Category Archives: frontal leucotomy

W.E. Henley’s toxic stoicism

W.E. Henley: emotional constipation

Dalrymple draws attention to the distressing mental disorder exhibited in ‘Invictus’ (1875):

Out of the night that covers me
Black as the pit from pole to pole,
I thank whatever gods may be
For my unconquerable soul.

In the fell clutch of circumstance,
I have not winced nor cried aloud.
Under the bludgeonings of chance
My head is bloody, but unbow’d.

Beyond this place of wrath and tears
Looms but the Horror of the shade,
And yet the menace of the years
Finds, and shall find me, unafraid.

It matters not how strait the gate,
How charged with punishments the scroll,
I am the master of my fate:
I am the captain of my soul.

He notes that the deranged ‘fortitude’ and emotional repression that the poem betrays are deeply problematic, being

part of what is known, including by the American Psychological Association, as toxic masculinity.

‘Fortitude’ is treason to the self

Dalrymple says that

if only Henley had been true to himself, he wouldn’t have bothered with all that captain-of-my-soul stuff.

Instead he would have gone into

  • counselling
  • cognitive behavioural therapy
  • psychotherapy

Courses of treatment of this kind, which might usefully have been accompanied by colectomy, frontal leucotomy, Metrazol-induced convulsion therapy, laxative therapy, and insulin coma therapy (Insulinschockbehandlung),

would really have sorted him out and rid him of the poisonous notion that misfortune was something to be overcome by making the best of things.

Dalrymple points out that in advertising his neurosis by producing verse of such hysterical irrationality, Henley

set a very bad example, for not everyone can overcome misfortune as did he. By becoming famous, by achieving a great deal despite pain and illness all his life, he inhibited myriad others from admitting their vulnerability and victimhood, thereby reinforcing toxic masculinity.

Rather,

it was Henley’s duty to have been angry and resentful at his fate, thereby giving work to psychologists and psychotherapists. If everyone went round being the captain of his soul, what would there be for psychologists to do? They would need counselling about their loss of income.

Henley lived in Woking in the latter part of his life, though he also maintained a flat in this Battersea block

St John the Baptist Churchyard, Cockayne Hatley, Bedfordshire

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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