History of the Lobotomy

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Introduction

It may be defined as:

“A neurosurgical procedure wherein the connections to and from the brain’s prefrontal cortex are cut. This procedure was performed to try and neutralize the mentally ill. The man responsible for this technique was named Walter Freeman”.

EARLY HISTORY OF LOBOTOMIES:

The first time lobotomies were performed in 1935 by Portuguese neurologists Dr. Antonio Egas Moniz and Dr. Almeida Lima. Initially, they made holes in the skull on and injected the connecting threads with alcohol to destroy them. However, this procedure resulted in too many difficulties, including injuries to other parts of the brain. Then it was decided by Moniz to use a tool called a leucotome. After making holes in the human skull, the doctor pushed hard on the back of the tool, which extended a wire or metal loop inside. By prolonging and then withdrawing the leucotome, the psychologist could remove cores of white matter.

Later In 1936, a neurologist and psychiatrist named Dr. Walter Freeman and his partner, Dr. James Watts, began to perform lobotomies in the United States. Ten years later, Freeman introduced a new method. Moniz’s technique, called a prefrontal lobotomy, required a patient to undergo general anesthesia in the operation theatre. Freeman wanted to find a method which was faster, more handy and less expensive, so he decided to get in to the brain through the eye sockets instead which is a modernize form of the treatment, termed as TRANSORBITAL LOBOTOMY.

HOW IT WORKS?

The lobotomy is considered as a kind of neurosurgery, or surgery which is done on the brain, known as psychosurgery. The idea behind transorbital lobotomy is that severe forms of psychological diseases can be treated by changing the way that the brain works. Doctors believed that the dispositions and sentiments of the patients are totally dependent upon the anterior lobes in the brain they thought they could calm their patient’s emotions and stabilize their temperaments without doing away with their intelligence and main functions of the organs.

It is basically a blind surgery in which the surgeon used to insert a sharp ice pick type of tool in the patient’s eye socket and when the doctor thought that he has reached the right spot then he would hit the tool with a hammer.

Due to this surgery the patient was handicapped for the rest of his life. People with psychiatric disorders, distorted nerves, chronic headaches and back aches were the major victims of lobotomy. If everything else failed, meaning their pain was medically inflexible, could not be treated with medication then lobotomy was used to treat those patients.

Freeman the founder of Transorbital lobotomy started practicing first on the dead bodies using an ice pick, due to which his method later known as the “ice pick lobotomy.” When he began performing the transorbital lobotomy on his patients, he used an object which was similar to ice pick called an orbitoclast. After going through the top of the eye socket, he could enter the brain just by tapping lightly on that object with a hammer to break through the thin layer of bone. Then he curled it to cut through the fibers. After pulling out the orbitoclast, the same procedure was continued on the other side. And the whole procedure of transorbital lobotomy took just 10 minutes or less.

WHAT WAS THE NEED OF A LOBOTOMY?

Following were the basic needs of lobotomy at that time:

It was used to treat the criminally insane people

Lobotomies were also used to “cure” political discordant.

It was assumed that the procedure was used routinely on prisoners against their will.

The use of lobotomy was strongly criticized on the grounds that it invaded the civil rights of the patients.

WHEN AND WHY PEOPLE STOPPED USING THIS METHOD OF PSYCHOSYRGERY?

The use of lobotomies eventually began to decline in the mid to late 1950, and this happened due to several reasons. Firstly, although there had always been opponents of this technique, opposition reacted very fiercely towards the use of lobotomy. Secondly, and most importantly, anti-psychotic drugs became widely available. These had much the same effect as psychosurgery gone wrong; thus, the surgical method became rapidly outdated by the chemical lobotomy.

MAJOR SUCCESSFUL AND UNSUCCESSFUL SURGERIES OF LOBOTOMY:

The top most appealing and noticeable surgeries of lobotomy are as follows:

ALICE HOOD HAMMATT:

This was the first prefrontal lobotomy which was performed in the U.S in 1936 by Dr. Walter Freeman and Dr. James Watts. This surgery was performed on 63 year old Alice Hood Hammatt. Alice Hood Hammatt was born in 1873. This surgery became successful as Alice’s husband thought that she behaved normally, reduced anxiety and stayed out of mental hospitals. Alice died in 1941 due to contracted pneumonia.

