Where can I get a lobotomy? Lobotomy - what is it? Why is a lobotomy needed? Why and why

Many times you have probably heard the expression “only a lobotomy will help here,” or something similar. Let's figure out what a lobotomy is.

What is a lobotomy?

Lobotomy is a type of neurosurgical operation, also known in psychosurgery as leucotomy. The essence of the operation is to separate the frontal lobe of the brain from the rest of it, by resection of the white matter of neuronal connections. Thus, the connection of the frontal lobes with other parts of the brain is terminated, but the frontal lobes themselves are not affected or damaged. As a result, the influence of the frontal lobes on the central nervous system is stopped, as a result of which the patient loses the ability to make decisions, his will weakens and, often, a person who has undergone a prefrontal lobotomy turns into a vegetable.

Initially, lobotomy was performed without craniotomy by inserting a surgical instrument into the brain through the eye opening. The first such tool was an ice pick, until Walter Freeman (a famous American psychiatrist who played a significant role in popularizing this method) developed the leukotome and orbitoclast - special knives for performing lobotomies. To cut the white connective tissue, the surgeon placed a knife against the patient's eye socket and struck the knife with a surgical hammer. The knife, separating a thin layer of bone, entered the skull under the frontal lobes, after which the surgeon made several movements with the knife in different directions, destroying the substance of the neuronal connections.

The use of this method was fraught with frequent damage to the frontal lobes, so in the second half of the twentieth century, the practice of osteoplastic craniotomy began. The surgeon opened the skull, which provided the necessary overview of the surgical field and allowed for more precise tissue resection without damaging the frontal lobes. After the operation, the skull was sutured, and the patient was given a lifelong diagnosis of Frontal Lobe Syndrome.

Lobotomy is a terrible and inhumane intervention into the human brain. Why do they do a lobotomy then? Many disputes about the ethical and practical side of lobotomy arose from the very beginning of the practice of lobotomy, and on December 9, 1950, Order No. 1003 was issued, which prohibited the use of lobotomy in medicine. Lobotomy was used only in extreme and hopeless cases of schizophrenia, when long and systematic use of other traditional methods of treating schizophrenics did not produce results. And when some seriously ill, hopeless patients who had undergone lobotomy found peace and mental stability, it became clear why a lobotomy was needed.

Lobotomy has been relatively successful in treating paranoid schizophrenia. Patients returned to normal life and work (sometimes), getting rid of psycho-emotional disorders, and healthy members of society felt safe.

Lobotomy, formerly leucotomy, is a form of psychosurgery. This is one of the neurosurgical operations that involves cutting the tissues that connect the main part of the brain to the frontal lobe. The consequence of a lobotomy is the elimination of the influence of the frontal lobe of the brain on the central nervous system.

Lobotomy is also known as a type of punitive psychiatric procedure. This operation leads to a partial lack of thinking and will in the patient. It is used mainly by doctors and Scientologists instead of euthanasia, for severely advanced mental illness in humans.

Why do they perform a brain lobotomy?

Lobotomy is done in cases of serious illness associated with mental disorder in patients. After a lobotomy, the patient is given a lifelong diagnosis of frontal lobe syndrome.

There are several methods of this operation, but the most effective is considered to be transorbital lobotomy, after which very calm people are obtained instead of potential rapists, maniacs and mentally ill people. In some cases, the patient may experience side effects associated with lack of motivation, lethargy, and occasionally partial memory loss. There are also cases when, after a lobotomy, a person turned, roughly speaking, into a “houseplant,” that is, without feelings.

Wikipedia about lobotomy

Lobotomy was developed in mid-1935 by Portuguese physician Egas Moniz. A year later, the first operation was performed, which the developer called leucotomy.

After some time, Moniz was awarded the Nobel Prize, and leucotomy began to be practiced in many countries. In the mid-20th century, more than four thousand lobotomies were performed per year in the United States. Although many have criticized the use of this procedure on ethical grounds. In connection with this, in the late 50s of the last century, lobotomies were sharply reduced. On the territory of the USSR, the use of lobotomy was officially prohibited by the authorities in 1950, but some still practiced it at their own peril and risk.

