Lobotomy
Lobotomy | ||
---|---|---|
Specialty psychosurgery | | |
ICD-9-CM | 01.32 | |
MeSH | D011612 |
A lobotomy (from
In the past, this treatment was used for treating psychiatric disorders as a mainstream procedure in some countries. The procedure was controversial from its initial use, in part due to a lack of recognition of the severity and chronicity of severe and enduring psychiatric illnesses, so it was said to be an inappropriate treatment.[3]
The originator of the procedure, Portuguese neurologist
The use of the procedure increased dramatically from the early 1940s and into the 1950s; by 1951, almost 20,000 lobotomies had been performed in the United States and proportionally more in the United Kingdom.[6] A large number of patients were gay men.[7] More lobotomies were performed on women than on men: a 1951 study found that nearly 60% of American lobotomy patients were women, and limited data shows that 74% of lobotomies in Ontario from 1948 to 1952 were performed on female patients.[8][9][10] From the 1950s onward, lobotomy began to be abandoned,[11] first in the Soviet Union[12] and Europe.[13]
Outline
Historically, patients of lobotomy were, immediately following surgery, often
The purpose of the operation was to reduce the symptoms of
The consequences of the operation have been described as "mixed".[16] Some patients died as a result of the operation and others later committed suicide. Some were left severely brain damaged. Others were able to leave the hospital, or became more manageable within the hospital.[16] A few people managed to return to responsible work, while at the other extreme, people were left with severe and disabling impairments.[17] Most people fell into an intermediate group, left with some improvement of their symptoms but also with emotional and intellectual deficits to which they made a better or worse adjustment.[17] On average, there was a mortality rate of approximately 5% during the 1940s.[17]
The lobotomy procedure could have severe negative effects on a patient's personality and ability to function independently.[18] Lobotomy patients often show a marked reduction in initiative and inhibition.[19] They may also exhibit difficulty imagining themselves in the position of others because of decreased cognition and detachment from society.[20]
Walter Freeman coined the term "surgically induced childhood" and used it constantly to refer to the results of lobotomy. The operation left people with an "infantile personality"; a period of maturation would then, according to Freeman, lead to recovery. In an unpublished memoir, he described how the "personality of the patient was changed in some way in the hope of rendering him more amenable to the social pressures under which he is supposed to exist." He described one 29-year-old woman as being, following lobotomy, a "smiling, lazy and satisfactory patient with the personality of an oyster" who could not remember Freeman's name and endlessly poured coffee from an empty pot. When her parents had difficulty dealing with her behaviour, Freeman advised a system of rewards (ice cream) and punishment (smacks).[21]
History
In the early 20th century, the number of patients residing in mental hospitals increased significantly
The clinician-historian Joel Braslow argues that from malarial therapy onward to lobotomy, physical psychiatric therapies "spiral closer and closer to the interior of the brain" with this organ increasingly taking "center stage as a source of disease and site of cure".[33] For Roy Porter, once the doyen of medical history,[34] the often violent and invasive psychiatric interventions developed during the 1930s and 1940s are indicative of both the well-intentioned desire of psychiatrists to find some medical means of alleviating the suffering of the vast number of patients then in psychiatric hospitals and also the relative lack of social power of those same patients to resist the increasingly radical and even reckless interventions of asylum doctors.[35] Many doctors, patients and family members of the period believed that despite potentially catastrophic consequences, the results of lobotomy were seemingly positive in many instances or, were at least deemed as such when measured next to the apparent alternative of long-term institutionalisation. Lobotomy has always been controversial, but for a period of the medical mainstream, it was even feted and regarded as a legitimate last-resort remedy for categories of patients who were otherwise regarded as hopeless.[36] Today, lobotomy has become a disparaged procedure, a byword for medical barbarism and an exemplary instance of the medical trampling of patients' rights.[3]
Early psychosurgery
Before the 1930s, individual doctors had infrequently experimented with novel surgical operations on the brains of those deemed insane. Most notably in 1888, the Swiss psychiatrist
Intending to ameliorate symptoms in those with violent and intractable conditions rather than effect a cure,
In 1912, two physicians based in Saint Petersburg, the leading Russian neurologist Vladimir Bekhterev and his younger Estonian colleague, the neurosurgeon Ludvig Puusepp, published a paper reviewing a range of surgical interventions that had been performed on the mentally ill.[47] While generally treating these endeavours favorably, in their consideration of psychosurgery they reserved unremitting scorn for Burckhardt's surgical experiments of 1888 and opined that it was extraordinary that a trained medical doctor could undertake such an unsound procedure.[48]
We have quoted this data to show not only how groundless but also how dangerous these operations were. We are unable to explain how their author, holder of a degree in medicine, could bring himself to carry them out ...[49]
The authors neglected to mention, however, that in 1910 Puusepp himself had performed surgery on the brains of three mentally ill patients,[n 5][51] sectioning the cortex between the frontal and parietal lobes.[52] He had abandoned these attempts because of unsatisfactory results and this experience probably inspired the invective that was directed at Burckhardt in the 1912 article.[48] By 1937, Puusepp, despite his earlier criticism of Burckhardt, was increasingly persuaded that psychosurgery could be a valid medical intervention for the mentally disturbed.[n 6][54] In the late 1930s, he worked closely with the neurosurgical team of the Racconigi Hospital near Turin to establish it as an early and influential centre for the adoption of leucotomy in Italy.[55]
Development
Leucotomy was first undertaken in 1935 under the direction of the
Frontal lobes
The source of inspiration for Moniz's decision to hazard psychosurgery has been clouded by contradictory statements made on the subject by Moniz and others both contemporaneously and retrospectively.
