Ladislas Meduna

Ladislas Joseph Meduna (1896-1964) portrait 1

Ladislas Joseph Meduna (1896-1964) was a Hungarian neuropsychiatrist

Ladislas J. Meduna was a Hungarian neurologist and psychiatrist whose pioneering work in convulsive therapy laid the foundation for modern biological psychiatry. Rooted in neuropathology, Meduna hypothesised in the early 1930s that epilepsy and schizophrenia were antagonistic disorders. Observing gliosis in epileptics and its absence in schizophrenia, he reasoned that artificially induced seizures might improve psychotic symptoms. In 1934, he began administering camphor and later cardiazol (metrazol) to provoke seizures in patients with catatonic schizophrenia with promising results.

Though his chemically induced seizures heralded a new era in somatic psychiatry, Meduna’s methods were rapidly supplanted by the electrical approach pioneered by Cerletti and Bini in 1938. Nonetheless, Meduna remained a significant figure, later relocating to the United States where he continued exploring the biological basis of psychiatric illness. His interests expanded to include the dream-like psychosis of oneirophrenia, and carbon dioxide therapy, which he used to induce altered states of consciousness in select patients. His later writings reflect a philosophical and scientific commitment to understanding the mind through brain physiology.

Meduna was a brilliant neuropathologist, a thoughtful theorist, and a clinician driven by experimental boldness. While the painful and unpredictable nature of chemical convulsion led to its clinical decline, his work remains historically pivotal. His vision that mental illness could be treated through biologically grounded methods anticipated the neuropsychiatric revolutions that followed.

Biographical Timeline
  • Born László Meduna on March 27, 1896 in Budapest, Hungary.
  • 1914 – Enrolled in medical studies at Pázmány Péter University. Interrupted studies to volunteer on the Italian front during World War I (1915-1918).
  • 1921 – Graduated MD from Pázmány Péter University. Commenced studies in neuropathology at the Hungarian Institute of Pathology under Károly Schaffer
  • 1926–1933 – Conducted neuropathological research at the University of Budapest, focusing on glial cell density in epilepsy vs. schizophrenia.
  • 1933 – Appointed to the Department of Psychiatry at the University of Budapest. Began experimental work on inducing seizures in animals using camphor. Observed pathological glial differences in epilepsy and schizophrenia; hypothesised antagonism between the two
  • January 23, 1934 – First camphor-induced convulsive treatments in a patient with catatonic schizophrenia at Lipótmező Asylum.
  • 1934–1937 – Developed and applied convulsive therapy (camphor and Metrazol) in over 100 cases; faced resistance from academic establishment. Published initial findings on convulsive therapy (1935)
  • 1939 – Fled Hungary due to rising fascism; moved first to Switzerland, then Italy.
  • 1940 – Emigrated to the United States; joined Loyola University Medical School in Chicago.
  • 1941–1942 – Became licensed in Illinois and held clinical roles at Cook County Hospital and St. Luke’s Hospital.
  • 1943 – Appointed Associate Professor of Psychiatry at the University of Illinois Medical School.
  • 1947 – Publicly acknowledged that electroconvulsive therapy (ECT) had replaced chemical convulsion therapy
  • 1949 – Published Oneirophrenia, proposing it as a distinct confusional psychosis.
  • 1950 – Developed carbon dioxide therapy (“Meduna’s mixture“) to induce altered states of consciousness
  • 1951 – CIA interest documented in use of CO₂ therapy for psychological effects (Project Artichoke)
  • 1950–1959 – Played leading roles in several psychiatric societies, including founding the American Society of Medical Psychiatry.
  • 1959 – Founded the Journal of Neuropsychiatry and served as Editor-in-Chief until his death.
  • Died on October 31, 1964 in Chicago, Illinois, USA.
Key Medical Contributions
The Origins of Convulsive Therapy (1934)

In the early 1930s, Meduna observed the histological distinction between patients with epilepsy and those with schizophrenia. Through autopsy studies, he noted increased glial cell counts in epileptics, and decreased glial cell counts in the brains of schizophrenic patients. From this, Meduna hypothesised a biological antagonism between the two conditions and proposed that generating epileptic seizures in patients with schizophrenia might alleviate their symptoms.

…if I can stimulate epileptic seizures in schizophrenics then these… will alter the chemical and humoral processes in the body in a way… that the suppression of the disease will be made physiologically possible.

