November 15th, 2011

The New Jersey State Lunatic Asylum

Dorothea Dix founded the New Jersey Lunatic Asylum on May 15, 1848. It's completion marked the opening of the first mental hospital in the entire state.
Though conceived and built with the noble intentions to aid those who could not help themselves, this lunatic asylum (later renamed the Trenton Psychiatric Hospital) is awash in disturbing history.
It was a dark time. Not only for the hospital, but for the medical community as a whole, and it all began when a Dr. Henry Cotton became the medical director in 1907.

Cotton was a firm believer that the key factor to the onset and persistence of mental illness could be found in the form of infections within one's body.
To preserve and restore the troubled minds of the patients under his care, he and his staff took to removing the patient's teeth, as the teeth were thought to house infections.
If that remedy failed to have a positive effect, more body parts were systematically removed from the patient. Other organs seen as a threat of infection, and therefore removed included
the tonsils and sinus, which were next on the list if pulling of teeth did no good. From there the patient could loose a number of internal organs, including but not limited to;
the colon, cervix, ovaries, gall badder, stomach, spleen, and testicles. Based solely upon his own research and experimentation, Cotton publicly reported a wonderful success rate for his patients.
The concept of infections was still new science at the time, and due to his alleged link between that and mental illness, Cotton garnered much praise in the medical community
both in the United States and Europe.

In a sad irony, the surgeries cotton preformed were done in an era before the use of antibiotics, resulting in a high mortality rate... due to postoperative infections.
Many of the patients at Trenton Psychiatric were mentally handicapped, some quite severely so. Still, even they were noticing that many of the people who went under Cotton's knife
ended up dead some time thereafter. This resulted in patients who became very fearful of surgery, and would literally be dragged into the operating room in a state of panic.

Eventually Cotton's methods began to draw the attention of other members of the psychiatric field, who felt that surgical procedures did little to help with one's mental state.
Dr. Meyer, head of the psychiatric clinic and training institution at John Hopkin's University was contacted to do an independent overview of the work occurring at Trenton Psyche.
Meyer commissioned a member of his staff, Dr. Phyllis Greenacre, to critique Cotton's work at the hospital. She began in the fall of 1924, after Dr. Meyer had returned from a visit
to the hospital which left him with concerns about Cotton's methods and the system by which his work was reviewed.

Dr. Greenacre's initial feelings upon entering the hospital were unsettling. She was taken aback by how disturbing it was that most of the patients lacked teeth, therefore making speech
and the simple act of eating meals very difficult to watch. When delving into the paperwork regarding Cotton's surgical treatments and results, she found the official records to be impossible
to draw results from. Not only were they poorly documented, they also held many contradictions. By 1925 interest in the hospital reached the NJ State Senate, which launched their own
investigation into the hospital and the practices of it's staff.

During this turbulent time Dr. Cotton became quite ill. Some speculate that he suffered from a mental breakdown, but this is not known for sure.
Regardless, he diagnosed himself as ailing from several infected teeth. After having them removed Cotton announced himself as cured, and returned to work at the hospital.
Soon after Cotton opened a private practice in Trenton NJ, which did very well and made him quite wealthy. Dr. Meyer, who initiated the critique of Dr. Cotton's methods at Trenton Psychiatric
instructed Dr. Greenacre to cease her work. Despite her wanting to complete her report, Greenacre was reassigned and her report was left forever unfinished.
The lack of critique meant that Dr. Cotton was free to continue his unchecked. Cotton died of a sudden heart-attack in 1933. The New York Times, as well as numerous other professional publications
in the United States and abroad heralded his death as the passing of one of society's great men and forward thinkers.
Dr. Cotton's wake left hundreds dead and thousands mutilated.

*Primarily this set of images was taken in and around the "New Building" constructed in the early 1900's. Trenton Psyche is still partially in use,
mostly operating out of the center of the old Kirkbride building. Due to this, parts of the building we were in remained on the power grid... for some reason.
It was more than a little eerie to round certain corners and come upon a decaying corridor lit with a few flickering florescent lights...

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