Amygdaloid Neurosurgery for Aggressive Behaviour, Sydney, 1967–1977: Chronological Narrative

Abstract

In 1964, Professor Leslie Gordon Kiloh became acting director of the newly built neurosurgical research facility at Callan Park Mental Hospital. In 1966, he advised bilateral amygdaloidotomy for the treatment of a 16-year-old aggressive and self-harming male patient. Following major improvement in that patient's condition, a further 19 patients were treated by amygdaloid surgery. In 1974, Kiloh's team reported that 39% of the first 18 patients treated had persisting improvement but one patient sustained persisting hemiplegia. The program was suspended in 1977 by the New South Wales (NSW) Government, following allegations by a senior nurse that patients at the neurosurgical unit had been mistreated. A Ministerial Committee of Inquiry proposed that stringent legislative controls should be applied to psychosurgery. The Committee expressed reservations about amygdaloid psychosurgery in particular. Psychosurgery referrals declined after that date. Since 2007, under the revised NSW Mental Health Act, all forms of neurosurgery for psychiatric disorder are prohibited.

Amygdaloid Neurosurgery for Aggressive Behaviour, Sydney, 1967–1977: Societal, Scientific, Ethical and Other Factors

“…1 Kiloh could not have wished for better resources to employ in pursuit of his biological clinical and research interests, including his interest in psychosurgery.…”

“…An account of the genesis, progression and demise of this project is provided in an accompanying paper. 1 Historians and sociologists have emphasized the complexities of the interactions among psychological, social and political factors that affect the creation and progression of psychiatric research projects. 2Á4 The current paper examines the contribution of seven factors of postulated relevance to the existence of the ANP.…”

A portrait of prefrontal lobotomy performed at the Royal Prince Alfred Hospital in Sydney by Dr Rex Money

“…4 Such a facility, designated the Cerebral Surgery and Research Unit, was opened in 1958 within the grounds of Callan Park Mental Hospital at Rozelle with Dr Harry Bailey as its director. 5 The controversial career of Dr Bailey is described elsewhere. 6 Within the Department of Neurosurgery at RPAH the authors could not find documentation of surgical procedures other than a log book listing surgical operations performed between 1955 and 1964.…”

“…4 Such a facility, designated the Cerebral Surgery and Research Unit, was opened in 1958 within the grounds of Callan Park Mental Hospital at Rozelle with Dr Harry Bailey as its director. 5 The controversial career of Dr Bailey is described elsewhere. 6…”

The uses of history and of philosophy within psychiatry

“…Importantly also, there is no way that a 21 st century psychiatrist might anticipate or understand the existence of a law in New South Wales that prevents deep brain stimulation for psychiatric disorders without knowing the history of psychosurgery in Sydney between the late 1940s and the late 1970s. 4 The two papers in this issue of AP 2,3 deal only with the earliest phase of that story, but the reader might conclude that the whole saga commenced as a high-stakes experiment with great attendant risks.…”