Back in the 16th century there was a famous physician in Spain, doctor Villalobos, who would be the physician of Emperor Charles V, which is no small honour, as only the best ones would be selected for the role. However, as he was a Jewish converso, he quickly became the butt of jokes about doctors, which is extremely unfair as he was a great man of medicine, and an important translator of classic literature.

I offer you here a couple of the jokes about Villalobos that were told in the 16th century, compilated in that great book titled "Libro de chistes de Luis de Pinedo y amigos":

Doctor Villalobos, when the royal court was in Toledo, entered a church in order to attend mass, and started praying in the altar of the Fifth Sorrow, and as he was praying there a lady from Toledo, called Lady Ana de Castilla, passed by and, as soon as she saw him started saying:

"Take away from me this Jew who killed my husband", as he had treated the man from a sickness of which he died.

A lad came then in a hurry to doctor Villalobos and said:

"For the love of God, please, come with me to see my father, he is very ill".

Villalobos replied: "My brother, can't you see that woman there insulting me and calling me jew because I killed her husband? And that lady over there weeping and with her head down, for she says I killed her son? And now you want me to kill your father?"

Another one, a bit on the same tenor:

When prince Philip was very young, some bulls were being run in the Corredera in Valladolid; and as a bull charged fiercely against a man immediately close to the window where he was, he feared and trembled.

The empress, very worried, said, "I'm sure afraid that this boy will turn out a coward".

To this, Villalobos replied: Don't Your Majesty worry. When I was little, I was the most scaredy jew out there, and everything frightened me. And look at me now, there is no person I don't kill.

I've posted on here quite a bit about psychosurgery/lobotomy, but there are some other drastic procedures used to treat mental illness in the era of psychiatry before the advent of pharmaceutical treatments. Here are two risky but well-established options.

Insulin coma therapy/Insulin shock therapy: A fellow named Manfred Sakel came up with technique. He had a patient who was diabetic who was accidentally administered too much insulin and fell into a coma. When he was woken, his presenting psychiatric symptoms seemed better. Sakel thus concluded that inducing insulin comas was a way to treat mental illness, mainly schizophrenia and other psychotic disorders. Insulin shock therapy was time and labor intensive, you had to have a special unit. Patients were given massive doses of insulin to cause a coma that was life threatening if not very carefully monitored. They would remain in this coma for WEEKS at a time, only being partially roused to eat and use the bathroom. He came up with this in a clinic in Austria, and it was introduced in the US and Britain. He had a theory for why it worked, but honestly it just boils down to the theory that you brought patients out of agitation and into a rested state, and from there you could "jolt" someone out of mental illness. They were already trying that with ECT, electroconvulsive therapy, but thanks to Sakel, this was an option as well.

Sakel was a very eccentric guy, and basically lost it when insulin shock therapy fell out of favor. It fell out of favor because, well, it didn't work and also, it killed people. This was a HUGELY risky treatment. Putting someone in an insulin coma is VERY dangerous and you can kill people even when you are very careful. The line between coma and dead is hazy and different for each person. I'm an insulin dependent diabetic and every one of us is prescribed a drug someone can inject you with to save your life if your blood glucose level drops you too low to remain conscious. The idea of doing that to a person on purpose is pretty reckless. But if you want even more recklessness, check out:

Surgical bacteriology - there was an emerging theory that mental illness was caused by bacterial infections - bacteriology and infectious disease medicine were finally getting off the ground at this time. A the head doctor at Trenton State Hospital, Henry Cotton, who incidentally had FAR less respect for patients than the pioneer of the transorbital lobotomy (Walter Freeman) ever did, became the driving force behind this theory in the US. (Dr. Freeman was on a similar enough path that he's useful for comparison purposes, despite not precisely contemporaneous). This is an appealing theory, because infections can be rooted out and possibly cured. He became obsessed with the idea of focal infections - hidden pockets of infection that had become the source of a patient's illness. So he removed these focal sources. He started with abscessed teeth. If/when that didn't work, he took out the healthy ones (no anesthesia of course). And he kept on removing things until a patient got well, got too sick for more 'treatment', or died. Tonsils, adenoids, gallbladders, spleens, testicles, ovaries, bladders, colons, cervixes . . . that's what I can think of off of the top of my head. His biography should have more, if you are interested. The treatment has a significant history, though much shorter than that of lobotomy, and more volatile, because Cotton was simply not the doctor or scientist or even the smooth talker that Freeman was. The history of the procedure is more barbaric (in my opinion), every single patient was a guinea pig, and the treatment Cotton created was never really there to help people, it was entirely about Cotton, his ego, and his status.

Freeman was able to die of diabetic complications alone and in obscurity, unhappy that he and his groundbreaking treatment had been cast aside for these "barbaric" chemicals. Cotton was not so lucky. He was aggressive, and as I said above not the scientist and doctor Freeman was. Also he was killing a significantly higher percentage of his patients. He was killing some prominent ones too. Eventually he was hauled before the New Jersey State Senate. He appeared to come out on top. He was vindicated. But during the lengthy trial, he had a nervous breakdown. Although he would go on to open a lucrative mental health practice that catered to the most exclusive clients, illness and eventually criticism plagued him (he was rumored to have removed some of his own teeth). Eventually, after he was retired from the hospital and people stopped dropping dead from unnecessary resections of large swathes of their healthy GI system, trouble started to brew again. By 1932 there were not one but two reports being compiled on him internationally, and in 1933 he dropped dead from a heart attack, possibly stress.

