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An intact human brain.
An intact human brain.
A human brain that has undergone lobotomy.
A human brain that has undergone lobotomy. The human brain controls the Central nervous system (CNS by way of the Cranial nerves and Spinal cord, the Peripheral nervous system (PNS
Close up of "ice picks"
Close up of "ice picks"

A lobotomy (Greek: lobos: Lobe of brain, tomos: "cut/slice") is a form of psychosurgery, also known as a leukotomy or leucotomy (from Greek leukos: clear or white and tomos meaning "cut/slice"). Greek (el ελληνική γλώσσα or simply el ελληνικά — "Hellenic" is an Indo-European language, spoken today by 15-22 million people mainly The frontal lobe is an area in the Brain of Mammals It is located at the front of each Cerebral hemisphere and positioned anterior to (in front of the The brain is the center of the Nervous system in animals All Vertebrates and the majority of Invertebrates have a brain For the Tourniquet album refer to Psycho Surgery. Psychosurgery is a subset of Neurosurgery ( Surgery It consists of cutting the connections to and from, or simply ruining, the prefrontal cortex. These procedures often result in major personality changes and possible mental disabilities. Lobotomies were used in the past to treat a wide range of severe mental illnesses, including schizophrenia, clinical depression, and various anxiety disorders, as well as people who were considered a nuisance by demonstrating behaviour characterised as, for example, "moodiness" or "youthful defiance". Mental disorder or mental illness is a psychological or behavioral pattern that occurs in an individual and is thought to cause distress or disability that is not expected as Schizophrenia ( from the Greek roots schizein (σχίζειν "to split" and phrēn Major depressive disorder, also known as major depression, unipolar depression, unipolar disorder, clinical depression, or simply depression After the introduction of the antipsychotic Thorazine, lobotomies fell out of common use[1] and the procedure has since been characterized "as one of the most barbaric mistakes ever perpetrated by mainstream medicine". Antipsychotics are a group of Psychoactive drugs commonly but not exclusively used to treat Psychosis, which is typified by Schizophrenia. Chlorpromazine (as chlorpromazine Hydrochloride, abbreviated CPZ, marketed in the US as Thorazine) is a Phenothiazine Antipsychotic [2]

Contents

History

In 1890, Dr. Gottlieb Burckhardt removed pieces of the frontal lobes of six patients in a psychiatric hospital in Switzerland. A psychiatric hospital (previously called insane asylum, mental hospital; or derogatorily looney bin, nut house or Funny Farm) is Switzerland (English pronunciation; Schweiz Swiss German: Schwyz or Schwiiz Suisse Svizzera Svizra officially the Swiss Confederation One died after the operation, and another was found dead in a river 10 days after release (whether by accident, suicide, or crime is unknown). The others exhibited altered behavior. These experiments marked one of the first forays into the field of psychosurgery.

The Portuguese physician and neurologist António Egas Moniz pioneered a surgery called prefrontal leucotomy in 1935. António Caetano de Abreu Freire EGAS MONIZ ('ɛgɐʃ mu'niʃ ( November 29, 1874 &ndash December 13, 1955 The procedure involved drilling holes in the patient's head and destroying tissue in the frontal lobes by injecting alcohol. He later improved the technique using a surgical instrument called a leucotome that cut brain tissue with a retractable wire loop. A leucotome is a Surgical instrument used for performing lobotomies. [3] Moniz won the Nobel Prize for medicine in 1949 for this work. The Nobel Prize in Physiology or Medicine (Nobelpriset i fysiologi eller medicin is awarded once a year by the Swedish Karolinska Institute. [4]

The American neurologist and psychiatrist Walter Freeman was intrigued by Moniz's work, and with the help of his close friend, a neurosurgeon named James W. Watts, he performed the first prefrontal leucotomy in the U. A psychiatrist (also archaically called an alienist) is a Physician who specializes in Psychiatry and is certified in treating Mental disorders Neurosurgery is the surgical discipline focused on treating those central, Peripheral nervous system and spinal column diseases amenable to surgical James Winston Watts (1904 &ndash 1994 was a Neurosurgeon, born in Lynchburg Virginia and a graduate of the Virginia Military Institute and the University of S. in 1936. Freeman and Watts gradually refined the surgical technique, and created the Freeman-Watts procedure (the "precision method," the standard prefrontal lobotomy). The Freeman-Watts prefrontal lobotomy still required drilling holes in the scalp, so it had to be performed in an operating room by trained neurosurgeons. Walter Freeman believed that this surgery would be unavailable to the patients who needed it most: those that lived in state mental hospitals with no operating rooms, no surgeons, no anesthesia, and very little money. Anesthesia, or anaesthesia (see spelling differences; from Greek grc αν- an-, "without" and grc αἲσθησις Freeman wanted to simplify the procedure so that it could be carried out by psychiatrists in mental asylums, which housed roughly 600,000 American inpatients at the time. A psychiatrist (also archaically called an alienist) is a Physician who specializes in Psychiatry and is certified in treating Mental disorders A psychiatric hospital (previously called insane asylum, mental hospital; or derogatorily looney bin, nut house or Funny Farm) is

