Madhouse and The Lobotomist: Reviews by Tillman, Jane G. Psychoanalytic Psychology. 2007 Jan Vol 24(1) 187-191.

Abstract
Reviews the books, Madhouse: A Tragic Tale of Megalomania and Modern Medicine by Andrew Scull (see record 2005-06776-000); and The Lobotomist: A Maverick Medical Genius and His Tragic Quest to Rid the World of Mental Illness by Jack El-Hai (see record 2005-02343-000). In both books, 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. 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. Jack El-Hai gives us the next segment of psychiatric surgery in his book The Lobotomist, a biography of the neurologist, turned surgical outlaw, Walter Freem an, MD. Walter Freeman was a neurologist fascinated with science and experimentation. Settling into work at St. Elizabeth’s hospital in Washington, DC, in 1924, Freeman eventually joined the faculty of George Washington University where he remained until 1954. At that time neurosyphilis was the scourge of mental hospitals producing thousands of victims who were totally disabled by the neurological sequellae of tertiary illness. Thus lobotomy became an efficient outpatient procedure that could be applied to a larger patient population. Both of these books are important reading. Of all the great medical advances of the last century, surely the one that stands out as perhaps the greatest is the Nuremberg Code of 1947, which requires a competent patient giving informed consent to treatment and to research efforts.