Prefrontal Lobotomy or Leucotomy

The idea of brain surgery as a means of improving mental health got started around 1890, when Friederich Golz, a German researcher, removed portions of his dogs’ temporal lobes, and found them to be calmer, less aggressive.  It was swiftly followed by Gottlieb Burkhardt, the head of a Swiss mental institution, who attempted similar surgeries on six of his schizophrenic patients.  Some were indeed calmer.  Two died.

One would think that that would be the end of the idea.  But in 1935, Carlyle Jacobsen of Yale University tried frontal and prefrontal lobotomies on chimps, and found them to be calmer afterwards.  His colleague at Yale, John Fulton, attempted to induce “experimental neurosis” in his lobotomized chimps by presenting them with contradictory signals.  He found that they were pretty much immune to the process.

It took a certain Antonio Egaz Moniz of the University of Lisbon Medical School to really put lobotomy on the map.  A very productive medical researcher, he invented several significant improvements to brain x-ray techniques prior to his work with lobotomy.  He also served as the Minister of Foreign Affairs and the Ambassador to Spain.  He was even one of the signers of the Treaty of Versailles, which marked the end of World War I.

He found that cutting the nerves that run from the frontal cortex to the thalamus in psychotic patients who suffered from repetitive thoughts “short-circuited” the problem.  Together with his colleague Almeida Lima, he devised a technique involving drilling two small holes on either side of the forehead, inserting a special surgical knife, and severing the prefrontal cortex from the rest of the brain.   He called it leukotomy, but it would come to be known as lobotomy.

Some of his patients became calmer, some did not.  Moniz advised extreme caution in using lobotomy, and felt it should only be used in cases where everything else had been tried.  He was awarded the Nobel Prize for his work on lobotomy in 1949.  He retired early after a former patient paralyzed him by shooting him in the back.

 

Notable Example of lobotomies:

Rose Marie “Rosemary” Kennedy (September 13, 1918 – January 7, 2005) was the third child and first daughter of Rose Elizabeth Kennedy née Fitzgerald and Joseph Patrick Kennedy, Sr., born little more than a year after her brother, future U.S. President John F. Kennedy. She underwent a prefrontal lobotomy at age 23, which left her permanently incapacitated.

“We went through the top of the head, I think she was awake. She had a mild tranquilizer. I made a surgical incision in the brain through the skull. It was near the front. It was on both sides. We just made a small incision, no more than an inch… We put an instrument inside… We made an estimate on how far to cut based on how she responded.” James Watts

These words describe the lobotomy that was carried out in 1941 on Rosemary Kennedy, sister of the then future US President. Said to have been intended to cure her mood swings, the procedure left Rosemary with urinary incontinence and the mental age of a child – staring blankly at walls for hours, her speech unintelligible.

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