Lobotomy - Knowledge

346:, once the doyen of medical history, the often violent and invasive psychiatric interventions developed during the 1930s and 1940s are indicative of both the well-intentioned desire of psychiatrists to find some medical means of alleviating the suffering of the vast number of patients then in psychiatric hospitals and also the relative lack of social power of those same patients to resist the increasingly radical and even reckless interventions of asylum doctors. Many doctors, patients and family members of the period believed that despite potentially catastrophic consequences, the results of lobotomy were seemingly positive in many instances or, were at least deemed as such when measured next to the apparent alternative of long-term institutionalisation. Lobotomy has always been controversial, but for a period of the medical mainstream, it was even feted and regarded as a legitimate last-resort remedy for categories of patients who were otherwise regarded as hopeless. Today, lobotomy has become a disparaged procedure, a byword for medical barbarism and an exemplary instance of the medical trampling of 338:(1938), served to galvanize a profession which had been both therapeutically moribund and systemically demoralized. Unlike other medical disciplines (e.g., Cardiology, Dermatology, Orthopedics, etc.) which applied surgical and pharmacological treatments that were both apparent and measurable regarding their efficacy, psychiatry had often struggled with quantification. These novel remedial methodologies, however, meant that (at the time) modern psychiatric treatments were no longer relegated to the metaphysical or abstract, and this increased the popularity of the field among clinicians and prospective patients alike. Suddenly, conditions like insanity, psychosis, and others felt less like incurable afflictions, and more like surmountable diagnoses - emboldening psychiatrists to attempt new procedures. Additionally, the relative (and quantitative) success of the shock therapies, despite the considerable risks they posed to patients, also helped to inspire doctors in the field to pioneer ever more drastic forms of medical interventions up to, and including, lobotomies. 540:, named Becky and Lucy who had had frontal lobectomies and subsequent changes in behaviour and intellectual function. According to Fulton's account of the congress, they explained that before surgery, both animals, and especially Becky, the more emotional of the two, exhibited "frustrational behaviour" – that is, have tantrums that could include rolling on the floor and defecating – if, because of their poor performance in a set of experimental tasks, they were not rewarded. Following the surgical removal of their frontal lobes, the behaviour of both primates changed markedly and Becky was pacified to such a degree that Jacobsen apparently stated it was as if she had joined a "happiness cult". During the question and answer section of the paper, Moniz, it is alleged, "startled" Fulton by inquiring if this procedure might be extended to human subjects suffering from mental illness. Fulton stated that he replied that while possible in theory it was surely "too formidable" an intervention for use on humans. 811:

Médico-Psychologique on the results of the second cohort of patients leucotomised by Lima. Sobral Cid, who had supplied Moniz with the first set of patients for leucotomy from his own hospital in Lisbon, attended the meeting and denounced the technique, declaring that the patients who had been returned to his care post-operatively were "diminished" and had experienced a "degradation of personality". He also claimed that the changes Moniz observed in patients were more properly attributed to shock and brain trauma, and he derided the theoretical architecture that Moniz had constructed to support the new procedure as "cerebral mythology." At the same meeting the Parisian psychiatrist, Paul Courbon, stated he could not endorse a surgical technique that was solely supported by theoretical considerations rather than clinical observations. He also opined that the mutilation of an organ could not improve its function and that such cerebral wounds as were occasioned by leucotomy risked the later development of

