Sophisticated and essentially humane treatments in healthcare and medicine are often seen as indicators of an evolved, modern society. After all, the manner in which we look after our sick people is one of the defining factors in our effectiveness as a health-conscious and scrupulous nation.
In spite of this, it may surprise some to discover how wrong healthcare techniques can go when delivered with just the right amount of ignorance. Stories of inexplicably bizarre and torturous procedures litter our recent past. What follows is a journey through some of the more notorious and ill-conceived approaches aimed at restoring people to physical and mental wellness — namely, the 10 most barbaric treatments in the history of modern healthcare.
Trepanning is an infamous surgical technique involving scraping or drilling a hole in the patient's skull in order to treat intracranial diseases. The practice is at least 8,000 years old and, perhaps surprisingly, has survived into the modern era. Cave paintings point to the fact that the procedure was originally thought to heal migraines, epileptic seizures and serious mental disorders.
More modern examples of the technique include the use of trepanation in epidural and subdural hematomas. The process — which is used for surgical access to certain parts of the brain — is generally referred to as a craniotomy by modern surgeons.
Some people have even been known to voluntarily undergo the procedure, most notably Peter Halvorson, who in 1972 self-administered trepanation with an electric drill. He remains an ardent supporter of the alarming method, and is founder and director of the International Trepanation Advocacy Group.
9. Bariatric Surgery
Sometimes referred to as a "lobotomy of the stomach," bariatric surgery is a form of weight loss surgery performed on patients who are morbidly obese. The concept behind the procedure is that weight loss be achieved either by implanting a medical device — for example, a gastric band — or shockingly, by removing part of the stomach itself.
Studies have shown the very real risks of serious health complications following this form of surgery. From a survey of 2,522 patients who had undergone the treatment, 21.9 % developed problems during the hospital stay itself and a staggering 40% experienced issues within six months of the procedure. The surgery remains popular and, within reason, is available to anyone.
8. Insulin Shock Therapy
The disturbingly named insulin coma therapy, or insulin shock therapy, was a type of psychiatric treatment widely used in hospitals in the 1930s through the 1950s. It involved repeatedly administering large doses of insulin to patients, with the aim of causing daily comas over a course of several weeks.
Predominantly used to treat schizophrenia, the treatment was introduced to the medical community in 1933 by the Austrian-born psychiatrist Manfred Sakel. During a standard length of treatment, injections of insulin were given six days a week for around two months, although courses lasting up to two years have been recorded.
The decline of the treatment was sharp. It was heavily criticized as early as 1953 when the British psychiatrist Harold Bourne wrote of "the insulin myth," claiming that the treatment had no effect on schizophrenia at all. By the end of the 1950s, the therapy had fallen out of favor, mostly because of the length of time it took and the nursing supervision it required. However, it has been recorded as continuing until as late as the 1970s in China and the former Soviet Union.
Symphysiotomy is a method of surgery used on pregnant women experiencing difficult or obstructed labor. During the procedure — which was first advocated by the French surgeon Severin Pineau in 1597 — the cartilage of the pubic symphysis is widened to allow childbirth. Typically, the operation was (and is) used when a caesarean section was not an available option. Its use continues in developing countries to this day.
Not surprisingly, the operation comes with a great deal of risk attached. Bladder and urethra injury, infection, severe pain and long-term walking difficulty have all been associated with the treatment. Symphysiotomies have been the subject of much debate within the medical community for some time. This is most notably the case in Ireland, where women who underwent the procedure between the 1950s and 1980s claim to have been left with serious side effects, including depression, impaired mobility and incontinence.
The tonsillectomy is one of the most famous surgical operations in the medical world. The procedure, which is at least 3,000 years old, is employed primarily in repeated cases of acute tonsillitis. Its use was far more common a generation or two ago, but it is to this day still one of the most common operations performed on children in the USA. At least modern patients do not have to deal with the tonsil guillotine, a gruesome looking instrument employed for over 80 years after its introduction in 1828!
Critics of the tonsillectomy claim that removing the tonsils does little for the symptoms long term and merely causes unnecessary suffering. Quite aside from the resulting pain, tonsillectomy has been linked to dramatic weight gain in children, according to a recent study. It shows that the chance of a child becoming overweight or obese rises to 61% in cases where the adenoids are not also removed and an inflated 136% when the adenoids are removed with the tonsils.