The lobotomy operation can be seen in many films and read in books. What is especially noteworthy is that after this procedure, it is described how the patient falls into a vegetative state with a lack of thinking. This is due to the fact that everyone wants to emphasize the inhumanity of this method of psychosurgery, which actually kills the patient.

Transorbital lobotomy

American psychiatrist Walter Jay Freeman, who was a leading promoter of lobotomy, developed a new technology in which there was no need to drill into the patient's skull. This technology was called transorbital lobotomy, and it soon began to be used much more often than the old leucotomy. Transorbital lobotomy was considered a less painful procedure, and the possibility of side effects was significantly reduced. The first transorbital lobotomy was performed by Freeman using electric shock as an anesthetic. Using a tool that resembled a chisel, he pierced a thin section of bone and went straight into the brain. After this, the connective tissues were cut with one movement of the instrument.

History of lobotomy in the West

Lobotomy in the USSR

Egorov proposed his own modification of lobotomy. Instead of closed access through a burr hole or the roof of the orbit, he used osteoplastic trepanation, which gave a wide view of the surgical field and made it possible to more accurately navigate in determining the target of surgical intervention. The lobotomy was carried out sparingly, as a rule, only in one frontal lobe, its polar parts and always in front of the anterior horn of the lateral ventricle and subcortical ganglia. With this technique, damage to the pyramidal tracts and subcortical formations was excluded.

B. G. Egorov considered the theoretical basis for the therapeutic effect of lobotomy to be the separation of the prefrontal cortex and subcortex. Academician L.A. Orbeli, who consulted and collaborated with the Institute of Psychiatry of the Ministry of Health of the RSFSR, wrote that “he takes the liberty of talking about the physiological conclusions following from the lobotomy,” namely: “the separation of the frontal lobes from the rest of the central nervous system leads not so much to exclude the role of the frontal lobes from their participation in the formation of cortical processes, which leads to eliminating or weakening the possible influence of the subcortical nodes on the cerebral cortex and establishing the influence of the cerebral cortex on subcortical formations,” and at the same time “intracortical connections are almost not disrupted.”

The selection of patients for lobotomy was very strict. The surgical method was proposed only in cases of ineffectiveness of previous long-term treatment, including insulin comas and electroconvulsive therapy. All patients not only underwent a general clinical and neurological examination, but were also carefully studied psychiatrically. Postoperative control was dynamic and objectified; both gains in the emotional sphere, behavior and social adequacy of surgical activity, as well as possible losses, were recorded. All this made it possible to develop certain indications and contraindications for prefrontal lobotomy.

A new direction in the 1940s in Leningrad was developed by the neurosurgeon Professor I. S. Babchin. He developed a gentle surgical approach for performing lobotomies. To approach the frontal lobes, burr holes were placed parasagittally. Next, the frontothalamic pathways were damaged using a leucotome of an original design. I. S. Babchin called his operation “frontal leucotomy.” At the same time, research began to study the anatomy and topography of the cortical-subcortical pathways. M. S. Korotkevich in her PhD thesis clarified the connections between the cerebral cortex and the subcortical nuclei. A. A. Vagina in her doctoral dissertation substantiated the lobotomy, having managed to complete important fragments before the ban: “Anatomical analysis of experimental leucotomy” and “Connections of the frontal lobe with the thalamus”.

Lobotomy began to be performed in other cities of the USSR (Gorky, Kyiv, Kharkov, Alma-Ata, Sverdlovsk, Rostov-on-Don, etc.). The total number across the country began to amount to hundreds of observations. Not all patients with incurable schizophrenia benefited from surgical intervention. In addition, when performed without the proper conditions and surgical skill, it often resulted in various complications that created an unfavorable impression of the method.

The battle of opinions about the admissibility of lobotomy as a therapeutic method initially took place within natural frameworks and forms. Opponents and supporters of psychosurgery discussed the problem at the Plenum of the All-Union Scientific Society of Neuropathologists and Psychiatrists.

