Henry
cotton has often been described as a megalomaniac, who ghoulishly tortured and
killed hundreds of patients without any real scientific merit. However such
claims ignore the prominent figures that assisted Cotton in his infamous work
and the overall complexity of the scandal. To truly to ascertain the motives
behind Cotton's work it is key to consider these factors and his life before
Trenton.
Trained as a psychiatrist, Henry Cotton received the highest quality education available at his time. Completing his studies at John Hopkins under “Adolf Meyer”, a figure who was dubbed the ‘godfather’ of psychiatry, instantly made Cotton one of the most promising psychiatrists of his epoch. This status was further augmented upon his arrival to the scandalous Trenton hospital. Prior to Cotton’s arrival, the New Jersey hospital was plagued with medical misconduct and mistreatment of patients. When Cotton arrived at the asylum he was met with “deplorable conditions,” with guards treating patients inhumanely, wielding unchecked violence (Wessely 2009). Cotton with his contemporary education immediately eradicated most restraints and trained physicians to treat patients with care. These actions coupled with his “glittering résumé” ensured Cotton a glorified and possibly, an undeserving status (Scull 2005). In fact, the media feted his theory of focal sepsis, when introduced in 1915 , with the New York Times heralding Cotton as a scientific genius whose theories gave “high hope” for the future (Wessely 2009) .Cotton was hence enabled to instantly promote his radical ideas without any intervention .No one dared question the lack of scientific merit in his theory, as Cotton was now a messiah of psychiatry, who was going to reform the “old asylum to a modern hospital”. This initial hype that surrounded Cotton was perhaps what lead to the horrid dealings in Trenton
Trained as a psychiatrist, Henry Cotton received the highest quality education available at his time. Completing his studies at John Hopkins under “Adolf Meyer”, a figure who was dubbed the ‘godfather’ of psychiatry, instantly made Cotton one of the most promising psychiatrists of his epoch. This status was further augmented upon his arrival to the scandalous Trenton hospital. Prior to Cotton’s arrival, the New Jersey hospital was plagued with medical misconduct and mistreatment of patients. When Cotton arrived at the asylum he was met with “deplorable conditions,” with guards treating patients inhumanely, wielding unchecked violence (Wessely 2009). Cotton with his contemporary education immediately eradicated most restraints and trained physicians to treat patients with care. These actions coupled with his “glittering résumé” ensured Cotton a glorified and possibly, an undeserving status (Scull 2005). In fact, the media feted his theory of focal sepsis, when introduced in 1915 , with the New York Times heralding Cotton as a scientific genius whose theories gave “high hope” for the future (Wessely 2009) .Cotton was hence enabled to instantly promote his radical ideas without any intervention .No one dared question the lack of scientific merit in his theory, as Cotton was now a messiah of psychiatry, who was going to reform the “old asylum to a modern hospital”. This initial hype that surrounded Cotton was perhaps what lead to the horrid dealings in Trenton
The history surrounding Trenton further explains Cotton’s controversial treatment plans for his patients. Cotton was no maverick in accepting that germs were the source for illness. Early 20th century was marked by the paradigm of bacteriology, with physicians "embracing the laboratory as a source of cultural authority"(Wessely 2009). Prominent clinicians at major centres of modern scientific medicine as the Mayo Clinic in Minnesota and the Johns Hopkins medical school in Baltimore all promoted the treatment of toxins as the key to curing mental illness. Thus it seems almost logical that Cotton promoted the focal sepsis theory as it stemmed from the ideas of such highly respected figures. However it was the support from the Cotton’s respected mentor that truly explains how Cotton was able to carry such brutal acts without intervention.
The latter part of Cotton’s career was plagued by accusations and scandals. More and more doctors discovered the lack of credibility in Cotton’s work. Yet he did not admit failure or stop his work. Whether for money or fame, Cotton continued to publish his “falsified results” in the paper, welcoming visitors to observe his work at Trenton, right till the end of his career. So firm was his belief that he chose to extract his own teeth to prevent a mental breakdown and convinced his wife and two children to do the same. When considering such behaviour one can’t help but question Cotton’s sanity or his ulterior devious motives.
In
fact, towards the end of his career Cotton’s initial regard for the patient’s
emotional wellbeing seemed to have disappeared altogether. No longer did he
care for whether the treatment caused pain or even death among patients. Despite having no training in surgery,
Cotton, with his inflated ego, decided to take over and perform the surgeries
himself – removing teeth, tonsils and even portions of the intestine. Doctors that observed the
patients that survived Cotton’s operation described the scene as gruesome and
disturbing, with patients having difficulty in eating with all their teeth removed.
Cotton disdain towards patient care extended to
operating without consent. Despite the
high mortality rate and active protest from families, Cotton claimed “being
persistent, often against the wishes of the patient" was the only way to be
successful(Scull 2005).This
inculcates doubt as to Cotton’s intentions . If Cotton really cared about the well-being of his patients why did continue operating when the results were a
failure? This is further accentuated
by Cotton’s warped justifications for his damning results, claiming “psychotic patients in whom the infection has been
long-standing and of great and specific virulence, are not good surgical risks
and yield a higher mortality rate "(Scull 2005)
So who was Henry Cotton -an altruistic visionary or an
obsessive megalomaniac with no regard for others? His preliminary actions were purportedly carried
out with good intentions. The support he received from his peers and the media
could have easily clouted his decisions. Yet later in his career he
clandestinely falsified statistics and repeatedly performed surgeries with
little to no regard for his patients.
Such misconduct paint him as a gruesome monster hungry for power and wealth.
Whatever Cotton might have been his works remain as a reminder of the failures that exist in the history of medicine.
