THE CONTROVERSIAL NEUROSURGERY: TRANSORBITAL LOBOTOMY
In the Second International Congress of Neurology (London,1935) Yale neurobiologist John Fulton gave a presentation on the cortical function of chimpanzees, in which he showed that surgical removal of their frontal lobes changed their behaviour completely from throwing tantrums to a much pacified state.
In the audience was Portuguese neurologist Antonio Egas Moniz and 14 years later in 1949, he received perhaps the most controversial Nobel prize ever awarded, for pioneering the neurosurgical procedure of Lobotomy.
The Prefrontal cortex is associated with higher level decision-making, reasoning, creativity, social behaviour. It is connected to the Thalamus which relays sensory and motor signals. So, the aim of lobotomy was to damage the white matter present in the frontal lobe which comprises of nerve fibres carrying messages through electrical impulses.
Moniz used to use a surgical instrument called a leucotome, to cut out several sections of the frontal lobes to treat patients suffering from different mental illness ranging from depression to panic disorder to schizophrenia. Although most of his patients had suffered a diminished or degraded personality, the report of the success of his treatment popularised the technique.
Though the technique became widely popular, neuropsychiatrist Walter Freeman wanted to simplify the procedure. So, instead of drilling holes in the skull Freeman thought of approaching the frontal lobes through the eyes socket, and this new technique was called Transorbital Lobotomy.
To perform this procedure a thin surgical instrument called an orbitoclast had to be placed under the eyelid against the top of the eyesocket and it was malleted 2inch inside the frontal lobe to cut the white matter of the frontal lobe.
Freeman performed the first transorbital lobotomy in 1946 on Elen Ionesco, and by the end of 1951 almost 20000 individuals had been lobotomized in the US. At the end of WW2, many veterans suffering from mental trauma were lobotomised to free up spaces in the hospitals. Many of the patients died as a result of the operation, few were able to leave the hospitals and others received severe impairments.
One of the most infamous failures of Freeman's surgery was Rosemary Kennedy, sister of president John F. Kennedy. During her teenage Rosemary had become rebellious and moody, so her doctor suggested that lobotomy would calm her down. Freeman was yet to pioneer his transorbital surgery so he performed the prefrontal lobotomy on her, which left her with a mental capacity of a child. Rosemary spent rest of her life in an institution staring into space for hours.
In 1950 a drug named Thorazine was synthesised which was the first in a series of Antipsychotic drugs. The availability of these drugs marked the end of the Lobotomy. In 1967, Freeman performed his last lobotomy on a patient who died from Brain haemorrhage.
Approximately, 40000 people in the US and 20000 in the Great Britain had been lobotomized. Even after the ban in most of the countries, it is still performed in a few hospitals around the world. Muniz's Nobel prize has been called to revoke many times, but the Foundation has declined to take any action.
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| Antonio Egas Moniz |
In the audience was Portuguese neurologist Antonio Egas Moniz and 14 years later in 1949, he received perhaps the most controversial Nobel prize ever awarded, for pioneering the neurosurgical procedure of Lobotomy.
Moniz used to use a surgical instrument called a leucotome, to cut out several sections of the frontal lobes to treat patients suffering from different mental illness ranging from depression to panic disorder to schizophrenia. Although most of his patients had suffered a diminished or degraded personality, the report of the success of his treatment popularised the technique.
To perform this procedure a thin surgical instrument called an orbitoclast had to be placed under the eyelid against the top of the eyesocket and it was malleted 2inch inside the frontal lobe to cut the white matter of the frontal lobe.
One of the most infamous failures of Freeman's surgery was Rosemary Kennedy, sister of president John F. Kennedy. During her teenage Rosemary had become rebellious and moody, so her doctor suggested that lobotomy would calm her down. Freeman was yet to pioneer his transorbital surgery so he performed the prefrontal lobotomy on her, which left her with a mental capacity of a child. Rosemary spent rest of her life in an institution staring into space for hours.
In 1950 a drug named Thorazine was synthesised which was the first in a series of Antipsychotic drugs. The availability of these drugs marked the end of the Lobotomy. In 1967, Freeman performed his last lobotomy on a patient who died from Brain haemorrhage.
Approximately, 40000 people in the US and 20000 in the Great Britain had been lobotomized. Even after the ban in most of the countries, it is still performed in a few hospitals around the world. Muniz's Nobel prize has been called to revoke many times, but the Foundation has declined to take any action.
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