Category Archives: lunacy

British social policy defined

An idiocy wrapped in a lunacy wrapped in an absurdity, to produce misery and squalor

Dalrymple writes:

A tax on knowledge is a terrible thing, but a tax on ignorance, prejudice, evasion and half-truth is worse. That is what every British household with a television must pay, for the privilege of having the earnest but frivolous lucubrations of the BBC purveyed to it, whether it wants them or not.

This poll tax — or licence fee, as it is known — is the equivalent of nearly $200 per household a year, and is thus worth evading. Unfortunately, it costs nearly three times as much to catch evaders as the licence fees would have raised if paid. One proposal is to halve the licence fee for single mothers. Dalrymple comments:

In other words, we should subsidise a subsidy, in the name of a universal right to misinformation and trashy entertainment (and at the same time confer yet another incentive for single parenthood).

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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Bureaucratic mentality

H.M. Prison Winson Green, where Dalrymple was a specialist

H.M. Prison Birmingham

Speaking grosso modo, Dalrymple writes that prison officers he worked with were more astute and kinder than staff at psychiatric hospitals.

They had not had their heads filled with psychological jargon. When they came to me to tell me that a prisoner was not himself, or was acting strangely, or that ‘he’s not your typical con’, I soon learnt to take their observations seriously.

Rampton Secure Hospital

Rampton Secure Hospital

Dalrymple says that prisoners he knew were in general

far more afraid of psychiatric hospitals than they were of prisons. One of their most plaintive cries was, ‘You’re not nutting me off, are you, doctor?’

In official reports of disastrous cases in psychiatric hospitals, salient phrases include ‘lessons have been learnt’ and ‘errors of communication’.

One could write almost all reports on disastrous cases before they have occurred. By ‘lessons have been learnt’ is meant ‘it will be exactly the same next time’.

The lesson that has been learnt

is always that a new form, longer and more complex than the old, should be introduced. The form-filling gets in the way of genuine contact with or concern for the patient. The form-filling is the work itself.

Mental mastery

Drawing by Hyacinth Freiherr von Wieser at the Prinzhorn Collection, 'the first, largest, and best collection of art by psychotic patients'. Dalrymple goes on: 'To Dr Hans Prinzhorn [1886-1933] belongs the honour, to my mind a considerable one, of having recognized artistic merit in the productions of psychotic persons and not merely pathological manifestations of grossly disordered psyches. It bespeaks a laudable openness and largeness of spirit in him as well as an admirably independent aesthetic judgment.'

Drawing by Hyacinth Freiherr von Wieser. Held at the Prinzhorn Collection, ‘the first, largest, and best collection of art by psychotic patients’, says Dalrymple. ‘To Dr Hans Prinzhorn [1886-1933] belongs the honour, to my mind a considerable one, of having recognized artistic merit in the productions of psychotic persons and not merely pathological manifestations of grossly disordered psyches. It bespeaks a laudable openness and largeness of spirit in him as well as an admirably independent aesthetic judgment.’

A doctor writes

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Dalrymple is available to answer any questions you may have about corpulence, intemperance, liverishness, lunacy, narcosis, senility, hemp, alimentation, misopædia, inoculation, etc., etc.

All-pervasive lunacy

Screen Shot 2013-04-05 at 01.44.48Dalrymple says he doubts, after publication next month of the fifth edition of the APA’s Diagnostic and Statistical Manual, that it will be possible any longer to find anyone, anywhere, who is not suffering from some form of mental illness.