"Classics in ECT": Early Paper on the Use of Succinylcholine

"Classics in ECT" brings you this very early paper about succinylcholine use:
Use of succinylcholine in E.C.T., with particular reference to its effect on blood pressure.

ADDERLEY DJ, HAMILTON M.Br Med J. 1953 Jan 24;1(4803):195-7. doi: 10.1136/bmj.1.4803.195.PMID: 13009136

The pdf is here.

And from the text:

With complete relaxation it is difficult to determine whether an adequate convulsive dose has been given. We have employed two methods for this purpose: (a) By noting the autonomic component of the
cerebral discharge which constitutes the fit; the simplest observation is to look for dilatation of the pupils, and, particularly, injection of the conjunctivae. (b) As this method is not always accurate with ganglion-blocking agents we have devised a specific manceuvre to demonstrate the presence of the fit. Immediately before succinylcholine is injected a tourniquet or a sphygmomanometer cuff is fixed round the opposite arm. If this be kept tight enough to compress the artery until the current is passed the effects of the shock will be observed in that arm only. Thus the patient may be seen lying absolutely motionless apart from a slightly modified clonic fit in the blocked arm. By this means one is never in doubt about the effectiveness of the current.

This is not the earliest paper to describe the use of succinylcholine in ECT, but it is still a very early one. It focuses on one aspect of succinylcholine use (does it cause an increase in BP?), but for the modern reader, there are other, more fascinating points. Is this the first description of the "cuff method" (see text excerpt above) in the literature?

I think so, but would be glad to be corrected, if a reader knows otherwise. 

One marvels that the elements of modern ECT (oxygen, anesthetic agent, muscle relaxant) are all present in 1953. Succinylcholine is quaintly referred to as "scoline," not "sux," but that may be a Britishism, not an anachronism.

And yes, this is THE Max Hamilton, of the Hamilton Rating Scale for Depression.