Portuguese neurologist Antonia Moniz performed the first lobotomy in , drilling holes into a patient's skull, pouring alcohol into the frontal cortex to sever the nerves, before coring sections of the brain with hollow needles. This procedure, which he called a "leucotomy", was supposed to cure a variety of mental health issues, particularly depression and schizophrenia, for patients who were believed to be beyond help.
Today, we know that his method was barbaric and the fact that he wasn't a doctor should have sent shudders down the spines of anybody in contact with him. Yet, in , Moniz received a Nobel Prize for his work.
There have been widespread calls for his prize to be revoked but nothing has been done about it yet. The theory that mental health could be improved by psychosurgery first came from Swiss neurologist Gottlieb Burckhardt, who claimed he had a 50 per cent success rate when he operated on schizophrenics.
Even though his colleagues criticised his work, Burckhardt claimed that, following the operation, the patients appeared to calm down. This "calmness" was more likely due to the patients being in a "zombie-like" or vegetative state, unable to speak or think for themselves. US neuropsychiatrist Walter Freeman was intrigued with Moniz's work and decided to experiment for himself. Freeman believed that mental illness was caused by overactive emotions, and if the brain was cut up, he'd be effectively cutting away those emotions.
After practising for a few weeks on cadavers, Freeman performed the first frontal lobotomy in the US, on year-old Alice Hood Hammatt, a housewife from Kansas who was believed to be suffering from anxiety and depression. Assisted by Dr James Watt, Freeman drilled holes in Hammatt's skull over the left and right frontal lobes. They then inserted a leucotome a narrow shaft through the hole on the left side into the exposed part of the brain. An hour later, Freeman declared the operation was a success, even though Hammatt suffered a convulsion in the weeks following the surgery.
Hammatt died five years after her surgery, although she managed to spend the last years of her life away from mental institutions. This so-called success led Freeman to come up with a new plan. He wanted to devise a lobotomy that was faster and less messy than drilling holes into a person's skull.
So he went back to experimenting on cadavers, searching for an easy way to access the brain. He used a tool he'd found in his kitchen — an ice pick. Freeman realised he could easily reach the brain by using the icepick, which was into the brain through the eye sockets; he named this radically invasive form of brain surgery a "transorbital lobotomy" but it became more commonly known as the "icepick lobotomy". The barbaric procedure was responsible for at least deaths and left thousands of people in a vegetative state.
Sadly, in many cases, that was believed to be an improvement in the lives of many mentally ill people as they were now easier for mental institutions or family members to take care of.
He personally performed , travelling across the US, until complications and psychiatric meds eliminated the procedure. First, the patient was rendered unconscious by electroshock or simply given a local anaesthetic depending on their mental health.
Then the icepick-like instrument was inserted above the patient's eyeball. Using a hammer, the icepick was hammered into the eggshell thin bone above the eye, where the instrument was wriggled back and forth to sever the connections to the prefrontal cortex in the frontal lobes of the brain. It's difficult to believe that an icepick can be hammered into the most complex part of the human body — the brain — while the instrument was moved from side to side by a man who was not a surgeon.
The operation was over in around 10 minutes and in at least a third of all cases, rendered the patients compliant, docile and mute with childlike behaviour. Twelve-year-old Howard Dully was forced to have a lobotomy because, as his stepmother insisted, he was "defiant, daydreamed and even objected to going to bed". In other words, he was a typical year-old. He was taken to several doctors who all concluded that Howard was "just normal". But his stepmother took him to Freeman who suggested the boy undergo a lobotomy.
People could no longer live independently, and they lost their personalities, he added. Mental institutions played a critical role in the prevalence of lobotomy. At the time, there were hundreds of thousands of mental institutions, which were overcrowded and chaotic. By giving unruly patients lobotomies, doctors could maintain control over the institution, Lerner said. That's exactly what unfolds in the novel and film "One Flew Over the Cuckoo's Nest," in which Randle Patrick McMurphy, a violent but sane man who declares himself insane to avoid a prison sentence, is sent to mental hospital and given a lobotomy that leaves him mute, unresponsive and vacant-eyed.
But in this case, it was "disturbingly real," he said. Lobotomies declined in popularity in the s, as their undesirable side effects became more well-known. Criticism of the procedures also grew among medical professionals who said the doctors who performed lobotomies were not neurosurgeons, neglected to report negative outcomes for many of their patients, and overall had "a lack of scientific rigor," according to the Frontiers in Neuroscience study.
By the mids, scientists had developed psychotherapeutic medications such as the antipsychotic chlorpromazine, which was much more effective and safer for treating mental disorders than lobotomy. Nowadays, mental illness is primarily treated with drugs and psychotherapies. In cases where drugs or talk therapy are not effective, people may be treated with electroconvulsive therapy, a procedure that involves passing electrical currents through the brain to trigger a brief seizure, according to the Mayo Clinic.
Lobotomy is rarely, if ever, performed today, and if it is, "it's a much more elegant procedure," Lerner said. This article was updated on Oct. Live Science.
Jump to: When was the first lobotomy? How is a lobotomy performed? They were the operative tools in lobotomy, also known as leucotomy, an operation which was seen as a miracle cure for a range of mental illnesses.
For millennia, mankind had practised 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 behaviour were suffering from fixed circuits in the brain.
In , in a Lisbon hospital, he believed he had found a solution. 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 , then spreading it across the globe.
From the early s, 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, operations a year in the UK at its peak.
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