Abstract
1) The author divised a modification of E S. T. in which the shock was given just at the moment when the effect of S. C. C. reached the peak and at the same time the central anticonvulsive action of Thiamylal Natrium, a ultra-short narcotic, vanisched. The timing of the administration of both agents and electrigation was determined accurately so as to fit this purpose.
2) In this method E. S. T. is administrated under complete musclar relaxation, nevertheless, the feeling of suffocation accompanying strong anxiety, besides the reduction of therapeutic effect and the danger of respiratory paralysis due to Barbiturates could be perfectly prevented. Therefore it is regarded not only as a ideal clinical procedure, but as a beneficial method for the investigation of central changes induced by E. S. T. without the influences of general convulsion.
3) The symptoms of autonomic nervous system i. e. pulse, blood pressure, pupilary finding etc. and the findings in C. B. C. observed in the course of this treatment were just the same as those in unmodified E. S..
This proves the fact that there is no central inhibition of convulsion, and that muscular convulsion has nothing to do with the changes described above.
4) The change of blood sugar induced by this method was far less than that by unmodified E. S. and less than that by E. S. under narcosis with Barbiturates. It was clarified that the change of blood sugar should be regarded as induced, not centrally as believed hitherto, but by the muscle action during convulsion.
5) The electrocardiogram showed tacnycardia and a little elevation of ST and T waves in V1 record, during convulsion.
6) The brain wave showed in complete spike and wave complex during convulsion.
This finding, alike the electrocardiogram above mentioned, is significant as that gotten during electroshock therapy without influence of muscle discharge and narcosis.
7) It was recogneized that the therapeutic effect of this method was superior to that of unmodified E. S. and E. S. under narcosis with Barbiturates, judging from the numbers of treatments that were enongh to bring about full remission of depressive patients. It is presumed that the effectiveness tdepends upon the length of the duration of convulsion.
