Incomparable Oleum Cephalicum:
(Sulfuric acid applied to the scalp)
The best method for the cure of lunaticks
Thomas Fallowes
1705 AD

1. In 1705 AD, Thomas Fallowes, doctor and mad house owner, claimed he cured insanity with "blisters". This was a common procedure of the day, that produced clear fluid blisters, when sulfuric acid was applied to the scalp. (Oleum Cephalicum). It is like the blister that forms under a bubble of skin when you burn yourself with oil or hot water. This practice continued for hundreds of years until the end of the humoral medicine in 1858 AD. The idea was that vapours from bad melancholy blood needed to vent out of the scalp to cure the insane! In his own words, "I have discovered a noble Medicine proper to it, being the Incomparable Oleum Cephalicum, a Composition so very curious, and which I have known the Use and Benefit of in so many Instances, that I can venture to assure it to be the Best Medicine in the World, in all the Kinds of Lunacy I have met with. It is of an excellent and most pleasant Smell; and by raising small Pustules upon the Head, which I always anoint with it, opens the Parts which are condens'd, and made almost insensible, by the black Vapours fix'd upon the Brain; it confirms the Texture of the Brain, strengthens the Vessels, and gives a Freedom to the Blood and Spirits inclos'd in them : Being given at first beginning of Disorder, it removes the Cloudiness of the Mind, makes the Patient chearful, lively and active, and when apply'd after the greatest Fury and Passion, it never fails to allay the Orgasm of the Animal Spirits, and sweetly compose 'em. It removes the Terror of the Mind, scatters the Vapours that are the Cause of Enormous Dreams, to which Distracted Persons are almost constantly subject; and procures quiet easy and natural Sleep, to which when the Patient can be brought, without the use of Opiates, he cannot miss of an entire Cure; the Distemper will soon be discharg'd, and I have known it frequently to produce a Cure in the Space of one Month." Note that Fallowes believed that blistering truly cured insanity and was his treatment of choice because he got tangible results: "I can venture to assure it to be the Best Medicine in the World, in all the Kinds of Lunacy I have met with". The real question is how chemically burning the scalp cures insanity! The long and wide use of this quacky treatment only underscores that insanity is a spiritual, not bodily problem. Obviously nothing changed in the body, but perhaps placebo or just the enduring torturous pain was enough for those misbehaving to cure themselves! They had to make a decision. Stop being insane or continue to endure the pains and discomforts of treatment. (Incomparable Oleum Cephalicum: The best method for the cure of lunaticks, Thomas Fallowes, 1705 AD)
2. "While private madhouses figured little in the seventeenth century they became increasingly important in the eighteenth and private madhouse owners began to commit and commend themselves in print particularly when like Fallowes they could boast of an antimaniacal nostrum. Unlike his colleague Irish he did not pretend to write a treatise on insanity but came straight to the point in praise of his 'Incomparable Oleum Cephalicum' as 'the Best Medicine in the World, in all Kinds of Lunacy'. He sold it 'at Four Pound a Quart' over the counter for those who could not afford in-patient treatment in his house where he emphasised that he 'never us'd any Violence to any Patient', and that far from 'almost starv'd, in order to a Cure' he fed them well 'by good Kitchin Physick'. These claims in his advertisement throw an interesting light on practice in other madhouses and reslect the early rise of public feeling against maltreatment of the insane which gathered momentum as the century advanced and eventually led to legislation for their safeguard. The `Oleum Cephalicum' was of course nothing 'Incomparable' but one of the many animal, vegetable and mineral substances by which inflammation was set up on the skin of the shaven head. This was standard medical practice and regarded as an advance on the ancient method of simply removing the hair to give 'the grosse vapours' offending the brain a chance 'to fume out' (Lemnius 1576). It was believed that the running sores caused by vesicants and other counter-irritants and by the making of setons and issues facilitated the discharge of noxious humors. The more purulent they became and the longer they discharged the greater the expected therapeutic effect. As Fallowes put it, his `Oleum Cephalicum . . . by raising small Pustules upon the Head . . . opens the Parts which are condens'd by the black Vapours . . . confirms the Texture of the Brain, strengthens the Vessels, and gives a Freedom to the Blood and Spirits inclos'd in them'. Although today this treatment like so many psychiatric treatments seems laughable if not monstrous, it must again like so many psychiatric treatments, have been followed by some cures for which post hoc ergo propter hoc is only one of a number of possible explanations. The astonishing fact remains that it was widely used throughout the eighteenth and nineteenth centuries, sporadically even in the twentieth and was advocated by the most respected physicians. Even the great Edward Jenner (1749-1823), MD St Andrews & hon. Oxon, FRS, convinced himself on the basis of a few successfully treated cases that counter-irritation by means of an artificial eruption excited on the shaven head by tartarised antimony would cure many cases of insanity (A letter to Charles Henry Parry . . . On the influence of artificial eruptions in certain diseases, 1822. London, Baldwin et al.). And in fact tartar emetic remained in use as a counter-irritant until officially reported 'discontinued' in the British Pharmaceutical Codex of 1937. A different way of producing the same result was introduced by J. C. Prichard and recorded by his son and pupil the surgeon Augustin Prichard (1818-1898), MD Berlin, FRCS in A few medical and surgical reminiscences, 1896 (Bristol, Arrowsmith, pp. 19-2o). In the 182os in the lunatic wards of St. Peter's Hospital his father 'originated the plan of making the long issue in the scalp . . . A cut was rapidly made with a sharp scalpel, through the thickness of the scalp from just above the occipital protuberance to the edge of the hair in front, and filled with a string of peas, which soon set up the needed suppuration as counter-irritation to the morbid process going on within the skull'. Prichard's 'long issue in the scalp' may well have been 'new' but the insertion of peas into an incision was old and indeed routine in Ryder's time (1685). As late as 1883 at a quarterly meeting of the Medico-Psychological Association in a discussion on the therapeutic value of shock Dr (later Sir) George Henry Savage (1842-1921), physician superintendent Bethlem Hospital, consulting physician and lecturer on mental diseases Guy's Hospital, asked `whether other members of the specialty were reverting to the old lines, as he felt most distinctly that he was doing. He would like to shave many more heads and apply many more counter-irritants than he did. There was a general feeling against it, and it did not look ornamental . . .' Dr Henry Rayner, medical superintendent Middlesex County Asylum Hanwell, lecturer in mental diseases Middlesex Hospital, said 'he had been using blistering very extensively for the last year or two, with very satisfactory results, particularly in cases of stupor'. And Dr Daniel Hack Tuke, lecturer in mental diseases Charing Cross Hospital and author of the classic Chapters in the history of the insane in the British Isles (1882) 'thought it would be a great pity if Dr Savage, from the idea of there being a general feeling against shaving patients' heads, should be deterred from applying so excellent a remedy as a blister or some form of counter irritation. The cases which improved after a long period of insanity, often owed their recovery to counter irritation induced either by man or nature' (Journal of Mental Science, 1884. Vol. 29, p. 600)." (300 years of Psychiatry, Richard Hunter, 1963, p293)

