Choc acétylcholinique

Acetyl-cholinic shock has been proposed in the Forties, as a treatment for schizophrenia, by the Italian Professor, Adamo Maria Fiamberti. The present writer feels it might be justified to analyze the theoretical foundations of this therapy, as, in the first half of the twentieth century, two varieties of direct action on the brain (malaria therapy of Wagner von Jauregg and lobotomy of Egaz Moniz) have been awarded by the Nobel Prize. This reward has obviously stimulated research. At approximatively the same time, an epidemiological study by Nyiro and Jablonsky concluded there existed some kind of antagonism between epilepsy and schizophrenia. This conclusion led Laszlo von Meduna to use Cardiazol (Metrazol) as a therapeutic agent, and, finally, Cerletti and Bini to realise electric shock therapy, while Sakel advised insulin coma treatment (Sakel was aware that, in some cases, insulin coma would generate convulsions). Fiamberti's suggested therapy followed the same path, but, beside, used the recent discovery of neuro transmitters in the brain (their presence in the peripheral nervous system was known, since the beginning of the twentieth century). The present paper describes techniques used by Fiamberti and describes some of the unwanted side effects. Among those, two appear to be rather alarming - mydriasis lasting a few minutes and fibrinolysis of the clot, which has been described by Soviet transfusionists (Yudin), as occurring regularly in patients who died of sudden death. Yudin used cadaver blood for transfusions. All these therapies are actually using either total rest (as did the often lethal cure), or, on the opposite, a kind of organismic jolt. Finally, only the electric shock has survived, though we do not know yet how it functions.