The accumulated... clinical experience, based on material from over 400 people, operated patients, has shown that the operation of frontal lobotomy is a relatively effective and relatively safe method of treating some forms of severe schizophrenia, which are completely untreatable by other currently existing conservative methods.

Lobotomy ban

According to some estimates, the ban on lobotomy in the USSR was not associated with ideological motives, but was due to purely scientific considerations, such as the lack of a strictly substantiated theory of lobotomy; absence of strictly developed clinical indications and contraindications for surgery; severe neurological and mental consequences of the operation, in particular “frontal defect”.

For example, it was noted that one of the reasons for the ban on prefrontal leucotomy was the presence in some patients who had undergone surgery in the past of decreased intelligence and the presence of a psychoorganic syndrome of varying severity, including convulsive epileptiform seizures, a violation of the body diagram with depersonalization, memory and mental disorders abilities, apato-abulia and apraxia, violent laughter and crying, speech disorders, gluttony, increased sexuality, attacks of eye rolling, rhythmic hyperkinesis, oral reflexes (proboscis, sucking).

In May 1950, psychiatrist Professor Vasily Gilyarovsky proposed to return to the discussion of leucotomy in order to prohibit its use as a method of treatment in psychiatric institutions. The issue was again considered at the Plenum of the All-Union Scientific Society of Neuropathologists and Psychiatrists on June 22-24, 1950. The adopted resolution confirmed the previous decision: “Recognize the use of frontal leucotomy as a method of treating mental illness as appropriate in cases where all other methods of treatment have not had a therapeutic effect”.

28 of the 30 members of the Board voted for this resolution, two were against. Professor Gilyarovsky insisted that his dissenting opinion be recorded: “I do not consider leucotomy a treatment method that can be recommended to psychiatric institutions.”

V. A. Gilyarovsky obtained an order from the USSR Ministry of Health to verify the results of using prefrontal leucotomy locally. In the report on the inspection of the Leningrad Institute. V. M. Bekhterev indicated that 176 patients underwent leukotomy, of which 152 were diagnosed with schizophrenia. The commission demonstrated 8 patients with good results, but all of them had certain defects and some organic decline. The operations were performed by both surgeons and psychiatrists. Patients after leukotomy were usually transferred to other medical institutions, and therefore long-term outcomes were not properly studied.

Soon, an article by the same Gilyarovsky was published in the magazine “Medical Worker” (No. 37 of September 14, 1950) “Pavlov’s teaching is the basis of psychiatry.” It sharply criticizes the lobotomy method. For example:

It is assumed that cutting the white matter of the frontal lobes disrupts their connections with the thalamus and eliminates the possibility of stimuli coming from it that lead to excitation and generally upset mental functions. This explanation is mechanistic and has its roots in the narrow localizationism characteristic of American psychiatrists, from where leucotomy was brought to us.

