Surgery for the treatment of psychiatric illness: the need to test untested theories

Abstract

I run a clinic for sufferers with chronic fatigue syndrome (CFS), sometimes also called myalgic encephalomyelitis (ME), and known to a previous generation of neurologists as ‘neurasthenia’ or ‘nerve weakness’. It is my practice to record all the previous treatments that any patient has received. Perhaps three or four times a year someone will tell me about their trip to a private clinic where they received ‘colonic lavage’. This was to ‘remove the toxins’ that they have been told are contributing to their fatigue, debility and exhaustion. The fact that they have still come to our clinic suggests that the treatment has not been successful. Despite that, very few express any retrospective scepticism about the procedure, nor regrets for the often considerable money with which they have parted for this and other ‘detoxifications’. The procedure seems logical – numerous media articles remind us that we are ‘overloaded’ with toxins, especially given our modern polluted environment and our poor diets, rich in carbohydrates, awash with food additives and swimming in chemicals. One popular book on ME is called Overload: Beating ME;1 numerous other self-help books, and countless magazine and newspaper articles continue to promote the idea that ME is a very modern illness, linked to the increasing assault on our bodies by a wide range of contaminants and hazards – not just food additives, but also dental amalgam, candida infection, mercury in vaccines, pesticides, electromagnetic radiation and chemicals of almost any description. Those who see patients complaining of multiple chemical sensitivity (MCS) will recognize the above, and more. It all seems very modern, and anyone reading this literature would probably conclude that this is a condition unique to our age, a hubristic response to our despoilation of our planet. But it is not new. A hundred years ago such theories were espoused by at least some of the most conventional, establishment and orthodox doctors of the period. And while I might regret the fact that my patients seem to have parted with their money for such little benefit, at the beginning of the 20th century many patients paid with their lives as a result of action based on the same theories.