Forgotten histories of psychosurgery, and facing our fears

Asylum Science

In 1890, T. Claye Shaw and Harrison Cripps related the case of a male patient at Banstead asylum who was suffering from general paralysis of the insane – a diagnosis now believed to refer to neurosyphilis. Post-mortem examinations of these patients often found large amounts of cerebro-spinal fluid (CSF) in the skull, and it was findings like these that could be used to inform treatment of the living patient. Under Cripps’s care, it was suggested that the patient had excess fluid in the skull that ‘was exercising considerable pressure’ and causing excruciating headaches. As a means of relieving this intra-cranial pressure, trepanation was performed – the removal of a small piece (or pieces) of bone from the skull.

A Bronze Age skull showing the marks of trepanation. © Wellcome Images.

In the historiography of psychosurgery, the use of trepanation in general paralysis is frequently absent. Searching index entries for ‘Psychosurgery’…

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