Design and assessment of psychosurgical studies

Abstract

The following amusing episode from the early days of American medica practice was recently related by Lee Birk (1973):

On a panoramic hilltop one rainy afternoon in colonial America, about 200 years ago, perhaps during one of the dread yellow fever epidemics, Benjamin Rush, signer of the Declaration of Independence, framer of the Constitution and “Father of American Psychiatry”, is said to have emerged inexplicably from his horse-drawn carriage, suddenly overcome with a sense of his healing mission and his therapeutic method; in this mood with a burst of zealotry, he is said to have shaken his cane at the city below while uttering the words: “Bleed and purge all the city!” This done, he got back in the carriage and drove on to see his next case.