Lobotomy: History, Procedure & Risks

Lobotomy is a kind of Neurosurgical treatment for psychiatric and neurological disorders. It is an invasive surgery involving the severing certain portions of the frontal lobe of the brain.

• In the 1920 and 1930, psycho surgeries and other such invasive surgeries which posed a great risk to the patient were considered a common method to treat mental health disorders. 
• Many invasive psychosurgeries were proclaimed to be useful in treating a variety of psychiatric disorders. One of them was Lobotomy.
• It is an invasive surgery in which the surgeon directly performs on the nerve cells of the brain. 
• It was introduced in the early 1900s and was widely performed in the 1930s and 1940s. 
• There was little evidence of it's effectiveness and utility. 
• When more severe side effects of lobotomy became prevalent and so it's use was discarded. 

Today, lobotomy and other similar surgeries are not performed because of it's devastating effects on the patient. It has been banned in many countries and declared illegal by imposing strict laws against lobotomy. 

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Key Terms: Psychology, Psychiatry, Psychosurgery, Lobotomy, Leucotome, Schizophrenia, Mental Illness, Invasive Surgery, Control and Coordination

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What is Lobotomy?

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Lobotomy, also known as leukotomy, is a type of invasive brain surgery in which a whole is drilled through the skull or a leucotome is inserted through the eye socket and the frontal lobe of the brain is severed.

• It was used mainly in the treatment of mood disorders like schizophrenia. 
• It was based on the supposed theory that there are specific portions in the frontal lobe that causes the mental disorder and the removal or separation of such portions of the prefrontal cortex may cure the disease. 
• Although some people did see improvements in conditions, many other people experienced life alternating Side Effects, disability or even death. 
• Lobotomy fell out of favour in the 1950s with the development of antipsychotic medication and the introduction of effective psychotherapies.
• Today, lobotomy is not practised anywhere in the world as the practitioners consider it ineffective.

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History of Lobotomy

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In the early 19th and 20th centuries, there were no drug medications for treating mental health disorders, psychotherapy was still in its early stages and the psychiatric hospitals were overcrowded due to the increasing number of mentally challenged patients. 

All these factors compelled doctors to look for new ways to treat mental health disorders. This is how the lobotomy procedure came into existence. 

• In the year 1935 successful experiments were performed on chimpanzees by Yale neuroscientist John Fulton and his colleague Carlyle Jacobson. 
• Later that year, the first human experiments were conducted by Portuguese Neurologist, Antonio Egas Moniz, and his colleague, Almeida Lima. 
• A journal even once stated that lobotomy was a success for patients with conditions such as depression, anxiety disorders and chronic schizophrenia. 
• The lobotomy procedure became popular in many countries such as United States, UK and most parts of Europe.

After the procedure, the patient becomes quiet and docile which was interpreted as a sign of success. But it did not take much time to degrade the functionality and conscience of the patient. 

• The ill-effects could be soon visible within a couple of years which included irregular bladder and Bowel movement, increased temperatures, vomiting, and eye problems in many cases permanent disability was also reported. 
• Other effects were mostly psychological and many people committed suicide following it. 
• As the adverse effects of the surgery became known, the surgery was soon abandoned in the 1950 and 1960 and more focus was given to developing better drugs and psychotherapy to treat mental health disorders.

Read Also: What is Anxiety?: Causes, Symptoms & Treatment 

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Procedure of Lobotomy

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In procedure of lobotomy, there are different types as given below:

• Frontal lobotomy: The surgeon drills a hole on both sides of the skull and cut through the brain tissue with an instrument resembling an ice pick.
• Transorbital lobotomy: The surgeon inserts are leucotome through the eye socket and goes through a thin layer of bone with a mallet to access the brain. As already mentioned, lobotomy damages the cells of the prefrontal cortex of the brain, so here are the ways by which the cells of the frontal cerebrum damage done:
• Topectomy: In this, the surgeon removes a portion of the frontal lobe.
• Leucotomy: In this, the surgeon severs connections between the frontal lobe and the thalamus.
• Neuro-injections: Injections of sclerosing agents in which drug is injected that hardens the fiber connecting the frontal lobe with the thalamus.

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Risks of Lobotomy

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Lobotomy worsens the symptoms and so the patients' conditions also degrade.

• Lobotomy was often performed without consent and without proper sterilization, all of which added to the risks associated with this procedure. 
• It is estimated that tens of thousands of lobotomies were performed alone, in the USA between 1930 and 1960, many of which were done without taking prior consent from the patient/patient's family member. Nearly 74% of the surgery were performed on women.

Some of the many risks associated with Lobotomy were:

• Loss of Bowel Control
• Seizures
• Apptite Changes
• Changes in language ability
• Brain infection
• Changed Mental and behavioral patterns
• Loss of senses

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Physical effects on the body

Physical complications which were the side effects of the surgery are as follows:

• Disturbed bladder and bowel movement: Lobotomy causes loss of control over the body functions. Thus, the person in concerned experiences irregular Bowel and bladder movements.
• Eating disorders: There is a disruption in the sensations of Hunger which causes the patient to eat a lot on some days and then go on for days without food. Thus, the patient becomes more susceptible to developing eating disorders.
• Other symptoms: The other symptoms that are experienced by patients who underwent lobotomy are headaches, seizures and increased susceptibility to other mental health disorder such as dementia, Alzheimer’s, etc.

Lobotomy, which came up as a solution to treating mental illnesses itself became the cause of other mental disorders and serious health complications. 

As more and more people reported the side effects of lobotomy and the subsequent development of anti-psychotic drugs such as chlorpromazine, the use of lobotomy was largely abandoned by psychiatrists and neurosurgeons. 

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Things to Remember

• Lobotomy is a psycho-surgical procedure in which the neurons in the prefrontal cortex of the brain are removed or damaged by various methods.
• It is mostly used to treat a mental disorders such as schizophrenia mood disorders and chronic anxiety disorders.
• It is of two types – Frontal lobotomy and Tran orbital lobotomy.
• The side effects of lobotomy manifested in the form of mental and physical degradation and deterioration. 
• Some of the prominent Side Effects included loss of senses, lack of control over action, suicidal tendencies, seizures, memory and speech impairment, etc.

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