Lobotomy: Overview and History

Definition

• Lobotomy: A surgical operation severing connections in the brain's prefrontal cortex, formerly used to treat psychiatric and neurological disorders.
• Also known as leucotomy.

Historical Context

• Originated by Portuguese neurologist Antônio Egas Moniz, awarded the Nobel Prize in 1949.
• Popularity rose in the 1940s-1950s, particularly in the US and UK.

Procedure

• Involves cutting connections in the brain, particularly targeting the prefrontal cortex.
• Initially involved trephining and injection of alcohol; later methods involved cutting with a leucotome.

Notable Practitioners

• Walter Freeman: Prominent American neurologist who popularized the transorbital lobotomy using an icepick-like instrument.
• James W. Watts: Partnered with Freeman initially; parted ways due to ethical disagreements.

Impact and Decline

• Widely used between 1936 and the 1950s, with thousands of procedures performed globally.
• Criticism grew due to severe side effects, such as personality changes and chronic intellectual deficits.
• Development of antipsychotic drugs and ethical concerns led to its decline.

Ethical and Cultural Impact

• Controversial due to drastic effects on personality and limited consent by patients.
• Cultural depictions in literature and film, such as Ken Kesey's "One Flew Over the Cuckoo's Nest," criticized the practice.

Modern View

• Generally regarded as a historical example of medical malpractice.
• Some derivatives like cingulotomy are still in use for specific cases.

Additional Context

• Psychosurgery: Category of procedures that include lobotomy, aiming to treat mental disorders through surgical intervention.
• Lobotomy has been banned or restricted in many countries due to ethical concerns.