Do Not Be Surprised

Why throw away interesting stuff?

In preparing to move, I am sorting out my stuff. I always save little tidbits of interesting items. For instance, there was a short article about some man who just won a settlement against a tattoo parlor. The tattoo depicted a man stabbing someone in the back with a knife, with a caption that was supposed to read, “Why not, everybody else does it?” with ‘else’ spelled ‘elese’. That’s why spelling is so important in school. My wife wonders why I kept that article, can you believe it? It is the perfect object lesson for elementary school kids. But I digress.

Germ theory and mental illness

I found a review [1] of a book called Madhouse, A Tragic Tale of Megalomania and Modern Medicine by Andrew Scull. [2] This book details the career of Henry Cotton, the physician who was in charge of Trenton State Hospital at the beginning of the 20th century. Cotton was a believer in the ‘germ theory of disease’, which states that “ some diseases are caused by microorganisms.” [3] Cotton believed that by removing sources of infection from his patients he could cure mental illnesses. “[Cotton] then brought all the technological advances of modern bacteriology into the mental hospital, and set about proving that nearly all of those admitted with psychotic disorders were actually suffering from the effects of focal infection lurking somewhere in their bodies.” [4] With that idea in mind, and under his authority as head of Trenton State Hospital, he performed numerous surgeries on his patients. According to Patrick McGrath, “Within a few years of taking over Trenton State Hospital, he [Cotton] was removing the infected teeth and tonsils of dozens of his patients, not to mention their stomachs, gallbladders, colons, testicles and ovaries – with special emphasis on the right side of the hindgut, which, he declared, had particularly ‘decadent tendencies’”. [5]  Whereas he claimed an 85% cure rate, the postoperative death rate was 30%.


The idea of a biological cause of mental illness is not wildly outrageous. But the brain is hugely complex and the cutting out of a focal infection, without scientific evidence is bad science. The shame of this episode is the impunity with which this doctor was able to perform his experiments on human subjects. Many who did not consent and were actually dragged into the operating theater.

Be wary and question always

I am glad that I held on to this book review. It reminded me that one of the lessons we should never forget is that helpless and defenseless human beings always require advocacy.

Those without voices or champions will be victimized.

[1] McGrath P. “Madhouse”; Non elective surgery. New York Times 2005 May 25

[2] Scull, A. Madhouse. A Tragic Tale of Megalomania Yale University Press 2005

[4] Wessely, S. Surgery for the treatment of psychiatric illness: the need to test untested theories. J R Soc Med 2009: 102: 445–451

[5] McGrath P. “Madhouse”; Non elective surgery. New York Times 2005 May 25

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