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Madhouse: A Tragic Tale of Megalomania and Modern Medicine 1st Edition

2.9 out of 5 stars 10 customer reviews
ISBN-13: 978-0300126709
ISBN-10: 0300126700
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Editorial Reviews

From Publishers Weekly

In the early part of the 20th century, psychiatrist Henry Cotton was so obsessed with the idea that mental disorders were caused by infections that he had all his children's teeth pulled to prevent tooth decay from driving them mad. Unfortunately, he was the director of a New Jersey mental hospital and prescribed invasive surgeries—from tonsillectomies to the removal of colons and uteruses—for thousands of patients, some "dragged, resisting and screaming" to the operating room. The tale is horrifying, at times luridly so, but Scull, a sociologist specializing in the history of psychiatry, points out that Cotton was not a renegade scientist. Scull's meticulous historical narrative tracks the enthusiastic response within the psychiatric community of the time. Cotton's published research, as well as the reluctance of skeptics to attack his attempts at reconciling mental and physical health. The story changes gears abruptly with the arrival in 1925 of Phyllis Greenacre, an independent researcher assigned to audit Cotton's results, and takes another dark turn when her findings are suppressed to preserve Cotton's reputation. Scull's closing arguments for the story's modern relevance as an example of the mental health industry's tendency to protect its own at the expense of patients are largely successful, but it's the parallels with whistle-blowers in other fields that may call attention to this compelling account of a shameful episode.
Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved. --This text refers to an out of print or unavailable edition of this title.

Review

"A tour de force of investigative reporting and a provocative case study of megalomania, junk science and cronyism vs. the Hippocratic Oath. It's also a fast-paced medical thriller."--Sylvia Nasar, author of "A Beautiful Mind"


"The most impressive piece of narrative psychiatric history I have ever read."--William F. Bynum, Wellcome Centre for the History of Medicine


" The most impressive piece of narrative psychiatric history I have ever read." -- William F. Bynum, Wellcome Centre for the History of Medicine


" A tour de force of investigative reporting and a provocative case study of megalomania, junk science and cronyism vs. the Hippocratic Oath. It' s also a fast-paced medical thriller." -- Sylvia Nasar, author of "A Beautiful Mind"
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Product Details

  • Paperback: 384 pages
  • Publisher: Yale University Press; 1 edition (September 4, 2007)
  • Language: English
  • ISBN-10: 0300126700
  • ISBN-13: 978-0300126709
  • Product Dimensions: 6.1 x 1.1 x 9.2 inches
  • Shipping Weight: 9.6 ounces (View shipping rates and policies)
  • Average Customer Review: 2.9 out of 5 stars  See all reviews (10 customer reviews)
  • Amazon Best Sellers Rank: #422,542 in Books (See Top 100 in Books)

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Customer Reviews

Top Customer Reviews

Format: Hardcover
This book describes the treatment of a variety of psychiatric disorders using radical surgery by the American psychiatrist Joseph Cotton. He was a advocate of the doctrine of 'focal sepsis' which located the seat of mental illness in bacteriological infections of various body organs. While this may appear crank thinking now, Cotton was simply elaborating one trend in medical thinking at the time. Admittedly his elaboration was robustly surgical. 'Infections' leading to psychoses were found in the teeth, the sinuses, the ileum, colon, almost all parts of the intestines, the cervix, testicles, and naturally the stomach.

Cotton's 'enucleation' of offending organs and parts was intended to cure the patient. However, with mortality rates of 30%, the treatment was much worse than any disease. Cotton was effectively little more than a butcher that rountinely cut up his patients involuntarily. How did he get away with it for so long? What events finally opened a window on the horror of his methods? Well these are the stuff of the book. If you know any Kuhn or Lakatos, this book will absolutely grab your attention. Well worth reading.
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Format: Hardcover
Andrew Scull meticulously exposes blinkered practice, faulty ego, and inertia in the face of overwhelming facts. At times this book felt like a nightmarish novel but all the evidence was there-thousands of people experienced and witnessed a medical holocaust. I found it compelling and tragic. Little wonder that evidenced based medical practice emerged from catastrophes like these. Not to be missed by any patient who has ever thought of seeking a second opinion. Madhouse was my `read` of the year.
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Format: Paperback
When I talk about healthcare reform with psych students, I often
try to include an example or two from our own field in order to press
home that we are not immune from the scientific sloppiness and
misguidedness that afflicts american healthcare. I have often used
Egas Moniz's conflation of lab studies on frontal lobotomy in monkeys
and diminished retention of simple learning tasks with Freudian
theories about the causes of psychopathology & the tragedy of
frontal lobotomies in schizophrenics. Its never been an entirely
satisfactory example because the frontal lobe syndromes probably
did result in symptom reduction for some patients - reduced aggression
due to apathy, or disinhition "curing" withdrawal. Even misguided
reasoning sometimes, inadvertently, produces salutary results.

But Scull provides an even better example in the efforts of Henry
Cotton, the superintendent of Trenton State Hospital for the Insane
in the 1920s. Cotton believed in the "theory of focal infection" as
the cause of all forms of insanity - essentially an extension of delirium
to all the chronic cases warehoused in hospitals like his. In an era
when the differences between "Dementia Praecox" (Schizophrenia)
and "Manic-Depressive Illness" (Bipolar Disorder) were still not fully
appreciated, and state hospitals also housed severe depressives,
severe anxiety patients, mental retardation and demented patients,
Cotton's one-treatment-cures-all vision was surely a ray of hope.

In pursuit of "cures" he hired dentists and surgeons to come and remove
larger and larger numbers of "infected" organs - teeth, tonsils, adenoids,
colons, uteruses, segments of bowels, seminal vesicles, etc.
Read more ›
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Format: Paperback
It took me the first couple of chapters to become engaged, as I found the language florid and outdated, but I soon understood that the historical nature of the book and of the documents therein made such elucidations an easier path to enjoyment (if it can be said) of this book. I found this difficult to read as it takes into historical evidence the presumed relationship between many of the lead figures as fact, but still offers a more transparent glimpse into the environment of those who witnessed and enabled this misguided approach to continue than would a more traditional historical scope. "Madhouse" offers us potential insight into the professional encouragement without oversight and peer back slapping that produced a macabre and unseemly amount of deaths and disfigurements in the early part of the last century. That this period of psychiatric history has remained under the radar until recently is detrimental to the science, and I hope that recent (nonsurgical, nonchemical) approaches to what we now understand to be the neuroplastic mind are taken up with as much passion as Dr. Henry Cotton.

It is left for the reader to wonder if the psychiatric world is so scarred by such fatalities and failures as to continue to conflate success and speculate as to whether current treatments are efficacious, when the data is already out on much of what the state institutions (and mental health community services) have to offer. I presume the data are as conspicuous as what Dr. Cotton gave us to judge upon...
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Format: Paperback Verified Purchase
A very detailed book of the macabre history of trenton State Hospital. A bit of a tough read at times it can get very legally detailed but what a look into the minds of these doctors at the time.
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