Moniz began his experiments with leucotomy just three months after the congress had reinforced the apparent cause and effect relationship between the Fulton and Jacobsen presentation and the Portuguese neurologist's resolve to operate on the frontal lobes.
The frontal lobes had been the object of scientific inquiry and speculation since the late 19th century. Fulton's contribution, while it may have functioned as source of intellectual support, is of itself unnecessary and inadequate as an explanation of Moniz's resolution to operate on this section of the brain.
The first bilateral lobectomy of a human subject was performed by the American neurosurgeon
Nor was Moniz the only medical practitioner in the 1930s to have contemplated procedures directly targeting the frontal lobes.
Neurological model
The theoretical underpinnings of Moniz's psychosurgery were largely commensurate with the nineteenth-century ones that had informed Burckhardt's decision to excise matter from the brains of his patients. Although in his later writings Moniz referenced both the
[The] mental troubles must have ... a relation with the formation of cellulo-connective groupings, which become more or less fixed. The cellular bodies may remain altogether normal, their cylinders will not have any anatomical alterations; but their multiple liaisons, very variable in normal people, may have arrangements more or less fixed, which will have a relation with persistent ideas and deliria in certain morbid psychic states.[92]
For Moniz, "to cure these patients", it was necessary to "destroy the more or less fixed arrangements of cellular connections that exist in the brain, and particularly those which are related to the frontal lobes",
First leucotomies
The hypotheses underlying the procedure might be called into question; the surgical intervention might be considered very audacious; but such arguments occupy a secondary position because it can be affirmed now that these operations are not prejudicial to either physical or psychic life of the patient, and also that recovery or improvement may be obtained frequently in this way.
—Egas Moniz (1937)[96]
On 12 November 1935 at the Hospital Santa Marta in
By the conclusion of this first run of leucotomies in February 1936, Moniz and Lima had operated on twenty patients with an average period of one week between each procedure; Moniz published his findings with great haste in March of the same year.
Reception
Moniz rapidly disseminated his results through articles in the medical press and a monograph in 1936.[103] Initially, however, the medical community appeared hostile to the new procedure.[112] On 26 July 1936, one of his assistants, Diogo Furtado, gave a presentation at the Parisian meeting of the Société Médico-Psychologique on the results of the second cohort of patients leucotomised by Lima.[103] Sobral Cid, who had supplied Moniz with the first set of patients for leucotomy from his own hospital in Lisbon, attended the meeting and denounced the technique,[112] declaring that the patients who had been returned to his care post-operatively were "diminished" and had experienced a "degradation of personality".[113] He also claimed that the changes Moniz observed in patients were more properly attributed to shock and brain trauma, and he derided the theoretical architecture that Moniz had constructed to support the new procedure as "cerebral mythology."[113] At the same meeting the Parisian psychiatrist, Paul Courbon, stated he could not endorse a surgical technique that was solely supported by theoretical considerations rather than clinical observations.[114] He also opined that the mutilation of an organ could not improve its function and that such cerebral wounds as were occasioned by leucotomy risked the later development of meningitis, epilepsy and brain abscesses.[115] Nonetheless, Moniz's reported successful surgical treatment of 14 out of 20 patients led to the rapid adoption of the procedure on an experimental basis by individual clinicians in countries such as Brazil, Cuba, Italy, Romania and the United States during the 1930s.[116]
Italian leucotomy
In the present state of affairs if some are critical about lack of caution in therapy, it is, on the other hand, deplorable and inexcusable to remain apathetic, with folded hands, content with learned lucubrations upon symptomatologic minutiae or upon psychopathic curiosities, or even worse, not even doing that.
