Providentia

William James and the Medium

“Medium Stands Test… Professors at University Fail to Discover Any Trickery in Woman’s Acts – She Has Never Been Educated, but Converses in Several Languages while in a Trance and Writes like an Expert.”

Eusapia Palladino was riding high in 1907 following a series of tests at the University of Naples which apparently confirmed her amazing skills as a medium.  The tests, which had been arranged by the Society for Psychical Research, were conducted by several professors at the University as well as members of the Society who were also amateur conjurers.   Though the investigators had actually caught Palladino cheating during some of the séances she conducted, they concluded that she had also produced genuine evidence for the supernatural as well.

The newspaper coverage of the tests was largely enthusiastic (and with virtually no mention of the cheating).  According to the Washington Post story on August 25, 1907,  Palladino was “an ignorant woman and is known to have received no education whatever.  Nevertheless, while in a trance she was able to converse in several modern languages and writes in each of them in script that is like copper plate.”   The story also described how she made tables levitate, move curtains, produce spirit touches, and receive messages from the beyond.    Aside from scant mention of  her failures in previous tests, the coverage she generally received tended to describe her as one of the wonders of the modern age.

So, who was Eusapia Palladino?  Though she was born to a peasant family in southern Italy in 1854 and received little formal education,  she was certainly not as “ignorant” as the newspapers would later claim.   Still, it's hard to get a handle on much of her early history since most of it comes from her own, decidedly biased, account of how she launched her career as Europe’s most famous medium. 

 According to Palladino, she first discovered her spiritual gifts when she was fourteen years of age.  Already an orphan (her mother died when she was born and her father when she was twelve), she was living with another family when she became the focus of poltergeist activity.   As she would later state, she had no interest in spiritualism and only participated in séances to please her host family and avoid being sent to a convent.   

Within a few years however, she became famous for her séances and the wide range of supernatural  activity that reportedly occurred when she was in a trance.   By 1888, she was being scientifically tested by various scientists, including eminent Italian criminologist Cesare Lombroso.    It’s open to question as to how impartial these scientists really were and Eusapia’s own behaviour towards them may have played a role in their endorsement of her psychic gifts (some evidence suggests that she and Lombroso had a sexual relationship for a time).    

Despite being caught faking on numerous occasions, the circle of true believers  that  Palladino established seemed unable to see her as anything but a genuine psychic with amazing powers.  For decades, she toured Europe doing séances and being tested by celebrities and scientists alike.   In the many seances that she conducted across Europe, she would communicate with her spirit guide, John King, and display a range of impressive physical phenomena.  

Levitating tables was her specialty but she could also produce spirit hands and faces, play musical instruments without using her hands, make flowers and other objects appear out of thin air, and contact the dead. She was the talk of Europe in her day and was highly sought after (despite the enormous fees she charged).  Despite being caught faking numerous times,  the controversy over Palladino’s mediumship continued. Many genuine skeptics regarded her as a practiced fraud using a wide range of tricks that allowed her to fool many of the experts who tested her.  On the other side, there were the “open-minded” scientists such as Lombroso and Oliver Lodge who argued that there were enough unexplained  results to suggest that something supernatural was going on.

As for the times she was caught faking, Palladino and her manager explained this away as only occurring when her powers were not working at their best. This became more common as she grew older and her powers diminished (or skeptics began demanding tighter controls, your call).

It was only natural that she drew psychic researchers across Europe, including leading scientists such as Pierre and Marie Curie and Theodore Flournoy. Although she appeared to welcome attempts at scientific validation of her powers, researchers who dealt with her came to fear Palladino's volatile temper and frequent tantrums.  This was especially apparent during the  various attempts to control the conditions under which she conducted her seances. It was common for Palladino to storm out in a huff whenever things failed to go according to her expectations.

When she came to the United States in 1909, Palladino was in fine form with enthusiastic newspaper stories proclaiming the genuine nature of her powers.     Even on the steamer that brought her and her entourage across the Atlantic, she conducted three séances.  Cesare Lombroso had died that same year and she quickly took advantage of this by boasting that she was able to communicate with his spirit as well during the dozens of séances she conducted.

Among the observers who were apparently taken in by her tricks were magician Howard Thurston and Harvard philosopher, William James.   It was James (often called the “father of American psychology”) who become one of  her biggest supporters.   Already an ardent spiritualist, James was founding member of the American Society for Psychical Research and the author of various highly-respected works on religion and mysticism.   He had previously endorsed the mediumship skills of American medium  Leonora Piper by insisting that she knew details about his dead son William that she could not possibly have known.  Though later biographers have suggested ways that Piper could have gained  this information, the endorsement of someone like William James was considered powerful evidence in itself.

And then there was Hugo Munsterberg,  also of Harvard University.  Though it had been James who had first hired Munsterberg to run the psychological laboratory he had founded, they frequently clashed over Munsterberg’s persistent skepticism about spiritualism.   By 1909, James and Munsterberg were locked in a war of words over mediums such as Palladino.  James frequently accused Munsterberg of being overly analytical in rejecting supernatural explanations while Munsterberg in turn accused James of being naive.

After attending a number of seances, Munsterburg came to viewed Palladino as an alarming example of fraud masquerading as science. He wrote that Palladino was "a great artist, and as a vaudeville show she might be at the head of her profession, but I do not see how she can overcome in any cool observer, the feeling that it is trickery". It was during her American tour in 1909 when he attended a seance with Palladino and a "well-known scientist" (not named, but probably James).

During the seance, he sat on Palladino's left side and his companion on her right holding her hands and feet when the table behind them was supposed to move. Suddenly, there was a "wildly yelling scream". What Palladino did not know was that Munsterberg had arranged for an agent to slip in unobserved and to lie flat on the floor behind them to block any attempts at trickery. It turned out that she had slipped her foot out of her shoe and "with an athletic backward movement of the leg was reaching out and fishing with her toes" when the agent grabbed her foot (hence the scream).

Munsterberg was in his glory having caught Palladino in blatant fraud and many of his contemporaries viewed it as a refutation of James' views on psychic phenomena. As Josiah Royce later put it:  Eeny meeny, miny mo/Catch Eusapia by the toe/If she hollers, then we know/That James' doctrine isn't so.

Suffice it to say, James was not amused (although he acknowledged the fraud) and by the time of his death in the following year, he and Munsterberg were largely estranged. While Palladino had been caught in fraud before, this latest revelation seemed to put the final nail in her coffin and her career never really recovered.  Munsterberg's own abrupt death in 1916 put an end to his remarkable career as a psychologist and scientist and, while not as well known as other "ghostbusters" such as Harry Houdini,  his legacy of skepticism lives on.

 

William Crooke and the Goldmaker (Part Two of Two)

Continued from Part One

Despite being initially intrigued by Stephen Emmens' amazing claim, Sir William Crookes was first and foremost a scientist.   Along with asking for a "few more details" about the Argentaurum process and the apparatus that Emmens was using,  Sir William also asked for samples of the gold Emmens was supposedly creating so he could conduct his own scientific tests.   After  considerable stonewalling, Crookes than proposed visiting Emmens' factory and examining the entire operation in detail - and without any restrictions over what he might be allowed to see.