see also

Notes

1. Thorne B. M. Lobotomy // Corsini R., Auerbach A. Psychological Encyclopedia. St. Petersburg: Peter, 2006. - 1096 p.
2. Psychosurgery: yesterday and today (review of foreign publications) / Prep. S. Kostyuchenko // Bulletin of the Association of Psychiatrists of Ukraine. - 2013. - No. 3.
3. Kotowicz, Zbigniew. Psychosurgery in Italy, 1936–39 (unspecified) // History of Psychiatry. - 2008. - December (vol. 19, no. 4). - pp. 476-489. - ISSN 0957-154X. - DOI:10.1177/0957154X07087345.
4. Gross, Dominic; Schäfer, Gereon. Egas Moniz (1874-1955) and the "invention" of modern psychosurgery: a historical and ethical reanalysis under special consideration of Portuguese original sources (English) // Neurosurgical Focus (English) Russian: journal. - 2011. - Vol. 30, no. 2. - P. 8.
5. Kotowicz, Zbigniew. Gottlieb Burckhardt and Egas Moniz - Two Beginnings of Psychosugery (undefined) // Gesnerus. - 2005. - T. 62, No. 1/2. - P. 77-101. Archived from the original on December 15, 2011.
6. Dubynin V. A. Training course in neurophysiology for students of the Faculty of Biology of Moscow State University. Lomonosov // Moscow State University. - 2015.
7. Chavkin S. Mind Thieves. Psychosurgery and control of brain activity / Translation from English by S. Ponomarenko, I. Gavrilenko. Under the general editorship and with a foreword by Doctor of Law I. B. Mikhailovskaya. - M.: Progress, 1982.
8. Christmas D, Morrison C, Eljamel MS, Matthews K. Neurosurgery for mental disorder // Advances in Psychiatric Treatment. - 2004. - Vol. 10. - P. 189–199. Translation: Neurosurgical interventions for mental disorders
9. Leon Eisenberg (1998) Last Resort: Psychosurgery and the limits of medicine. NEJM 339:1719–1720
10. Comer P. Fundamentals of pathopsychology. - Fundamentals of Abnormal Psychology, 2001. - 617 p.
11. Tow, P. Macdonald. Personality changes following frontal leucotomy // Oxford University Press. - New York, 1955. - P. xv 262 pp.
12. Stuss, Donald T.; Benson, D. Frank. Neuropsychological studies of the frontal lobes // Psychological Bulletin. - Jan 1984. - T. 95 (1). - P. 3-28. - DOI:10.1037/0033-2909.95.1.3.
13. Gelder M., Gaeth D., Mayo R. Oxford Manual of Psychiatry: Trans. from English - Kyiv: Sfera, 1999. - T. 2. - 436 p. - 1000 copies. - ISBN 966-7267-76-8.
14. Partridge, Maurice. Pre-frontal leucotomy:. - Oxford: Blackwell Scientific Publications, 1950.
15. Dobrokhotova T.A. What is the place of psychosurgery in modern medicine? // Independent Psychiatric Journal. - 1995. - No. 4. - P. 18-22.
16. Review - Doctoring the Mind: Is Our Current Treatment of Mental Illness Really Any Good? by Richard Bentall, NYU Press, 2009, Review by Roy Sugarman, Ph.D., Aug 25th 2009 in Metapsychology online reviews, Volume 13, Issue 35
17. Bykov Yu. V., Bekker R. A., Reznikov M. K. Resistant depression. Practical guide. - Kyiv: Medkniga, 2013. - 400 p. - ISBN 978-966-1597-14-2.

Previously, doctors used lobotomies to try to heal patients with poor mental health. Today this method seems ridiculous, and the word “lobotomy” itself is often used as a joke. It has long been clear that the technique does not work, but it is completely unclear how they even tried to treat anything in this way.

1. The creator of the lobotomy received a Nobel Prize

Nowadays, lobotomy is considered a clear failure of psychiatry, but in the past the procedure was performed on any occasion. The method was developed by the Portuguese doctor Egas Moniz, who was the first to perform an operation called prefrontal leucotomy. He inserted a loop into the brain and, using rotational movements, caused minor damage to parts of the brain. This is how Monis treated schizophrenia - he realized that patients after surgery were much easier to manage.

Later, another doctor named Walter Freeman “improved” the method - he began to operate through the upper wall of the orbit. It was clearly faster. We know this procedure today as transorbital lobotomy. In 1949, Moniz received the Nobel Prize for his discovery, and the untested procedure gained widespread confidence. Now it could be carried out legally. Soon, lobotomies were performed on thousands of patients around the world. Exclusively for medicinal purposes, of course.

Relatives of some lobotomy victims petitioned the Nobel Committee to cancel the award because the procedure caused irreparable harm. The committee categorically refused to consider the requests and wrote a refutation, where it explained in detail how the committee’s decision was justified. Committee members believed that lobotomy was the best treatment for schizophrenia: it produces results, it is ahead of its time, after all, so why should the award for it be considered a mistake?

It should be noted that there were no precedents: the Nobel Committee has never canceled the award, and probably never will, because it is contrary to its policy. So Egas Moniz will remain in history as a brilliant doctor.

