James Lind Library

This TTextra is about the article Wessely S (2009). Surgery for the treatment of psychiatric illness: the need to test untested theories. JLL Bulletin: Commentaries on the history of treatment evaluation.

In this essay, Simon Wessely describes the theory of autointoxication, which arose in the 1890s, as an explanation for symptoms of fatigue, depression, insomnia and similar malaises.


The essence of the theory is that germs within the body were causing these symptoms.  The theory was influential in how clinicians thought about many different conditions, including mental health.  Radical treatments were devised and put into practice, including surgical removal of the colon.

at the beginning of the twentieth century many patients paid with their lives as a result of action based [untested] theories

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