In A Nutshell
In the early 1900s, two US surgeon-psychiatrists, Bayard Holmes and Henry Cotton, championed the removal of parts of the intestine to cure schizophrenia. Both men believed in “autointoxication,” insanity triggered by infectious bacteria in the patient’s body. Death rates were high and successes were questionable. By the mid-1930s, psychiatric treatment began to concentrate on brain pathways. However, recent studies suggest that gut bacteria may affect our physical and mental health, including a possible link to schizophrenia.
The Whole Bushel
In the early 1900s, two US surgeon-psychiatrists, Bayard Holmes and Henry Cotton, championed the removal of parts of the intestine to cure schizophrenia. Both men believed in “autointoxication,” insanity triggered by infectious bacteria in the patient’s body.
In Holmes’ case, it was the onset of schizophrenia in his son in 1905 that propelled him to find a cure for this devastating disease. In 1916, he thought he found the cause of schizophrenia, an intestinal blockage from excessive bacterial growth that sent histamine coursing through the body.
This occurred before antibiotic usage, so Holmes opted for a surgical solution. He operated on the patient’s appendix, making an opening into the intestine to wash out the bacteria and toxins daily. Tragically, he also put his son under the knife. Four days later, the young man died from surgical complications.
Along with his son, Holmes buried the details of what he had done. He rarely spoke about it and deliberately removed the evidence from his medical records. Amazingly, it didn’t stop him from operating on other psychiatric patients in the same way. From 1916 to 1919, Holmes and his associates performed the surgery on 22 patients. Two died. Although Holmes declared success in several cases, his colleague Horry Jones conducted research that ultimately questioned those results. Holmes fired Jones.
The other surgeon-psychiatrist, Cotton, performed his surgeries as director of Trenton State Hospital, a New Jersey psychiatric institution. However, Cotton didn’t limit himself to intestines. He also yanked out bladders, cervices, gall bladders, teeth, thyroids, tonsils, and more. Of the 645 psychiatric surgeries in which he removed part or all of the patient’s intestines, about one-third of his victims suffered from schizophrenia.
Cotton boasted of an 80 percent success rate, yet he admitted to losing 25–30 percent of his patients. Those numbers obviously don’t add up. Nevertheless, that means at least 161 and possibly as many as 194 people died from intestinal surgery for psychiatric conditions under his care. Cotton dismissed the deaths, saying they occurred because chronic psychosis had caused his patients to become weak physically. Even more outrageous, Cotton often proceeded without the consent of the patient’s family, sometimes deliberately defying the wishes of the family.
Although Cotton was publicly praised at first for his psychiatric efforts, he eventually came under fire from skeptics and lost his job as Trenton’s clinical director. However, he continued as the institution’s research director. Worse yet, he continued to operate at his own clinic. Cotton was obsessed with extracting teeth to prevent infections, which he saw as the cause of mental illness. As a precaution, he pulled all of the teeth of his wife and two sons. Years later, both sons committed suicide.
Holmes died in 1924, Cotton in 1933. In 1936, medical treatment for mental illness took a new turn when Portuguese neurologist Egas Moniz recommended operating on the brain to destroy specific brain pathways.
Interestingly, studies in the latter part of the 20th century showed that schizophrenia patients had better outcomes in third-world countries than in developed countries. Some researchers believe that first-world patients are overmedicated with psychiatric drugs. They concluded that selective, limited use of drugs, rather than continual usage, works better for most patients in the long term.
However, the pendulum is swinging back toward considering microbiota, intestinal bacteria, and other organisms, as the cause of many illnesses, including mental illness. Some researchers believe that manipulating gut bacteria may be the key to the prevention or treatment of asthma, autism, diabetes, obesity, and even schizophrenia.
As one example, scientists point to toxoplasma, an intestinal parasite, that makes rats unafraid of cats, their natural predator. It appears that toxoplasma permanently change the behavior of rodents. Even when the parasites are removed, the rodents remain unafraid of cats.
Some humans also live with toxoplasma in their intestines. Is it possible these organisms affect our behavior? Researchers don’t have the answers yet, but they’re looking into it. If so, there is some good news. Although microbiota can impact humans in negative ways, some studies have demonstrated that we can purposely change our gut bacteria to become healthier.
Show Me The Proof
Discover: The Tragic History of Surgery for Schizophrenia
Psychology Today: A Schizophrenia Mystery Solved?
ABC: Bacteria, gut organisms linked to health, autism, schizophrenia, depression, diabetes, allergies and obesity