This finally stirred Emmens to send a reply in October, 1897 which assured Crookes that there would be no point of his visiting.  He added that the "scientific world would not believe" in what Crookes found, even if he reported what he saw firsthand.   Though Sir William finally got the gold samples he asked for, the results were less than earthshattering since the samples turned out to be completely identical to ordinary gold with no sign of whatever transmutation process Emmens supposedly used.   Still, the scientist then promised to begin his own experiments using Emmens' process to see what might be found.  

This led to what Emmens would later describe as a "historical letter" from Crookes in which the eminent scientist shared in-depth details of what he found when he tried transforming silver into gold following the procedure outlined by Emmens.   Crookes himself was convinced that the experiment was a failure since there was only tiny discrepancy between the treated and untreated gold samples used and even went to far as to ask Emmens to spot where he had made an error.     

But as far Emmens was concerned, there was no error.   In his reply letter, dated March 7, 1898, he told Crookes that "I very heartily congratulate you on the success recorded in your letter of February 22nd...You have obtained 75 parts of gold for every 62 parts you commenced with.  This can't be explained away."   But he also added that Crookes' experiment "was so incomplete from my point of view that I feel quite surprised at its degree of success."     

More to the point, Emmens then announced to newspaper reports that the eminent Sir William Crookes had succeeded in partially verifying his Argentaurum process.   Hearing about this, Crookes then repeated the experiment carefully, this time using Mexican peso coins with a measurable silver content.  After determining that there was absolutely no gold to be found in the treated coins, he promptly sent his results to Emmens in another letter adding that "As my name has been so freely used in the newspapers of this country in connection with 'Argentaurum', I feel it will be my duty to communicate these results to the Press.  I will, however, wait until there is time to hear what you have to say about the experiment."  

Emmens then wrote back on March 31, 1898 and criticized the second experiment which he insisted was "defective in many particulars."   He insisted that Crookes had used abnormal Mexican pesos rather than the normal ones that he used in the first experiment.  By this time, Crookes had enough of Stephen Emmens and the high-handed way that he was dismissing what was a very carefully constructed test of Emmens' own process.   He added that "I am surprised and annoyed to see that you have published in the Spokane Miner a letter of mine which I especially marked "Private" and have used it to try to make the public believe that I have succeeded in transforming silver into gold.  When I last week wrote to you I was not aware of this gross breach of all the laws of courtesy and etiquette which govern correspondence between gentlemen all over the civilized world.  After such an occurrence, I cannot continue a correspondence with you."

While Emmens wrote back to protest his innocence as well as downplaying the seriousness of Crookes' allegations, he never received a reply, then or ever.  Not only did this mark the end of his correspondence with Crookes, it also meant the end of any serious attempt at validating Emmens's claims.    The newspapers, which had previously treated Emmens with cautious respect, suddenly realized that Emmens wasn't quite the scientific marvel he had appeared to be.

On Sunday, February 26, 1899, the New York Herald ran a feature story on Emmens which verified that he had sold  nearly 700 ounces of "Argentaurum gold" to the U.S. Treasury in 1899 alone.  All of the gold had been carefully assayed and found to be almost completely pure.  Suspecting fraud, the Herald then challenged Emmens to release the full details of his Argentaurum process so that an impartial panel of scientists could replicate his findings. 

Emmens, for his part, replied in a letter to the Herald that he was perfectly willing to accept the challenge, but with one or two conditions of his own. Among other things, he insisted that the only fair test would be to "duplicate my plant elsewhere.  I do not believe this could be done under a minimum cost of $10,000."   He also offered to have the panel of scientists come into his plant and do their investigating on site.  But, as he pointed out, "these gentlemen would probably do $15,000 worth of damage before they were ready to begin work.  That I should, of course, expect to be paid for."   

Naturally enough, the Herald withdraw its challenge and, well, that was pretty much it for Stephen Emmens.   Despite promising to demonstrate his process at the 1900 World's Fair, this never materialized and he simply dropped out of public sight.  While  one newspaper account suggests that Emmenns died not long afterward, I haven't been able to find any official obituary.  As for his  mysterious Argentaurum process, that seems to have died with him though the gold he had sold to the U.S. Treasury was real enough.   

As for where it came from originally, that pretty much depends on which of several explanations you happen to accept.   One explanation advanced in the early 1900s was that the "silver" Mexican pesos that Emmens used already contained some gold which his Argentaurum process then extracted.    Another explanation came from a report by one of the analysts at the U.S. Mint which found that Argentaurum gold contained impurities of a kind "commonly present in old jewelry."    Though either explanation may well be the correct one, the question of where the gold Emmens sold to the U.S. Treasury came from has never been answered.

So what can we say about "Doctor" Stephen Emmens?   Certainly he can be described as flamboyant and paranoid, buy he also had a knack for alienating just about every prominent scientist with whom he ever came in contact.  He was also blatantly dishonest in the way he misused scientific findings to promote his Argentaurum process and draw in potential investors.   Still, despite coming across as a flim-flam man, Emmens also seemed genuinely bitter over never receiving the scientific acclaim he felt he deserved.   Though other would-be alchemists kept the dream of creating gold alive, at least temporarily, none of them ever achieved the kind of fame that Emmens had.

Ir0nically enough, Stephen Emmens dream of creating gold was actually achieved in 1980, sort of.   Using a high-powered particle accelerator, researchers at the University of California's Lawrence Berkeley Laboratory managed to transmute bismuth into gold, at least at the atomic level.  Granted, they only produced about one-billionth of a cent worth at a relative cost of $10,000, but it was the thought that counted.  

Credit-  

Stephen H. Emmens and the transmutation of silver into gold,  George B. Kaufmann, Endeavour, Volume 7, Issue 3, 1983, Pages 150-154.  https://doi.org/10.1016/0160-9327(83)90009-11983

 

William Crookes and the Goldmaker (Part One of Two)

There is no honest man — not one — that can resist the attraction of gold! — Aristophanes

Forget iron, copper, tin, or silver, there is no question that gold is probably the earliest metal ever to be used by humans and proto-humans alike.  Not only has evidence of gold use been found in human settlements dating back to the Paleolithic, but virtually every known human civilization has used gold in symbols of authority, jewelry, and majestic works of art.   Throughout history, gold has been regarded as the most perfect of all the metals and revered as a symbol of the sun itself.  So is it any wonder that the main goal of alchemists was to find a way to convert base metals into gold?

Despite repeated failures, not to mention a stubborn refusal to accept that the principles on which alchemy was based were wrong, medieval and Renaissance alchemists (including such surprising name as Paracelsus and Isaac Newton) are still considered to have spurred the development of modern science.  Still, by the 19th century, the general consensus of most scientists was that it was impossible to transmute metals in the way that alchemists had once hoped.   Except for a few die-hard crackpots, that is..

