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Brain lobotomy: a historical and moral dilemma with no alternative?

Dates

on the October 28, 2019

Published in World Neurosurg

Collaborative research project led by Prof. A. Amelot (AP-HP, Department of Neurosurgery, La Pitié-Salpêtrière - Sorbonne-University, Pierre et Marie Curie School of Medicine, Paris, France) to which Dr. L.M. Terrier participated

Brain lobotomy: a historical and moral dilemma with no alternative?

Abstract

BACKGROUND:

Pioneered in 1936 by Portuguese neurologist and politician Egas Moniz, lobotomy was a definitive lesional surgery on the brain, which consisted in splitting white fibers in the frontal lobes. Sixteen years later, the first anti-psychotic medication appeared at Sainte-Anne mental hospital in Paris, brutally reducing the amount of surgical lobotomies in France and throughout the world. Lobotomy has been one of the most criticized medical procedures in history: thousands of patients were lobotomized around the world causing serious consequences on their personalities and intellectual functions.

METHODS:

In 1940's, French language was widely used as an alternative language in medical literature, explaining why we decided to focus a francophone review on this subject. Indeed, we conducted the first francophone literature review over the period 1935-1985. Moreover, for a clearer understanding of the background of the time, we studied the social historical environment.

RESULTS:

A total of 1340 cases of lobotomized patients were identified through a review of 29 studies. Indications were various and not only limited to mental illness. Indeed, they were also carried out in some rare cases, on patients with peptic ulcers or ulcerative colitis in order to stop gastrointestinal haemorrhage. Lobotomy techniques were numerous, varying from classic lobotomy to the trans-orbital injection of radioactive iridium 194.

CONCLUSION:

Subsequently, the psychiatric, societal and media contexts that lead to the emergence of lobotomy were discussed. Our aim was to highlight this period in the history of medicine while putting medical practices in perspective.

Copyright © 2019. Published by Elsevier Inc.

Keywords

#EgasMoniz; #Lobotomy; #psychosurgery

Contact :
Dr. Louis-Marie Terrier :