Without it's champion, and with mounting evidence of Cotton's fraudulent claims and the hidden deaths, the field of surgical bacteriology quietly wound into obscurity.

Early antipsychotic medications were very problematic because of complex, often drastic, and sometimes permanent side effect profiles, but they kept you away from insulin comas and with all of your body parts still attached to you.

Learn a little about the role of perfume as medicine in my response to the question: Outside of plague doctors stuffing their beaks with herbs, were perfumes believed to have prophylactic ability? That is, in Antiquity, the Middle Ages or the Early Modern period, did people applying perfumes to themselves believe that they were warding against disease?

A worthwhile podcast on the subject is Sawbones: a Martial Tour of Misguided Medicine, which traces the history of things we thought we knew about the human body.

As an insulin-dependent diabetic, I use hypodermic syringes to inject insulin into the subcutaneous fat of my abdomen 4 times per day. Did you know that this ubiquitous and common medical tool was invented in 1844 in Dublin, Ireland?

Francis Rynd was born in Dublin in 1801 and attended Trinity College Dublin where he was known for being a "wayward" student due to his busy social life and love of fox hunting. At Meath Hospital, he studied under surgeon Sir Philip Crampton, but because of the aforementioned activities he wasn't the best student at first: he skipped quite a bit of school. Because he recognized Rynd's potential, Crampton asked a younger associate, William Porter, to take Rynd under his wing. This arrangement yielded good results, and Rynd was able to qualify and establish his own practice. He became a member of the Royal College of Surgeons in 1830 and his practice attracted most of the Irish nobility, the successful, and the fashionable.

In 1836, Rynd became a surgeon at his old hospital, Meath.

Margaret Cox was a 59-year-old woman who was admitted to Meath in May 1844 for treatment of an episode of intense pain on the left side of her face - this particular episode had started 3 weeks prior, but the episodes of intense pain had a 5-year history. The usual treatments - bleeding, blistering, opium - hadn't provided relief, so she was admitted to hospital.

Though morphine was then - as now - a treatment for intense pain, Cox was taking it in pill form and found it ineffective. Dr Rynd decided to administer the morphine directly under her skin near the nerves. He improvised an instrument - a narrow, hollow tube with a cutting instrument at the end of it - that punctured the skin. The device didn't have the plunger that today's hypodermic syringes do, so the medicine traveled beneath the skin by gravity. 4 small injections of morphine were made into the face and, as he reported, "In the space of a minute, all pain (except that caused by the operation, which was very slight) had ceased, and she slept better that night than she had for months." After a week, the pain returned but at a fraction of the intensity. This time Dr Rynd injected pain medication twice and the pain subsided.

Dr Rynd wrote about this treatment for the Dublin Medical Press:

Margaret Cox, aetat. 59, of spare habit, was admitted into hospital, May 18, 1844, complaining of acute pain over the entire of left side of face, particularly in the supraorbital region, shooting into the eye, along the branches of the portio dura in the cheek, along the gums of both upper and lower jaw, much increased in this situation by shutting the mouth and pressing her teeth close together, and occasionally darting to the opposite side of the face and to the top and back of her head. On the 3rd of June a solution of fifteen grains of acetate of morphia, dissolved in one drachm of creosote, was introduced to the supra-orbital nerve, and along the course of the temporal,malar, and buccal nerves, by four punctures of an instrument made for the purpose. In the space of a minute all pain (except that caused by the operation, which was very slight) had ceased, and she slept better that night than she had for months. After the interval of a week she had slight return of pain in the gums of both upper and under jaw. The fluid was again introduced by two punctures made in the gum of each jaw, and the pain disappeared. After this the pain did not recur, and she was detained in hospital for some weeks, during which time her health improved, her sleep was restored, and she became quite a happy looking person. She left the hospital on the 1st of August in high spirits, and promised to return if she ever felt the slightest pain again. We conclude she continues well, for we have not heard from her since.

Though the concept of syringes nor injections weren't at all new, this was the first known hypodermic injection. Syringes and similar devices had been used for extractions from Galen's time, with the first cataract extraction by syringe performed in 900 CE, but this was a device for injection.

Rynd wrote in 1861, challenging claims from other doctors, notably Alexander Wood of Scotland, about his invention:

The subcutaneous introduction of fluids, for the relief of neuralgia, was first practised in this country by me, in the Meath Hospital, in the month of May, 1844. The cases were published in the “Dublin Medical Press” of March 12, 1845. Since then, I have treated very many cases, and used many kinds of fluids and solutions, with variable success.

He died later that year from a heart attack.

NOTE: Rynd got the ball rolling, other doctors such as Alexander Wood and Charles Gabriel Pravaz, and inventors such as Letitia Mumford Geer and Colin Murdoch modified and refined the hypodermic syringe into the instrument we recognize today that medical professionals and patients alike use to inject medications and vaccines.

Resources:

Irish doctor who invented the modern injection remembered

AskAboutIreland: Francis Rynd

Through the eye of the needle: A remarkable medical life

Medical Eponym Library: Frances Rynd

A history of syringes and needles