Tag Archives: lobotomy

History of Psychiatry: Hysteria in WWI, Leucotomy in Western Australia, and More

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A new issue of History of Psychiatry is now online. Full titles, authors, and abstracts below.

“‘A more perfect arrangement of plants’: the botanical model in psychiatric nosology, 1676 to the present day,” by Daniel Mason and Honor Hsin. Abstract:

Psychiatric classification remains a complex endeavour; since the Enlightenment, nosologists have made use of various models and metaphors to describe their systems. Here we present the most common model, botanical taxonomy, and trace its history from the nosologies of Sydenham, Sauvages and Linnaeus; to evolutionary models; to the later contributions of Hughlings-Jackson, Kraepelin and Jaspers. Over time, there has been a shift from explicit attempts to pattern disease classification on botanical systems, to a more metaphorical use. We find that changes in the understanding of plants and plant relationships parallel changes in the conceptualization of mental illness. Not only have scientific discoveries influenced the use of metaphor, but the language of metaphor has also both illuminated and constrained psychiatric nosology.

“Psychiatry in Portugal: Key actors and conceptual history (1884–1924),” by José Morgado Pereira. Abstract: Continue reading History of Psychiatry: Hysteria in WWI, Leucotomy in Western Australia, and More →

Special Issue! Neurosurgery, Psychiatry, and Function: The History of Altering Behavior, Thought, and Function Through Neurosurgery

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AHP readers may be interested in a recent special issue from Neurosurgical Focus on “Neurosurgery, Psychiatry, and Function: The History of Altering Behavior, Thought, and Function Through Neurosurgery.” Full titles, authors, and abstract follow below.

“Introduction. Neurosurgery, psychiatry, and function: the history of altering behavior, thought, and function through neurosurgery,” by Mark C. Preul, MD, T. Forcht Dagi, MD, Charles J. Prestigiacomo, MD, and Chris A. Sloffer, MD, MBA. No abstract.

“Sanger Brown and Edward Schäfer before Heinrich Klüver and Paul Bucy: their observations on bilateral temporal lobe ablations,” by Prasad S. S. V. Vannemreddy, MD, and James L. Stone, MD. Abstract:

Fifty years before a report on the complete bitemporal lobectomy syndrome in primates, known as the Klüver-Bucy syndrome, was published, 2 talented investigators working at the University College in London, England—neurologist Sanger Brown and physiologist Edward Schäfer—also made this discovery. The title of their work was “An investigation into the functions of the occipital and temporal lobes of the monkey’s brain,” and it involved excisional brain surgery in 12 monkeys. They were particularly interested in the then-disputed primary cortical locations relating to vision and hearing. However, following extensive bilateral temporal lobe excisions in 2 monkeys, they noted peculiar behavior including apparent loss of memory and intelligence resembling “idiocy.” These investigators recognized most of the behavioral findings that later came to be known as the Klüver-Bucy syndrome. However, they were working within the late-19th-century framework of cerebral cortical localizations of basic motor and sensory functions.

Details of the Brown and Schäfer study and a glimpse of the neurological thinking of that period is presented. In the decades following the pivotal work of Klüver and Bucy in the late 1930s, in which they used a more advanced neurosurgical technique, tools of behavioral observations, and analysis of brain sections after euthanasia, investigators have elaborated the full components of the clinical syndrome and the extent of their resections.

Other neuroscientists sought to isolate and determine the specific temporal neocortical, medial temporal, and deep limbic structures responsible for various visual and complex behavioral deficits. No doubt, Klüver and Bucy’s contribution led to a great expansion in attention given to the limbic system’s role in action, perception, emotion, and affect—a tide that continues to the present time.

“Editorial. The Klüver-Bucy syndrome and the golden age of localization,” by Chris A. Sloffer, MD, MBA. No abstract. Continue reading Special Issue! Neurosurgery, Psychiatry, and Function: The History of Altering Behavior, Thought, and Function Through Neurosurgery →

History of Psychiatry: Lobotomies, Therapies, the DSM, and More

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The March 2018 issue of History of Psychiatry is now online. Articles in this issue explore the history of lobotomy, moral therapy, the history of the DSM, and more. Full titles, authors, and abstracts below.

