Focal Infection--Don't Get One!
Categories: History , Nonfiction , Health & Nutrition
In the first part of the 20th century, as many as a quarter of all patients at mental institutions suffered from late-stage syphilis, which inevitably led to dementia and death. There were no effective treatments until the Viennese psychiatrist Julius Wagner-Jauregg noticed that syphilitic patients who also suffered from malaria sometimes recovered their faculties. Wagner-Juaregg had the idea of purposely infecting syphilitic patients with malaria. His hope was that the high fever produced by malaria would kill the spirochetes responsible for what was then called "general paresis."
It wasn't a perfect solution, obviously, but many times--apparently somewhere in the 30 percent range--it actually worked. Wagner-Juaregg won a Nobel Prize for his discovery in 1927. After WWII, thank goodness, we got to have antibiotics.
Wagner-Juaregg seems to have influenced psychiatrist Dr. Henry Cotton in his quest for a cure for mental illness. The results, of course, were horrible.
We might be tempted to ask who was worse: Dr. Henry Cotton (1876-1933) or Dr. Walter Freeman (1895-1972)? Dr. Freeman was the enthusiastic proponent of the lobotomy in the United States. (I wrote about him in an earlier blog.)
Dr. Cotton, director of the Trenton, New Jersey, State Hospital, believed that all mental illness was caused by "focal infection" (in this case, "focal" is synonymous with "pus") and could be cured by the removal of the infected body parts. He started out by removing absessed teeth, which could be a good idea even for non mentally ill people. He moved on, however, to removing tonsils, spleens, stomachs, genitalia, and finally the colon. The colon operations were particularly dangerous. As many as 30 percent of the Trenton patients died as a result of their operations. Dr. Cotton claimed an 85 percent cure rate among the survivors, but careful study showed no benefits at all for the surviving patients.
So you'd think Dr. Cotton would have stopped right there, right? The story of why he was allowed to proceed with his experiments makes up the frustrating body of this depressing work.
To Dr. Cotton's credit, sort of, he believed so strongly in his theory that he had his own teeth and those of his wife and children removed, just in case.
Jack David Pressman's Last Resort: Psychosurgery and the Limits of Medicine has little to say about Dr. Cotton, but he offers some defenses of the lobotomy: the people who received the operation often worked at unskilled jobs and so were able to return to those jobs despite their post-surgical limitations; the progress of medicine is seldom straightforward--even in non-mental-health areas, doctors often follow blind alleys before discovering a real cure (if you've visited visited Mammoth Cave, you'll remember the disastrous idea of using the cave as a hospital for tuburcular patients); getting patients out of mental hospitals and into the community was probably usually better for the patients than being confined to a hospital.
Okay--I believe those things. But still. I'd like to go on record saying that I want to keep those teeth I still have, and I don't want any brain surgery for mental-health reasons. I hope that's not too much to ask.
