Category Archives: experts

Kung Fu flu kick-starts a thousand PhD theses

Bonking boffin: the discredited and disgraced epidemiologist Neil Ferguson of Imperial College, London. He touted his alleged expertise on the Wuhan flu but his real interest lay in the legover arena

The theses about the epidemic will settle nothing once and for all, Dalrymple observes. There will always be a need for further research. Science, he points out,

is not a body of doctrine, an orthodoxy from which dissent is heresy. Its truths are multiform, contradictory, and provisional.

If politicians merely followed the science,

they would zigzag or careen like a drunken sailor; they would be at the mercy of the last qualified person to whom they spoke.

Politicians,

despised as they are (they are lower in public esteem even than journalists), are expected to deliver us from death, and if death supervenes it is they who are to blame. We hate them, but we run to them.

It is hard to feel sorry for politicians, says Dalrymple, for

they have chosen their career and (especially in modern conditions) have generally pursued power to the exclusion of all other possible goals, which is not admirable. As often as not, they have not much cultural or psychological hinterland, for they have no time or energy for it, which is why they are mostly not very interesting people. The trouble is that they are important (though perhaps not as important as they think they are), and for the rest of us to have to think about people who are important but not interesting is a kind of torture.

He notes that the problem for politicians in the time of the Chinese virus is that

they are faced with a population of experts. In only a few weeks, millions have become epidemiologists of the first rank, even those who in December would have been hard put to define what epidemiology was — if they had heard of it.

Bruce Lee

Colectomy will make you sane

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Henry Cotton

How do we know doctors aren’t in the grip of collective delusions?

Dalrymple notes that an untreated psychotic’s situation can be desperate, but points to the danger of professional abuse once authority is handed over to alleged experts.

He reminds us that among the treatments developed by psychiatrists are

  • frontal leucotomy: nerve pathways in brain lobes are severed from those in other regions
  • Metrazol-induced convulsion therapy: shocks are administered, giving rise to convulsions
  • insulin coma therapy (Insulinschockbehandlung): the patient is turned hypoglycemic with repeated injected insulin
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NJ State Hospital for the Insane, Trenton (John Notman, 1848)

Reviewing Andrew Scull’s Madhouse: A Tragic Tale of Megalomania and Modern Medicine (2005), Dalrymple looks at the case of Henry Cotton, head of the New Jersey State Hospital for the Insane at Trenton.

Cotton believed that madness was caused by focal sepsis — subclinical infection of the teeth, tonsils, sinuses and colon. The answer

was to remove the teeth and tonsils, wash out the sinuses, and cut out the colon. The latter operation, performed in the asylum by Cotton himself — though he had no formal training in surgery — had a death rate of up to 33 per cent.

The operation was a success but the patient died

Phyllis Greenacre with Curt Richter

Phyllis Greenacre with Curt Richter

Cotton was undeterred.

He claimed a very high success rate for his operations, many of which were forced upon unwilling patients: 85% of his lunatics were cured by them, he said. A self-promoter and publicist, he was lionised, especially in Britain.

His claims were disputed,

particularly by Phyllis Greenacre, who proved that the chief clinical effect of his operations was death.

But Cotton

was protected by his mentor at Johns Hopkins, Adolf Meyer, an intimidating pedant rather than a real scientist who was the doyen of US psychiatry for many decades. He wanted to avert a scandal that would damage the standing and power of the profession, and was prepared to countenance the continued mutilation of patients by Cotton to do so.

Adolf Meyer

Adolf Meyer

Meyer suppressed Greenacre’s work and was to write

a laudatory obituary of Cotton, though he must have known by then that Cotton was responsible for hundreds of deaths and untold misery.

How, asks Dalrymple, did so flimsy and, to our eyes, foolish a theory of the cause of madness come to be accepted? Dalrymple points out that

  • the germ theory of disease, which elucidated so many mysteries, was comparatively new
  • the syphilitic cause of general paralysis (from which up to a fifth of the asylum population suffered) had just been discovered
  • hidden infections do often result in acute confusion in the elderly, including hallucinations

It was a short step to hypothesise an infective cause for all madness.

Screen Shot 2016-04-03 at 13.56.25Cotton

believed in his theory to such an extent that, as a prophylactic, he extracted the teeth of two of his sons and subjected one of them to a colectomy. (Both committed suicide as adults.) Later he had his own teeth extracted, believing focal sepsis to be the cause of his angina.

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