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Antisocial Personality Disorder: Demon Doctors

January 18, 2011 6 comments

This is my second article in the series on antisocial personality disorder, which because of my unduly sloth has not been completed yet. The first post can be found by clicking on the link below:

1. History of the Antisocial Personality Disorder – up to 20th century

Those diagnosed with antisocial personality disorder (APD), a diagnosis that carries with it a lot of controversy, are characterized as being impulsive and highly aggressive. Mental deficiencies heat up a lot of polemic today, as it happens in most of the cases involving the gruesome shooting of a famous individual, such as Gabrielle Giffords. Occasions like the one that happened Jan. 8  create in some individuals enough hindsight bias to allow them to put a psychiatrist’s cap and assert with confidence, “All signs showed that he was a wannabe criminal.” Surely, we often meet eccentric individuals whose behavioral is a bit asocial, but must we really be so quick to conclude that a person with interrelationships problems has psychological difficulties? For now, lets focus on our four high-profile demon doctors:

1.

 

H.H. Holmes

Dr. Henry Howard Holmes (his real name was Henry Mudgett) is considered the first serial killer in the US.  He is known for opening a hotel south of Chicago that was nicknamed the Castle. From an early age he had a fascination with surgery, so he enrolled at the University of Michigan Medical School in Ann Arbor, where he stole stole bodies from the laboratory, which he latter disfigured, so that he could claim insurance on the allegedly accidental deaths. After finishing medical school, he sent his wife back to his birth-town, New Hampshire, and sought employment in Illinois at a druggist. The druggist, Dr. Holton, at that time was severely ill with cancer, so his wife, a future widow, was glad for the help that Holmes offered. Later he proposed to Mrs. Holton, now alone and despondent, to buy the store. She accepted on the condition that she be allowed to live on the second floor of the building where the pharmacy was located. Shortly, however, she mysteriously disappeared, and no one thought to question Holmes extensively about her quick departure. After that he bought some land across the street from the drugstore, where under a close supervision he build his own castle of horrors. He made sure that the workers he hired would not stay on the job for more than a week, so that the layout of the building would not create any suspicion. The Castle was three stories high. The first floor was left for exclusive shops, while the upper floors and the basement were entwined with mazes, secret hallways, trap doors, stairs leading to nowhere,  and gas pipes attached to a control panel in Holmes’ bedroom. The basement had an acid tank, a dissecting table, and a crematorium. In his Castle it is rumored that Holmes killed more than 200 victims, while he  admitted during the trial to 27 murders. Holmes behavior was particularly gruesome. He is the prototype killer, to whom the prospect of dying did not bring fear. A very well written and chilling article about him can be found here.

2.

Shiro Ishii

Dr. Shiro Ishii, a graduate of Kyoto Imperial University, has been involved with a large group of scientists in creating biological weapons. His story and the story of the Unit 731, a facility he helped create, is not very well known. Japan even today downplays its crimes against humanity during the Second World War, and after an agreement between America and Japan, most of the atrocities committed at Unit 731 have largely been covered up. Unit 731 was a concentration camp in Pingfang, whose  purpose was to develop biological weapons. Ishii had absolute rule over all the dealings in the Unit 731 and several other similar units in the region, and he was the one who largely orchestrated unwarranted experiments:

When he [Ishii] wanted a human brain to experiment on, guards grabbed a prisoner and held him down while one of them cleaved open his skull with an axe. The brain was removed and rushed to Ishii’s laboratory.

They [prisoners]were exposed to phosgene gas to discover the effect on their lungs, or given electrical charges which slowly roasted them. Prisoners were decapitated in order for Japanese soldiers to test the sharpness of their swords. Others had limbs amputated to study blood loss – limbs that were sometimes stitched back on the opposite sides of the body. Other victims had various parts of their brains, lungs or liver removed, or their stomach removed and their oesophagus reattached to their intestines.

