Editorial

It is incredibly easy to look at Henry Cotton and see a brutal megalomaniac willing to stop at nothing for his own sick pleasures, however in saying this, many other factors must first be acknowledged. Yes, it is true that throughout his lifetime, Cotton performed countless dangerous and inhumane surgeries in which the outcome for the patient was death or severe impairment, however, for Cotton, it was not the harming of the patient that intrigued and possessed him to continue, but rather it was what got him started in the first place - his powerful need to find a cure for madness.

Cotton, qualified as a psychiatrist, gained a hefty reputation for himself early in his career. Not only were his credentials “impeccable”, but also he had studied under Adolf Meyer, who, at this time, was an incredibly renowned and influential psychiatrist (Jones, 2005). It was thus no surprise that Cotton secured himself the position of medical director at the ‘large lunatic asylum’ (Daniels, 2005), Trenton State Hospital. Before Cotton’s arrival, this hospital was in a horrendous condition. Patients were disease-ridden and the staff were corrupt and neglectful of their patients. Upon his arrival, Cotton made numerous changes, including the elimination of mechanical restraints, cleaner working standards, the opening of a school for nurses, installation of fire alarms and the hiring of social workers and occupational therapists (Wessely, 2009). Here, it is made clear that Cotton did have good intentions from the outset, however, unfortunately for him and the families involved, somewhere along the way, he became misguided and could not see that he was doing more harm than good.

It was here, at the Trenton State Hospital, that Cotton developed his focal sepsis theory, in which he believed that madness was caused by an infection of the teeth, tonsils, sinuses and the colon. His solution? Naturally, it was to remove the source of infection by removal of teeth, the washing out of sinuses, and the removal of the colon. Tragically however, Cotton did not stop here. In patients hard to cure, he began removing organs of the digestive and reproductive systems (Jones, 2005). In 1923, Cotton asserted he was producing an 85% cure rate, when in reality 30% of his patients would not even survive the “treatment” (Jones, 2005). Conversely, what must be considered is the era in which Cotton lived. Today, not only has science progressed immensely, but society has laws in place to protect the freedom and safety of the individual. Cotton lived in an age in which little was known about sterility and there were no antibiotics. This in itself would have caused many of the deaths on Cotton’s hands.

For Henry Cotton, his pursuit to find a cure for madness, ironically enough, drove him mad. This man was so set on achieving his goal, which he lost sight of the reason he began in the first place. Cotton was not an evil man, but a man wanting to make a change. To him, he saw short-term consequences that would find him a long-term resolution. Otherwise, why would he extract his own teeth, or those of his own children, if he did not believe what he was doing was worthwhile? Yes, he did horrible and unnecessary things, but one cannot deny that Henry Cotton was a man of good intentions.