The Ice Pick of Oblivion: Moniz, Freeman and the Development of Psychosurgery

Abstract

Abstract. Between 1935 and 1955, psychosurgery was regarded as standard treatment for schizophrenics. Egas Moniz and Walter Freeman had revived it, after earlier experiments led to questionable results. Perhaps the most radical of the biological approaches in psychiatry, it generated controversy after physicians operated on thousands of patients. Claims of its safety and precision met with some resistance, and many who were judged to be relieved had serious side effects. This study traces the role played by Moniz and Freeman in the development of this treatment.

Psychosurgery: A History from Prefrontal Lobotomy to Deep Brain Stimulation

“…Between November 1935 and February 1936, Moniz and Lima performed lobotomies on nineteen more patients [15] . During this time, they revised their surgical technique and began using an instrument called a leucotome to destroy tissue in the frontal lobes [16] . Leucotomy had the best results on patients with agitated depression and involutional melancholia, the majority of whom Moniz classed as "greatly improved" [17] .…”

“…Moniz and Lima also discovered that the procedure did not remove the symptoms of psychosis or improve obsessive-compulsive symptoms, much like other therapies. However, Moniz considered the operation to be an overall success, since patients became calm and were often discharged from hospital [18] . Leucotomy was introduced into the United States in 1936 by the neurologist Walter Freeman and the neurosurgeon James Watts [19] .…”

“…This was a blind procedure which involved drilling into the skull near the top of the forehead, and then using a cannula (a sharp-ended tube) and leucotome to make "sweeping motions" and "stab incisions". This was done on both sides of the head with the patient potentially still awake [21,22] . This advanced procedure was termed the prefrontal lobotomy.…”

‘A matter for conjecture’: leucotomy in Western Australia, 1947–70

“…Examples of the former include in-depth local studies such as that of Crossley (1993), who examines the introduction of leucotomy to the UK through a single institution, the North Wales Hospital. The full date range of psychosurgical experimentation is also assessed in the literature; for example, Berrios (1997) goes deeper and examines the nineteenth-century ‘pre-history’ of psychosurgery, while Getz (2009) describes in more detail the roles of Moniz and Freeman.…”

Margaret Kennard (1899–1975): Not a ‘Principle’ of brain plasticity but a founding mother of developmental neuropsychology

“…He began at Yale as one of Yerkes’s staff of experimental animal psychologists, joining Fulton’s laboratory in 1931 (through whose efforts he obtained Rockefeller Foundation money for advanced primate studies, Getz, 2009). Jacobsen conducted selective behavioral studies of frontal-lesioned monkeys, with behavioral equipment and methodological sophistication provided by Yerkes and surgical facilities by Fulton (Pressman, 1998).…”