—Amarro Fiamberti[117]
Throughout the remainder of the 1930s the number of leucotomies performed in most countries where the technique was adopted remained quite low. In Britain, which was later a major centre for leucotomy,[n 14] only six operations had been undertaken before 1942.[119] Generally, medical practitioners who attempted the procedure adopted a cautious approach and few patients were leucotomised before the 1940s. Italian neuropsychiatrists, who were typically early and enthusiastic adopters of leucotomy, were exceptional in eschewing such a gradualist course.[55]
Leucotomy was first reported in the Italian medical press in 1936 and Moniz published an article in Italian on the technique in the following year.[55] In 1937, he was invited to Italy to demonstrate the procedure and for a two-week period in June of that year he visited medical centres in Trieste, Ferrara, and one close to Turin – the Racconigi Hospital – where he instructed his Italian neuropsychiatric colleagues on leucotomy and also oversaw several operations.[55] Leucotomy was featured at two Italian psychiatric conferences in 1937 and over the next two years a score of medical articles on Moniz's psychosurgery was published by Italian clinicians based in medical institutions located in Racconigi, Trieste, Naples, Genoa, Milan, Pisa, Catania and Rovigo.[55] The major centre for leucotomy in Italy was the Racconigi Hospital, where the experienced neurosurgeon Ludvig Puusepp provided a guiding hand.[n 15][55] Under the medical directorship of Emilio Rizzatti, the medical personnel at this hospital had completed at least 200 leucotomies by 1939.[121] Reports from clinicians based at other Italian institutions detailed significantly fewer leucotomy operations.[55]
Experimental modifications of Moniz's operation were introduced with little delay by Italian medical practitioners.
American leucotomy
The first prefrontal leucotomy in the United States was performed at the George Washington University Hospital on 14 September 1936 by the
Upon receipt of Moniz's monograph, Freeman reviewed it anonymously for the Archives of Neurology and Psychiatry.[131] Praising the text as one whose "importance can scarcely be overestimated",[131] he summarised Moniz's rationale for the procedure as based on the fact that while no physical abnormality of cerebral cell bodies was observable in the mentally ill, their cellular interconnections may harbour a "fixation of certain patterns of relationship among various groups of cells" and that this resulted in obsessions, delusions and mental morbidity.[132] While recognising that Moniz's thesis was inadequate, for Freeman it had the advantage of circumventing the search for diseased brain tissue in the mentally ill by instead suggesting that the problem was a functional one of the brain's internal wiring where relief might be obtained by severing problematic mental circuits.[132]
In 1937 Freeman and Watts adapted Lima and Moniz's surgical procedure, and created the Freeman-Watts technique, also known as the Freeman-Watts standard prefrontal lobotomy, which they styled the "precision method".[133]
Transorbital lobotomy
The Freeman–Watts prefrontal lobotomy still required drilling holes in the skull, so surgery had to be performed in an operating room by trained neurosurgeons. Walter Freeman believed this surgery would be unavailable to those he saw as needing it most: patients in state mental hospitals that had no operating rooms, surgeons, or anesthesia and limited budgets. Freeman wanted to simplify the procedure so that it could be carried out by psychiatrists in psychiatric hospitals.[134]
Inspired by the work of Italian psychiatrist
Freeman performed the first transorbital lobotomy on a live patient in 1946. Its simplicity suggested the possibility of carrying it out in mental hospitals lacking the surgical facilities required for the earlier, more complex procedure. (Freeman suggested that, where conventional anesthesia was unavailable, electroconvulsive therapy be used to render the patient unconscious.)[136] In 1947, the Freeman and Watts partnership ended, as the latter was disgusted by Freeman's modification of the lobotomy from a surgical operation into a simple "office" procedure.[137] Between 1940 and 1944, 684 lobotomies were performed in the United States. However, because of the fervent promotion of the technique by Freeman and Watts, those numbers increased sharply toward the end of the decade. In 1949, the peak year for lobotomies in the US, 5,074 procedures were undertaken, and by 1951 over 18,608 individuals had been lobotomized in the US.[138] An estimated 40% of Freeman's patients were gay men, lobotomized to change their sexual orientation. [7]
Prevalence
In the United States, approximately 40,000 people were lobotomized and in England, 17,000 lobotomies were performed. According to one estimate, in the three Nordic countries of Denmark, Norway, and Sweden, a combined figure of approximately 9,300 lobotomies were performed.[139] Scandinavian hospitals lobotomized 2.5 times as many people per capita as hospitals in the US.[140] According to another estimate, Sweden lobotomized at least 4,500 people between 1944 and 1966, mainly women. This figure includes young children.[141] And in Norway, there were 2,005 known lobotomies.[142] In Denmark, there were 4,500 known lobotomies.[143] In Japan, the majority of lobotomies were performed on children with behaviour problems. The Soviet Union banned the practice in 1950 on moral grounds.[144][145][146] In Germany, it was performed only a few times.[147] By the late 1970s, the practice of lobotomy had generally ceased, although it continued as late as the 1980s in France.[148]
