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Tillman, J.G. (2007). Madhouse: A Tragic Tale of Megalomania and Modern Medicine, by Andrew Scull, New Haven: Yale University Press, 2005, 360 pp., $30.00. The Lobotomist: A Maverick Medical Genius and His Tragic Quest to Rid the World of Mental Illness, by Jack El-Hai, Hoboken: John Wiley and Sons, Inc., 2005, 362 pp., $27.95.. Psychoanal. Psychol., 24(1):187-191.

(2007). Psychoanalytic Psychology, 24(1):187-191

Book Reviews

Madhouse: A Tragic Tale of Megalomania and Modern Medicine, by Andrew Scull, New Haven: Yale University Press, 2005, 360 pp., $30.00. The Lobotomist: A Maverick Medical Genius and His Tragic Quest to Rid the World of Mental Illness, by Jack El-Hai, Hoboken: John Wiley and Sons, Inc., 2005, 362 pp., $27.95.

Review by:
Jane G. Tillman, Ph.D.

In both Madhouse: A Tragic Tale of Megalomania and Modern Medicine and The Lobotomist: A Maverick Medical Genius and His Tragic Quest to Rid the World of Mental Illness, the history of experimental clinical psychiatry is laid bare with devastating accounts of the efforts to conquer mental illness by any means necessary. Both books are fascinating reading and may illuminate our current context in which the biological avenues for treating mental disorders continue to traffic in hopes of a one-size-fits-all cure, while psychoanalysis ambivalently struggles with how to conduct rigorous research to demonstrate the efficacy of our treatment

Andrew Scull's book Madhouse offers a well-documented historical account of a bizarre episode in American psychiatric history. The centerpiece of Scull's investigative work is Henry Cotton, MD, the superintendent of the Trenton State Hospital in Trenton, New Jersey, from 1907-1930. Dr. Cotton was hired to come to Trenton following a scandalous tenure by the previous superintendent, John Ward, in which patients were shackled or restrained for “years,” attendants were reported to rule over their charges with violence and abuse, and the squalor had produced dysentery and diarrhea in many of the patients, with a typhoid epidemic at the hospital in the spring of 1907 threatening the lives of hundreds. Added to the woes of Dr. Ward was the cover-up of the murder of a patient by hospital attendants. Into this scene, Henry Cotton arrived in late 1907 to institute reform and usher in modern psychiatry, in the tradition of his mentor Adolf Meyer, MD—one of the giants of early 20th century psychiatry. Meyer and his followers moved the profession of “alienists” into the modern era of scientific medicine and neuropsychi-atry advocating laboratory-based medicine.

Once Cotton arrived at Trenton, he was appalled by the conditions he found and instituted reforms such as eliminating the culture of violence by attendants, removing over 700 pieces of restraining equipment from the hospital, and introducing occupational therapy. So far so good.

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