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                  <text>-

October 11, 1986

.“W—Wr

Alexander Gralnick, M.D.
High Point Hospital
Port Chester, New York 1057 3

~

Dear Al,

ﬁwvvm—m-Nwmwww—mx—wmrww

Thank you for the fine old reprints. I very much enjoyed reading the article

on meningioma, as this remains an active topic of research and argument.

Mark Altschule‘s recall of the milieu vs shock therapy controversy hinges
on an assumption that he makes that modern 'shock therapy' has as poor a
clinical efficacy as the swing therapies of old. He is probably correct in his
estimate of insulin coma, but incorrect in the modern use of convuslive therapy.
With the introduction of psychotropic drugs, it was pomible to develop a strategy
of treating the severe mentally ill with the most effective intervention for their
syndrome —and, as you well know, the efficacy of ECT in patients with sevre
depressions and catatonia remains unmatched by all other therapies, including
milieu and psychotherapy.

-

wvr-zuu—w»

continue to look for old articles and books from the inception of the
'modern' shock therapy era, and I will be grateful for any other books or articles
you may find in your archives or shelves.
I

,

My

best regards.
Sincerely yours,

Max Fink, M.D.

Professor of Psychiatry

'

P.S. Irecently wanted to use Metrazol in a patient with a very high seizure
threshold, only to find that it has been withdrawn from the market by the FDA.
After some travail, I filed the appropriate papers and now have an IND for
Metrazole research. In a trip to Hungary this summer, I found that Metrazol was
still in use in their mental hospitals, precisely for the cases for which I wish to use
it. (With anesthesia, however.)

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