Other experiments involved hanging prisoners upside down to discover how long it took for them to choke to death, and injecting air into their arteries to test for the onset of embolisms. Some appear to have had no medical purpose except the administering of indescribable pain, such as injecting horse urine into prisoners’ kidneys. (Source)

The exact number of people who died either because of experimentation or because of the germ warfare is unknown, but estimates range from 200,000 to 580,000 people. After the war was over, Ishii was acquitted and many scientists at the Unit 731 went on to prominent careers, all in exchange for the data on biological weapons that Americans desperately wanted. He died of throat cancer in his home prefecture at the age of 69. More info on him can be found here.

3.

Linda Burfield Hazzard

Dr. Linda Hazzard, also known as the starvation doctor, is famous for her ‘starvation cures, which she declared could cure “anything from toothache to tuberculosis.” Needless to say, such cures had an aversive effect on her patients, and she knew how to make a profit out of it, either by appropriating their property while they were in her supervision or by demanding high fees. Hazzard had a large popularity among her followers, mainly because starvation cures were relatively common at that time (an old-fashioned counterpart to homeopathy, heh?). Her scheme was simple. She would advertise her treatments  in a newspaper or through her book, which usually convinced some individuals to come to her and seek help for their ailments. After that she put her patients in shabby hotels or shacks, took their property, either forcefully or through subversive means, managed to obtain the power of attorney over their lives, and made them undergo a cruel treatment, which involved eating nothing but low-calorie broth, painful enemas, and pummeling (i.e., beating her fists against the patients’ foreheads and backs ).  The unfortunate part was the lack of intervention:

The health director of Seattle said he couldn’t intervene, since Dr. Hazzard was licensed and the patients were willing participants in her deadly therapy. She had many loyal followers, and a commanding personality. Some of her patients were afraid of her, and couldn’t bring themselves to disobey her. But the health director did keep an eye on her in case she treated any children, at which point he said he would step in. (source)

She was eventually convicted for manslaughter and sentenced to Washington State Penitentiary. Her sentence didn’t last long because she was released on parole after two years and received pardon Governor Ernest Lister. Once out, she went with her husband to New Zealand and continued practicing quackery. The total number of victims that died because of her treatments is unknown.

4.

Marcel Petiot

As his name suggests, Petiot was born in France. He served in the French Infantry during WWI. Throughout his early life, from adolescence to his service in the military, he was diagnosed as having a variety of mental illnesses. However, the certitude of his mental instability was not verified, since most accounts started to surface after he became a notorious serial killer, and it is hard in these circumstances to decipher what accounts are due to hindsight bias or objective recording. After the war he completed the medical school and became an intern at a mental hospital. Later he was involved in over-prescribing drugs and fraud. During WWII Petiot assumed an alias, “Dr. Eugene,” who  provided “safe” passage for those in the German occupied France for a fee of 25.000 francs. All his clients were given lethal injections, and the bodies were stored in a quick lime pit and later burned in a furnace. His capture was largely due to his miscalculation:

The crimes of Dr Petiot came to light when he discovered that burying the bodies in a pit of quicklime was not dissolving the bodies as he had expected it to. So he started to burn the bodies in the building’s furnace, then left the building. The burning produced a lot of greasy black foul-smelling smoke, which on 11th March 1944 the neighbours complained about it. When the police arrived they discovered the chimney was on fire. It was the fire brigade therefore who discovered the source of the fire. (Source)

Eventually, he was arrested on October 1944 and charged with 26 murders. He confessed to only 19 of them, although the body count  was in the 60s when they captured him. A couple of articles on him can be found here, here, and here.

More info on the above serial killers can be found in Kenneth Isserson’s book Demon Doctors.

ResearchBlogging.org
Handel, D. (2004). DEMON DOCTORS: PHYSICIANS AS SERIAL KILLERS. By Kenneth V. Iserson. Tuscon, Galen Press, 2002, 441 pages, $28.95. Journal of Emergency Medicine, 26 (2), 261-262 DOI: 10.1016/j.jemermed.2003.12.007

Swanger, Andrew J (1998). Japanese scientists conducted biological research experiments.. World War II, 13 (2).

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History of the Antisocial Personality Disorder – up to 20th century

November 14, 2010 9 comments

Cow, Dog, Sheep, Apple, Strawberry, Horse, Orange, Snake, Giraffe, Pear, Blueberry.