Which bring us to "Dr." Stephen Emmens and his quest to turn silver into gold...

There seems to be little really known about Emmens' early life except that he was probably born in England or Ireland around 1844 or so.   Though he attended King's College in London and earned impressive degrees chemistry and physics, his insistence on referring to himself as "Doctor" seems questionable considering that there is no evidence of his ever earning a doctorate as such.    Still, despite a crippling injury that left him confined to a wheelchair, he was able to emigrate to the United States in the 1880s and quickly establish himself as a respectable scientist.  This included memberships in the American Chemical Society, the American Institute of Mining, Metallurgical and Petroleum Engineers, and as  President of the Research Society (which he founded).  

Emmens was never a scientist in the conventional sense of the term and often dedicated himself to challenging what he viewed as "establishment science" as well as restricting himself to any one scientific field.   Along with inventing a new high explosive which he christened Emmensite, he  reported discoveries in metallurgy and x-ray spectroscopy and wrote books on a dizzying array of subjects (including philosophy, punctuation, mining, polities and taxation, to name just a few).    He also tried disproving Newton's theory of gravitation and establishing a new theory which concluded, among other things, that the Earth had to be hollow and incapable of rotating on its own axis (suffice it to say, he wasn't widely regarded in some scientific circles).

But Emmens' greatest claim to fame was what he christened his Argentaurum process which he used to convert silver into gold (argent being Latin for silver and aurum for gold).   Though he reportedly began working on this new process in the early 1890s, it would be in 1896 that he first announced that he had succeeded in converting silver into what he described as an intermediate stage between silver and gold.   In fact, he boasted, "the metal which we have made from silver answers every test to which the United States Assay Office subjects the gold offered there for sale.  The metal made from pure silver by the process discovered by us could be proved to be gold in a court of law.  It not only answers every test of the Government mints, but it also has every quality required by the gold of commerce, having the same color, weight and strength." 

This new metal, which he dubbed Argentaurum naturally enough, was apparently created from silver through a complex process involving high pressure and low temperatures.  While his extraordinary claims were naturally dismissed by scientists themselves, the newspapers wasted no time in spreading the word about Emmens' supposed discovery.   Though quick to point out that the actual details of Emmens' process remained a mystery, some newspapers announced that Emmens was already producing enough gold through his process to by paid $150 a week by the United States Assay Office and that this was only the beginning.   

Emmens himself bragged that he could take $500,000 worth of silver and convert it into enough gold to make nearly a $3,ooo,ooo profit (minus the cost of the silver).  He added that, once his production facilities were at full capacity, he would produce 50,000 ounces of gold per month within a year.

Since Emmens was still largely snubbed by the scientific community, he decided to solicit the help of the man who was widely considered to be the most eminent scientist of that era.   Thus began the rather lively, and at times bizarre, correspondence that Emmens had with eminent chemist and physicist, Sir William Crookes. 

Along with being a fellow of the Royal Society and the discoverer of thallium and uranium-x, Crookes was also the inventor of the radiometer, then-President of the Chemical Society, and would later become President of the Royal Society as well.   He was also a devoted spiritualist and and President of the Society of Psychical Research, something that gave him somewhat of a reputation for open-mindedness on topics that extended well beyond what was considered true science.

As it happened, it was Crookes who first reached out to Emmens in 1897 to get more information on the Argentaurum process.   Emmens,  naturally flattered that a scientist of Crookes' reputation would write to him, responded by describing his process and the apparatus he used in great detail.  He also bragged that the "force engine" he was developing and which he invited Crookes to examine would "prove to be the most important piece of laboratory equipment ever produced."   Crookes, for his part, was naturally startled by Emmens' claims and replied that, "if there is no fallacy in your experiments, and I confess I do not see any, the discovery is one of the most important of this century."

But that would change soon enough...

Continue to Part Two

 

 

 

 

 

 

The Power of the Placebo

The Siege of Breda is one of the most graphic events of the Eighty Years War (also known as the Dutch War of Independence).   

Under the orders of Spanish general Ambrogio Spinola, the walled city of Breda in what is now the Netherlands was besieged by the Spanish army for more than eleven months.   So extreme were conditions inside the town for the 7,000 soldiers defending the town that they soldiers began dying of scurvy due to the lack of fresh fruit and vegetables.   Though curable through simple nutrition, scurvy is potentially deadly for anyone whose diet is low in Vitamin C and the Dutch soldiers were no exception.   Along with problems stemming from malnutrition, the long siege also led to a critical shortage in various medications, including medications for relieving pain (primarily opium and laudanum).     To solve this problem,  the garrison commander Justin of Nassau (a son of William of Orange), hit on a cunning plan.

Working with the city's doctors,  Justin had the doctors provide their patients with a powerful new medicine that he reportedly managed to smuggle in from the mysterious East.   The medicine was so strong that only a few drops in a gallon of water would clear up their symptoms.    The soldiers were impressed that their commander had managed to get them this medicine despite the risks and expense involved.  Except, of course, that the "medicine" in this case was nothing more than a mixture of wormwood, camomile, and camphor, carefully placed into small phials, which Justin provided to the doctors.  While available reports stated that "they took the medicine eagerly and grew well rapidly", there are likely limits to how well the power of suggestion could work in preventing the symptoms of scurvy.   Certainly men continued to die and only 3,500 Dutch soldiers were still alive by the time Justin surrendered the town.  

Though medical doctors had long observed that patient belief had a powerful effect on the body and how they responded to medical treatment, the first formal investigation into what would be called "the placebo effect" would not be until the early 19th century.   The word "placebo" is Latin for "I will please" and actually comes from a Latin translation of the Bible.   British physician John Haygarth published what would be the first treatise on the placebo effect when he investigated that medical effectiveness of a popular cure of the time known as "Perkins tractors."   Invented by American physician Elisha Perkins, these "tractors" consisted of two 3-inch metal rods made of steel and brass.  By using the tractors to "draw off the noxious electrical fluid that lay at the root of suffering", Perkins claimed to be able to cure a wide variety of illnesses, including rheumatism and arthritis. 

Even though conventional medical doctors were quick to denounce Perkins' invention as sheer quackery, many patients reported getting significant pain relief from the treatments and John Haygarth decided to investigate further.    Alarmed at the growing popularity of Perkins tractors among his patients in Bath,  Haygarth dem0nstrated that patients could get the same pain relief from rods made of virtually any substance and that they were unable to tell the difference between fake tractors and the "real" ones.   He also noted that some patients actually got worse instead of better which suggested that imagination could cause as well as cure disease.   

What mattered most was the credibility of the doctor (famous doctors were more likely to get positive results than obscure ones) as well as how credulous the patients were.    The best results appeared to come from both the doctor and the patient believing in the power of the medical treatment.    He prophetically commented that: "medical practitioners of good understanding, but of various dispositions of mind, feel different degrees of skepticism in the remedies they employ. One who possesses, with discernment, the largest portion of medical faith, will be undoubtedly of greatest benefit to his patients."

