Literature Review

Henry Cotton was a man of remarkable education, who carried with him a notable resume that earned him much respect in his field. He trained at the University of Maryland and at Johns Hopkins and was mentored by dominant figures in psychiatry at the time such as Adolf Meyer, Emil Kraepelin and Aloid Alzheimer. Cotton worked on the belief that mental illness was simply germ infestations that accumulated in the body and released poisons, which resulted in mentally ill. These infections, referred to as ‘focal sepsis’, were then surgically removed from patients by extracting affected organs and counter parts, leading to thousands of fatalities and mutilations. Since research and science have ruled out the need for such bizarre treatments, many have gone back and analysed Henry Cotton’s practices to determine if he was a well reasoned practitioner of his time or one who arrogantly could not accept the evidence of his failed practices and theory. Anne Hudson Jones’ journal ‘The cautionary tale of psychiatrist Henry Aloysius Cotton’ and Patrick McGrath’s article ‘'Madhouse': Nonelective Surgery’ from the New York Times examine Cotton’s works form some interesting points of views.

Hudson’s journal article draws in on the fact that it was Henry Cotton’s professional egotism that unfortunately lead to the horrific deaths at Trenton Psychiatric Hospital. In assessing Cotton’s nature she draws parallels to the conceited work of a Doctor Truffle who, removed patients belly buttons as they interfered with the straight lines of his stomach incisions. Such a comparison highlights that, much like Cotton, a practitioners need to succeed and ironically help others with a new direction in medicine can result in a clear disregard for the patient. Cotton’s flawed believes were fueled by his uncontrollable desire to be right, which lead to more rigorous treatments even after concerning results. Hudson states, ‘Emboldened by the high rates of cure that he believed he saw, Cotton became such a true believer that in patients recalcitrant to cure he began to remove gall bladders, stomachs, uteruses, ovaries, testicles, even colons.’

Henry Cotton was well respected and therefore it is no surprise he was able to widely enforce his theories of mental illness and execute his dangerous practices for as long as he did. It is with this fact that Hudson emphasizes that blame is ‘not confined to an aberrant, megalomaniac doctor [Cotton] but extended to prominent psychiatrists who endorsed Cotton's theories and emulated his treatments’.  The misguided wealth of support and protection from ignorant believers unfortunately allowed Cotton to prolong his horrific reign. She draws attention and blame to a system that failed many innocent mentally ill patients seeking refuge from their own minds, as investigations into the falsified reports and perceived success of Cotton’s works were sadly hidden and buried.