Resources for Communication Problems

Friday, August 22, 2008

Egas Moniz


"It is unavoidable that the prize sometime has been awarded for a finding that did not quite hold up. Reports on that would be interesting reading." One of the most controversial advances awarded a Nobel Prize was for the lobotomy, a surgical procedure that was used in the mid-20th century for the treatment of schizophrenia. But as this article reveals, there was no better alternative available at the time.
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Controversial Psychosurgery Resulted in a Nobel Prize

In 1936, the Portuguese neurologist Egas Moniz introduced a surgical operation, prefrontal leukotomy, which after an initial period came to be used particularly in the treatment of schizophrenia. The operation, later called lobotomy, consisted in incisions that destroyed connections between the prefrontal region and other parts of the brain.

At that time there did not exist any effective treatment whatsoever for schizophrenia, and the leukotomy managed at least to make life more endurable for the patients and their surroundings. The treatment became rather popular in many countries all over the world and Moniz received the Nobel Prize in 1949.

However, by this time the treatment had had its most successful period and in 1952 the first drug with a definite effect on schizophrenia was introduced, chlorpromazine, our first neuroleptic drug. Since about 1960 lobotomy, with a strongly modified technique (more discrete incisions), has been used only when there are very special indications such as in severe anxiety, and compulsive syndromes which have proved to be resistant to other forms of therapy. Perhaps about five operations a year are now being performed in Sweden.

However, I see no reason for indignation at what was done in the 1940s as at that time there were no other alternatives!

Therapeutic Alternatives for Psychotic Patients Before the 1930s

Introduction of Prefrontal Leukotomy

Refined Surgical Techniques

Side Effects on Personality

Who Were Operated On?

Why Was Psychosurgery so Popular in the 1940s?

Were the Patients Cured?

Development of Alternative Methods

Did Moniz Deserve the Nobel Prize?



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