What's a lobotomy?

What is lobotomy? It is a long-forgotten and ostracized method by modern psychiatrists. In Russia, lobotomy was forgotten starting in 1950, when this psychosurgical method was banned, while across the ocean, in the USA, up to five thousand similar operations were performed that same year.

What is lobotomy, what is its essence?

It is believed that the authorship of the lobotomy belongs to a citizen of Portugal, but the history of surgery refutes this fact. What a lobotomy is was known back in the 19th century, when the first operation in the history of psychiatry to remove the frontal lobes was performed in a Swiss clinic. Then, independently, the famous surgeon Bekhterev came up with the idea of deactivating the brain by damaging neural connections. The effectiveness of such intervention in brain activity was questioned and the experiments ceased. Prefrontal lobotomy received a "new breath" much later, when the method was improved to a simple, half-hour procedure.

Initially, this procedure was called leucotomy, from the Greek words λευκός, meaning white, and τομή – to cut. The author of this invention even received the Nobel Prize for his significant contribution to the impact on a number of acute mental illnesses. Thus, in 1949, the world recognized the merits of the Portuguese doctor Moniz, who developed a method for separating the tissues that connect the lobus frontalis cerebri – the frontal lobes with the brain. Until recently, it was believed that the frontal lobes are responsible for the activity of rational human activity, moreover, they were called the main zone controlling brain function. Unlike the animal world, the frontal lobes are more developed in humans, and without them, Homo sapiens cannot be considered as such. Psychiatrist Moniz believed that particularly dangerous, aggressive forms of psychosis can be neutralized, freeing the patient from the need to be human. Of course, the Portuguese doctor had other ideas and one cannot deny the general value of his work on the study of the structure of the brain, but the operations that he introduced into life are today recognized as inhumane almost throughout the world.

The surgical operation itself is quite simple in a technological sense. Its main task is to separate the frontal lobes that control the thought process from the rest of the brain structures. The first experiment that showed the world what a lobotomy is was conducted in the thirties of the last century. The author of the psychosurgical innovation did not perform the operation himself because of chronic gout, obviously fearing that his hand would tremble and the scalpel would damage the brain irreversibly. The procedure was carried out under his sensitive guidance by his devoted comrade-in-arms, also a resident of Portugal, a surgeon named Lim. The name of the experimental patient is unknown to history, as are the names of many other patients, the number of whom has reached thousands since the first operation. Psychiatrists immediately approved of such a radical way of solving pathological conditions and actively began to operate on the unfortunate patients of psychiatric hospitals. The frontal lobes were not damaged, the incision fell on the line of white matter, which was a neural connection between the lobes and other areas of the brain. After the operations, patients were diagnosed with “frontal lobe syndrome,” which remained with them for life.

What is a lobotomy, how was the operation performed?

The area above both eyes was carefully treated with an antiseptic and a local anesthetic to relieve pain. The first operations were performed without anesthesia at all, since it was believed that this area did not contain pain receptors.

A small incision was made with a movement from the bottom up. The surgeon felt the incision boundary with a scalpel, as the instrument encountered a small resistance from the elastic membranes of the brain. Then a cone-shaped section of tissue was cut out. Sensitivity in this area is low, and the patient, as a rule, does not experience strong painful sensations.

A special instrument, a probe, was inserted into the incision, through which blood and cerebrospinal fluid were removed. Then the incision was treated and sutured.

Literally five to seven days later, the patient could be discharged and return, in the opinion of doctors, to normal life. However, the lack of a clearly and thoroughly described rationale, the emphasis only on practical experimental actions often led to the fact that the operations transformed patients into apathetic creatures, far removed from the real world. In addition to the fact that patients lost the ability to reason, they often had seizures resembling epilepsy.

The whole world learned what a lobotomy was, although Moniz called the operation differently. The authorship of the term "lobotomy" belongs to another experimenter, the American doctor Freeman, who shared the laurels and glory of the Nobel Prize with his Portuguese colleague. It was Freeman who became a real fan of bringing patients into a state of "plants", having developed a new technology for turning off the brain. Freeman performed operations using a specific anesthesia - electric shock.

Despite the growing popularity of the neutralization of particularly aggressive and hopeless patients in terms of psychiatric care, many doctors were extremely negative about such a radical procedure. Gradually, their protest took on a large scale, and many side effects of postoperative surgery, including lethal ones, only intensified the process. Soon, many clinics stopped practicing lobotomy, in addition, the latest developments in pharmacology made it possible to successfully manage mental illnesses with the help of drug therapy. Obsessions (obsessive states), manic-depressive psychosis in the acute stage, severe forms of schizophrenia were effectively treated with pills and psychoanalysis. Prefrontal lobotomy as a method became an "outcast" in the world of medicine.

What is lobotomy? This is already the history of psychosurgery and psychiatry, as paradoxical, striking the imagination with its sometimes barbaric and scientifically unfounded methods as treatment with electric shock or immersion in ice water. Modern methods and technologies for treating patients in psychiatric clinics do not involve such radical experiments: firstly, it is inhumane, secondly, it is practically ineffective and sometimes dangerous not only for intellectual activity, but also for the life of the patient.