As Haygarth observed in his 1800 paper Of the Imagination as a Cause and as a Cure of Disorders of the Body,  what really caused pain relief was the belief that patients were getting an apparently effective treatment.    Haygarth concluded in his paper that his results showed "to a degree which has never been suspected, what powerful influence upon diseases is produced by mere imagination".     While his research into the power of  belief would be largely overlooked by medical historians (he is mainly remembered as a pioneer in smallpox inoculation),  he is still the first physician to raise questions about the placebo effect which have haunted discussions of alternative medical treatments ever since.  

At the same time that John Haygarth was making his groundbreaking observations on the power of positive belief in relieving pain, the influence of Franz Mesmer and his disciples was also being felt across Europe and North America.   Despite attempts by skeptics such as Benjamin Franklin and Antoine Lavoisier to debunk Mesmer's work, mesmerists would ply their trade for decades afterward and physicians often had trouble understanding how they were accomplishing their apparently miraculous cures.   

Along with mesmerism, the early 19th century was also seeing a rise of interest in homeopathy.  Based on the "like cures like" doctrine of Samuel Hahnemann, homeopathic practitioners began offering their treatments for various illnesses with only anecdotal evidence from satisfied patients to prove that it even worked.    The first formal clinical trial to test the effectiveness of homeopathic medicine was carried out in Russia in 1832.   Not coincidentally, it was also the first clinical trial to use a placebo in medical research.   Tests comparing homeopathic medicine with placebo pills made of flour paste showed no real difference in medical effectiveness.     After publishing these results, the term "placebo effect" became well-known to medical researchers across Europe and North America (though homeopathic medicine seems not to have been seriously derailed by the findings).

In another informal test of the placebo effect, French physician Albert Matthieu informed many of his tuberculosis patients at the Hopital Andral in Paris of a powerful new treatment for tuberculosis that had recently been discovered in Germany.   This new treatment, which he dubbed "antiphymose" was supposed to yield wonderful results in people suffering from tuberculosis and the news quickly spread with patients demanding that the drug be tested on them.   After a time, Matthieu began conducting clinical trials which the drug he had supposedly received from Germany.   All patients receiving antiphymose injections were carefully tested on a regular basis to see if their weight and temperature changed as a result of the new treatment. 

According to the results, antiphymose had a powerful effect on tuberculosis patients receiving the injections.   Not only did the patients gain weight but their chronic fever was reduced as well.  Some gained as much as three kilograms of weight while other symptoms such as persistent coughing and insomnia improved as well.    When the antiphymose injections stopped, the old symptoms returned as well and patients quickly lost the weight they had gained before.    Only afterward did Matthieu reveal that there was no such treatment as antiphymose.   What they had received was simply sterilized water and saline.   The record fails to record how the patients responded to being deceived, even in a good cause.

While the placebo effect is an acknowledged part of modern medicine (and the driving force behind most alternative medical treatments), the power of the placebo continues to influence how many patients respond to treatment.    As patients and doctors alike believe that a treatment will work, patients tend to recover faster than they might do otherwise.   When a newer (and more expensive) drug comes out however, the drug it replaces often performs less well in research because doctors are less confident in how it will help patients.   Research has shown that simply changing the size and colour of a pill can be enough to change its apparent effectiveness. 

But how exactly does the placebo effect work?   Research into using placebos for pain  suggests that increased endorphin levels and reduced cholecystokinin production in the brain may lead to placebo-induced pain relief.    A 1978 study showed that the opioid antagonist naloxone can block endorphins and prevent the placebo effect from occurring.   These results only appear to apply to pain relief however.  

But, the power of belief can also play a role in worsening symptoms as well.   Much like the placebo effect, nocebos (coming from the Latin phrase for "I will harm") can have a powerful effect on health by making many medical conditions worse and may even play a role in "voodoo deaths" linked to curses.   Various proposed explanations for the placebo (and nocebo) effect include suggestion,  operant and classical conditioning, cognitive dissonance, the Hawthorne effect, and expectancy effects though they are all largely based on speculation.  All that we can say  for certain is that the exact mechanism for the placebo and nocebo effects are (still) unknown.

Is there such a thing as a placebo-responder personality?   While some researchers have attempted to link patient responding to placebos to suggestibility or other personality traits, the  results have been largely inconclusive.   In studies observing how subjects respond to placebos over multiple trials, no consistent pattern has been identified.   In other words,  the same subjects who respond to placebos in one trial may not respond in later trials or vice versa.    It is also difficult to decide exactly what the placebo effect can affect.   Though most research into placebo use focuses on pain relief,  some studies suggest that belief in placebos can accomplish much more, including relieving swelling and changing serum cortisol levels.     The extent to which the placebo effect can relieve symptoms can range from no effect at all to total relief in some cases.

In identifying the different factors that can make placebos effective, researchers have identified the following:

• The nature of the intervention - the more intrusive the intervention, the more effective the placebo effect seems to be.  "Sham surgery" (skin incisions without an actual operation) seems to be at least partially effective in relieving symptoms for most patients receiving it.     Placebo injections also appear more effective than placebo pills with the more discomfort associated with the sham treatment, the better.    Treatments that are more "exotic", i.e., involving complicated technology or a radical new medical technique also seems to increase the effectiveness of the placebo.
• The credibility of the one providing the treatment -  Doctors with a high degree of status showing strong belief in their treatment are more likely to have a positive effect on their patients.   Also, therapists showing warmth and empathy to their patients will get better results on average.
• Patient expectation -  If the patient is involved in the treatment and has developed a sense of trust in the doctor and the treatment being received, the placebo effect is likely to be stronger.
• The nature of the complaint - Though most placebo research has focused on pain relief, a wide range of other symptoms appear to be affected by belief as well.   Biofeedback research suggests that many physiological functions can be consciously controlled although it is still unknown whether some complaints or disorders may be more "placebo prone" than others.
• The treatment setting -  A 1994 clinical study found that therapeutic setting was the only significant predictor for nocebo effects, i.e., patients in some clinical centres were more likely to experience adverse reactions to a placebo than patients in other centres.   This suggests that even the location where treatment is received may play a role in whether the placebo effect occurs.

It is also important to understand that simply observing patients improving after taking a placebo cannot be considered evidence for a placebo effect at work.    According to Edward Ernst and his colleagues,  evidence for a "true placebo effect" needs to rule out other factors that might be contributing to patients getting better.    This can include natural recovery from illness, regression towards the mean,  patient bias, or other time-related factors that researchers failed to take into account.    In other words, simply seeing a patient improve does not mean that a placebo effect is occurring although  this "perceived placebo effect" is often confused with the real effect.    To make medical research even more complicated, proving that a treatment is really effective means showing that the positive benefits are greater than what could be accounted for by the true and perceived placebo effects. 