2. Many people thought lobotomy was a better alternative.

You may be wondering: How did the practice of piercing a person's eye with a tool that looks like a small ice pick become so popular? But the doctors had a good goal: to help people suffering from schizophrenia and other severe mental illnesses. The doctors who advocated lobotomy were not aware of all the risks of brain surgery. They couldn't see what they were doing, but the reason for the operation was justified: psychiatric hospitals were a terrible place for patients, and the procedure could help them lead something like a normal life.

The problem is that at that time there were no drugs that could calm a violent patient for a long time. A severely mentally ill person could cause great harm to himself or others, so sometimes drastic measures were required. Patients often had to be placed in straitjackets and placed in a private room with padded walls. In such conditions, violence was commonplace. Treatment was difficult and brutal, and without an effective treatment, schizophrenics and other patients had no hope of ever leaving the hospital.

Lobotomy seemed like a way out of a terrible situation for both patients and doctors. It’s a pity that in the end it became not a solution, but a dead end.

3. Patient monitoring

Moniz was the first to use lobotomy. Freeman made it popular. But at the same time, the pioneers of lobotomy did not approve of each other's methods. Moniz believed that the Freeman method (transorbital lobotomy) was not the most responsible way to do brain surgery. Freeman pierced the brains of patients for their own good with too much enthusiasm. But Moniz's method also had many disadvantages.

Moniz did not monitor the further fate of his patients. He didn't even have sufficient evidence to draw conclusions. Strange, isn't it? He performed brain surgery using a new technique that had never been tested anywhere before!

Moniz treated patients and monitored their behavior just a few days after breaking the connections in their heads. Many believe that the criteria for determining whether a patient was truly normal were biased: the doctor really wanted the result to be positive. Let's be clear: Moniz found improvement in most patients because that's what he wanted to find. Freeman, although he practiced perhaps a more barbaric method, worked with patients after surgery. He did not abandon them until his death.

4. Surgically induced childhood

Freeman coined a term for people who had recently undergone a lobotomy: surgically induced childhood. He believed that patients' lack of normal mental abilities, distraction, stupor, and other characteristic effects of lobotomy occurred because the patient regressed—reverted to a younger mental age. But at the same time, Freeman did not even imagine that damage could be caused to the individual. Most likely, he believed that the patient would eventually “grow up” once again: the re-adulting would happen quickly and ultimately lead to complete recovery. And he suggested treating the sick (even adults) in the same way as naughty children would be treated.

He even suggested that parents spank their adult daughter if she misbehaved, and later give her ice cream and a kiss. The regressive behavior patterns that often appeared in lobotomized patients disappeared over time in few, leaving the person mentally and emotionally paralyzed for the rest of their lives.

Many patients could not control urination. They really behaved like very naughty children: they instantly became excited by various stimuli, showed attention deficit disorder and uncontrollable outbursts of anger.

5. Informed consent

Nowadays, doctors must first inform the patient about what will be done, what the risks and possible complications are, and only then begin complex physical or mental treatment. The patient, being of sound mind, must understand the risk, make a decision and sign the documents.

But in the days of lobotomy, patients had no such rights, and informed consent was treated carelessly. In fact, the surgeons did whatever they wanted.

Freeman believed that a mentally ill patient could not give consent to a lobotomy, since he was not able to understand all its benefits. But the doctor did not give up so easily. If he could not obtain consent from the patient, he went to relatives in the hope that they would give consent. To make matters worse, if the patient had already agreed but changed his mind at the last minute, the doctor would still perform the operation, even if he had to “turn off” the patient.

In many cases, people had to agree to a lobotomy against their will: doctors or family members decided for them, who, perhaps, did not want to harm, but treated the treatment irresponsibly.

6 Lobotomy Destroyed People's Lives

Most often, a lobotomy either turned a person into a vegetable, or made him more obedient, passive and easily controlled, and often also less intelligent. Many doctors perceived this as “progress” because they did not know how to deal with difficult patients. If the lobotomy did not kill the patient, then doctors considered any irreparable brain damage to be side effects of the treatment.