WARNER BAXTER:

Warner Baxter was born in 1889 and was an American author and highest paid actor in Hollywood at his time. Baxter suffered from arthritis. To ease his pain he decided to have a surgery of lobotomy. Unfortunately, the surgery was not successful and Warner Baxter died shortly after the surgery in 1951.

JOSEF HASSID:

Josef Hassid was born in Poland in 1923 and was famous violinist. He experienced a memory lacks while performing and in 1941 he faced deep depression and suffered a nervous breakdown. Josef remained in Long Groove Hospital mental asylum until his death at the age of 26 in 1950 due to an unsuccessful lobotomy.

HOWARD DULLY:

Howard Dully was born in 1948 and faced the surgery of transorbital lobotomy at 12 years of age. His mother brought him under this procedure because he always objected on going to bed and used to daydream a lot. Howard took years to recover from the surgery. He was institutionalized, locked up and was eventually homeless and an alcoholic as well. Gradually, he restrained and received a college degree.

ROSEMARY KENNEDY:

Rosemary was considered to have violent mood swings and a stormy personality. At the age of 23, Rosemary experienced the surgery of transorbital lobotomy as suggested by the doctors. After the surgery, Rosemary reduced to a sophomoric personality that left her incontinent and she used to stare at blank walls for hours. Her verbal skills were reduced to meaningless babble. Her surgery was successful and she died a natural death in 2005.

PROS AND CONS OF LOBOTOMY:

According to Katie Gallagher, the major pros and cons of lobotomy are mentioned below:

The major advantages of lobotomy are mentioned below:

It was once believed that this procedure could treat a wide range of psychiatric conditions.

For whom the surgery worked out those people experienced a change in personality and their perception also used to change towards things.

In many situations, the patients were calmer after the surgery.

The surgery was done only took few minutes and local anesthesia was used.

The major disadvantages of lobotomy are mentioned below:

This procedure rarely became successful.

Patients used to lose their lives due to this deadly surgery.

Some changes in personality were also quite strange.

The patients were also unable to function properly.

Patients were unable to put themselves in place of others due to decreased cognition and detachment from the society.

Victims also faced problems of speech.

The procedure was very horrid and it was also difficult for veterans, neurosurgeons and psychiatrists to bear it.

The patients also became inactive and uninterested.

CRITICISM ON LOBOTOMY:

The idea behind discovering the method of Lobotomy was that through this mental health could be improved. There are many positives that could come from lobotomy but some negative effects of lobotomy were also there due to which many psychologists objected upon the procedure of lobotomy later. Some of the major criticisms and the reason behind those criticisms are given below:

Freeman the father of lobotomy completed his last lobotomy before it was banned from operating. The reason behind banning the lobotomy was that, when he performed his third lobotomy on his longtime patient, she had gone through with a brain hemorrhage and passed away.

An editorial issued a Journal of the American Medical Association in 1941 which said that “No doctor can yet assert that this is or is not a truly worthwhile procedure. The ultimate decision must await the production of more scientific evidence.” [Source: Diefenbach].

Dr. Nicolai Oseresky a soviet psychiatrist said that lobotomies “violate the principles of humanity” and change “an insane person” into “an idiot”.

All these criticisms lead this procedure of psychosurgery towards the decline and that is how it was banned in the world later.

CONCLUSION:

In a nutshell, Lobotomy is a surgical method which involves the splitting of nerves that connect the anterior lobes to the rest of the brain.

The basic idea behind this surgery which was later proven as unacceptable was that these nerves were somehow malformed in patients with certain mental disorders. It was also believed to be beneficial for those who were suffering from depressions, schizophrenia and severe chronic pains i.e. chronic back pains, severe headaches, etc.

The primary outcomes resulted from a lobotomy were significant personality changes, changes in energy, drive, enthusiasm, interest, etc. The truth is that there were some very unpleasant results, tragic results, and few excellent results are also there in between. It is something that should be explored, researched and understood by the people. It will be very useful if we discover a safer way to perform this surgery.

REFERENCES:

http://psychcentral.com/blog/archives/2011/03/21/the-surprising-history-of-the-lobotomy/

http://science.howstuffworks.com/life/inside-the-mind/human-brain/lobotomy4.htm

http://scienceblogs.com/neurophilosophy/2007/07/24/inventing-the-lobotomy/

“lobotomy” Surgery of the Brain by Justin Adams (SLCC Biology 1090)

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