Psychosurgery.

Abstract

AN EDITORIAL (20) in 1940 referred to "radically wrong, meddlesome surgery," which was a "violation of the Hippocratic oath." An opposing view was expressed by Fiamberti (26) : "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." The first opinion is written by a man who fears an indiscriminate cutting of lobes and hemispheres by unconscionable surgeons and the second by one who is motivated by the depressing picture of the hopeless, deteriorated, backward schizophrenic patient. Strong opinion and emotional bias continue to becloud the issue of psychosurgery.The earliest psychosurgery is accredited to G. Burckhardt, superintendent of a mental hospital in Switzerland, who in 1890 operated upon the brains of six disturbed psychotic patients. There was one postoperative death, one recovery, and at least two postoperative convulsive complications. But Burckhardt was impressed with the possibilities of this method.At the International Neurological Congress held in London in 1935, Fulton and Jacobsen (54) reported briefly on behavioral changes that developed in two chimpanzees after bilateral ablation of the frontal association areas. Stimulated by this report, Egas Moniz (105, 106) in 1936 introduced bilateral prefrontal lobotomy in man.