If I tell you to memorize the list of words given above, you will very likely use clustering to do that. After all, it is easy to remember something when you put it into a conceptual category, such as fruits and animals. The same process of concept formation exists when we define human behavior. When a person is belligerent, callous, insensitive and impulsive, we realize that we need to come up with a label through which we would describe these behavioral patterns that defy conventional norms. Now, for diagnostic purposes, clinical psychologists and personality disorder theorists use antisocial personality disorder as the commonly accepted term in order describe all the cognitive and behavioral patterns that through our folk psychology we attribute to sociopaths, antisocials, and psychopaths interchangeably.  Nevertheless, the term did not acquire a scientific meaning overnight. What are, then, the meaning’s origins?

There is no specific date that I can list. Humans have a variety of adjectives that are very similar to what we would describe as antisocial PD, and they probably use/used them indiscriminately.  A merchant who was been cheated by a customer somewhere in the 18th century would employ such expletives as knave, rogue, low-birth, villain, and scoundrel to describe the customer, while today, a citizen who is outraged by the government would rely on qualifiers like godless, blood-sucker, and fear-monger when describing a politician. These words, however, have little objective value. English language is rich in profanity and beauty, and its use is often influenced by our mistakes of attribution, us-versus-them thinking, education level, and culture. Psychology, a social science, requires a distinct definition based on observations.

Philippe Pinel, a French physician who developed a more humane approach towards the care of mental patients, noted in his Treatise on Insanity(1806) that several of his patients had a tendency for damaging and impulsive behavior. These patients, in addition to their hazardous inclinations, had an unimpaired intelligence and a full awareness about their wrongful behavior. Pinel described these patients as having la folie raisonnante (“insane without delirium” or “manic without delirium”). It is important to notice that he did not use the term in a derogatory, value-laden fashion. The definition was intended to be descriptive.

The same attitude that Pinel had towards the use of terms in describing pathologies was not shared by other physicians. For the most part, it was believed that someone who committed a morally wrong act because of dispositional factors.  It was out of question to feel pity for a thief or criminal; hence, antisocials were worthy of condemnation. James Cowles Prichard borrowed some of Pinel’s findings and coined the term moral insanity, which many physicians used to show their condescension to those who had no restraint against immoral compulsions. This attitude started a confirmation bias that was prevalent throughout the 19th century, 20th century, and 21st century pathology of antisocial personality disorder.

A prime example of this confirmation bias was the work of Cesare Lombroso, an Italian criminologist who tried to link anatomical defects to antisocial behavior.  Lombroso thought that criminals and other delinquents have some atavistic similarities with beasts. That is, the more beast-like you look, the more criminal you are. (A book by Samuel Robert Wells, which you can find here, has a large number of findings and drawings related to atavism). Here is a drawing that exaggerates some of those similarities:

A man with atavistic features. From: New Physiognomy or Signs of Character (1871)

 

Needless to say, such studies were performed in a Freudian fashion, where contradictory evidence is overlooked or neglected. The conclusions reached were of no good, too. For example, look at the drawing below. Based on arbitrary physiological differences between low and high foreheads, here is the recommendation given in Well’s book:

If thou hast a long, high forehead, contract no friendship with an almost spherical head; if thou hast an spherical head contract no friendship with a long, high, bony forehead. Such dissimilarity is especially unsuitable for matrimonial union.

A drawing showing the alleged psychological relationship between high and spherical foreheads. From: New Physiognomy or Signs of Character (1871)

Similar, absurd conclusions were reached by looking at differences between the profiles of different people and their intelligence:

Grades of Intelligence. From: New Physiognomy or Signs of Character (1871)

Luckily, at the end of the 19th century, physicians abandoned the penchant to morally classify individuals and approached the study of the antisocial personality disorder from a scientific perspective–through observation. J.L. Koch proposed in 1981 that the term moral insanity be dropped because it had a stigma attached to it and replace it with psychopathic inferiority. Eventually the word inferiority was discarded because it had a negative connotation and the term psychopathic was used (Millon et. al, 2004).

In the next post, I will talk about Demon Doctors.