Interesting facts about lobotomy

Egash Moniz

In 1935, Portuguese psychiatrist Egas Moniz hypothesized that the intersection of afferent and efferent fibers in the frontal lobe might be effective in treating mental disorders. To test this assumption, the first operation was performed a year later by Professor of Neurosurgery Almeida Lima, but under the direct supervision of Moniz. The lobotomy procedure consisted of the following: a loop was inserted into the brain with the help of a conductor, and the brain tissue was damaged by rotational movements. The frontal parts themselves were not damaged, and only the white matter of the neuronal connections connecting the frontal parts with other parts of the brain was cut. This procedure has been touted as a rescue tool in desperate situations.

After completing about a hundred such operations and conducting follow-up observation of patients, which consisted of a subjective assessment of the mental state, Monish reported successful results and began to popularize this method. in 1936, he published the results of surgical treatment: according to Dr. Moniz, a third of his patients after surgery recovered from incurable mental ailments, and the second third had a significant improvement in health.

Although the quality of the research was criticized in the scientific audience, E. Moniz wrote hundreds of articles and books on lobotomy, which led to the rapid adoption of the procedure on an experimental basis by individual clinicians around the world. And in 1949, Egash Moniz was awarded the Nobel Prize in Physiology or Medicine "for the discovery of the therapeutic effects of leukotomy in certain mental illnesses."

Lobotomy performed by Walter Jackson Freeman

After Moniz was awarded the Nobel Prize, leukotomy has become more widely used. American psychiatrist Walter Jackson Freeman became the leading propagandist for the operation. He developed a new technique that did not require drilling into the patient's skull and called it "transorbital lobotomy." With the suggestion of Freeman and James Watts, both the procedure itself and the name "lobotomy" became more common. He performed his first lobotomy using electroconvulsive therapy for pain relief.

He aimed the tapered end of an ice-picking surgical instrument at the bone in the eye socket, punctured a thin layer of bone with a surgical hammer, and inserted the instrument into the brain. After that, the fibers of the frontal lobes of the brain were dissected by the movement of the knife handle. Freeman argued that the procedure would remove the emotional component from the patient's "mental illness." The first operations were carried out using a real ice pick. Subsequently, Freeman developed special instruments for this purpose - a leucotome, then an orbitoclast.

Carefully conducted studies have revealed that, in addition to the lethal outcome, which was observed in 1, 5-6% of the operated, about a quarter of the patients were left to live with the intellectual capabilities of a pet. But aggression subsided, which helped to introduce lobotomy as an economically cheap method of treatment in psychiatric clinics. In the early 1950s, about 5, 000 lobotomies a year were performed in the United States, without Freeman's medical education, nevertheless, he performed about 3, 500 such operations, traveling around the country in his own van, which he called "lobotomobile"

Lobotomy was also practiced in the USSR. 1945-1950 lobotomy was performed on about 400 patients in order to further track the effectiveness of such treatment methods. Tracked down and banned due to the lack of validity of the theory, unclear indications for surgery and severe neurological and mental consequences after surgery.