Incomparable Oleum Cephalicum: The best method for the cure of lunaticks, Thomas Fallowes, 1705 AD

THOMAS FALLOWES (fl. 1705)
Quack, self-styled M D, owner of a private madhouse

The best method for the cure of lunaticks. With some account of the incomparable Oleum Cephalicum used in the same, prepared and administred by Tho. Fallowes, M.D. at his house in Lambeth-Marsh, 1705 London, for the author (pp. 22) pp. 14-22

THE INCOMPARABLE OLEUM CEPHALICUM

This Medicine has been Sold at a very great Price, I having had Ten Pound a Quart for it : But tho' the Composition is extreamely rich, and the Drugs from which it is drawn very dear, I have, by frequent Experiment, discovered a much better Way of making it; and upon this Account, and in Compassion to the Poor, who are afflicted in this manner, have prepar'd a Quantity to be sold at Four Pound a Quart, at my House . . .

It must be own'd, good Management of the Patient is a great Assistance to the Cure; and the rough and cruel Treatment, which is said to be the Method of most of the Pretenders to this Cure, is not only to be abhorr'd, but on the contrary, all the Gentleness and Kindness in the World, is absolutely necessary, even in all the Cases I have seen; and as I have never us'd any Violence to any Patient, so all the Patients in my House have not only constant Plenty of good and wholsom, but also variety of Food .. . And for such Persons as can't take the Care of applying the Oil, or the Toil and Burden of such Patients upon themselves, or that have not Conveniency to order and manage them, (which is an inexpressible Trouble,) I assure them of such Entertainment as is fit for Persons of any Degree or Quality, in my House, in Lambeth-Marsh. The Conveniences may be easily observ'd upon view; the Situation is in an Air neither too subtle and thin, nor too gross; the Gardens to the House are Commodious, Large and Pleasant, into which the Patients are admitted, in their Intervals, and with a Person to attend them. There is as much Privacy as can be desired, and very good Rooms, and 'tis within such a Distance from the City as any Patient may be visited by their own Physitian or Chirurgion, if they think sit; for I shall be ready to admit them: And as Chalibeat Waters and Cold-bathing are of great Use in this Case, so we have the Advantage of being nigh to Lambeth-Waters, which are universally, and justly esteem'd as good as any; and to the Cold Bath in Southwark-Park, which is an excellent Cold Spring, and whither my Servants can easily attend any Patient. I shall attend any Gentleman to consult upon the Case of his Friend, and am always ready to serve Mankind upon such Terms as shall be acknowledg'd Reasonable, proportion'd to the Character and Condition of every Patient.

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