Bayard Holmes (1852-1924) and Henry Cotton (1869-1933): Surgeon-psychiatrists and their tragic quest to cure schizophrenia.

Early 20th-century medicine was dominated by the infectious theory of disease. Some leading physicians believed that infection or the accumulation of toxic substances from bacterial stasis caused a wide range of diseases, including schizophrenia. In the case of schizophrenia, one theory held that intestinal stasis lead to the bacterial production of toxins that affected brain function, resulting in psychotic illness. This theory predicted that clearing the stasis by drainage or by removal of the offending organ would be curative. Bayard Holmes and Henry Cotton, surgeon-psychiatrists, achieved notoriety for their efforts to cure schizophrenia surgically. Their endeavours were not only a failure but resulted in tragedy to their families and to a wider population. Treatment of their own sons also represented a violation of the ethics of their time. This account describes the life and career of Holmes and Cotton and reappraises their work in the light of recent developments. © IMechE 2014.