bumptious Kenneth Tillotson, reported encouraging results from a therapy they called hypothermia. Like Dr. Willard’s drowning regimen of a century and a half before—and like the various shock therapies coming into use during the twentieth century—the hypothermia cure reduced the body to a near-death state by lowering the patient’s body temperature. It was not hibernation, the doctors emphasized, and was decidedly not refrigeration. “We object to the word refrigeration,” they wrote, “because it implies that the object treated is refrigerated and that the temperature is reduced considerably lower than is compatible with life.” Their modus operandi and their conclusions seem comic to us now, all the more so because
they cited an 1805 cold-water dunking of an English convulsive as an important precursor for their experiment. But Talbott and Tillotson produced two important results: Four of the ten patients whose body temperatures they lowered by twenty degrees or more for periods of up to sixty-eight hours (!) showed marked improvements. The mental state of one sixteen-year-old boy cleared to the point where he could leave the hospital and go home. And one patient, a forty-six-year-old male paranoid schizophrenic whom they kept cold and semiconscious for fifty hours, died when his lowered blood pressure never came back again. The doctors injected him with adrenaline and caffeine, to no avail. “It is hoped that this would not have occurred,” Talbott and Tillotson wrote. But it did.
The procedure sounds, well, chilling. After sedating the schizophrenic patients with a barbiturate (Nembutal) and a muscle relaxant (Evipal), the doctors wrapped them in special blankets manufactured by the Therm-O-Rite Products Company of Buffalo, New York, through which they circulated a refrigerant. A stomach tube pumped glucose into the patient to keep him or her alive, and a thermocoupled rectal thermometer transmitted bodytemperature readings every other minute. The patients were garden-variety catatonic, paranoid, and hebephrenic (the “laughing disease”) schizophrenics. One young woman, a twenty-five-year-old medical student, had already received Dauernarkose (continuous sleep), insulin shock, metrazol, and typhoid vaccine therapies before coming to McLean. She had an unusual reaction to the cold: Her mental acuity cleared when her body temperature was more than ten degrees below normal, and she then reverted to her disturbed condition as the thermometer approached 98.6. She had three hypothermia treatments and was classified as a success, although she remained at the hospital. Overall, the doctors claimed success in four cases, temporary improvements in four others, and no discernible effects in the remaining two. The younger patients with shorter histories of mental illness responded better than the older patients; it was the oldest patient who died.
Talbott and Tillotson derived a “modicum of hope” from their work: “The results would seem to be at least equally as promising as insulin and metrazol in the treatment of schizophrenia,” they wrote. They felt compelled to add that “hypothermia does not cause morphologic damage,” meaning bodily harm. That is true, unless one includes death by cardiac arrest.
A kinder, gentler form of therapy was the various water treatments that had been administered to mental patients since the end of the eighteenth century. (A young psychiatrist once asked Paul Howard, who joined the McLean staff before World War II, why patients comported themselves better after hydrotherapy treatment. “Don’t you always feel more relaxed after a nice, warm bath?” was Howard’s commonsensical reply.) The 1922 McLean nurses’ manual lists no fewer than seventeen different hydrotherapy regimens, from the foot bath to the shampoo. Most are categorized as “tonic baths” and administered in the “hydriatic suite” in the basement of the women’s gymnasium. Here are a few of the
they cited an 1805 cold-water dunking of an English convulsive as an important precursor for their experiment. But Talbott and Tillotson produced two important results: Four of the ten patients whose body temperatures they lowered by twenty degrees or more for periods of up to sixty-eight hours (!) showed marked improvements. The mental state of one sixteen-year-old boy cleared to the point where he could leave the hospital and go home. And one patient, a forty-six-year-old male paranoid schizophrenic whom they kept cold and semiconscious for fifty hours, died when his lowered blood pressure never came back again. The doctors injected him with adrenaline and caffeine, to no avail. “It is hoped that this would not have occurred,” Talbott and Tillotson wrote. But it did.
The procedure sounds, well, chilling. After sedating the schizophrenic patients with a barbiturate (Nembutal) and a muscle relaxant (Evipal), the doctors wrapped them in special blankets manufactured by the Therm-O-Rite Products Company of Buffalo, New York, through which they circulated a refrigerant. A stomach tube pumped glucose into the patient to keep him or her alive, and a thermocoupled rectal thermometer transmitted bodytemperature readings every other minute. The patients were garden-variety catatonic, paranoid, and hebephrenic (the “laughing disease”) schizophrenics. One young woman, a twenty-five-year-old medical student, had already received Dauernarkose (continuous sleep), insulin shock, metrazol, and typhoid vaccine therapies before coming to McLean. She had an unusual reaction to the cold: Her mental acuity cleared when her body temperature was more than ten degrees below normal, and she then reverted to her disturbed condition as the thermometer approached 98.6. She had three hypothermia treatments and was classified as a success, although she remained at the hospital. Overall, the doctors claimed success in four cases, temporary improvements in four others, and no discernible effects in the remaining two. The younger patients with shorter histories of mental illness responded better than the older patients; it was the oldest patient who died.
Talbott and Tillotson derived a “modicum of hope” from their work: “The results would seem to be at least equally as promising as insulin and metrazol in the treatment of schizophrenia,” they wrote. They felt compelled to add that “hypothermia does not cause morphologic damage,” meaning bodily harm. That is true, unless one includes death by cardiac arrest.
A kinder, gentler form of therapy was the various water treatments that had been administered to mental patients since the end of the eighteenth century. (A young psychiatrist once asked Paul Howard, who joined the McLean staff before World War II, why patients comported themselves better after hydrotherapy treatment. “Don’t you always feel more relaxed after a nice, warm bath?” was Howard’s commonsensical reply.) The 1922 McLean nurses’ manual lists no fewer than seventeen different hydrotherapy regimens, from the foot bath to the shampoo. Most are categorized as “tonic baths” and administered in the “hydriatic suite” in the basement of the women’s gymnasium. Here are a few of the
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