In a real sense, the placebo effect is a part of all medical treatments, whether intended or not.  Many of the factors that make the placebo effect more powerful are also used by caring health professionals to reassure patients and make them more confident that the treatment will be effective.   That same confidence also plays a role in the perceived benefits that patients being treated with alternative medicine often experience and which, in turn, are taken as "proof" of their effectiveness.   Virtually every practitioner of alternative medicine can produce anecdotes provided by apparently grateful clients.   Though these glowing anecdotes can seem convincing to people desperate for a cure,  there are always limits to what can be accomplished by belief alone. 

While there are certainly colourful stories of the placebo effect at work,  relying on placebos to treat patients often invokes a critical problem in medical ethics.  Is it permissible for doctors to lie to their patients, even in a good cause?  And can practitioners of alternative medicine be considered to be providing a valuable service to patients if the placebo effect makes the treatment more effective than it might otherwise be?  

There are still too many unanswered questions about how and why placebos work despite the enormous amount of research that has been done to date.   Though the placebo effect has a long and venerable history, it remains a mystery in many ways.   And perhaps it always will be.

How Does COVID-19 Affect Dementia Patients?

The number of positive and death cases from coronavirus disease 2019 (COVID-19) is still increasing until now. One of the most prone individuals, even in normal situations is patients with dementia. Currently, no study provides clear evidence regarding the link between dementia and COVID-19. A new study published in the Archives of Gerontology and Geriatrics analyzes the relationship between dementia and poor outcomes of COVID-19 infection. The authors  systematically searched the PubMed and Europe PMC database using specific keywords related  to COVID-19 and dementia. The quality of the study was assessed using the Newcastle Ottawa Scale (NOS) tool for observational studies. Statistical analysis was done using Review Manager 5.4 software. A total of 24 studies with 46,391 dementia patients were included in the subsequent meta-analysis. which showed that dementia was associated with composite poor outcome [RR 2.67 (95% CI 2.06—3.47), p< 0.00001, I² = 99%, random-effect modeling] and its subgroup which comprised of risk of COVID-19 infection [RR 2.76 (95% CI 1.43—5.33), p = 0.003, I² = 99%, random-effect modeling], severe COVID-19 [RR 2.63 (95% CI 1.41—4.90), p = 0.002, I² = 89%, random-effect modeling], and mortality from COVID-19 infection [RR 2.62 (95% CI 2.04—3.36), p< 0.00001, I² = 96%, random-effect modeling]. The authors concluded that extra care and close monitoring should then be provided to patients with dementia to minimize the risk of infections, preventing the development of severe and mortality outcomes. (PsycInfo Database Record (c) 2020 APA, all rights reserved)

For the abstract

Why Are People So Skeptical About Psychology?

Why can't psychologists get respect?

A provocative article published a few years back in American Psychologist tackles that very question.  Written by the late Emory University psychologist , Scott Lilienfeld (also one of the co-authors of 50 Great Myths of Popular Psychology: Shattering Widespread Misconceptions about Human Behavior), the article examines why psychology has become the "Rodney Dangerfield of the sciences" with a public reputation for being unscientific. 

While the science of psychology has often faced legitimate criticism for overly depending on statistical significance testing, overly vague psychological models, and political correctness that limits legitimate scientific investigation into sensitive issues,  most of those criticisms have been raised by psychologists on the inside seeking to strengthen the discipline as a whole.  As a result, these disputes are often invisible to people outside psychology itself and public skepticism concerning psychology typically focuses on misunderstandings of what psychology is and the sorts of questions that psychologists attempt to answer.  

This pervasive misunderstanding can have far-reaching consequences.   Not only do elected politicians voting on science funding often short-change psychological research projects for not being "real science" (including omitting psychology from some funding agencies lists for  STEM disciplines), but potential mental health consumers who might otherwise benefit from psychological treatment may be reluctant to seek help due to misconceptions about what a psychologist actually does.

While psychologist advocacy groups (including the American Psychological Association and the Association for Psychological Science) have tried to fight back against these misconceptions, public attitudes concerning psychology and psychological research have been slow to change.  In 2006, the American Psychological Association Science Directorate released a pamphlet titled  Prepare Now to Prevail If Your Research is Attacked:  Self-Defense for the Psychological Scientist which basically advised researchers on how to defend themselves  against political, media, and public attacks that misrepresent their findings.   The pamphlet provides basic self-defense tips such as: 

• Be aware that the grant application abstract from your research is accessible to and searchable by the public and Congress and should describe your research in lay terms.
• Create an easy-to-understand, one-page summary of your research that illustrates why it is important to the public.
• Request media training from your university.  and
• Establish a relationship with your university’s public and legislative affairs office.

Unfortunately, as Dr. Lilienfeld pointed out in his article, efforts by researchers to fight misconceptions about their research are only mildly effective since they overlook the underlying reasons for widespread skepticism about psychology.   In addressing this skepticism, he focused on two basic questions:  a) are the negative views of psychology's scientific status held by many outsiders warranted? and b) what are the principal sources of the views?   

Negative media views about psychology date to the very beginnings of psychology itself with early psychologists such as William James who wrote uncritically about spiritualism and other pseudoscientific fads.  While other psychologists including Hugo Munsterberg and Theodore Flournoy distinguished themselves as skeptical debunkers, their efforts tended not to be so well-publicized.  Early attempts by forensic psychologists to prove the credibility of psychological research in the courtroom also helped damage the credibility of psychologists as a whole.  As one example, Harvard psychologist, Hugo Munsterberg, had a particularly troubling love-hate relationship with the media and his testimony during the 1907 Harry Orchard trial severely undermined the credibility of the fledgling science of forensic psychology for years afterward.  Regardless of the scientific merits of the research, media  controversies surrounding psychologists such as William Moulton Marston and his lie detector, B.F. Skinner' and his "Heir Conditioner", and Wilhelm Reich and orgone technology likely reinforced the view of mental health researchers as wooly-headed and unscientific.

Even in the the present day, numerous editorials and unflattering stories about psychological research are still common.  A 1982 New York Times editorial by Nicholas Wade reported on a Psychology Today survey that asked eleven psychologists to identify the most significant finding in psychology for the previous fifteen years.   The editorial, titled "If This is Consensus, Psychology Can't Be Much of a Science" used the lack of consensus among the polled psychologists and concluded that  "The results are astonishing: it would seem that there have been none".  The editorial's author added that the failed consensus "evinces a serious problem in their academic discipline".    It was during this same period that David Stockman, President Reagan's then-Director of the Office of Management and Budget justified the decision to slash behavioural science funding by declaring that psychology was a pseudo-science. 

Along with unflattering criticisms of psychology in the media, opinion surveys have indicated that large segments of society continue to view psychology as unscientific and that daily life experiences were often sufficient to provide most people with adequate exposure to make informed opinions about human behaviour.  One 1998 survey study found that both the general population and college faculty rated psychology and sociology as being significant lower than five other disciplines (biology, chemistry, economics, medicine, and physics) in terms of their "contribution of the discipline to society".  Psychologists were specifically identified as being lower in expertise than most other disciplines and that the general population was typically better off relying on "common sense".