Many people who asked for an appeal against Moniz's Nobel Prize complained that they or their relatives were not only not cured, but also irreparably damaged, which made them forever different from who they were. There was a case when one pregnant woman underwent a lobotomy because of headaches alone, and she never became the same: for the rest of her life she remained at the level of a small child, unable to eat or take care of herself.

Another example: a boy named Howard Dulley was given a lobotomy at the request of his stepmother - she did not like that Howard was a difficult child. Freeman seriously recommended this method as a way to change personality. And the boy spent his life losing himself forever.

7. Surgical theater

It is believed that Freeman was too happy to be able to legally perform transorbital lobotomies on all patients indiscriminately. Not only did he not consider it necessary to properly inform the patient about the risks and the procedure, but he also boasted of his successes in front of excited people. Freeman often completed the procedure in ten minutes - somehow short for complex brain surgery, even if it were the most useful operation in the world. Unfortunately, the doctor himself did not think so.

He once performed 25 lobotomies in a day. It was he who first figured out the “humane” use of electric shock to perform operations while patients were unconscious. Worse, Freeman would sometimes lobotomize both sides of his brain just to show off. It is impossible to say exactly how many people he ruined their lives.

8. Chemical lobotomy

Today, a lobotomy is considered an absurd, barbaric procedure. But quite recently it was practiced everywhere, without even understanding what they were doing. I would like to believe that lobotomy disappeared forever because doctors finally realized what they were doing. But in reality, it was simply replaced by more effective treatment.

Of all the doctors, perhaps only Freeman adored lobotomy. Other doctors didn't like this procedure, but they resorted to it when they thought there was nothing else to do. But time passed, and the operation was replaced by psychotropic drugs. A medicine called aminazine appeared, which was initially called a “chemical lobotomy.”

People were afraid that chlorpromazine could also change personality forever. But the drug clearly did not turn patients into mindless children who cannot even control basic body functions. And soon lobotomy was abandoned forever as a medical practice.

. Lobotomy is a neurosurgical operation that involves cutting the tissue connecting the frontal lobes of the brain with the rest of it; the consequence of such an intervention is to eliminate the influence of the frontal lobes of the brain on the central nervous system.

Unlike medical brain surgery,
Aimed at alleviating physically existing problems, psychosurgery (psychoneurosurgery) destroys healthy brain tissue, and many doctors condemn it for its crippling effects on the patient.

Psychosurgery uses various methods to damage the brain
- cutting with a scalpel, cauterization with implanted electrodes, or tearing the frontal lobes with an ice pick (lobotomy).

The Origins of Torture "Treatment": Origins
Psychosurgery dates back to the Middle Ages, when medicine practiced an operation called “trepanation” (cutting out circular areas in the skull). In those days they believed that this would cause demons and evil spirits to leave a person.

Modern psychosurgery has its origins in an 1848 incident in which an explosion caused an iron rod to enter worker Phineas Gage's cheek and emerge from the top of his head. Before this misfortune, Gage was a capable workman, a believer, and had a well-balanced mind
and developed business skills. After the rod was removed from his head and he recovered, Gage turned into a short-tempered, dismissive and intolerant man who constantly railed against religion.

The fact that It is possible to change human behavior by partially damaging the brain without killing it , did not go unnoticed, and in 1882, the warden of a mental hospital in Switzerland, Gottlieb Burckhardt, became the first famous psychosurgeon.

He removed cerebral tissue from six patients in the hope that "the patient might change from restless to quiet imbecile." Although one of them died and the rest developed epilepsy, paralysis, or aphasia (loss of the ability to use and understand words), Burckhardt was pleased that the patients calmed down.

In 1935, Egas Moniz, a professor of neurology in Lisbon, Portugal, performed the first lobotomy, inspired by an experiment in which the frontal lobes of the brain were removed from two chimpanzees. After an experiment on chimpanzees, Moniz performed a lobotomy on
people, suggesting that the source of mental disorder is rooted in a part of the brain.
In this way, a blockade of pathways is introduced into the brain, at the site of the defect.
And at such a barrier, no complex pathological psychoproduction (hallucinations, delusions, urges of drug addiction... pedophilia) are simply capable of arising.

