Bayard Holmes (1852–1924) and Henry Cotton (1869–1933): Surgeon–psychiatrists and their tragic quest to cure schizophrenia

Abstract

Early 20th-century medicine was dominated by the infectious theory of disease. Some leading physicians believed that infection or the accumulation of toxic substances from bacterial stasis caused a wide range of diseases, including schizophrenia. In the case of schizophrenia, one theory held that intestinal stasis lead to the bacterial production of toxins that affected brain function, resulting in psychotic illness. This theory predicted that clearing the stasis by drainage or by removal of the offending organ would be curative. Bayard Holmes and Henry Cotton, surgeon-psychiatrists, achieved notoriety for their efforts to cure schizophrenia surgically. Their endeavours were not only a failure but resulted in tragedy to their families and to a wider population. Treatment of their own sons also represented a violation of the ethics of their time. This account describes the life and career of Holmes and Cotton and reappraises their work in the light of recent developments.

Evidence for Reductionist or Anti-Reductionist Approaches of Mental Processing

“…While interventions can be made blind to mechanisms, the history of these interventions in psychiatry is poor. In the 20th century these included ice baths, malaria-induced fevers, insulininduced comas, electrical or drug-induced seizures, removal of teeth or parts of the digestive tract (Khazan, 2014;Davidson, 2016), and lobotomy (Breggin, 1993). These shock approaches had little or no evidence to support their use, but they were still confidently used in mainstream psychiatry: the psychiatrist R.D.…”

Neurobiological reduction: From cellular explanations of behavior to interventions

“…While interventions can be made blind to mechanisms, the history of these interventions in psychiatry is poor. In the 20th century these included ice baths, malaria-induced fevers, insulin-induced comas, electrical or drug-induced seizures, removal of teeth or parts of the digestive tract ( Khazan, 2014 ; Davidson, 2016 ), and lobotomy ( Breggin, 1993 ). These shock approaches had little or no evidence to support their use, but they were still confidently used in mainstream psychiatry: the psychiatrist R.D.…”

The microbiome and mental health: Hope or hype?

“…This not only led to treatments targeted toward changing the gut via oral consumption of products comprising things such as lactic acid-producing bacteria, 5 but also involved extreme measures such as gastrointestinal surgery for schizophrenia -a procedure associated with high mortality and little else. 6 The flawed translation from scientific theory to clinical utility marked the beginning of the end for this school of thought and should be reflected on as the field, buoyed by strong preclinical work, again attempts to transition into the realm of treatment. One reason for the initial departure from the concept of autointoxication was purported to have been that, in parallel to the legitimate scientific interest in the effects of intestinal bacteria on health, charlatans were alert to the financial possibilities offered by the idea that cleaning out the colon could instantly improve well-being and began to sell a variety of alternative health products linked to improving your gut microflora and your sense of well-being.…”