A 2008 marketing study commissioned by the American Psychological Association reflected ongoing public misgivings about the scientific value of psychology.  While 82 per cent of study respondents agreed that psychological research helped to improve people's lives, only a minority of participants had a clear idea of what psychologists actually did or the full range of research issues addressed by psychological research.  The overwhelming consensus was that psychology is a "soft science" with less rigour than most other disciplines as well as requiring less time to develop expertise as opposed to other sciences.   Other studies have shown widespread skepticism about psychology's value to society compared to other scientific disciplines seen as more important.

But why is this skepticism so widespread?  According to Dr. Lilienfield, the skepticism often focuses on six common misconceptions about psychology that are often cited by critics:

• Psychology is merely "common sense"
• Psychology does not use scientific methods
• Psychology can not yield meaningful generalizations because everyone is unique
• Psychology does not yield repeatable results
• Psychology can not make precise predictions
• Psychology is not useful to society

While psychologists can respond to these misconceptions effectively, Dr. Lilienfield stresses that widespread skepticism is often reinforced by the slowness on the part of psychologist to weed out those questionable practice that often still thrive.   These practices include the continuing use of treatments and tests that do not have adequate scientific support such as alternative medicine, "recovered memories" of past abuse using hypnosis or other suggestive techniques, as well as the failure of psychologists to use the best evidence-based treatments to treat emotional or behavioural problems.   Of the thousands of self-help books (many of which prominently feature the authors as psychologists), only a small percentage actually off scientifically tested information.  These books often feature oversimplified advice or make elaborate claims that go well beyond established scientific research.   Also, there seems to be widespread resistance among psychologists to test established mental health treatments scientifically which can often feed into public skepticism.

In the end, this failure to police psychology as a whole means that media psychologists such as Dr. Phil McGraw and Dr. Laura Schlessinger (whose Ph.D is in physiology) are free to present themselves as psychology's public face and to dispense unscientific advice freely.  That  the American Psychological Association invited "Dr. Phil" to speak at its 2006 annual convention to highlight the effective communication of psychology to the public reflects the problem that many psychologists face in being accepted as scientists.  Even the very word "psychologist" is often a source of confusiondue to role diffusion between psychologists, psychotherapists, psychoanalysts, social workers, and psychiatrists who often provide highly similar services.   Surveys have consistently shown that large segments of the American general population are unable to distinguish between different mental health professionals.

Along with the general role confusion facing psychologists seeking acceptance, Dr.Lilienfeld also identified cognitive biases underlying public skepticism of psychological research.   These include hindsight bias (regarding a research conclusion as seeming obvious in hindsight),  that research questions addressed by psychologists are often perceived as less difficult to answer than questions addressed by scientists in other disciplines, the failure to distinguish basic from applied research, the popularity of reductionist explanations of human behaviour (including explanations based on neuroscience, biochemistry, and human evolution),  as well as the refusal to accept that certain subjects can be tested empirically at all, a.k.a  the scientific impotence excuse. 

So where does this leave us?   While large segments of the general population are still skeptical of psychology's value, survey data suggests some cause for optimism although there is considerably more that needs to be done.   As Dr. Lilienfeld points out, psychologists cannot blame their continuing credibility problems exclusively on public misconceptions.    The failure of psychologists to embrace evidence-based practices and to keep advocating treatments that have been shown not to work effectively is definitely part of the problem.  As well, we shouldn't let flashy media psychologists continue to be seen as psychology's public face instead of the more legitimate research psychologists who can provide a more balanced view of what psychology is really about.   Since academics are often reluctant to confront pseudoscience, misconceptions continue to flourish.

In his conclusion, Dr. Lilienfeld made the following recommendations:  on the individual level,  psychologists need to make a greater effort to make their work available to the public through popular writing (Daniel Kahnemann, Steven Pinker, Dan Ariely,  Christoper Chabris and Daniel Simons are all examples of psychologists who have written bestselling books on psychology).   On the institutional level, universities and psychology advocacy groups need to make a greater effort to integrate psychological research into psychology's public face instead of simply reacting blindly to controversies as they arise.  He also stresses the need to debate the often legitimate objections that many people raise to questionable practices in psychology and to weed out those fads that are ultimately damaging to our reputations as psychologists.  Psychologists should stop feeling threatened by public skepticism and learn to recognize that this skepticism can be a useful way of identifying potential problems in our profession and how we are seen by non-psychologists.

To close this post, I think Dr. Lilienfeld's closing words would probably work best:

Just as former New York City Mayor Ed Koch (1981) became famous for asking his constituents “How'm I doing?” as a means of gauging his performance, we as a field should continually be asking the general public “How are we doing?” and be prepared to take their critical feedback to heart if their answers are not to our liking

For the abstract.

 

Does the Gut Microbiome Affect How People Respond to Antipsychotic Medication?

Patients with psychosis usually respond to one antipsychotic drug and not to another; one third fail to respond to any. Some patients, who initially do well, stop responding. Some develop serious side effects even at low doses. While several of the reasons for this variability are known, many are not. A new review published in the journal Behavioral Brain Research examines the potential role of intestinal organisms in response/non-response to antipsychotics. Much of the literature in this field is relatively new and still, for the most part, theoretical. A growing number of animal experiments and clinical trials are starting to point, however, to substantial effects of antipsychotics on the composition of gut bacteria and, reciprocally, to the effects of microbiota on the pharmacokinetics of antipsychotic medication. Because so many factors influence the constituents of the human intestine, it is difficult, at present, to sort out how much one or more either enhance or dampen the benefits of antipsychotics or the character/severity of the adverse effects they induce. Dietary and other therapies are being devised to reverse dysbiosis. If successful, such therapies plus the modification of factors that, together, are known to determine the composition of microbiota could help to maximize the effectiveness of currently available antipsychotic therapy. (PsycInfo Database Record (c) 2020 APA, all rights reserved)

For the abstract

Sterilizing the Heiress

From the day she was born, Ann Cooper Hewitt's life consisted of one legal battle after another.  Born in 1914 from an extramarital affair between millionaire inventor Peter Cooper Hewitt and Maryon Bruguiere (later Maryon Bruguiere Hewitt D'Erlanger McCarter), it took a divorce from Peter's first wife and a belated marriage to Ann's mother to legitimize her.   Even then, Peter had to formally adopt his natural daughter given the laws against illegitimacy that were in force at the time.   This would lead to a long and vicious inheritance battle after Peter's death in 1921 as his siblings disputed Ann's right to her father's money.  Still, after years of legal wrangling, Ann's legitimacy was upheld and her father's estate would remain under the control of her much-married mother.   By the time she turned twenty-one, Ann seemed assured of receiving her inheritance and taking full control of her life.

And then her mother had her sterilized...