Egas Moniz was awarded the Nobel Prize in Physiology or Medicine in 1949 “for his discovery of the therapeutic effects of leucotomy (lobotomy) in certain mental diseases.” A study that looked at Moniz's 12 years of practice found that his patients suffered seizures, recurrences of their original conditions, and died shortly after receiving the lobotomy. However, all this did not dissuade other “doctors” from following the same path.

American psychiatrist Walter Jay Freeman
became the leading propagandist of this operation. He performed his first lobotomy on September 14, 1936, using electric shock as pain relief. Used as an anestheticelectro shock , he used a surgical hammer to hammer the tip of an ice pick into the skull through the bone of the orbital socket of the eye.
The movement of the instrument severed fibers in the frontal lobes of the brain, causing irreversible damage to the brain.
Freeman argued that the procedure would remove the emotional component from the patient’s “mental illness” and didBy 50 -ty operations per day.
His students increased this figureup to 78 lobotomies per day

Between 1946 and 1949, number of lobotomies performed
increased tenfold. Freeman himself observed or personally conducted approximately3500 lobotomies , creating an entire army of zombies.

By 1948 The mortality rate from lobotomies reached three percent . However, Freeman continued to actively travel from the city to
city, actively promoting his procedures in lectures and publicly performing lobotomies on patients in a theatrical manner. The press called his tour "Operation Ice Pick."

The first president of the USSR Academy of Medical Sciences, the founder of Soviet neurosurgery N. N. Burdenko, spoke out against psychosurgery and lobotomy for mental illnesses. \

But in 1947, after his death, psychosurgery received
support for the Institute of Neurosurgery of the USSR, of which B. G. Egorov became the director in 1947, at the same time taking the post of chief neurosurgeon of the Ministry of Health.
In the USSR, lobotomy was performed sparingly, only in one frontal lobe.

The selection of patients for lobotomy was very strict.

The surgical method was offered only in cases
ineffectiveness of previous long-term treatment, including insulin therapy and electric shock.

The lobotomy method was recognized as fundamentally acceptable, but only in the hands of experienced neurosurgeons and in cases where no other therapy is effective and the damage is considered irreversible. From 1945 to 1950. a lobotomy was performed in Leningrad155 sick.
Having analyzed the results of lobotomy in 120 patients followed up for a follow-up period of up to 2.5 years. - found that improvement of varying degrees was achieved in 61% of those operated on. At the same time, in 21% there is a complete remission without any frontal symptoms with the possibility of returning to highly skilled and responsible work. At the same time, some patients showed a frontal defect, which sometimes predominated over schizophrenia.

Lobotomy has proven to be most effective for paranoid schizophrenia. For simple forms of schizophrenia and catatonic stupor, surgical intervention was not successful.

The opponent of lobotomy, psychiatrist V. A. Gilyarovsky, proposed
prohibit the use of this treatment method in psychiatric institutions.
He obtained an order from the USSR Ministry of Health to check the results of using prefrontal leucotomy locally.
In the report on the inspection of the Leningrad Institute. V. M. Bekhterev stated that176 patients underwent leukotomy , of which 152 were diagnosed with schizophrenia.
The commission demonstrated 8 patients with good results, but all of them had certain defects and some organic decline. The operations were performed by both surgeons and psychiatrists. Patients after leukotomy were usually transferred to other medical institutions and therefore long-term outcomes were not properly studied.

Soon an article by the same Gilyarovsky was published in the magazine
“Medical worker” (No. 37 of September 14, 1950) “Teaching
Pavlova - the basis of psychiatry" with criticism of the lobotomy method. : "It is assumed that cutting the white matter of the frontal lobes disrupts their connections with the thalamus and eliminates the possibility of stimuli coming from it that lead to excitation and generally upset mental functions. This explanation is mechanistic and has its roots in the narrow localizationism characteristic of American psychiatrists,
from where the leucotomy was transferred to us.”