5. Surgical Treatment for Mental Health
Dr. Henry Andrews Cotton (1876-1933) is an infamous figure in the history of medicine. He had a firmly held belief that mental health problems could be treated by employing surgical methods. To him, insanity was caused by untreated bodily infections and had to be dealt with accordingly. This meant the removal of teeth, tonsils, gall bladders, stomachs, spleens, testicles, colons and anything else suspected of harboring infection.
Helped by generously exaggerated success rates — which may or may not have had any grounding in reality — Cotton achieved a great deal of fame during the early 1920s. However, his methods soon came under the scrutiny of his contemporaries, most notably Dr. Phyllis Greenacre, who criticized Cotton and the New Jersey State Hospital where he was medical director. Cotton himself later conceded that the death rates for his "treatments" had been around 30 percent, although other estimates put the number closer to 45 percent.
4. Mercury Treatment
Today, mercury is known and understood to be a potentially poisonous metal that causes severely harmful effects after prolonged exposure. However, this was not always the case. Indeed, the liquid metal has been used as a diuretic, disinfectant and laxative. Amazingly, it was also once used as a treatment for syphilis, with the doctors who employed such dubious methods regularly mistaking the effects of mercury poisoning for the symptoms of the sexual disease itself.
Even going into the early 20th century, mercury was still given to children as a dewormer and laxative. Merbromin, mercury containing topical antiseptic used to treat minor cuts and scratches is still used to this day. It has been banned in the US but is widely available in other countries.
3. Electroconvulsive Therapy
Electroconvulsive therapy, more commonly known as electroshock therapy, has a divisive and largely undignified past. Primarily used in treating severe depression and mania, the controversial technique was discovered when Italian neuropsychiatrist Ugo Cerletti observed pigs being prepared and pacified for slaughter by having their temples pumped with electrical charges. This rather grim interest transferred itself to the human animal, and soon Cerletti and his colleague Lucio Bini were performing ECTs on people.
Developing at a similar time to insulin shock therapy (see #8) in the 1940s, ECTs were found to cause previously difficult and troublesome patients to become placid and controllable. However, the practice has also attracted much criticism, with opponents of the method pointing out the noted side effects — including memory loss and fractured bones — not to mention the fact that it had been used as a form of abuse. It remains for many an objectionable and wholly barbaric form of therapy.
Bloodletting is one of the oldest medical practices and one that, surprisingly, continued into the 20th century. It has its basis in the classical world of Hippocrates and the ancient Greeks and their belief in the four "humors": black bile, yellow bile, phlegm and blood. It was their theory that each of the humors needed to be in balance for a person to experience optimal health. If someone was ill, went the thinking, they probably had an excess of one the elements, hence the need for a technique such as bloodletting.
This strange practice went on into modern times and was even supported by Sir William Osler in the 1923 edition of his textbook The Principles and Practice of Medicine. Today, it has been established beyond all reasonable doubt that bloodletting does far more harm than good. However, modern bloodletting (or phlebotomy) is very occasionally used as a treatment in a few diseases, including hemochromatosis and polycythemia.
The lobotomy, or leukotomy, perhaps the most barbaric treatment in the history of modern healthcare, is a neurosurgical procedure that involves severing the connections to and from the frontal lobes of the brain. Since its inception in 1935, it has been a highly controversial form of treatment. Yet, despite concerns about the process, lobotomies were part of mainstream mental healthcare for over 20 years.
Criticism of the treatment came early, with the Swedish psychiatrist Snorre Wohlfahrt stating in 1947 that it was "distinctly hazardous to leucotomize schizophrenics." Further concerns about the safety and the morality of the practice came thick and fast. The former Soviet Union banned it in 1950 and other countries gradually followed suit, with many nations outlawing it by the 1970s.
Today, the general public knows of the discredited operation chiefly through cinematic portrayals such as Jack Nicholson's lobotomized mental patient in the 1975 adaptation of Ken Kesey's 1962 novel One Flew Over The Cuckoo's Nest.