The evolution of mental illness during the scandal
The conclusion of the 18th Century marked the beginning of the campaign
for humane treatment of the mentally ill, a pivotal revolution within
the field of psychiatry. With the methods and techniques of doctors
under the microscope, doctors were pressured to reform their treatment
of patients, especially procedures considered cruel or violent.
This period in history, often termed the “asylum era”, featured a rapid
increase in the number of mental hospital as more and more patients
flocked to hospitals for psychological ailments. This prompted an
expansion in the private sector of madhouses too, due to the economic
advantage of the time. “From the physician’s viewpoint, economic and
social circumstances, to a great degree, are responsible for not being
able to offer a cure to the individual” (Scull, 2005).
Trenton Psychiatric Hospital was one of the first public mental
institutions in which patients were treated as actually ill, rather than
like inmates of a prison. Nevertheless, Cotton’s treatments, like other
relatively experimental theories in their development, were extremely
invasive and often had high associated risks. As Scull (2005)
elucidated, modern physicians of the time ‘worked on the assumption that
the human body is its own worst enemy, and thus … concluded that the
road to health lay through the extraction or amputation of whatever body
part could be held responsible for the dysfunction’. This, however,
lacked ethical etiquette and patient care, gaining Cotton his reputation
as an arrogant and reckless dictator at Trenton.
The influence of Cotton’s work by Bacteriological revolution and Germ theory
With medicine still at its infancy,the birth of the bacteriological paradigm was perceived as a revolution in the medical field. The discovery of the disease causing organism of tuberculosis by Robert Koch along with Louis Pasteur's germ theory of disease ,developed as a result of his observations of the role of microorganisms in the fermentation, shifted the medical world’s focus to somatic rather that heritable causes for illness. Focal sepsis stemmed from these theories and .Assuming that diseases are caused by ‘hidden pockets of infection or by the toxins released by the bacteria sheltering ‘’(Scull 2005)Cotton attempted to cure mental illness. According to Cotton, popular sites of bacteria hideouts were tonsils, teeth, appendix, the intestines, cervix and the foreskin. High death rates due to post surgery and peritonitis were observed. However, should Cotton be blamed? After all, ‘he thought he was doing the right thing or because his treatments were in accord with contemporary standards of medical culture’(Scull 2005).
Contemporary Treatments
The proposition of Cotton’s treatment today seems barbaric however at the time, his idea was almost a break through as it provided mentally ill patients with hope. Prior to Cotton’s ‘Focal Sepsis’ many American physicians believed that psychological illness were heritable and incurable. The somatic approach adopted by Cotton ensured that physicians were at least attempting to treat the illness
It is perhaps important to recognise that in treating the mentally ill we have almost always chosen treatment methods that directly or indirectly harm patients,. However each method has taught us something more about mental illness and contributed to our understanding of its treatment.
Although our current society is improving its treatments towards the mentally ill, we still posses some barbaric methods of treatment.
Electroshock Therapy (ECT) which involves placing electrodes on the forehead and passing electrical currents through the brain in order to induce a seizure lasting 30 to 60 seconds. This treatment was controversial due to its hazards on the patients. (Electroconvulsive Therapy (ECT) 2013)
Deep brain stimulation which uses the device implanted in the brain to send electrical impulses. Such method is usually applied to severe obsessive compulsive disorder(Medtronic Neuromodulation 2013.)
Electroshock Therapy (ECT) which involves placing electrodes on the forehead and passing electrical currents through the brain in order to induce a seizure lasting 30 to 60 seconds. This treatment was controversial due to its hazards on the patients. (Electroconvulsive Therapy (ECT) 2013)
Deep brain stimulation which uses the device implanted in the brain to send electrical impulses. Such method is usually applied to severe obsessive compulsive disorder(Medtronic Neuromodulation 2013.)
In light of this it is perhaps important to question , wereCotton’s actions really as gruesome as we perceive them to be? Even in our contemporary society we often use somewhat torturous devices to treat the mentally ill , so in a time where knowledge about mentally ill was scarce weren't Cotton’s actions justified?
