Great and Desperate Cures: The Rise and Decline of Psychosurgery and Other Radical Treatments for Mental Illness

Abstract

Prefrontal leukotomy was developed in Portugal in 1935 by the neurologist Egas Moniz for the treatment of psychiatric disorders. Careful examination of Moniz' papers suggests to modern readers that the procedure was illconceived and ineffective, but it was introduced into the United States by neuropathologist Walter J. Freeman, who tirelessly promoted it until his death in 1972. Between 1948 and 1952, tens of thousands of patients worldwide were subjected to mutilation of their brains despite early and growing scientific criticism. Freeman himself did 3500 leukotomies. It was soon possible to show that the theoretical basis in brain physiology for the destruction of the pathways of the frontal lobes was flimsy, that the motivations were often economic, and that the results were appalling. By 1951, the Soviet Union, usually supportive of physical therapies in psychiatry, had banned the operation, and by the late 1960s leukotomy had been virtually abandoned everywhere else.