LOBOTOMY

surgical operation in which the nerve pathways in a lobe or lobes of the brain are severed from those in other areas; the operation formerly was used as a radical therapeutic measure to help grossly disturbed schizophrenics, manic-depressives, and other mentally ill patients. The lobotomy was introduced in 1935 by two Portuguese neurophysicians, Antnio Egas Moniz and Almeida Lima. The practice was soon widely adopted, largely because there were few other viable therapeutic measures at the time for quieting chronically tense, agitated, delusional, intractable, or violent patients. The prefrontal lobotomy, a common type, involved severing the nerve pathways in the two frontal lobes of the brain, after entry to the brain had been achieved by boring two holes in the skull. This method was soon replaced by the transorbital lobotomy, in which an instrument like an ice pick was forced through the back of the eye sockets, piercing the thin bone that separates the eye sockets from the frontal lobes; the pick's point was then inserted into the frontal lobes. A lobotomy was favoured for those patients who did not respond to electroshock treatments; the emphasis was on making such patients more manageable. A large proportion of such lobotomized patients did afterward show reduced tension or agitation, but many also showed such effects as increased apathy and passivity, lack of initiative, an inability to concentrate, and a generally decreased depth and intensity of their emotional response to life. Lobotomies were performed on a wide scale during the 1940s and up until about 1956, when antipsychotics, antidepressants, and other drugs that were much more effective in quieting mentally disturbed patients and alleviating their distress came into use. Lobotomies and other forms of psychosurgery have incurred strong ethical objections because the irreversible physical defects that they cause in the brain strike at the very core of the human personality. Lobotomies are now performed only very rarely and are generally frowned upon by neuropsychiatric professionals.