Surgery for the treatment of psychiatric illness: the need to test                untested theories

Wessely, Simon

doi:10.1258/jrsm.2009.09k038

Cited by 15 publications

(11 citation statements)

References 12 publications

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“…Top-down, psychosomatic-oriented theorists [117] continue to haul out Lane and Cotton as exhibits A and B to exclaim that autointoxication as it relates to mental health was nonsense [118] - with nary a mention of the history of the other not-so-Great Men, and the emerging gut-brain-microbiome research. Psychosomatic researchers continue in their quest to show that IBS is provoked by neuroticism – non-prospective, x-sectional population studies show high degrees of neuroticism correlate with IBS severity, and the Pubmed abstracts boldly conclude that ‘ These results suggest that neuroticism is involved in the pathophysiology of IBS ’ [119].…”

Section: Discussionmentioning

confidence: 99%

Intestinal microbiota, probiotics and mental health: from Metchnikoff to modern advances: part III – convergence toward clinical trials

2013

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Rapid scientific and technological advances have allowed for a more detailed understanding of the relevance of intestinal microbiota, and the entire body-wide microbiome, to human health and well-being. Rodent studies have provided suggestive evidence that probiotics (e.g. lactobacillus and bifidobacteria) can influence behavior. More importantly, emerging clinical studies indicate that the administration of beneficial microbes, via supplementation and/or fecal microbial transplant (FMT), can influence end-points related to mood state (glycemic control, oxidative status, uremic toxins), brain function (functional magnetic resonance imaging fMRI), and mental outlook (depression, anxiety). However, despite the advances in the area of gastro-biological psychiatry, it becomes clear that there remains an urgent need to explore the value of beneficial microbes in controlled clinical investigations. With the history explored in this series, it is fair to ask if we are now on the cusp of major clinical breakthroughs, or are we merely in the quicksand of Autointoxication II?

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Section: Discussionmentioning

confidence: 99%

Intestinal microbiota, probiotics and mental health: from Metchnikoff to modern advances: part III – convergence toward clinical trials

2013

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“…However, it was soon apparent that the routine removal of teeth could not predictably cure circulatory, neurodegenerative, or kidney diseases. Patients demonstrated a worsening of arthritic symptoms and, not surprisingly, developed digestive complications following therapeutic edentulation (Cecil & Angevine, ; Vaizey & Clark‐Kennedy, ), and in many cases, were cured of their psychiatric ailments even in the absence of edentulation (Wessely, ; Shorter, ). As medical experimentation and animal model research grew more sophisticated, significant flaws were identified in Rosenow's, Hartzell and Henrici's, and Price's studies, notably the lack of controls and the massive doses of bacterial inoculum used.…”

Section: The Oral Microbial Ecosystem – Real Estate and Habitatsmentioning

confidence: 99%

From focal sepsis to periodontal medicine: a century of exploring the role of the oral microbiome in systemic disease

Kumar

2016

The Journal of Physiology

197

139

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The oral microbiome is established within a few minutes after birth and consists of stable multi-species communities that engage in a dynamic equilibrium with the host immune system. Dental caries, endodontic infections and periodontal diseases are bacterially driven diseases that are caused by dysbiotic microbiomes. Over a century ago, the focal infection theory implicated these infections in the aetiology of several systemic diseases, ranging from arthritis to neurodegenerative diseases. However, a lack of concrete evidence, combined with the urgency with which clinicians embraced this approach without regard for appropriate case selection, led to its demise within 30 years. In the last decade of the 20th century, the concept of periodontal medicine was introduced to explain the correlations that were being observed between periodontitis and cardiovascular disease, rheumatoid arthritis, Alzheimer's disease, pulmonary disease, pre-term delivery of low birth weight infants and metabolic disease. It was proposed that periodontal pathobionts played a causal role in the initiating or exacerbating certain diseases either by direct invasion or by stimulating a florid immune-inflammatory response that extended into the systemic circulation. This review will examine the strength of current evidence in establishing a causal link between oral pathobionts and systemic disease.

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“…Although Cotton published many papers in the peer-reviewed literature, he was perceived more as engaging in self-promotion through the public media. While Cotton's reputation was clearly damaged by the New York study, as well as similar findings by others including Englander, 25 he continued to pursue his work. He was scarred by two investigations, one by Phyllis Greenacre (1894–1989), a young psychiatrist sent by Adolf Meyer, and the other by a committee of the New Jersey Senate, led by Senator William Bright.…”

Section: Henry Cottonmentioning

confidence: 86%

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

Davidson

2016

J Med Biogr

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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.

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Surgery for the treatment of psychiatric illness: the need to test untested theories

Cited by 15 publications

References 12 publications

Intestinal microbiota, probiotics and mental health: from Metchnikoff to modern advances: part III – convergence toward clinical trials

Intestinal microbiota, probiotics and mental health: from Metchnikoff to modern advances: part III – convergence toward clinical trials

From focal sepsis to periodontal medicine: a century of exploring the role of the oral microbiome in systemic disease

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

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