Timeline of Events
LATE 1800's
1922
- Henry A. Cotton studied in Europe under Emil Kraepelin and Alois Alzheimer, considered the pioneers of the day. He was a student of Dr. Adolf Meyer of Johns Hopkins School of Medicine, who dominated American psychiatry in the early 1900s.
- The New Jersey State Lunatic Asylum in Trenton, the first public mental hospital in the state of New Jersey, was founded on May 15, 1848. Dr. Horace A. Buttolph was the hospital's first superintendent, during his time the hospital admitted and treated 86 patients.
- Germ theory which states that many diseases are caused by the presence and actions of specific micro-organisms within the body was developed and became the leading theory in Europe and the United States, suppressing existing miasma and contagion theories of disease and in doing so radically changed the practice of medicine
- In 1907 Dr. Henry Cotton, at age thirty, became the medical director of the New Jersey state hospital in Trenton, removing mechanical restraints and making patient care the top priority.
- Dr. Cotton based his treatment of patients around his theory that mental illness was the result of bacterial infections and pus found throughout the body. His theories were highly regarded by medical organisations across the globe.
- Cotton implemented his theories by having patients teeth pulled out, as he suspected them of harbouring hidden infections. He would then move to their tonsils and sinuses if it didn't “cure” the patient and then on to more vital organs such as stomachs, spleens, testicles, ovaries and colons. As a way of “treatment” some patients were even subjected to such invasive organ removal that they were barely alive at all.
- Dr. Cotton declared a cure rate of 85 percent and patients and their families pleaded to be treated at Trenton some paying excessive amounts of money.
- Margaret Fisher the daughter of Irving Fisher, who was a wealthy and famed Yale economist was transferred to Trenton. Originally diagnosed as schizophrenic in Bloomingdale asylum, Cotton noted retention of decal matter in the faecal colon and enlargement of the colon. This diagnosis was followed by numerous colonic surgeries.
- Margaret Fisher died November 7th 1919 from streptococcal infection.
- The danger behind some of Cottons surgeries began to be recognised by the mentally ill. Fear began to develop in the hospital and some patients violently fought back as they were forced into surgery.
- Many “treatments” were not voluntary.
- On January 11th, Cotton began a series of lectures at Princeton on his breakthrough medical theories to an audience of about 400. He was highly respected in the medical world and many continued to believe in Cotton’s theories, even Mr Fisher insisting that there had been a physical cause of his daughter’s death.
1922
- Journalist, Thomas Quinn Beeslay for the New York Times reviewed the published version of Cotton's lectures stating "At the State Hospital at Trenton, N.J., under the brilliant leadership of the medical director, Dr. Henry A. Cotton, there is on foot the most searching, aggressive, and profound scientific investigation that has yet been made of the whole field of mental and nervous disorders... there is hope, high hope... for the future."
- Mental illness rates were growing fast across the country.
- With Cotton's agreement, Adolf Meyer , head of the most respected psychiatric clinic and training institution for psychiatrists in the US sent a former student, Dr. Phyllis Greenacre, to evaluate Cotton’s work, as he increasing began to doubt Cotton's view on surgery.
Greenacre's study being in the fall of 1924
- The report was completed with precise and shocking results. Greenacre's found staff records to be disorganised and the true "recovery" rate to be no more than 32 per cent, and a mortality of 45 per cent among those mentally ill patients who had lost their colons.
- Cotton was furious at the results of the data, however Meyer failed to allow the findings to be published and even more shockingly allowed the 'slaughter' to proceed.
- An investigation into Cotton's treatments was launched after criticism of the hospital reached the New Jersey State Senate. Testimonies were gathered from former patients and employees of the hospital.
- Countering the criticisms on September 24, the New York Times stated “eminent physicians and surgeons testified that the New Jersey State Hospital for the Insane was the most progressive institution in the world for the care of the insane, and that the newer method of treating the insane by the removal of focal infection placed the institution in a unique position with respect to hospitals for the mentally ill" and other support of Henry A. Cotton by many professionals and politicians.
- During the public hearing Cotton fell ill, some saying he suffered a ‘nervous breakdown’. He diagnosed himself as suffering from several infected teeth and had them removed. He pronounced he was cured and returned to work.
- Meyer's silence guaranteed the practices to continue.
- In October, Cotton retired from his position as medical direct the State hospital. This marked the end of such invasive surgeries, but the hospital continued to adhere to Cotton’s human treatment guidelines, and to carry out his less risky medical procedures until the late 1950s. The removal of patient's teeth continued as normal practice until 1960.
- Emil Frankel began his own report on Cotton's work noting that he had seen Greenacre’s report and agreed with it substantially, his report failed to be completed.
- Henry A. Cotton continued to direct the staff at Charles Hospital until his death in May.
- Cotton died of a heart attack at his private club in Trenton.