The two diseases are pathophysiologically antagonistic…inducing epileptic seizures might therefore cure schizophrenia.

Meduna, 1934

Meduna used camphor oil injections, and later Metrazol (pentylenetetrazol), to provoke seizures in experimental animals. On January 23, 1934, he administered the first seizure-inducing injection to a man (Zoltán L.) with catatonic schizophrenia. The treatment produced dramatic effects and after a course of nine seizures, the patient regained speech and mobility.

By 1937, Meduna had treated over 100 patients and published “Die Konvulsionstherapie der Schizophrenie,” a seminal work on convulsive therapy. His method, though later superseded by ECT, introduced the concept of somatic seizure induction as a treatment for psychosis.

Oneirophrenia and Altered Consciousness (1950)

In the latter part of his career, Meduna shifted his attention from convulsive therapies to the study of altered states of consciousness. This culminated in his 1950 monograph Oneirophrenia: The Confusional State, in which he attempted to characterise a distinct psychiatric syndrome marked by dream-like consciousness, confusion, hallucinations, and depersonalisation—without the delusions or deterioration typical of schizophrenia.

The patient lives in a world of dreams, where reality and unreality intermingle without the awareness of contradiction.

Meduna, Oneirophrenia (1950)

Meduna proposed that oneirophrenia was an identifiable, transient confusional state seen in various contexts, including early schizophrenia, fevers, toxic psychoses, or drug effects. Though the term did not enter wide psychiatric usage, his attempt reflected a broader mid-century movement to classify consciousness disturbances as part of a biological psychiatry framework. It foreshadowed discussions on delirium, dissociation, and psychotomimetic states and is relevant to modern neuropsychiatry and psychedelic research.

Carbon Dioxide Therapy and “Meduna’s Mixture”

During the 1940s–50s, Meduna pioneered the use of carbon dioxide to induce therapeutic altered states. Patients inhaled a gas mixture composed of 30% CO₂ and 70% O₂, later known as “Meduna’s mixture” or carbogen. Patients reported intense, cathartic experiences followed by mental clarity.

This induced rapid unconsciousness followed by a vivid “transitional” phase upon regaining awareness during which patients reported intense dreams, hallucinations, and emotionally cathartic memories. Meduna observed that this period could facilitate psychiatric insight, particularly in patients with obsessive-compulsive or dissociative symptoms. Meduna explored its utility in neurosis, anxiety, and schizophrenia, viewing it as a form of psychophysiological reset.

Though the technique was never widely adopted due to its intensity and discomfort, it attracted attention from both clinical psychiatry and intelligence agencies. Declassified CIA documents from Project Artichoke show intelligence interest in CO₂-induced states for interrogation purposes. Though largely abandoned, CO₂ therapy anticipated modern interest in psychotropic-assisted treatments and breathwork-induced transformation.

Emigration, Chicago Years, and Legacy in Neuropsychiatry

Facing growing fascism in Hungary, László Meduna emigrated to the United States in 1940. He took up a position at Loyola University Medical School and later joined the University of Illinois, becoming Associate Professor of Psychiatry. In 1959, he founded the Journal of Neuropsychiatry, cementing his role as a pioneer in the emerging field. Meduna’s later work focused on consciousness, psychosis, and the brain, culminating in a blend of rigorous neuropathology and speculative theory. Though ECT eclipsed his metrazol method, his biological vision for psychiatry remains foundational.

Diverging Paths to Convulsive Therapy: Meduna vs Cerletti

Meduna and Ugo Cerletti represented contrasting paradigms in psychiatric innovation. Meduna’s convulsion therapy emerged from a biologically testable hypothesis, grounded in pathology and pharmacology. Cerletti, a systems-oriented neurologist, viewed chemical seizures as too imprecise and dangerous.

In 1938, Cerletti and Bini introduced electroconvulsive therapy (ECT), offering greater control and fewer complications. Within a decade, ECT had supplanted metrazol. Meduna acknowledged the shift: “You know this old convulsive therapy is past history for me and I believe for almost every psychiatrist.” Still, his foundational role in initiating seizure therapy remains undisputed.

Major Publications
References

Biography

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BA MA (Oxon) MBChB (Edin) FACEM FFSEM. Emergency physician, Sir Charles Gairdner Hospital. Passion for rugby; medical history; medical education; and asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | On Call: Principles and Protocol 4e| Eponyms | Books |

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