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Learn About the Lobotomy: Why This Procedure is Done and How it Affects the Patient

written by: Emma Lloyd • edited by: Leigh A. Zaykoski • updated: 8/31/2009

The history of the lobotomy procedure is an especially tragic one. Once believed to be an effective treatment for mental illness, the lobotomy is now recognized as a barbaric and highly damaging practice.

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    Early History

    The origins of the lobotomy procedure lie in the late nineteenth century, when German scientist Friederich Golz experimented on the brains of dogs. Golz discovered that removal of the temporal lobe made the animals quieter.

    In 1892, Swiss insane asylum supervisor Gottlieb Burkhardt operated on six schizophrenic patients, removing parts of their cortexes. Two of the patients died, and others were calmer following the operation, while Brurkhardt himself was criticized as a result of his experiments.

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    Lobotomy in the Twentieth Century

    It wasn’t until 1935 that psychosurgery came into focus again, this time as a result of experimental discoveries made in American laboratories. The principle discovery made was that the cortex of the brain was linked to aggressive and emotional behavior, and that destruction of the cortex seemed to reduce aggression.

    Yale University researcher Carlyle Jacobson observed that chimpanzees became less aggressive and more manageable after their frontal and prefrontal cortexes were damaged. In addition, Jacobsen noted that the animals seemed no less intelligent following the procedure. Another Yale neurologist, John Fulton, noted that after removal of the prefrontal cortex in chimpanzees, the animals could not be provoked into developing experimental neuroses.

    Based on the ideas of Fulton, a neuropsychiatrist named Antonio Egas Moniz believed that certain psychoses could be cured or diminished if the cortex of the brain was destroyed. Working with a neurosurgeon named Almeida Lima, Moniz developed a procedure called leucotomy, in which a type of wire knife was inserted into the brain and moved sideways to sever the nerves which connected the cortex to the rest of the brain. For some patients, the procedure resulted in a reduction of depression or anxiety.

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    Walter Freeman and the Ice-Pick Lobotomy

    Many psychiatrists were steadfastly opposed to the procedure, but one American physician, named Walter Freeman, was excited by its possibilities. Together with neurosurgeon James Watts, he began to operate on American patients, and became convinced that it was a miracle cure, of sorts. In the 1940s Walter Freeman developed the prefrontal “ice-pick” lobotomy, in which a tool similar in shape to an ice-pick was inserted into the roof of the eye socket. The tool was inserted and then tapped to drive it into the brain. Once inserted, the pick was moved from side to side to destroy prefrontal cortex brain tissue. The entire procedure took only a few minutes.

    The lobotomy came heavily into favor as a result of the new ease of the procedure. In 1949 Antonio Egas Moniz was awarded the Noble Prize for his discovery of the procedure, and this helped to further legitimize the use of the lobotomy as a treatment for mental illness.

    In the post-war years between 1939 and 1951, tens of thousands of people were lobotomized in the United States and several other countries. Many cases ensued in which children and adults were lobotomized due to mildly disruptive behavior rather than true mental illness. One famous case is that of Howard Dully, who was lobotomized at the age of twelve with the consent of his mother, who found him difficult to manage. Most lobotomies were performed without the informed consent of the individual being operated on.

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    Late Twentieth Century view of Lobotomy

    In the early 1950s, neurosurgeons, psychiatrists, and others began finally to speak against the lobotomy procedure. With ethical and medical objections accumulating - barely one third of procedures had any positive effect - the procedure fell out of favor quickly. The development of new psychiatric medications such as Thorazine helped to hasten this process.

    Use of the lobotomy procedure gradually decreased throughout the 1960s and 1970s; however lobotomies were performed in the 1980s in Belgium, France, the U.K., and the U.S. In a small number of countries the procedure is still carried out very occasionally.

    During the twentieth century nearly 40,000 people were lobotomized in the United States alone, with a further 17,000 people in Britain and around 9,000 in Scandinavia. The results, for people who underwent the procedure, as well as their families, were tragic. For a full one third of patients, the lobotomy had absolutely no effect, and for another third, symptoms actually grew worse. The lobotomy procedure is now known as “one of the most barbaric mistakes ever perpetrated by mainstream medicine.” (American Experience)

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    References and Further Reading

    American Experience. The Lobotomist. (Complete program viewable)

    Renato M.E. Sabbatini, PhD. The History of Psychosurgery. Brain & Mind Magazine, June 1997. by Christine Johnson