László Meduna's pilot studies with camphor inductions of seizures: the first 11 patients

In his autobiography, László Meduna described the first session of convulsive therapy using intramuscular camphor as occurring on January 23, 1934 at Royal National Hungarian Institute of Psychiatric and Neurology at Budapest-Lipótmezo in Hungary. Unearthed records of the patients treated at this institution reveal that Meduna's dose-finding experiments began on January 2, 1934. The symptomatology and history of illness, diagnosis, socio-demographic data, the seizure characteristics, and immediate and long term outcomes of the first 11 patients are described. These first trials elicited seizures in less than half the injections. Seizures of various durations (including missed seizures) and double (tardive) seizures were recorded. Mutism, refusal to eat requiring tube feeding, and other signs of catatonia dominated the psychopathology of 7 of the first 11 patients. Two improved sufficiently to be discharged from the hospital and third patient became fit for occupational therapy. These records exhibit the meticulous systematic nature of the first human trials with induced seizures and the fortuitous nature of the first human trials with induced seizures and the fortuitous nature in patient selection of catatonic patients--an illness that is most responsive to induced seizures.