The brain operation that won a Nobel Prize, then became a byword for barbarism.
In 1949 the Nobel Prize in medicine went to António Egas Moniz for the leucotomy, better known as lobotomy: cutting connections to the brain's frontal lobes to treat mental illness. Tens of thousands of people underwent it. Within decades it was discredited, and there have been calls for the prize to be withdrawn.
In the early twentieth century, psychiatric hospitals were overflowing and effective treatments were scarce. Psychiatry turned to drastic physical therapies, from deliberate malaria infection to insulin shock and electroconvulsive therapy. In this climate the Portuguese neurologist Egas Moniz argued that mental illness came from fixed, unhealthy circuits in the brain that could be broken by cutting nerve fibres in the frontal lobes. On 12 November 1935 in Lisbon, his colleague Pedro Almeida Lima, operating because Moniz lacked surgical training, performed the first of these operations.
Moniz published results on 20 patients within months, claiming most had improved, though follow-up was brief and every patient had complications. In the United States, Walter Freeman and the neurosurgeon James Watts took up the procedure in 1936. Freeman later devised a 'transorbital' version, reaching the frontal lobes through the eye socket after testing the idea with a kitchen ice pick; it took minutes and needed no operating theatre. Watts objected, and their partnership ended. Heavily promoted in the press, lobotomy was performed on about 40,000 people in the US and some 17,000 in England, more often on women than men.
The operation often calmed agitation, but at the cost of personality and intellect: many patients became apathetic, emotionally blunted and lacking initiative, and some died. A survey of British patients operated on between 1942 and 1954 judged 13 per cent fully recovered and 28 per cent significantly improved, but 25 per cent unchanged and 4 per cent killed by the surgery. Freeman himself called the result 'surgically induced childhood'.
Soviet psychiatrists condemned it early, and the USSR banned it in 1950 as contrary to the principles of humanity. The arrival of antipsychotic drugs hastened its decline, and by the late 1970s the practice had largely stopped. Historians see it partly as a well-meant, desperate response to patients who seemed beyond help and who had little power to refuse. The neuroscientist Torsten Wiesel has called Moniz's prize a terrible mistake.
Source: Wikipedia — Lobotomy · Text summarised from Wikipedia (CC BY-SA 4.0)