On November 29, 1950, the Pravda newspaper sent to the Minister
Healthcare of the USSR published the day before in it “Letter to the editor» — « Against one pseudoscientific treatment method", which stated in particular:

“One example of the impotence of bourgeois medicine is the “new method of treating” mental illness that is widely used in American psychiatry - lobotomy (leucotomy) ...
Naturally, among our doctors, brought up in the spirit of the glorious traditions of the great humanists - Botkin, Pirogov,
Korsakov, armed with the teachings of I.P. Pavlov, there can be no place for such “Treatment Methods” as lobotomy. Nevertheless, we also found people who liked this overseas fruit of pseudoscience. Back in 1944, the head of the department of psychiatry at the Gorky Medical Institute, Professor M.A. Goldenberg, performed a lobotomy operation.”

The day after the signal from PravdaNovember 30, 1950 of the year a meeting of the Presidium of the Medical Scientist took place
Council of the USSR Ministry of Health. It was decided
Refrain from using leucotomy for neuropsychiatric diseases, such as
a method that contradicts the basic principles of surgical treatment by I. P. Pavlov.
Lobotomy in the USSR was officially banned!

Most people think that psychosurgery, or lobotomy, is no longer used. Unfortunately, it is not.

Today, shyly calling it "neurosurgery for mental disorders", advocates of psychosurgerysuch as the Scottish Health Secretary, propose that lobotomy be used on patients without their consent.

In Russia, in 1997-1999, Dr. Svyatoslav Medvedev, director of the St. Petersburg Institute of the Human Brain, admitted committing more than100 psychosurgical operations conducted mainly among adolescents for the treatment of drug addiction.

In 1999, Alexander L. entered the Institute of the Human Brain,
where he had to undergo psychosurgery to treat his drug addiction
dependencies. The operation was performed without anesthesia. During the operation,
lasting four hours, four holes were drilled into his skull. Sites
the brains were frozen out with liquid nitrogen, and this caused painful sensations. When
he was discharged, the wounds on his head festered so much that they required repeated
hospitalization. A week after the operation, L. felt a craving for drugs.
Two months later he returned to taking drugs.

So:

1. Side effects
effects of psychosurgery - loss of control over urination and defecation,
epileptic seizures and brain infections - have been well known since the late 1940s.

2. Psychosurgeons
trying to change behavior by destroying completely healthy brain tissue.

3. During brain surgery, the mortality rate among patients reaches 10%. Some psychiatrists
Even the suicides that followed the operation were called a “successful” result.

4. Therapy "deep brain stimulation" (DBS), "transcranial magnetic stimulation"
(TMS) and other developments of this kind represent the latest
psychiatric experiments in the treatment of the “mentally ill.”
.
Electroshock and "psychosurgery" are particularly sad chapters in the history of psychiatry's senseless search for physical causes and physical "cure" methods for what was never the result of a physical or biological problem. Even if some peculiar or socially unacceptable behavior or irrational thinking that we call mental illness is partly or wholly caused by a biological disorder, today it is “treated” with methods that are irrational and harmful to psychiatric patients. The disgrace of the psychosurgical part of the history of psychiatry - and in some places of its present - is generally recognized, even among most psychiatrists. This is why psychosurgery is rarely mentioned by psychiatrists today. Like most quack therapies, even "psychosurgery" has its supporters not only among the doctors or lawyers who practice it, but also among at least a few of those who have received it - or perhaps I should say - at least a few of those who have received it. who, psychologically speaking, survived it. The amount of damage caused by “psychosurgery” varies widely. The degree of damage depends on the size and location of the areas of the brain that are severed. This turns some people into "plants", but if a psychosurgeon cuts out a very small area of ​​brain tissue, it may have little or no effect on the "patient", except for the strength of the effect of suggestion, or placebo.

Sources: Lobotomy - origins ; History of psychosurgery (sixth paragraph from top); Lobotomy - PBS documentary, on Walter Freeman