One of the most revered psychiatrists of the early 20th Century was Dr. Henry A. Cotton (1876-1933). As Medical Director of the New Jersey State Hospital at Trenton, Dr. Cotton revolutionized the treatment of the mentally ill with innovations such as the elimination of the promiscuous use of mechanical restraints, the institution of daily staff meetings to review the care of each patient, and the advancement of the practice of "surgical bacteriology."
Surgical bacteriology was based on the premise that mental disease usually was caused not by genetics or environment but instead by infection, as evidenced by the fact that people with high fevers often became delusional and experienced hallucinations. Cotton taught that removal of the infected organ would cure the mental disease. Cotton usually started with extracting teeth as the most likely source of the infection. If this did not do the job, he would then perform a tonsillectomy. If the patient still exhibited signs of a psychiatric disorder, he would then move on to removal of all or part of the testicles, ovaries, gall bladder, stomach, spleen, cervix, or, one of his favorites, the colon. He considered masturbation to be a psychiatric disorder and performed colonectomies on children so that they would not take up the practice.
Cotton claimed a cure rate of 85%, which at first blush contradicted a fatality rate of 30 to 45% (depending on which source you believe). In that there were no antibiotics in use at the time, the higher fatality rate is far more likely. Part of the inconsistency between the cure rate and the fatality rate can be explained by the fact that Cotton would often proclaim that a patient was cured of the mental disorder even while the victim was lying in bed dying of sepsis.
Cotton's theories were widely accepted by the medical community. He received many requests to speak at prestigious medical institutions and associations in the United States and Europe. Many families of the mentally ill, as well as the patients themselves in some cases, eagerly sought his services as being on the cutting edge of psychiatry.
Unfortunately, many of the patients and their families did not initially realize the extent of the mutilations which would be performed or even that surgery would necessarily be part of the Cotton regime. Once the patient was admitted, no one would obtain the consent of the patient or the responsible family member before Cotton would get out his knife.
Ultimately, even the most demented patients would see their fellow inmates with missing teeth and gaping surgical wounds and figure out that they should not look forward to "treatment sessions." The situation probably led to a fairly stressful environment for the patient.
Cotton condemned the dental profession for salvaging teeth when they could be removing them instead.
The doctor was, at least, was not a hypocrite. He had his own teeth pulled as well as those of his wife and his two children.
During his 26-year tenure at the New Jersey State Hospital, Dr. Cotton removed over 11,000 teeth and performed over 645 major surgeries.
Cotton condemned the dental profession for salvaging teeth when they could be removing them instead.
The doctor was, at least, was not a hypocrite. He had his own teeth pulled as well as those of his wife and his two children.
During his 26-year tenure at the New Jersey State Hospital, Dr. Cotton removed over 11,000 teeth and performed over 645 major surgeries.
"Surgical bacteriology" remained recognized as valid psychiatric therapy until the 1950s.
No comments:
Post a Comment