Images from the Burden Neurological Institute

Recently I went to see the Wellcome Collection’s “Brains” exhibition, where one of the display cases featured electroconvulsive therapy (ECT).

In the case there was an early ECT machine, some rubber mouthgags manufactured by Ectron (a somewhat older version of their current model) and a Royal College instruction poster from 1982 which summarised “the principal points of good technical practice”.

The caption seemed slightly confused: “From the 1930s until the 1980s, physicians thought the key to effective ECT was the severity of the seizure”. An “adequate” seizure is still thought to be necessary; as for the convulsion I don’t think it was ever seen as important therapeutically and, in any case, the gag is designed to protect the mouth from damage caused by the action of the electric shock on the facial muscles, rather than from the convulsion.

Beside the case there were clips of film showing people undergoing ECT in the 1940. There was a warning about the film containing images that “some might find disturbing”. A viewing hood had been installed after people fainted in the exhibition (I don’t know if they were fainting at the ECT film – there was also a brain surgery film elsewhere in the exhibition) and you were given a postcard at the entry to the exhibition warning you not to go in if you were prone to fainting.

The first film was a Wellcome Trust 1947 film which showed someone receiving ECT first without, and then with, an anaesthetic and muscle relaxant. It was a useful reminder that there is nothing “new” about modified ECT, although people were still occasionally being given unmodified ECT in Britain into the 1980s and, in many part of the world, still are.

The other film was taken at the Burden Neurological Institute in the early 1940s and showed two people, a man and woman, undergoing unmodified ECT, that is without anaesthetic and muscle relaxants, so they had a convulsion. First was the woman. She was wearing pyjama bottoms and was naked above the waist. Next was the man and at first sight he appeared to be wearing a vest as well as pyjama bottoms although on closer inspection the vest might have been painted on. I have been trying to think of a good reason why a woman would need to be naked above the waist whilst undergoing ECT. It reminded me of something I had come across when I was looking into the history of the Burden Neurological Institute for a previous post. In a 1933 volume dedicated to the memory of the late Reverend Harold Nelson Burden, there was a chapter by Dr Richard J.A. Berry, director of medical services at the Stoke Park Colony (where the Burden Neurological Institute had been set up), entitled “Mental deficiency pictorially recorded (enlarged and extended from the British Medical Journal 29 October 1932)” which featured poignant photographs of girls and women facing the camera in rows, first with their uniforms on and then naked except for knicker-like garments. Again, there seemed to be no good reason for showing the women’s breasts.

The label to the film clips in the exhibition told people that they “came from a period when procedures for obtaining consent for filming were less carefully considered than they are today”. Was that intended as an apology, a reminder, an invitation to reflect on matters relating to consent, or what?

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