“History of lobotomy in Poland,” by Kinga J?czmi?ska. Abstract:

In Poland, there were 176 cases of prefrontal leucotomy performed by Moniz’s method between 1947 and 1951. There were also several cases in which alternative psychosurgical techniques were used: prefrontal topectomy by Bilikiewicz and colleagues, and prefrontal topischemia by Ziemnowicz. This article analyses the following: publications by Choróbski, who performed lobotomy in Poland, and by Korzeniowski, who assessed its short-term results; a report by Bornsztajn, who reviewed general results of the method; and clinical research by Broszkiewicz and by Konieczy?ska, who assessed Polish patients in terms of long-term results of lobotomy. Negative clinical evaluation of lobotomy led to its abandonment in Poland, a decision strengthened by a regulation that forbade lobotomy in the USSR and impacted Polish psychiatry.

“Rotation therapy for maniacs, melancholics and idiots: theory, practice and perception in European medical and literary case histories,” by Sheila Dickson. Abstract:

This article examines the development and use of rotation therapy in the emerging field of psychiatry at the beginning of the 19th century, and the cross-fertilization between British, Irish, German, French and other European proponents of ‘Cox’s Swing’. Its short-lived popularity is linked to prevalent Enlightenment thought, to the development of an industrial and technological society, to the modern medical theories of irritability, and to the new practice of ‘moral management’ of the mentally ill. Case studies documenting the use of the Swing are considered from these perspectives, and are compared with contemporary public reactions in the form of publications in newspapers and of a literary text by German Romantic author Ludwig Achim von Arnim.

“François Leuret: the last moral therapist,” by Edward M Brown. Abstract: Continue reading History of Psychiatry: Lobotomies, Therapies, the DSM, and More →

Lobotomy on Retro Report: First, Do No Harm

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The New York Times‘s Retro Report has produced a new video on the history of lobotomy, First, Do No Harm. As Retro Report describes,

For centuries scientists have studied the brain and still our understanding, particularly when it comes to the treatment for those suffering with severe, often untreatable mental illness, remains elusive. As scientists around the world are beginning ambitious programs to study the human brain in unprecedented ways, Retro Report explores the evolution of the surgical and biological treatments over the decades. From the brutal, but once considered mainstream treatment of lobotomy to biological cocktails, to the beginnings of what many hope will be a more elegant understanding of the brain through technology.

More details here.

Mical Raz in The Psychologist: Looking Back: Interpreting Lobotomy – The Patients’ Stories

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The January 2014 issue of The Psychologist, the flagship publication of the British Psychological Society (BPS), is now online and includes an article on patient experiences of lobotomy. In “Looking Back: Interpreting Lobotomy – The Patients’ Stories” historian of medicine Mical Raz describes how patients and their families experienced the lobotomies preformed by Walter Freeman in the first half of the twentieth century. As Raz describes,

Freeman’s commitment toward the patients and the restoration of their health seemed so evident to patients and their families that even in cases of an unsuccessful lobotomy leading to disability or death, the families of the patients expressed their gratitude to him. Following a patient’s death after a second surgical attempt, the patient’s sister thanked Freeman and his partner, James Watts, for their ‘concern and interest’ in her sister’s condition. She was sure, she added, that her sister also would have thanked the physicians, ‘if she were able to do so’ (Maeve Ingber’s sister to James Watts, 1948). In his response, Freeman wrote that he and Watts had been ‘greatly disappointed in the outcome’. Yet he added that this had been a ‘situation of extraordinary difficulty where surgery offered the only opportunity for giving her peace of mind’. Commending the sister for her positive attitude toward ‘this unfortunate outcome’, Freeman thanked her for her letter (WF to Maeve Ingber’s sister, 1948). The physicians’ willingness to attempt surgery, and thus provide even a slim hope of cure, was interpreted as evidence of their care and dedication. For the families, this expression of interest and what was seen as a sincere desire to help their loved one was so significant that the results of the lobotomy, even the death of the patient, could be interpreted in a positive manner.

The article can be read in full here.

New Book: Mical Raz’s The Lobotomy Letters

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Physician and historian of medicine Mical Raz‘s new book on the history of American psychosurgery is now in print. Raz’s book, The Lobotomy Letters: The Making of American Psychosurgery, explores the history of this controversial procedure through the letters of patients, physicians, and families. The volume is described as follows:

The rise and widespread acceptance of psychosurgery constitutes one of the most troubling chapters in the history of modern medicine. By the late 1950s, tens of thousands of Americans had been lobotomized as treatment for a host of psychiatric disorders. Though the procedure would later be decried as devastating and grossly unscientific, many patients, families, and physicians reported veritable improvement from the surgery; some patients were even considered cured.