Criticism
As early as 1944, an author in the
Concerns about lobotomy steadily grew. Soviet psychiatrist Vasily Gilyarovsky criticized lobotomy and the mechanistic brain localization assumption used to carry out lobotomy:
It is assumed that the transection of white substance of the frontal lobes impairs their connection with the thalamus and eliminates the possibility to receive from it stimuli which lead to irritation and on the whole derange mental functions. This explanation is mechanistic and goes back to the narrow localizationism characteristic of psychiatrists of America, from where leucotomy was imported to us.[151]
The Soviet Union officially banned the procedure in 1950[152] on the initiative of Gilyarovsky.[153] Doctors in the Soviet Union concluded that the procedure was "contrary to the principles of humanity" and "'through lobotomy' an insane person is changed into an idiot".[146] By the 1970s, numerous countries had banned the procedure, as had several US states.[154]
In 1977, the US Congress, during the presidency of Jimmy Carter, created the 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. The committee concluded that some extremely limited and properly performed psychosurgery could have positive effects.[155]
Torsten Wiesel has called the award of the Nobel Prize to Moniz an "astounding [error] of judgment ... a terrible mistake",[156] and there have been calls for the Nobel Foundation to rescind the award; the Foundation has not done so, and its website still hosts an article defending lobotomy.[157][5]
Notable cases
- Rosemary Kennedy, sister of US president John F. Kennedy, underwent a lobotomy in 1941 that left her incapacitated and institutionalized for the rest of her life.[158]
- Howard Dully wrote a memoir of his late-life discovery that he had been lobotomized in 1960 at age 12.[159]
- Josef Hassid, a Polish violinist and composer, was diagnosed with schizophrenia and died at the age of 26 following a lobotomy performed on him in England.[160]
- Swedish modernist painter Sigrid Hjertén died following a lobotomy in 1948.[161]
- American playwright Tennessee Williams' older sister Rose received a lobotomy that left her incapacitated for life; the episode is said to have inspired characters and motifs in some of his works.[162]
- It is often said that when an iron rod was accidentally driven through the head of Phineas Gage in 1848, this constituted an "accidental lobotomy", or that this event somehow inspired the development of surgical lobotomy a century later. According to the only book-length study of Gage, careful inquiry turns up no such link.[163]
- In 2011, Daniel Nijensohn, an Argentine-born neurosurgeon at Yale, examined X-rays of Eva Perón and concluded that she underwent a lobotomy for the treatment of pain and anxiety in the last months of her life.[164]
Literary and cinematic portrayals
Lobotomies have been featured in several literary and cinematic presentations that both reflected society's attitude toward the procedure and, at times, changed it. Writers and film-makers have played a pivotal role in turning public sentiment against the procedure.[5]
- Robert Penn Warren's 1946 novel All the King's Men describes a lobotomy as making "a Comanche brave look like a tyro with a scalping knife", and portrays the surgeon as a repressed man who cannot change others with love, so he instead resorts to "high-grade carpentry work".[165]
- Tennessee Williams criticized lobotomy in his play Suddenly, Last Summer (1958) because it was sometimes inflicted on homosexuals – to render them "morally sane".[5] In the play, a wealthy matriarch offers the local mental hospital a substantial donation if the hospital will give her niece a lobotomy, which she hopes will stop the niece's shocking revelations about her son.[166] Warned that a lobotomy might not stop her niece's "babbling", she responds, "That may be, maybe not, but after the operation, who would believe her, Doctor?".[167]
- In Ken Kesey's 1962 novel One Flew Over the Cuckoo's Nest and its 1975 film adaptation, lobotomy is described as "frontal-lobe castration", a form of punishment and control after which "There's nothin' in the face. Just like one of those store dummies." In one patient, "You can see by his eyes how they burned him out over there; his eyes are all smoked up and gray and deserted inside."[165]
- In Sylvia Plath's 1963 novel The Bell Jar, the protagonist reacts with horror to the "perpetual marble calm" of a lobotomized young woman.[165]
- Elliott Baker's 1964 novel and 1966 film version, A Fine Madness, portrays the dehumanizing lobotomy of a womanizing, quarrelsome poet who, afterward, is just as aggressive as ever. The surgeon is depicted as an inhumane crackpot.[168]
- The 1982 biopic film Frances depicts actress Frances Farmer (the subject of the film) undergoing transorbital lobotomy (though the idea[169] that a lobotomy was performed on Farmer, and that Freeman performed it, has been criticized as having little or no factual foundation).[170]
- The 2018 film The Mountain centers on lobotomy, attitudes about mental health in general, in 1950s America. The protagonist, a young man whose mother had been lobotomized, takes a job as a medical photographer for a doctor whose character is loosely based on Freeman.[171][172]
