["Even electricity cannot work wonders!". Neglected achievements by German psychiatrists around 1880 in the treatment of depressions and psychoses]

Abstract

Parallel to the recent reneurobiologization of psychiatry as a subject, therapies based on electricity and elektrcomagnetism are returning to mental health care. Around 1880, the application of brain stimulating treatment on patients was particularly popular among German psychiatrists. This fact has largely been ignored in historical psychiatric research as present day practices, in particular deep brain stimulation (DBS), have frequently been seen solely within the tradition of brain surgery. Against this background the present study aims to revive the first trials of non-surgical electrical brain stimulation on depressive and psychotic patients, highlighting a 2-part study published by Wilhelm Tigges. It was Tigges along with Rudolph Gottfried Arndt and Wilhelm Erb who tried to establish clear rules on the most beneficial application methods and doses. Interestingly, Tigges's therapy was successful in cases of severe depression with chronification potential, i.e. precisely the clinical picture for which brain stimulation therapies are reserved today as a last option and ascribed an easing and even curing potential. Trigges also found that electricity produced almost no positive effect whatsoever with madly insane patients and hence anticipated the current non-application of DBS on these patients. After 1890 electrotherapeutic approaches in psychiatry were marginalized, first and foremost as no clear and reliable rules could be verified for their application, nor could their mode of action be fully explained. The success of electrotherapy in psychiatry was also restricted due to limitations of the time, namely (1) electrophysiology only emerging as a discipline, (2) the electrophysical medical apparatus industry only beginning to be established and (3) the lack of generally accepted guidelines and electrotherapy restriction to individual, barely generalizable experience (eclecticism). Present day applications of electricity, mainly DBS, have overcome these problems.