945:. Freeman had first encountered Moniz at the London-hosted Second International Congress of Neurology in 1935, where he had presented a poster exhibit of the Portuguese neurologist's work on cerebral angiography. Fortuitously occupying a booth next to Moniz, Freeman, delighted by their chance meeting, formed a highly favourable impression of Moniz, later remarking upon his "sheer genius". According to Freeman, if they had not met in person, it is highly unlikely that he would have ventured into the domain of frontal lobe psychosurgery. Freeman's interest in psychiatry was the natural outgrowth of his appointment in 1924 as the medical director of the Research Laboratories of the Government Hospital for the Insane in Washington, known colloquially as St Elizabeth's. Freeman, who favoured an organic model of mental illness causation, spent the next several years exhaustively, yet ultimately fruitlessly, investigating a 625:, a French neuropsychiatrist, who commenced the session by reviewing the state of research on the frontal lobes, and concluded that "altering the frontal lobes profoundly modifies the personality of subjects". This parallel symposium contained numerous papers by neurologists, neurosurgeons and psychologists; amongst these was one by Brickner, which impressed Moniz greatly, that again detailed the case of "Patient A". Fulton and Jacobsen's paper, presented in another session of the conference on experimental physiology, was notable in linking animal and human studies on the function of the frontal lobes. Thus, at the time of the 1935 Congress, Moniz had available to him an increasing body of research on the role of the frontal lobes that extended well beyond the observations of Fulton and Jacobsen. 645:, the French physician Maurice Ducosté reported in 1932 that he had injected 5 ml of malarial blood directly into the frontal lobes of over 100 paretic patients through holes drilled into the skull. He claimed that the injected paretics showed signs of "uncontestable mental and physical amelioration" and that the results for psychotic patients undergoing the procedure was also "encouraging". The experimental injection of fever-inducing malarial blood into the frontal lobes was also replicated during the 1930s in the work of Ettore Mariotti and M. Sciutti in Italy and Ferdière Coulloudon in France. In Switzerland, almost simultaneously with the commencement of Moniz's leucotomy programme, the neurosurgeon François Ody had removed the entire right frontal lobe of a 957:. Praising the text as one whose "importance can scarcely be overestimated", he summarised Moniz's rationale for the procedure as based on the fact that while no physical abnormality of cerebral cell bodies was observable in the mentally ill, their cellular interconnections may harbour a "fixation of certain patterns of relationship among various groups of cells" and that this resulted in obsessions, delusions and mental morbidity. While recognising that Moniz's thesis was inadequate, for Freeman it had the advantage of circumventing the search for diseased brain tissue in the mentally ill by instead suggesting that the problem was a functional one of the brain's internal wiring where relief might be obtained by severing problematic mental circuits. 271:

patients in novels, plays, and films further diminished public opinion, and the development of antipsychotic medications led to a rapid decline in lobotomy’s popularity and Freeman’s reputation. Others could leave the hospital or become more manageable within the hospital. A precarious amount of people managed to return to responsible work, while at the other extreme, people were left with severe and disabling impairments. Most people fell into an intermediate group, left with some improvement of their symptoms but also with emotional and intellectual deficits to which they made a better or worse adjustment. On average, there was a mortality rate of approximately 5% during the 1940s.

741:, and create what Moniz termed a "frontal barrier". After the first operation was complete, Moniz considered it a success and, observing that the patient's depression had been relieved, he declared her "cured" although she was never, in fact, discharged from the mental hospital. Moniz and Lima persisted with this method of injecting alcohol into the frontal lobes for the next seven patients but, after having to inject some patients on numerous occasions to elicit what they considered a favourable result, they modified the means by which they would section the frontal lobes. For the ninth patient they introduced a surgical instrument called a 1038:

lobotomized 2.5 times as many people per capita as hospitals in the US. According to another estimate, Sweden lobotomized at least 4,500 people between 1944 and 1966, mainly women. This figure includes young children. And in Norway, there were 2,005 known lobotomies. In Denmark, there were 4,500 known lobotomies. In Japan, the majority of lobotomies were performed on children with behaviour problems. The Soviet Union banned the practice in 1950 on moral grounds. In Germany, it was performed only a few times. By the late 1970s, the practice of lobotomy had generally ceased, although it continued as late as the 1980s in France.

778:. Their most prominent symptoms were anxiety and agitation. The duration of their illness before the procedure varied from as little as four weeks to as much as 22 years, although all but four had been ill for at least one year. Patients were normally operated on the day they arrived at Moniz's clinic and returned within ten days to the Miguel Bombarda Mental Hospital. A perfunctory post-operative follow-up assessment took place anywhere from one to ten weeks following surgery. Complications were observed in each of the leucotomy patients and included: "increased temperature, vomiting, 1008:

of such lobotomized patients exhibited reduced tension or agitation, but many also showed other effects, such as apathy, passivity, lack of initiative, poor ability to concentrate, and a generally decreased depth and intensity of their emotional response to life. Some died as a result of the procedure. However, those effects were not widely reported in the 1940s, and at that time the long-term effects were largely unknown. Because the procedure met with seemingly widespread success, Moniz was awarded the 1949 Nobel Prize for Physiology or Medicine (along with Swiss physiologist

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overwhelming demand for the operation. In 1945 Freeman streamlined the procedure, replacing it with transorbital lobotomy, in which a picklike instrument was forced through the back of the eye sockets to pierce the thin bone that separates the eye sockets from the frontal lobes. The pick’s point was then inserted into the frontal lobe and used to sever connections in the brain (presumably between the prefrontal cortex and thalamus). In 1946 Freeman performed this procedure for the first time on a patient, who was subdued prior to the operation with electroshock treatment.

