Ugo Cerletti

Following medical studies in Rome and Turin, Ugo Cerletti specialised in neurology and neuropsychiatry, studying in Paris with Pierre Marie (1853-1940) and Ernest Dupré (1862-1921), in Munich with Emil Kraepelin (1856-1926) and Alois Alzheimer (1864-1915), and in Heidelberg with Franz Nissl (1860-1919).

Cerletti was subsequently appointed head of the Neurobiological Institute, at the Mental Institute of Milan, and in 1924 received a lecturing post in Neuropsychiatry in Bari. In 1928 he succeeded Enrico Morselli (1852-1929) in the Chair of the Department of Mental and Neurological Diseases at the University of Rome, where he developed electroconvulsive shock for the treatment of several kinds of mental disorder, a discovery that made him world-famous.

In Genoa, and later in Rome, Cerletti 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 from the observation that epilepsy with its grand mals and schizophrenia didn't seem to occur together often. He also watched pigs being anaesthetised with electroshock before being butchered, in Rome. Cerletti first used ECT in a human patient, a diagnosed schizophrenic with delusions, hallucinations 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.

Electric shock treatment quickly replaced insulin and Metrazol as the favourite form of shock treatment, and became the most effective method of controlling troublesome asylum inmates. In the succeeding years, Cerletti and his co-workers 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.

Before the introduction of electroconvulsive therapy, it was known that accidental death by cardiac arrest could result from as little as 70 to 80 milliampères in the human. It was also known in this early period that voltage applied to the head, as in legal electrocution, produced haemorrhage and rupture of cranial contents. Ugo Cerletti demonstrated that electricity in the range of 100 volts and 200 milliampères is rarely fatal when the current path is confined to the head, but does evoke a grand mal seizure marked by a stereotyped succession of events. 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.

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, neurosyphilis, etc. In 1950, he received an honorary degree by the Sorbonne (University of Paris), in addition to a long list of awards and degrees.

We thank Johannes van der Schaar for information submitted.

• L'Elettroshock.
  Rivista Sperimentale di Frenatria., 1940, I: 209- 310.
• H. Baruk:
  Professor Hugo Cerletti.
  Bulletin de l’Académie nationale de médecine, Paris, 1966 Nov 8, 150(28):574-579
• E. Edea:
  Ugo Cerletti.
  Archivio di psicologia, neurologia e psichiatria, 1966 May; 27(3):198-202.
• L. B. Kalinowsky:
  History of convulsive therapy.
  Annals of the New York Academy of Sciences, 1986;462:1-4.