See also
- Bilateral cingulotomy – destruction of a part of the brain
- Bioethics and medical ethics
- Frontal lobe disorder
- Frontal lobe injury
- Psychosurgery
- History of psychosurgery in the United Kingdom
Notes
- ^ Walter Rudolf Hess, who was the joint winner with Moniz of the Nobel Prize in 1949 for his work on the function of the midbrain, had no involvement with leucotomy.[4]
- ^ A 1937 report detailed that in the United States there were then 477 psychiatric institutions with a total population of approximately 451,672 patients, almost half of whom had been resident for a period of five years or more.[22] The report also observed that psychiatric patients occupied 55 per cent of all hospital beds in America.[22] Conditions within US mental hospitals became the subject of public debate as a series of exposes were published in the 1940s.[23] A 1946 Life magazine article remarked that the nation's system of mental hospitals resembled "little more than concentration camps on the Belsen pattern";[24] a point the piece emphasized with documentary photography that depicted patient neglect and dilapidated material conditions within psychiatric institutions.[25]
- ^ Ugo Cerletti, the Italian psychiatrist and joint inventor with Lucio Bini of electroconvulsive therapy, described psychiatry during the interwar period as a "funereal science".[26] Likewise Egas Moniz, the inventor of leucotomy, referred to the "impotência terapeutica" (therapeutic impotence) of existing therapeutic remedies during the 1930s.[27]
- ^ The patient he thought improved subsequently committed suicide.[43]
- ^ According to Puusepp, the three patients had manic depression or considered "epileptic equivalents".[50]
- ^ Puusepp admitted to his 1910 experimentation with psychosurgery in a 1937 publication.[53] At that point he had completed a series of 14 leucotomies to relieve aggressive symptoms in patients. Convinced that the results had been positive in these cases, he felt that further research into psychosurgery was warranted.[52]
- Versailles Treaty negotiations,[56] but after the Portuguese coup d'état of 1926, which ushered in the Ditadura Nacional (National Dictatorship), the Republican Moniz, then 51 years old, devoted his considerable talents and energies to neurological research entirely. Throughout his career he published on topics as diverse as neurology, sexology, historical biography, and the history of card games.[57] For his 1927 development of cerebral angiography, which allowed routine visualisation of the brain's peripheral blood vessels for the first time, he was twice nominated, unsuccessfully, for a Nobel Prize. Some have attributed his development of leucotomy to a determination on his part to win the Nobel after these disappointments.[58]
- cerebral ventriculography. Freeman, who would later play a central role in the popularisation and practice of leucotomy in America, also had an interest in personality changes following frontal lobe surgery.[52]
- ^ The patient had meningioma, a rare form of brain tumour arising in the meninges.[75]
- ^ Brickner and Davidoff had planned, before Moniz's first leucotomies, to operate on the frontal lobes to relieve depression.[83]
- ^ Moniz wrote in 1948: 'sufferers from melancholia, for instance, are distressed by fixed and obsessive ideas ... and live in a permanent state of anxiety caused by a fixed idea which predominates over all their lives ... in contrast to automatic actions, these morbid ideas are deeply rooted in the synaptic complex which regulates the functioning of consciousness, stimulating it and keeping it in constant activity ... all these considerations led me to the following conclusion: it is necessary to alter these synaptic adjustments and change the paths chosen by the impulses in their constant passage so as to modify the corresponding ideas and force thoughts along different paths ...'[90]
- ^ Lima described his role as that of an "instrument handled by the Master".[99]
- ^ Before operating on live subjects, they practised the procedure on a cadaver head.[84]
- ^ It was estimated by William Sargant and Eliot Slater that 15,000 leucotomies had been performed in the UK by 1962.[118]
- ^ The 14 leucotomies reported by Puusepp in his 1937 paper were performed at the Racconigi Hospital.[120]
- ^ Frank Freeman, Walter Freeman's son, stated in an interview with Howard Dully that: "He had several ice-picks that just cluttered the back of the kitchen drawer. The first ice-pick came right out of our drawer. A humble ice-pick to go right into the frontal lobes. It was, from a cosmetic standpoint, diabolical. Just observing this thing was horrible, gruesome." When Dully asked Frank Freeman, then a 79-year-old security guard, whether he was proud of his father, he replied: "Oh yes, yes, yeah. He was terrific. He was really quite a remarkable pioneer lobotomist. I wish he could have gotten further."[135]
- ^ Rodney Dully, whose son Howard Dully had had a transorbital lobotomy performed on him by Walter Freeman when he was twelve years old, stated in an interview with his son that: "I only met him [Freeman] I think the one time. He described how accurate it [transorbital lobotomy] was and that he had practised the cutting on, literally, a carload of grapefruit, getting the right move and the right turn. That's what he told me."[135]
Citations
- ^ Kaempffert 1941, p. 18.
