If there is a subtext to Scull's mostly cool and appraising survey, it is indeed the propensity of the doctors to go mad for their theories and to regard abandonment of doubt as tantamount to professional strength. The notorious surgeon Henry Cotton, who was allowed during the interwar years to bring havoc to the lives of his patients in New Jersey, was already the protagonist in one of Scull's earlier books, Madhouse(meaning not so much a residence for the mad, but a site of mad operations). Cotton's reign at the Trenton State Hospital is also briefly recapped here. His crazed surgical practices were based upon his settled view that the patients were almost invariably suffering from sepsis; their condition often required, in his eyes, the excision of parts or the whole of their internal organs. He caused much misery (and many deaths) with his unfettered assaults upon stomachs, spleens, cervixes and colons. Despite the serious misgivings of colleagues, nobody seemed able to stop him or blow the whistle. Such institutional failings and cover-ups, a collective incapacity to curb the lunacy of the individual or coterie, as we know all too well from more recent scandals, provide the most shocking story of all.
From Cotton we move on to the vicissitudes of insulin treatment, the sagas of those experiments to deliberately infect physically healthy patients with the blood of malaria sufferers, and so to the postwar brain operators such as Walter Freeman, who so refined the treatment that he boasted of how he could deal with a dozen or more people in sequence in a single afternoon.
more here.