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Home » A Sad and Strange Chapter

A Sad and Strange Chapter

June 1, 2005
Daniel Carlat, MD
From The Carlat Psychiatry Report
Issue Links: Editorial Information | PDF of Issue
Daniel Carlat, MD Dr. Carlat has disclosed that he has no significant relationships with or financial interests in any commercial companies pertaining to this educational activity.
There have been many misguided treatments for bipolar disorder and other major mental illnesses throughout the history of psychiatry, but perhaps none has been as misguided--and as damaging--as the one practiced by Henry Aloysius Cotton, M.D. Once a student of Adolf Meyer, Emil Kraepelin, and Alois Alzheimer, he headed the New Jersey State Hospital in Trenton in the early years of the twentieth century. Caught up in the contemporary excitement about bacterial origins of disease, he came to believe that the source of psychosis lay in low-grade chronic infections in obscure regions of the body. He became convinced that mental health could be fully restored through "surgical bacteriology." By 1916, he had begun his crusade with the teeth, removing anything that seemed the least bit unusual from the mouths of his patients. When this had no beneficial effect, he went on to remove tonsils, spleens, cervixes, colons, and stomachs in search of the "focal sepsis." Referrals to Cotton's hospital were copious enough to allow him to open a private hospital in Trenton, and the technique spread across the nation and to England as well. Although acknowledging that the death rate from his abdominal surgeries was 30% (later shown to be closer to 45%), Cotton continued these procedures until his death in 1933.

Source: Andrew Scull in the Princeton Alumni Weekly (11 May 2005), from his forthcoming book Madhouse, Yale University Press.
General Psychiatry
KEYWORDS bipolar_disorder
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Daniel Carlat, MD

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Table Of Contents
A Sad and Strange Chapter
Ivan Goldberg, M.D., on Treating Bipolar Depression
Lab Monitoring with Mood Stabilizers: Let’s Get Real
Antidepressants in Bipolar Disorder: The Controversy Continues
Equetro: New Name, Old Drug
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