- ^ "Lobotomy: Definition, Procedure & History". Live Science. Retrieved 28 June 2018.
- ^ a b Raz 2009, p. 116
- ^ Nobelprize.org 2013.
- ^ a b c d Sutherland 2004
- ^ Levinson, Hugh (8 November 2011). "The strange and curious history of lobotomy". BBC News. BBC.
- ^ a b Kaye, Hugh (25 April 2023). "The dark history of gay men, lobotomies and Walter Jackson Freeman II". attitude. Retrieved 28 June 2023.
- ISBN 978-0472119448. Retrieved 12 August 2017.
- ^ El-Hai, Jack (21 December 2016). "Race and Gender in the Selection of Patients for Lobotomy". Wonders & Marvels. Retrieved 12 August 2017.
- ^ "Lobotomies". Western University. Archived from the original on 14 March 2016. Retrieved 12 August 2017.
- ISBN 9780495090793.
- S2CID 46563971.
- ^ Gallea, Michael (Summer 2017). "A brief reflection on the not-so-brief history of the lobotomy". BCMedical Journal. 59: 302–04. Archived from the original on 7 February 2019. Retrieved 4 February 2019.
- ^ Noyes & Kolb 1962, pp. 550–55
- ^ Partridge 1950, pp. 470–71
- ^ a b Cooper 2014, pp. 143–54.
- ^ a b c Valenstein 1997, pp. 499–516
- ^ Szasz 2007, pp. 151–72
- ^ Freberg 2010, pp. 416–17
- ^ Shutts 1982
- ^ Raz 2013, pp. 101–13
- ^ a b Feldman & Goodrich 2001, p. 650; Mashour, Walker & Martuza 2005, p. 411
- ^ Maisel 1946; Wright 1947; Deutsch 1948;Feldman & Goodrich 2001, p. 650; Pressman 2002, pp. 148–50
- ^ Albert Q. Maisel, "Bedlam 1946, Most U.S. Mental Hospitals are a Shame and a Disgrace", Life 20 (1946), pp. 102–03, quoted in Pressman 2002, p. 149
- ^ Pressman 2002, pp. 148–49.
- ^ Shorter 1997, p. 218.
- ^ a b Gross & Schäfer 2011, p. 5
- ^ Swayze 1995, pp. 505–15;Hoenig 1995, p. 337; Meduna 1985, p. 53
- ^ a b Pressman 2002, p. 200
- ^ Brown 2000, pp. 371–82.
- ^ Shorter 1997, pp. 190–225; Jansson 1998
- ^ Healy 2000, p. 404; Braslow 1995, pp. 600–05; Braslow 1997, pp. 89, 93
- ^ Braslow 1997, p. 3.
- ^ Cooter 2012, p. 216
- ^ Porter 1999, p. 520.
- ^ Pressman 2002, p. 428; Raz 2009, pp. 116, 129
- ^ Gross & Schäfer 2011, p. 1; Heller et al. 2006, p. 727; Joanette et al. 1993, pp. 572, 575; Kotowicz 2008, p. 486; Manjila et al. 2008, p. 1; Noll 2007, p. 326; Reevy, Ozer & Ito 2010, p. 485; Steck 2010, pp. 85–89; Stone 2001, pp. 79–92; Suchy 2011, p. 37; Mareke & Fangerau 2010, p. 138; Ford & Henderson 2006, p. 219; Green et al. 2010, p. 208; Sakas et al. 2007, p. 366; Whitaker, Stemmer & Joanette 1996, p. 276
- ^ a b Berrios 1997, p. 68
- ^ a b c Berrios 1997, p. 69
- ^ Berrios 1997, pp. 69, 77
- ^ a b Tierney 2000, p. 26
- ^ Whitaker, Stemmer & Joanette 1996, p. 276; Berrios 1997, p. 69
- ^ Stone 2001, p. 80.