Freeman decided to access the frontal lobes through the eye sockets, instead of through drilled holes in the scalp. In 1945, he took an icepick from his own kitchen and began to test the new surgical technique on cadavers. An icepick is a tool used to break-up pick or chip at Ice. It resembles a Scratch awl, but is designed for picking at ice rather than wood A cadaver or corpse is a dead Body. "Cadaver" is normally used as a more formal term for a body being used in medical training or research The technique was called "transorbital lobotomy," and it involved lifting the upper eyelid and placing the point of a thin surgical instrument (often called a leucotome or orbitoclast) under the eyelid and against the top of the eyesocket. An orbitoclast was a Surgical instrument used for performing transorbital lobotomies. A hammer or mallet was then used to drive the leucotome through the thin layer of bone and into the brain. The leucotome was then moved from side to side, to sever the nerve fibers connecting the frontal lobes to the thalamus. The thalamus (from Greek θάλαμος = room chamber, IPA= /ˈθæləməs/ is a pair and symmetric part of the brain In selected patients, the butt of the leucotome was pulled upward, sending the tip farther back into the brain and producing a "deep frontal cut," a more radical form of lobotomy. The leucotome was then withdrawn, and the procedure was repeated on the other side. Walter Freeman first performed a transorbital lobotomy on a live patient in 1946. This new form of psychosurgery was intended for use in State mental hospitals that often did not have the facilities for anesthesia, so Freeman suggested using electroconvulsive therapy to render the patient unconscious. Electroconvulsive therapy ( ECT) also known as electroshock, is a controversial psychiatric treatment in which Seizures are electrically induced [5]

Concerns about lobotomy steadily grew. The USSR banned the procedure in 1950. The Union of Soviet Socialist Republics (USSR was a constitutionally Socialist state that existed in Eurasia from 1922 to 1991 [6] Doctors in the Soviet Union concluded that the procedure was "contrary to the principles of humanity", and, that it turned "an insane person into an idiot". [7] Numerous countries subsequently banned the procedure, including Yugoslavia, Germany and Japan, as did several U. See also Kingdom of Yugoslavia, Socialist Federal Republic of Yugoslavia, Federal Republic of Yugoslavia Yugoslavia ( Serbo-Croatian Germany, officially the Federal Republic of Germany ( ˈbʊndəsʁepuˌbliːk ˈdɔʏtʃlant is a Country in Central Europe. For a topic outline on this subject see List of basic Japan topics. S. states. Lobotomy was legally practiced in controlled and regulated U. S. centers and in Finland, Sweden, Norway (2005 cases[8]), the United Kingdom, Spain, India, Belgium and the Netherlands.

In 1977, the U. S. Congress created a National Committee for the Protection of Human Subjects of Biomedical and Behavioral Research to investigate allegations that psychosurgery — including lobotomy techniques — was used to control minorities and restrain individual rights. For the Tourniquet album refer to Psycho Surgery. Psychosurgery is a subset of Neurosurgery ( Surgery It also investigated after-effects of the surgery. The committee concluded that some extremely limited and properly performed psychosurgery could have positive effects.

By the early 1970s the practice had generally ceased, but some countries continued small-scale operations through the late 1980s. In France, 32 lobotomies were performed between 1980 and 1986 according to an IGAS report; about 15 each year in the UK, 70 in Belgium, and about 15 for the Massachusetts General Hospital of Boston. [9]

Scale

Quantitatively, most lobotomy procedures were done in the United States, where approximately 40,000 persons were so treated. Great Britain performed procedures on 17,000 people, and the three Scandinavian countries had a combined figure of approximately 9,300 people treated. [10] Scandinavian hospitals lobotomized 2. 5 times as many people per capita as hospitals in the United States. [11]