The Lobotomy Letters gives an account of why this controversial procedure was sanctioned by psychiatrists and doctors of modern medicine. Drawing from original correspondence penned by lobotomy patients and their families as well as from the professional papers of lobotomy pioneer and neurologist Walter Freeman, the volume reconstructs how physicians, patients, and their families viewed lobotomy and analyzes the reasons for its overwhelming use.

Phineas Gage Website!

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A webpage providing information on Phineas Gage has recently relaunched. The Phineas Gage Information Page was created by Malcolm Macmillan at the University of Melbourne but is now maintained by The Center for the History of Psychology at the University of Akron.

Included on the site are sections dedicated to Phineas Gage’s story, the detailing of damage done to Gage’s skull, the indirect contribution Phineas Gage’s case provided brain surgery, and a section providing references for further reading on Phineas Gage.

Explore the entire site here.

BBC Radio4: The Lobotomists

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After posting about BBC Radio4’s new program A History of the Brain earlier this week, we bring to your attention yet another BBC Radio4 production: The Lobotomists. To mark the 75th anniversary of the first lobotomy performed in the United States, the program explores the work of Portuguese doctor Egas Moniz who first developed the lobotomy (or leucotomy), as well as the work of neurologist Walter Freeman and neurosurgeon Sir Wylie McKissock, who took up the procedure in the United States and Britain respectively. The Lobotomists can be heard online here and AHP’s previous posts on Walter Freeman and lobotomies can be found here.

A lengthy description of The Lobotomists is available on the program’s website and reproduced below:

2011 marks a 75th anniversary that many would prefer to forget: of the first lobotomy in the US. It was performed by an ambitious young American neurologist called Walter Freeman. Over his career, Freeman went on to perform perhaps 3,000 lobotomies, on both adults and later on children. He often performed 10 procedures or more a day. Perhaps 40,000 patients in the US were lobotomised during the heyday of the operation – and an estimated 17,000 more in the UK.

This programme tells the story of three key figures in the strange history of lobotomy – and for the first time explores the popularity of lobotomy in the UK in detail.

The story starts in 1935 with a Portuguese doctor called Egas Moniz, who pioneered a radical surgical procedure on the brain. Continue reading BBC Radio4: The Lobotomists →

Psychiatry, Photography & Lobotomy Bibliography

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As a followup to our recent post about Miriam Posner‘s work on the lobotomy photographs of Walter Freeman, I would like to draw AHP‘s readers attention to a recent posting on Posner’s blog, Academitron. For anyone interested in learning more about the role of photography in the history of psychiatry/psychology, Posner has posted “Psychiatry, Photography, and Lobotomy: A Bibliography,” an extensive list of works on the subject.

You can find that list here, and Posner’s blog here.

Lobotomy Photography as Medical Evidence

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Science and the Arts, a project of NPR’s Science Friday, has posted a slideshow of Dr. Walter Freeman‘s before and after photographs of lobotomy patients. The slideshow is based on the work of Miriam Posner, Mellon Postdoctoral Research Associate at Emory University, who also narrates the slideshow. Prosner recently completed her Yale University dissertation on Freeman and his lobotomy photographs. She argues that for Freeman the photographs served as medical evidence of the benefits of lobotomy and provided justification for his focus on external behavior rather than their mental states when evaluating surgical outcomes.

As Posner writes on her website,

Walter Freeman (1895 – 1972) was a neurologist who pioneered and popularized lobotomy. In this procedure, the brain’s frontal lobe is separated from the thalamus. The effects of lobotomy vary from patient to patient, but the procedure was designed to make aggressive mental patients less dangerous. Freeman thought that lobotomy had wider applications, and he administered lobotomies to patients suffering from depression and pain. All in all, Freeman performed more than 3,500 lobotomies, often as outpatient procedures…The neurologist was also an avid photographer, obsessively documenting his patients before and after their procedures. Freeman also made a series of films showing lobotomies and their effects. After he stopped performing lobotomies in the early 1960s, Freeman crossed the country in his van (nicknamed the Lobotomobile), tracking down former patients and snapping their photographs.

The full slideshow can be viewed here.

Thanks to Cathy Faye for bringing this to AHP‘s attention.