- ^ Berrios 1997, p. 70
- ^ Manjila et al. 2008, p. 1
- ^ Kotowicz 2005, pp. 77–101
- ^ Bechterev & Puusepp 1912; Kotowicz 2008, p. 486
- ^ a b Kotowicz 2005, p. 80; Kotowicz 2008, p. 486
- ^ Quoted in Berrios 1997, p. 71
- ^ Feldman & Goodrich 2001, p. 149
- ^ Kotowicz 2005, p. 80; Kotowicz 2008, p. 486; Berrios 1997, p. 71
- ^ a b c d Feldman & Goodrich 2001, p. 649
- ^ Puusepp 1937
- ^ Kotowicz 2008, p. 486
- ^ a b c d e f g Kotowicz 2008, p. 477
- ^ Tierney 2000, p. 23
- ^ Tierney 2000, p. 25; Tierney 2000, pp. 22–23; Kotowicz 2005, pp. 78
- ^ Shorter 1997, p. 226; Tierney 2000, pp. 25
- ^ Doby 1992, p. 2; Tierney 2000, pp. 25
- ^ El-Hai 2005, p. 100
- ^ a b Berrios 1997, p. 72
- ^ Pressman 2002, pp. 13–14, 48–51, 54–55; Berrios 1997, pp. 72–73; Shorter 1997, p. 226; Heller et al. 2006, p. 721
- ^ Heller et al. 2006, p. 721
- ^ a b Pressman 2002, p. 48.
- ^ Pressman 2002, p. 48; Heller et al. 2006, p. 721
- ^ Pressman 2002, p. 48; Berrios 1997, p. 73
- ^ Berrios 1997, p. 73
- ^ Pressman 2002, pp. 48–50
- ^ Pressman 2002, p. 50
- ^ Berrios 1997, pp. 72–73
- ^ Pressman 2002, pp. 48–55; Valenstein 1997, p. 541
- ^ Pressman 2002, pp. 51, 55
- ^ a b c d e f Pressman 2002, p. 51
- ^ Bianchi 1922; Pressman 2002, p. 51; Levin & Eisenberg 1991, p. 14
- ^ a b Pressman 2002, p. 52; Kotowicz 2005, p. 84
- ^ Brickner 1932
- ^ a b Kotowicz 2005, p. 84
- ^ a b Quoted in Pressman 2002, p. 52
- ^ a b c d e Pressman 2002, p. 52
- ^ Quoted in Freeman & Watts 1944, p. 532
- ^ Pressman 2002, p. 53
- ^ a b Valenstein 1990, p. 541
- ^ a b Valenstein 1997, p. 503
- ^ a b Feldman & Goodrich 2001, p. 650
- ^ Quoted in Valenstein 1990, p. 541
- ^ Valenstein 1990, p. 541; Feldman & Goodrich 2001, p. 650; Kotowicz 2008, p. 478
- ^ Berrios 1997, p. 77; Valenstein 1990, p. 541; Valenstein 1997, p. 503
- ^ Quoted in Valenstein 1997, p. 503
- ^ Gross & Schäfer 2011, p. 1
- ^ Quoted in Berrios 1997, p. 74
- ^ Kotowicz 2005, p. 99; Gross & Schäfer 2011, p. 1
- ^ Quoted in Kotowicz 2005, p. 88
- ^ Quoted in Feldman & Goodrich 2001, p. 651
- ^ Berrios 1997, p. 74
- ^ Kotowicz 2005, p. 89
- ^ a b Moniz 1994, p. 237.
- ^ Kotowicz 2005, pp. 80–81; Feldman & Goodrich 2001, p. 650
- ^ Gross & Schäfer 2011, p. 2; Kotowicz 2008, p. 482
- ^ , Gross & Schäfer 2011, p. 2
- ^ Tierney 2000, p. 29; Kotowicz 2005, pp. 80–81; Gross & Schäfer 2011, p. 2
- ^ Pressman 2002, p. 54
- ^ Finger 2001, p. 292.