Cases

Literary and cinematic portrayals

Lobotomies have been featured in several literary and cinematic presentations that both reflected society's attitude towards the procedure and, at times, changed it. The 1946 novel All the King's Men by Robert Penn Warren described a lobotomy in such nauseating detail "that [it] would have made a Comanche brave look like a tyro [novice] with a scalping knife". All the King's Men is a Novel by Robert Penn Warren, first published in 1946 Robert Penn Warren (April 24 1905 &ndash September 15 1989 was an American poet Novelist, and literary critic and was one of the founders of New Criticism. The surgeon is portrayed as a repressed person who couldn't change others with love but instead resorted to "high-grade carpentry work". [16] In Tennessee Williams's 1958 play, Suddenly, Last Summer, the protagonist is threatened with a lobotomy to stop her from telling the truth about her cousin Sebastian. Thomas Lanier Williams III (March 26 1911 &ndash February 25 1983 better known as Tennessee Williams, was a major American playwright who received many of the top theatrical Suddenly Last Summer is a one-act play by Tennessee Williams. [17] The surgeon said, "I can't guarantee that a lobotomy would stop her—babbling!!!" To which her aunt responded, "That may be, maybe not, but after the operation who would believe her, Doctor?"[18]

A most damning portrayal of the procedure is found in Ken Kesey's 1962 novel One Flew Over the Cuckoo's Nest and the subsequent 1975 movie adaptation. One Flew Over the Cuckoo's Nest (1962 is a Novel written by Ken Kesey. One Flew Over the Cuckoo's Nest is a 1975 Comedy-drama film directed by Miloš Forman. McMurphy was lobotomized after he angrily attacked Nurse Ratchet. The operation is described as brutal and abusive, a "frontal-lobe castration". Chief Bromden is shocked: "There's nothin' in the face. Just like one of those store dummies. " Another patient's surgery changed him from an acute to a chronic condition. "You can see by his eyes how they burned him out over there; his eyes are all smoked up and gray and deserted inside. "[16]

Other sources include Sylvia Plath's depiction of a young woman, Valerie, who was lobotomized in her 1963 novel The Bell Jar. Sylvia Plath (October 27 1932 &ndash February 11 1963 was an American Poet, Novelist and Short story Writer. The Bell Jar is American writer Sylvia Plath 's only novel which was originally published under the Pseudonym "Victoria Lucas" The character Esther reacts with horror to her "perpetual marble calm". [16] Elliott Baker's 1964 novel and 1966 film version A Fine Madness portrayed the dehumanizing lobotomy of a womanzing, quarrelsome poet who, in the end, is just as aggressive as ever. Elliott Baker ( December 15, 1922 &ndash February 9, 2007) born Elliot Joseph Cohen, was a Screenwriter and Novelist A Fine Madness (1966 is a Motion picture Comedy based on the 1964 novel by Elliott Baker that tells the story of Samson Shillitoe a frustrated The surgeon is portrayed as inhumane and a crackpot. [19] The 1982 biopic Frances included a fictional, disturbing scene of the eponymous actress Frances Farmer undergoing transorbital lobotomy. Frances is a 1982 Universal Drama film starring Jessica Lange, Kim Stanley, Sam Shepard. Frances Elena Farmer ( September 19, 1913 &ndash August 1, 1970) was an American film television and theater actress Whether a lobotomy ever occurred or whether it was performed by Dr. Freeman himself is a matter of much debate. [20]

