factor
to the degree that there is a tendency in schizophrenia to
lowered indexes for carbohydrates in the blood. The observed
systematic increase in electroconvulsiOf therapy from the time
of one attack to another of initial quantities of the total
amount of albumin we are inclined to consider as being a sort
of slag, which could hardly be said to have any positive value,
This increase of albumin could hardly help disturb us since a
hyperprotein condition typical for many serious somatic ill-
nesses even among this kind of patients (in particular for
schizophrenia) is often observed to be accompanied by a marked
loss in weight in spite of adequate nourishment (such at least
are our observations which have been confirmed by ablonskaya
and Ignatov). In using our own method we do not observe a
comparable increase.
Biochemical investigations made with respect to a nurter
of patients for several months after they had completed their per-
iod of therapy by the method in question disclosed among those who
had remissions a tendency toward normalization of metabolism
(albumin coefficient, albumin and globulin fraction, sugar, lac-
tic acid, potassium/calcium coefficient, chlorides). Patients
Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
 Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
remission or no remission whatsoever showed
who had an incomplete
a normalization of dual sAp ecies oi' metabolism, most often
~-ndtvn.
carbohydrate, while at the same time indexes of albumin and mineral
raetaboli.sm remained pathological.
Let us cite an example.
Patient K. (case history' No 27G)
Control biochemical investigations th respect to patients,
~barbarnil. (barbitol amyl ?), disclosed
who had received only one _.
an insi_gnifa-cant fluctuation of the total album n, the A/G Go-
other indexes. There ~.s created the irnpresSJ.on
ea.iicient, and
roistering of soporifics and the prolonged sleep
that the adm
they bring on aid the preservation o the stability of the in-
ternal habitat.
s the fact that the magnitude of the A/G
Th:Ls explain
and other indexes during the time and an hour after
coefficient
r ht am litude wave in contrast to c1as.:>>i?
treatment disclose a all., p
cal convulsion therapy.
Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
 Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
Case History Total Al- A1bup Globu- A/G Co- Sugar in
No 2570 burriin minx lin efficient Percent of a
Milligram
in Grams
First Treatment (20 January 197 )
Before Combined
Treatment 73 3.5 3.8 0.92 71
During Shock 8,5 3. 5,1 0.67 82
Third Treatment (2L January 1947)
,f
Before Combined
Treatment
7.2
2.7
11.5
86
During Shock
7.8
3$
4.3
0,81
95
Sixth Treatment ('31 January 19117)
Before combined
Treatment
7.5
2.7
11.8
o.56
86
During Shock
7,6
3.1
11.5
0.69
102
Four Months After Completion of Treatments
7113 11.6 2,7 1.7 85
We emphasized the intimate connection between the tendency
toward remission and the protein condition. The method we have been
describing gives additia1 proof that the /G coefficient can give to
M31 ..
Declassified in Part - Sanitized Copy
Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
 Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
a certain degree prognostic assistance as well as indications
relative to the merit of continuing or stopping the course
Of treatment. In cases in which there is no remission we gen-
erally notice a considerable variability in the contents of the
to?bal albumin in blood-serum and in the A/G coefficient, as well
as a tendency for a decrease of this coefficient because of an
increase of the coarse dispersion fraction. In cases where there
is remission, the picture of an (inverse) decrease of the albumin
fraction should be evaluated as a bad prognostic factor, which,
in all probability, is connected with the nervous effect of
convulsion therapy on the cerebral mechanisms, in particular
on the vegetative centers, and this, as we have shown in
previous work, leads to a secondary modification of metabolism.
Hematological investigations are in complete agreement
with biochemical findings relating apparently to the non-specific
neurohumoral segment. According to our method the effect on
erythropoese and on leucopoese shows the same tendencies as in
electroconvulsion therapy with the only difference that the ob-
served changes are not as marked and return more quickly to the
original state (Vun der). Thus the leucocyte reaction is also
in leucocytes is less sigN nificant than in electroconvulsion therapy. In ther//~
f w; . S1JVU rW .rln ....:.Ui::,atY.?wAYNMNU31t11 Ni 11 '. "UG?r 1Jf.lr?vd1?ti.,ndAdIliayJUV{yp1XMl.1y4.;.f.7~'
expressed Y after the attack but the increase leucocyteL for-
mula there is also to be observed a significant weakening in the
displacements of those elements which are more sharply expressed
in electroconvulsion therapy, thus, eosinphiles do not show any
tendency to decrease or disappear. Not a single time was there
noticed a predominance of myeloid tendencies in the neutrophile
reaction. A reticulocyte reaction causes a fluctuation in the
Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
 Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
direction of increase irrllnediately after a seizure accompanied
by a return to the original figure. The number of erythrocytes
has a tendency to increase irrfaediately after a seizure, but then af?
ter a period of 15 minutes it begins to increase.
All that has been said offers a sufficient basis for em-
phasizing certain advantages of the method we are proposing
over the usual pharmacological and electroconvla,lSion therapies.
Active therapy is connected to a number of inescapable
disturbances in the organism, a part of which is indissolubly
and intimately bound. to the actual process of positive thera-
peutic action ( this is expressed in the stimulation of the central
vegetative apparatuses, which is connected to the desintoxicating
action of electroconvulsion therapy already discussed in a number
of earlier reports), while another part abets the onset of compli-
cations and interferes with the appearance of remission. It is
necessary to take all measures that would reduce to a minimum
qs,
these unfavorable factors arid thereby work still fuiher in the
direction of making active therapy more humane.
Our method seems to make a contribution to some degree
A careful cat gestic study of patients who had been
treated with prolonged unbroken sleep in our clinic (Geshelina
and Lyusternik) showed the tremendous effectiveness o1' this
method of therapy. ore than 60 percent of patients who had
reraissions remained in this condition for more than 10 years.
Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
 Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0
Treatment by y prolonged sleep, initiated by us in 193, re"
ceyved at that brae the warm approval of I, b. Pavlov. In
our method we see the efficient combination of the factor of
with
sleep proven and tested/electroconvt~.si.on therapy.
As we have already indicated in our article dedicated. to
T. kPavlov stiml~l ati on by e1ectroconvu1.5i0n therapy first
. ,
effects a change in the vital protopathic region and then ir~
radiates for a very short period in the direction of the cortex
brain. We succeeded in proving this quite convincingly
of the
by the method of conditioned reflexes. At the present time
nt data to prove the physiological value of
there is suffa.cie
combined therapy y from the point of vier of I. P; Pavlov' s teach-
first glance the combination of stimulating and narcotic
ings. At
aradoxical. besides convulsion therapy
action woulcl seem to be p
not only does not contradict the protective inhiition theory
creates in itself certain tendencies toward the onset of
but
additional protective inhibition as a result of the acute ex-
haustion that takes place daring; a convulsion attack. This,
incidentally, expresses itself in such a way that sleep takes
place a.1raneda.atEly after the convulsion attack and it is this that
to when speaking of protective inhibition. This additional
we refer
jnhibitiofl, induced aaificially, is made use of in our proposed
method of combined therapy.
[ End of Article]
Declassified in Part - Sanitized Copy Approved for Release 2012/05/10 : CIA-RDP82-00039R000100230006-0