- ^ a b c Kotowicz 2005, p. 81
- ^ a b c Feldman & Goodrich 2001, p. 651
- ^ Jansson 1998; Gross & Schäfer 2011, p. 2; Feldman & Goodrich 2001, p. 651. For Moniz's account of the procedure see, Moniz 1994, pp. 237–39
- ^ Kotowicz 2005, p. 81; Feldman & Goodrich 2001, p. 651; Valenstein 1997, p. 504
- ^ Berrios 1997, p. 75
- ^ Kotowicz 2005, p. 92
- ^ Berrios 1997, p. 75; Kotowicz 2005, p. 92
- ^ a b Gross & Schäfer 2011, p. 3
- ^ Berrios 1997, p. 74; Gross & Schäfer 2011, p. 3
- ^ a b Kotowicz 2008, p. 482
- ^ a b Quoted in Kotowicz 2008, p. 482
- ^ Kotowicz 2008, pp. 482–83
- ^ Kotowicz 2008, p. 483
- ^ Feldman & Goodrich 2001, p. 652; Kotowicz 2005, p. 81
- ^ Quoted in El-Hai 2005, p. 182
- ^ Kotowicz 2008, pp. 486 n.1; Sargant & Slater 1963, p. 98
- ^ Kotowicz 2008, pp. 476–77
- ^ Puusepp 1937; Kotowicz 2008, pp. 477, 486
- ^ Kotowicz 2008, pp. 477, 487
- ^ a b Kotowicz 2008, p. 478
- ^ a b El-Hai 2005, p. 182
- ^ a b El-Hai 2005, p. 182; Finger 2001, p. 293; Weiss, Rauch & Price 2007, p. 506
- ^ Shorter 1997, p. 227; Pressman 2002, p. 78
- ^ a b Pressman 2002, p. 76; Feldman & Goodrich 2001, p. 649
- ^ Pressman 2002, p. 76; Kotowicz 2005, p. 94
- ^ Pressman 2002, p. 73
- ^ Pressman 2002, pp. 73–75
- ^ Quoted in Pressman 2002, p. 76
- ^ a b c Pressman 2002, p. 76
- ^ a b Pressman 2002, p. 77
- ^ Finger 2001, p. 293
- ^ El-Hai 2005, p. 184.
- ^ a b Dully 2005.
- ^ El-Hai 2005
- PMID 28859561.
- ^ Shorter 1997, pp. 227–28
- ^ Tranøy & Blomberg 2005, p. 107
- ^ Tranøy 1996, pp. 1–20
- ^ Ogren & Sandlund 2005, pp. 353–67
- ^ Goldbeck-Wood 1996, pp. 708–09
- ^ "Jesper Vaczy Kragh: "Sidste udvej? Træk af psykokirurgiens historie i Danmark" (Dansk Medicinhistorisk Årbog 2007)" (PDF). Archived from the original (PDF) on 5 March 2016. Retrieved 20 January 2018.
- ^ Lichterman 1993, pp. 1–4
- ^ USSR Ministry of Health 1951, pp. 17–18
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- ISBN 3-927408-82-4
- Comité Consultatif National d'Ethique. 25 April 2002. Archived from the original(PDF) on 20 July 2011. (French national consultative committee on ethics, opinion #71: Functional neurosurgery of severe psychiatric conditions)
- ^ Ogren & Sandlund 2005.
- ^ Wiener 1948, p. 148.
- ^ Gilyarovsky 1950
- ^ Lichterman 1993, pp. 1–4; USSR Ministry of Health 1951, pp. 17–18
- ^ Gilyarovsky 1973, p. 4
- ^ Wood & Wood 2008, p. 153.
- ^ DHEW 1977.
- ISBN 978-1-4128-0895-8.
- ^ Jansson 1998.
- ^ Feldman 2001, p. 271
- ^ Day 2008
- ^ Prior 2008
- ^ Snyder & Steffen-Fluhr 2012, p. 52
- ^ Kolin 1998, pp. 50–51
- ^ Macmillan (2000, p. 250, 1999–2012)
- ^ Nijensohn 2012, p. 582
- ^ a b c Grenander 1978, pp. 42–44
- ^ Bigsby 1985, p. 100
- ^ Williams 1998, p. 15
- ^ Gabbard & Gabbard 1999, pp. 119–20
- ^ Arnold 1982.
- ^ Bragg 2005, pp. 72–75; El-Hai 2005, pp. 241–42
- ^ Lapin, Andrew (25 July 2019). "A Lobotomist Struggles To Hang on in the Brilliant, Blistering 'The Mountain'". NPR. Retrieved 8 November 2020.
- ^ Kohn, Eric (30 August 2018). "'The Mountain' Review: Jeff Goldblum and Tye Sheridan Are Lost Souls in Rick Alverson's Beautiful, Fractured America". IndieWire. Retrieved 8 November 2020.
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External links
- My Lobotomy Radio story: Interview with Sallie Ellen Ionesco, lobotomised in 1946
- Mental Cruelty: Sunday Times article on lobotomy and contemporary psychosurgery
- Lobotomy's back: Discover article on cingulotomy
- 'My Lobotomy': Howard Dully's Journey. NPR Radio Documentary
- A Qualified Defence of 'Then': QJM
- Ten Notable Lobotomies
- Nobel Panel Urged to Rescind Prize for Lobotomies
- The Lobotomists: BBC Radio 4 documentary on the history of lobotomy