Neuroscience in the early 20th Century – Lobotomies

Neuroscience has come a long way since the 1940s. As a matter of fact, it was more in the realm between Sigmund’s Freud’s psychology and Mary Shelley’s Frankenstein. Treatments for brain problems — ranging from mental illness to brain surgery, appear to us today to be something more akin to Hollywood’s horror movies.

Prior to the use of drugs, in the mid-1950s, to treat mental problems there was one procedure in particular that stands out as horrific today, but was effective some of the time in alleviating some mental problems. Unfortunately it was used more often then it needed to be, and was not always as successful as was intended — the lobotomy.

The first surgery to treat mental illness was performed in Portugal in 1935 by a surgeon named Egas Moniz. The procedure was called a “leucotomy,” and was later changed to “lobotomy.” It involved the drilling of holes in the patient’s skull to reach the brain and cut the nerve connections.

A newer version of Moniz’ technique, the transorbital or “ice-pick” lobotomy, was performed in Washington, D.C. by a psychiatrist named Walter Freeman on January 17, 1946 on a violently suicidal housewife — Ellen Ionesco. According to Freeman’s son, Frank, his father believed his less invasive version of Moniz’ technique would revolutionize mental health treatments at a time when there were few options.

By using electroshock to render the patient unconscious, the surgeon then moved a sharp ice pick like instrument around in the area above the patient’s eyeball — going through the orbit of the eye and through the frontal lobes of the brain. This procedure changes the temperament of a patient to be more calm and pleasant.

According to her Ionesco’s daughter, Angelene Forester, her mother changed her personality to a “peaceful” person almost immediately after the surgery. In her case the treatment was called a success.

Tens of thousands of patients underwent lobotomies between the late 1930s and early 1940s. Initially the surgery was performed on those who suffered from severe depression or schizophrenia. Later it was extended to include treatment for migraine headaches, and to change criminal tendencies with violent behavior problems. Even children were treated, and at least one was as young as four.

Dr. Freeman performed a lobotomy on a 12-year-old boy named Howard Dully in 1960. Dully was large for his age. Dully himself sought to find out the reason why he had the procedure done on him and was able to get information from Freeman’s archives.

According to the notes, Dully’s mother had died and his new stepmother was afraid of him because of his size. She described him to the doctor as being “defiant and savage-looking.” According to his notes, “He objects to going to bed but then sleeps well. He does a good deal of daydreaming and when asked about it he says ‘I don’t know.’ He turns the room’s lights on when there is broad sunlight outside.” Other doctors she had taken him to said he was a normal boy.

“I’ve always felt different,” Dully said. “I wondered if something’s missing from my soul. I have no memory of the operation, and never had the courage to ask my family about it.”

Freeman and Mrs. Dully convinced Howard’s father the lobotomy was the cure for his “problems.” That operation, which lasted a total of 10 minutes, changed Howard Dully’s life forever. Now he says, “When Lou Dully realized the operation didn’t turn him “into a vegetable, she got me out of the house. I was made a ward of the state.”

Forty-five years later Dully confronted his father to ask him “why.” His father’s response was, “”I got manipulated, pure and simple,” Rodney Dully says. “I was sold a bill of goods. She sold me and Freeman sold me. And I didn’t like it.” Dully has come to terms with it and moved on.

Dr. Elliot Valenstein, who wrote Great and Desperate Cures, a book about the history of lobotomies said, “There were some very unpleasant results, very tragic results and some excellent results and a lot in between.”

In 1949 Egas Moniz won the Nobel Prize for his lobotomy procedure, which some believed made the procedure seem more “legitimate,” and all criticism of it seems to go away.   A campaign is currently underway by the families of Moniz’ patients to persuade the Noble Prize committee to take back the prize, calling it “barbaric.”

Freeman performed over 2,500 lobotomies throughout his lifetime. He stopped practicing in 1967 when a housewife he was operating on died from a brain hemorrhage. He continued to spend the rest of his life trying to prove his theory correct.

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