Hello! On Monday, I published Part 1 of a historical look at the ways in which mental illness was once treated. Here’s Part 2. It’s not any better.
4. Fever therapy
Some general basics here: You don’t just get a fever because your body hates you. Fevers occur when your body has an infection, and your temperature raises to fight off the foreign germ invaders.
Keep this in mind, and allow me to introduce you to Hilda, a patient who was suffering from what the early 20th century referred to as “general paresis of the insane,” (or GPI) caused by advanced syphilis. Hilda was confined to a psychiatric clinic in Austria when she came down with a pretty serious fever. She recovered from the fever…and her psychosis.
How they thought it worked
Hilda’s doctor, Dr. Julius Wagner-Jauregg, attributed Hilda’s sudden recovery to the fever. Using other GPI patients, Wagner-Jauregg began to experiment by injecting patients with a slew of other illnesses, including streptococcal bacteria (strep throat), tuberculin (tuberculosis) and malaria (freakin malaria).
However, for many, the therapy actually worked:
“Patients who previously behaved bizarrely and talked incoherently now were composed and conversed normally with Dr. Wagner-Jauregg. Some patients even appeared cured of their syphilis entirely. Here in the twenty-first century it may not seem like a favorable bargain to trade one awful disease for another, but at least malaria was treatable with quinine, a cheap and abundant extract of tree bark.”
Fever therapy (also known as Pyrotherapy) was used as late as the 1930s, when special machines were constructed to induce a fever.
The therapy did work…for GPI. And GPI only. And it did have the nasty side effect of giving someone whatever deadly illness they were injected with, complete with a 15% chance of…death.
The problem, of course, is that this wasn’t understood. Pyrotherapy (side note: this is the greatest name ever, because it sounds like you are being healed with fire) worked by killing the microorganisms which caused GPI, but there was no such equivalent for other forms of mental illness.
Meanwhile, pyrotherapy was used to treat a variety of different psychiatric disorders, including depression and schizophrenia. New, exciting ways were brought in to treat fevers to, expanding to everything from typhoid to electric blankets. Observations at the time showed that the therapy could work in very limited circumstances, but most of the time, there was no improvement.
As for Wagner-Jueregg? He, too, won a Noble prize. Apparently, they are not as hard to get as one would previously expect!
Nothing’s calmer than a nice, relaxing bath to destress you after a long, tough day, right? Well, what about being soaked in icy cold towels and made to stay in a bath overnight?
How they thought it worked
According to this 2015 Psychology Today article, in older times, mental illness was thought about in “spiritual terms” – and water was seen as an antidote. As a result, water became to be viewed as a common cure to a variety of mental illnesses. This became particularly prominent in the 18th century, when two types of hydrotherapies became prominent:
• The douche (shower), in which a “constant torrent of water could either cool the heat of madness or rouse the melancholic.”
• The balenum (bath), which was just meant to calm someone down.
With the rise of psychiatric hospitals, the practice became more prominent and a variety of different pieces of equipment were developed for the practice, including bath boxes, dunking devices (I don’t think they mean those carnival games) and more.
While this all sounds relatively harmless, in it’s more extreme forms, the therapy could be downright cruel and dangerous. According to one review, in some cases, “A patient could expect a continuous bath treatment to last from several hours to several days, or sometimes even over night.”
The therapy faded from prominence in the early 20th century as other bad ideas replaced this one (insulin shock, electroshock and more).
Here’s the thing though: While forcing someone to do anything against their will is almost always a bad thing, taking a bath can be good for your mental health, so this therapy wasn’t entirely off base! According to this Guardian article, taking a bath can increase your core temperature. This, in turn, is associated with a “moderate but persistent” mood increase.
So, hop on into the tub! Just…don’t strap yourself in. Bad call there.
Trephination is the fun-filled process by which a hole was cut in someone’s skull. It is one of the oldest forms of therapy, with evidence for the practice dating all the way back to 6500 BCE. Its use wasn’t just confined to mental illness; no no, that would at least limit those who suffered from this God-awful practice. Instead, trepanning was used for a variety of illnesses, including seizures, migraines and head wounds, as well as pain.
Is was used as recently as the Renaissance, around which time one can assume that it began to occur to practitioners that cutting a big ole hole in someone’s skull was not necessarily the greatest practice.
How they thought it worked
Similar to hydrotherapy above, trephination was used because of a different understanding of mental illness. The hole cut in one’s skull would allow for bad spirits to get out, or good spirits to get in. This, in turn, would relieve mental illness.
At the same time, trephination had other uses. Skull discs would be collected and used as good luck charms or amulets, and in ancient Egypt, the scrapings of a skull were used to make potions (hey, why let a good thing go to waste!)
What is even more remarkable is that these operations did not kill everyone on the spot. There is ample evidence that many survived the procedure, as evidenced by skull regrowth among those who had the operation.
Do I really need a “but, actually” section here? Drilling holes in the skulls of people is, generally speaking, a bad practice, m’kay?
Now, that being said, there are exceptions to every rule, and skull-holes has those exceptions as well. In limited instances, such as in the case of brain injury, and specifically epidural and subdural hematomas.
Of course, skull removal is never used for mental illness at this point. Thank God.