In an incredible lawsuit filed in a San Francisco court in January, 1935, Ann Cooper Hewitt, sued her mother. two San Francisco doctors, and a State Health Department psychiatrist of being part of a scheme to seize control of her estate by having her declared mentally incompetent and subsequently sterilized.   The suit, which called for $500,000 in damages, accused Maryon (then known as Mrs. McCarter) of years of riotous living, all funded by money embezzled from Ann's estate.   Along with gambling trips and numerous affairs, Maryon had been notorious for years with her frequent trips flitting between Europe, New York, and San Francisco.

Since the rise of the eugenics movement at the dawn of the 20th century, sterilization of people  deemed to prove "genetically unfit" had been perfectly legal across numerous countries in North America and most European countries.  For anyone suffering from mental illness, criminal behaviour, low intelligence, or virtually any other quality that might be deemed inferior, compulsory sterilization remained a popular option supported by numerous lawmakers and social reformers.  In the United States, the legality of compulsory sterilization had been upheld by the landmark Buck vs Bell Supreme Court decision of 1924 as well as numerous laws such as the 1924 Sterilization Act passed in Virginia.  Though countless patients would be sterilized, often without their knowledge, critics charging that people could be sterilized for even trivial reasons tended to be dismissed.

For Ann Cooper Hewitt, however, things were very different.   In the lawsuit filed by her attorneys, she maintained that her sterilization had taken place at a San Francisco hospital on August 18, 1934.   The surgeons who had carried out the operation, Tilton E. Tilman and Samuel G. Boyd, were two of San Francisco's most prominent doctors and had apparently received permission to carry out Ann's sterilization following an assessment by social worker Mary S. Scally.   According to Ann, she had no idea that she was being sterilized and that it had taken place while she was undergoing an emergency appendectomy.  As the lawsuit pointed out, the terms of Ann's trust fund were quite clear that Maryon would only inherit her late husband's estate if Ann died childless.  And so, the sterilization took place just months before her daughter turned twenty-one.

In responding to the allegations raised by the lawsuit,  both of the surgeons named admitted to the sterilization but insisted that they had examined Ann first and found her to be "feebleminded with the mental age of a child of 11 years."    This finding was apparently based on a battery of intelligence tests that Ann had undergone in 1934, apparently at her mother's urging, though Ann  had no idea why she was being tested.   As for Ann's mother, her lawyer insisted that the operation had been carried out "for society's sake" and further hinted that Ann had been sterilized due to her "erotic tendencies," evidence of which would be brought out in the courtroom if the case came to trial.  Almost immediately, Ann's lawyers responded with an affidavit from a New Jersey psychiatrist who had been close to Ann her entire life and who verified that she was "correctly oriented in all spheres."    Not only was Ann fluent in three languages, but she was well-read and articulate.    

In what was gearing up to be the trial of the decade, San Francisco's district attorney announced that Ann's mother and the two doctors would be charged with "mayhem", a crime that would legal to lengthy legal sentences for all three.    Though Ann was reluctant to press charges, both doctors were ordered held for trial.   As for Maryon McMaster, she apparently panicked due to her new notoriety.   Fleeing to New York, she registered at the Plaza Hotel under an assumed name and, after a week in hiding, was found in a New Jersey hospital following an apparent suicide attempt. 

When questioned about her reasons for Ann's sterilization, Maryon defended her decision by saying that Ann had already been expelled from numerous schools for "scandalous behavior" due to her "erotic tendencies."   She also insisted that Ann was "easily infatuated by men in uniform, regardless of their station."   Two years earlier, Ann had become intimately involved with a chauffeur and Maryon had been forced to step in to break up the relationship.  She also had to buy back letters reportedly written by her daughter which contained "references to things that should not be written about."   This, along with the intelligence test results, was enough for Maryon to agree with the doctors that Ann was "feeble-minded."

As for the doctors, their defense focused on California legislation authorizing sterilization for anyone committed to a home for the feeble-minded.   While this didn't apply to Ann, Tilton E. Tilman maintained that this still applied in her case.  Speaking as a member of the San Francisco Lunacy Commission, he stated that "where the family has sufficient means, the feeble-minded person is taken care of at home, but the situation is the same."   He also insisted that there was nothing unusual about being paid $8000 by Maryon to form his diagnosis, something he justified by the need to hire special nurses and the many hours he spent assessing her.  As for Samuel Boyd, who actually performed the surgery, he justified not telling anyone about the real nature of the operation, including Ann, because "it might cause harm to the girl's future."    How Ann was able to learn the truth about what was done to her is still a mystery.

After long legal haggling and behind-the-scenes negotiating, the case was settled out of court.  The two doctors were found not guilty due to lack of evidence and all charges were dropped against Ann's mother.  It's hard to say what kind of relationship Ann had with her mother afterwards but Maryon died just a few years later at the age of 55.    As for Ann herself, she married a garage foreman just a year after the case was dropped (her mother may have had a point about Ann's fondness for men in uniform).  This marriage ended quickly on the grounds of "mental cruelty" and Ann, who would be known to the press as the "sterilized heiress" for the rest of her life, would go on to marry five more times.  She died in 1956 at the age of 42 and left her entire estate to her sixth husband.   They had no children.

Despite the brief flurry of publicity over Ann's case, compulsory sterilization would continue to be practiced for decades after her case was settled.  While the eugenics arguments that were originally used to justify sterilization were discredited due to the gruesome revelations of Nazi war crimes, thousands of people would continue to be sterilized well into the 1960s and beyond, many of them with no idea of what had been done to them.  Few of them ever received the kind of publicity that followed Ann Cooper Hewitt, but their stories were likely just as important.  

Even if they have never been told.

 For more information

Nine-Year-Old Girl Plays Piano During Delicate Brain Operation

"I played the piano for at least 6 hours, I also played mobile games. I feel better now.” 

When the parents of nine-year-old Soumeya first brought her to the Birla Hospital in the city of Gwalior in India's Madhya Pradesh province, doctors soon realized that she had a dangerous brain tumour that would require major surgery for removal.    To reduce potential damage to other parts of the child's brain affecting vision, movement, or speech,  the doctors decided that an Awake Craniotomy procedure would give them the best chance for success.

First pioneered by Canadian neurosurgeon Wilder Penfield in the 1920s for the treatment of epilepsy, an awake craniotomy involves the removal of part of the patient's skull  to allow surgeons to operate directly on the brain while patients are awake and able to communicate with the surgical team.   Given the potential risk of accidentally damaging nerve tissue in other parts of the brain, the surgical team used a local anesthetic to numb pain only in the part of the head where the surgery was being performed.  As for surgery on the exposed brain itself, no anesthetic is needed as the brain has no pain receptors.  Along with being an extremely difficult procedure, an awake craniotomy also requires extraordinary cooperation among all the members of the surgical team, including the neurosurgeon, neurologist, and anesthesiologist.   

