The strange and curious history of lobotomy

For millennia, mankind had practiced trepanning, drilling holes into skulls to release evil spirits.

The idea behind lobotomy was different. The Portuguese neurologist, Egas Moniz, believed that patients with obsessive behavior were suffering from fixed circuits in the brain.

In 1935, in a Lisbon hospital, he believed he had found a solution. “I decided to sever the connecting fibers of the neurons in activity,” he wrote in a monograph titled “How I came to perform frontal leucotomy”.

His original technique was adapted by others, but the basic idea remained the same.

Surgeons would drill a pair of holes into the skull, either at the side or top, and push a sharp instrument – a leucotome – into the brain. The surgeon would sweep this from side to side, to cut the connections between the frontal lobes and the rest of the brain.

Moniz reported dramatic improvements for his first 20 patients. The operation was seized on with enthusiasm by the American neurologist Walter Freeman who became an evangelist for the procedure, performing the first lobotomy in the US in 1936, then spreading it across the globe.

From the early 1940s, it began to be seen as a miracle cure here in the UK, where surgeons performed proportionately more lobotomies than even in the US.

Despite opposition from some doctors – especially psychoanalysts – it became a mainstream part of psychiatry with more than 1,000 operations a year in the UK at its peak. It was used to treat a range of illnesses, from schizophrenia to depression and compulsive disorders.

In 1949, Egas Moniz won the Nobel Prize for inventing lobotomy, and the operation peaked in popularity around the same time. But from the mid-1950s, it rapidly fell out of favour, partly because of poor results and partly because of the introduction of the first wave of effective psychiatric drugs.

What’s the modern equivalent?

Jack El-Hai, author of The Lobomotist wrote “I’m not criticising chemotherapy because it’s effective but compared to other treatments, in decades to come it will seem to be overly destructive and something that needed to be changed and will be changed.

“It’s a very similar judgement, that the pluses outweigh the minuses.”

Read the article in entirety http://www.bbc.co.uk/news/magazine-15629160