See also

References

  1. ^ Braslow, Joel T. Elliot S Valenstein, PhD is a professor emeritus of Psychology and Neuroscience at the University of Michigan. (1997). Mental ills and bodily cures psychiatric treatment in the first half of the twentieth century. University of California Press, 169. ISBN 0520205472.  
  2. ^ http://www.pbs.org/wgbh/amex/lobotomist/program/
  3. ^ Jansson, Bengt (1998-10-29). Year 1998 ( MCMXCVIII) was a Common year starting on Thursday (link will display full 1998 Gregorian calendar) Events 437 - Valentinian III, Western Roman Emperor, marries Licinia Eudoxia, daughter of his cousin Theodosius II Controversial Psychosurgery Resulted in a Nobel Prize. Nobelprize. org. Nobel Web AB. Retrieved on 2008-03-30. 2008 ( MMVIII) is the current year in accordance with the Gregorian calendar, a Leap year that started on Tuesday of the Common Events 240 BC - 1st recorded Perihelion passage of Halley's Comet.
  4. ^ The Nobel Prize in Physiology or Medicine 1949. Nobelprize. org. Nobel Web AB. Retrieved on 2008-03-30. 2008 ( MMVIII) is the current year in accordance with the Gregorian calendar, a Leap year that started on Tuesday of the Common Events 240 BC - 1st recorded Perihelion passage of Halley's Comet.
  5. ^ El-Hai, Jack (2005). The Lobotomist. Wiley. ISBN 0471232920.  
  6. ^ Приказ МЗ СССР 1003 (9 дек. 1950). Невропатология и психиатрия 20, no. 1 (1951): 17-18.
  7. ^ http://facstaff.unca.edu/ddiefenb/lobotomy.html
  8. ^ Norway compensates lobotomy victims. BMJ.
  9. ^ "La neurochirurgie fonctionnelle d'affections psychiatriques sévères" (PDF), Comité Consultatif National d'Ethique, 2002-04-25. See also 2002 (disambiguation Year 2002 ( MMII) was a Common year starting on Tuesday of the Gregorian calendar. Events 1607 - Eighty Years' War: The Dutch fleet destroys the anchored Spanish fleet at Gibraltar. (French) 
  10. ^ Tranøy, Joar; Blomberg, Wenche (03 2005). "Lobotomy in Norwegian Psychiatry" (PDF). History of Psychiatry 16 (1): 107. London, Thousand Oaks, Calif. , and New Delhi: SAGE Publications. doi:10.1177/0957154X05052224. A digital object identifier ( DOI) is a permanent identifier given to an Electronic document.  
  11. ^ Tranøy, Joar (Winter 1996). "(unknown title)". The Journal of Mind and Behavior (1): pp. 1–20. University of Oslo. ISSN 0271—0137. An International Standard Serial Number ( ISSN) is a unique eight-digit number used to identify a print or electronic Periodical publication.  
  12. ^ Special Olympics - History
  13. ^ My Lobotomy | Howard Dully and Charles Fleming
  14. ^ 'My Lobotomy': Howard Dully's Journey. NPR (November 16, 2005).
  15. ^ Dully, Howard (March 6th, 2008). Events 1079 - Omar Khayyám completes the Iranian calendar. 1454 - Thirteen Years' War: Delegates of 2008 ( MMVIII) is the current year in accordance with the Gregorian calendar, a Leap year that started on Tuesday of the Common My Lobotomy. Ebury Press. Random House Inc is the world's largest English-language general trade book publisher ISBN 9780091922122.  
  16. ^ a b c Grenader, M. E. (1978). "Of Graver Import Than History: Psychiatry In Fiction" (PDF). Journal of Libertarian Studies 2 (1): 42–44. Great Britain: Pergamon Press.  
  17. ^ Bigsby, C. W. E. (January 25, 1985). Events 41 - After a night of negotiation Claudius is accepted as Roman Emperor by the Senate Year 1985 ( MCMLXXXV) was a Common year starting on Tuesday (link displays 1985 Gregorian calendar) A Critical Introduction to Twentieth-Century American Drama: Volume 2. Cambridge University Press, p. 100. ISBN 978-0521277174. Retrieved on 2008-01-23. 2008 ( MMVIII) is the current year in accordance with the Gregorian calendar, a Leap year that started on Tuesday of the Common Events 393 - Roman Emperor Theodosius I proclaims his nine year old son Honorius co-emperor  
  18. ^ Williams, Tennessee (January 1998). Thomas Lanier Williams III (March 26 1911 &ndash February 25 1983 better known as Tennessee Williams, was a major American playwright who received many of the top theatrical Suddenly Last Summer. Dramatists Play Service, p. 15. ISBN 978-0822210948. Retrieved on 2008-01-23. 2008 ( MMVIII) is the current year in accordance with the Gregorian calendar, a Leap year that started on Tuesday of the Common Events 393 - Roman Emperor Theodosius I proclaims his nine year old son Honorius co-emperor  
  19. ^ Gabbard, Glen O. (March 1999). Psychiatry and the Cinema, 2nd Edition, American Psychiatric Publishing, Inc. , pp. 119–120. ISBN 978-0880489645. Retrieved on 2008-01-23. 2008 ( MMVIII) is the current year in accordance with the Gregorian calendar, a Leap year that started on Tuesday of the Common Events 393 - Roman Emperor Theodosius I proclaims his nine year old son Honorius co-emperor  
  20. ^ Bragg, Lynn (June 1, 2005). Events 193 - Roman Emperor Didius Julianus is Assassinated 987 - Hugh Capet is elected Year 2005 ( MMV) was a Common year starting on Saturday (link displays full calendar of the Gregorian calendar. Myths and Mysteries of Washington, 1st Edition, TwoDot, pp. 72–75. ISBN 978-0762734276. Retrieved on 2008-01-23. 2008 ( MMVIII) is the current year in accordance with the Gregorian calendar, a Leap year that started on Tuesday of the Common Events 393 - Roman Emperor Theodosius I proclaims his nine year old son Honorius co-emperor  

External links

Dictionary

lobotomy

-noun

  1. A surgical operation on the frontal lobe of the brain intent on treating certain mental illnesses.
  2. The severing of the prefrontal cortex from the thalamic region of the brain.
  3. The severing of the sympathetic nerve trunk.
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