Monitoring a patient's mental functioning during the operation often involves having that patient engaging in familiar tasks, including playing a musical instrument or doing mental exercises or video games.  Knowing that Soumeya enjoyed playing music on a synthesizer,  the surgical team decided that having her play would allow them to monitor her mental functions during the course of the lengthy operation.  “The case was challenging but the operation was successful with our team’s efforts," said neurosurgeon Abhishek Chauhan .  "When we were operating we asked her to play the piano. There were chances for the child to slip into paralysis but she was conscious throughout the operation.”   Initial reports indicate that the surgery was a success and Soumeya is expected to make a full recovery.

Though common in North America since the 1980s, the use of awake craniotomies have since spread to Europe and across Asia.    The procedure is  expected to become more widely used  in Asian hospitals given the number of potential patients that can be helped and better recovery time compared to less radical methods.  While not all awake craniotomy patients are expected to serenade their surgical team with music,  staying awake during these operations allow patients to preserve physical and mental functions that they consider vital and to return to their normal lives as quickly as possible.

The Kallikak Problem (Part Two of Two)

Continued from Part One

Despite the appeal of Goddard's book to eugenicists, not everyone was persuaded by his  findings.   One 1912 review in the British newspaper Guardian was particularly scathing in challenging the book's hereditarian bias.  In the review, the anonymous author pointed out that "One wonders, with effect how, with the most careful inquiry, anyone could obtain a diagnosis of true feeble-mindedness for past generations.  The author lays stress on the point that the two branches of the family did not differ in point of environment except insofar as the difference was due to their own difference in character.  But he does not allow for the facts:  (1) that the original feeble-minded son was illegitimate and therefore in quite a different position from the respectable normals and (2) that this difference in environment is handed on just as much as the physical heredity is handed on and goes far to determine the subsequent intermarriages.   He also talks lightheartedly of sterilization, as though the only objections to it were "sentimental" and not founded upon a rational perception of the extreme danger to society involved in treating human beings after such a fashion."

Sadly, this particular reviewer was very much in the minority concerning the potential danger of using Goddard's book to highlight the dangers of people with "inferior" genes.   Most other newspapers, especially in the U.S.., hailed the book as a "natural object lesson in heredity" that highlighted the risks of unrestricted breeding.   One editorial published on November 21, 1912 gave the panicked observation that feeble-minded individuals were multiplying at "twice the rate of the general population" and that they might eventually dominate society as a result.  

But what really made Goddard's Kallikak study so appealing to different political factions was how it could provide ammunition for a variety of different political crusades.   Vice crusaders agitating about prostitution and assorted other "immoral practices" could (and did) argue that feeble-mindednesst could lead women to gravitate or be forced into lives of prostitution and that such women needed to be protected  for their own safety.  Though Goddard himself insisted that there wasn't enough available data to prove that feeble-minded women were prone to "professional vice", other pundits, many citing Goddard's book, called for crackdowns on the red light districts found in most cities.   

On the other hand,  pundits railing against the dangers of immigration also invoked Goddard's study to show that potential immigrants needed to be carefully screened to keep out feeble-minded candidates.   Not only would it prevent them from turning to crime in the U.S. but would also prevent them from contributing their own inferior genes to America's melting pot.   Almost inevitably, Goddard himself set up an intelligence testing office at Ellis Island just a year after his study came out.  His immigration study results, released in 1917, declared that as much as eighty percent of all immigrants. particularly immigrants from specific ethic groups, met his criteria for feeble-mindedness.  That Goddard himself later revised this to forty percent did little to curb the calls for more stringent immigration laws to keep these "undesirables" out, not to mention establishing quotas that would remain in place for decades afterward.  

As for whether Goddard's study helped bolster the case for compulsory sterilization of people like Deborah Kallikak, that seems harder to establish.  Though sterilization laws were already on the books in some parts of the U.S. (Indiana had one as early as 1907), they certainly became more popular in the years following the publication of Goddard's book.   Ironically, Goddard himself was much more moderate in his own proposed solution for dealing with people he considered to be feeble-minded.  While he advocated keeping them in institutions where they could be trained to do simple work, sterilization was widely seen as a much more effective (not to mention cheaper) alternative.    

This led many overzealous medical doctors  to begin sterilizing people they considered to be feeble-minded, often without any form of informed consent and with only shaky legal justification.  One prominent sterilization advocate was Dr. Albert Priddy, long-time director of the Virginia State Colony for Epileptics and Feeble-minded.  Though sterilization wouldn't become legal in Virginia until 1924, Priddy had already conducted hundreds of sterilizations by them,  often based on his own harsh eugenics beliefs    This included sterilizing women he regarded as being "immoral" for being "too forward"  (one underage girl was sterilized because she was in the habit of "talking to the little boys").   It hardly seems surprising that Priddy often invoked Goddard's research to justify his actions, even when  this got him into trouble as families began fighting back.  

All of which led to the egregious Carrie Buck case and what Albert Priddy would regard as his greatest legal victory.  Buck, who had become an inmate at the Virginia State Colony in 1924, was deemed to be mentally unfit, largely due to her "unrestrained" behaviour with the opposite sex and giving birth to an illegitimate child.  Using intelligence tests which would be considered completely spurious by modern standards, Buck, her mother, and her young daughter Vivian were all deemed to be mentally unfit and, as a result, ideal candidates for sterilization and a perfect test case for more stringent sterilization laws.

Priddy was certainly in fine form when testifying during Carrie Buck's initial trial in fighting the sterilization order and the later case before the Supreme Court as he presented his evidence .  Many of the most prominent eugenicists of the day also testified.   Add in the fact that Carrie Buck's own mediocre lawyer (who failed to call a single witness on her behalf) and the the final verdict was no surprise to anyone.   All of which led to the appalling Buck vs Bell Supreme Court decision of 1927 in which Oliver Wendell Holmes, then associate justice of the Court concluded publicly that "three generations of idiots are enough."

Ironically, Goddard's Kallikak study wasn't introduced as evidence at the trial, largely because Goddard himself had come to accept that the study was obsolete due to the many scientific errors that had been made.   This included many of the same points raised by that anonymous Guardian reviewer in 1912 as well as questions concerning the actual paternity of Martin Kallikak Junior.   To Goddard's credit, he was often horrified at how his research was being used by eugenicists and he dedicated much of his remaining life to reforming special education for intellectually disabled children as well as recognizing the role that environment played in mental development.  He died in 1957 with much of his early eugenics research being largely forgotten.  

But while the end of World War II and the horrendous example of Nazi persecution helped doom the eugenics movement worldwide, the existing laws concerning sterilization remained on the books for decades afterward.   Though the rationale was often changed, the end result was still the same and thousands continued to be sterilized well into the 1980s. For that matter, compulsory sterilization continues to be seen in other countries, usually directed against minority groups lacking the resources to fight back.  

Though the "Kallikak" name still crops up at times in news stories and opinion pieces as a byword for "white trash" (including being the name of an ill-considered situation comedy in 1977),  it has been largely forgotten except as a warning about he dangers of  this kind of research and easily such research can be used to promote misinformation.   It is a warning that remains relevant even today.