cover image MADHOUSE: A Tragic Tale of Megalomania and Modern Medicine

MADHOUSE: A Tragic Tale of Megalomania and Modern Medicine

Andrew Scull, . . Yale Univ., $30 (360pp) ISBN 978-0-300-10729-6

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. Agent, Caroline Dawnay. (May)