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of the patient was changed in some way in the hope of rendering him more amenable to the social pressures under which he is supposed to exist." He described one 29-year-old woman as being, following lobotomy, a "smiling, lazy and satisfactory patient with the personality of an oyster" who could not remember Freeman's name and endlessly poured coffee from an empty pot. When her parents had difficulty dealing with her behavior, Freeman advised a system of rewards (ice cream) and punishment (smacks).

718:, Moniz initiated the first of a series of operations on the brains of people with mental illnesses. The initial patients selected for the operation were provided by the medical director of Lisbon's Miguel Bombarda Mental Hospital, José de Matos Sobral Cid. As Moniz lacked training in neurosurgery and his hands were impaired by gout, the procedure was performed under general anaesthetic by Pedro Almeida Lima, who had previously assisted Moniz with his research on 1289: 263:, and it was recognized that this was accomplished at the expense of a person's personality and intellect. British psychiatrist Maurice Partridge, who conducted a follow-up study of 300 patients, said the treatment achieved its effects by "reducing the complexity of psychic life". Following the operation, spontaneity, responsiveness, self-awareness, and self-control were reduced. The activity was replaced by inertia, and people were mostly left 484:. He had abandoned these attempts because of unsatisfactory results and this experience probably inspired the invective that was directed at Burckhardt in the 1912 article. By 1937, Puusepp, despite his earlier criticism of Burckhardt, was increasingly persuaded that psychosurgery could be a valid medical intervention for the mentally disturbed. In the late 1930s, he worked closely with the neurosurgical team of the Racconigi Hospital near 1029:

performed in the United States. However, because of the fervent promotion of the technique by Freeman and Watts, those numbers increased sharply toward the end of the decade. In 1949, the peak year for lobotomies in the US, 5,074 procedures were undertaken, and by 1951 over 18,608 individuals had been lobotomized in the US. An estimated 40% of Freeman's patients were gay men, lobotomized to change their sexual orientation.

291: 802:, and abnormal sensations of hunger". Moniz asserted that these effects were transitory and, according to his published assessment, the outcome for these first twenty patients was that 35%, or seven cases, improved significantly, another 35% were somewhat improved and the remaining 30% (six cases) were unchanged. There were no deaths and he did not consider that any patients had deteriorated following leucotomy. 568:

earlier unpublished account he wrote of the congress. In this previous narrative he mentioned an incidental, private exchange with Moniz, but it is likely that the official version of their public conversation he promulgated is without foundation. In fact, Moniz stated that he had conceived of the operation some time before his journey to London in 1935, having told in confidence his junior colleague, the young

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in the synaptic complex which regulates the functioning of consciousness, stimulating it and keeping it in constant activity ... all these considerations led me to the following conclusion: it is necessary to alter these synaptic adjustments and change the paths chosen by the impulses in their constant passage so as to modify the corresponding ideas and force thoughts along different paths ...'

1086:, created the National Committee for the Protection of Human Subjects of Biomedical and Behavioral Research to investigate allegations that psychosurgery – including lobotomy techniques – was used to control minorities and restrain individual rights. The committee concluded that some extremely limited and properly performed psychosurgery could have positive effects. 1053:

leucotomize schizophrenics" and that lobotomy was "still too imperfect to enable us, with its aid, to venture on a general offensive against chronic cases of mental disorder", stating further that "Psychosurgery has as yet failed to discover its precise indications and contraindications and the methods must unfortunately still be regarded as rather crude and hazardous in many respects." In 1948

927: 1200: – to render them "morally sane". In the play, a wealthy matriarch offers the local mental hospital a substantial donation if the hospital will give her niece a lobotomy, which she hopes will stop the niece's shocking revelations about her son. Warned that a lobotomy might not stop her niece's "babbling", she responds, "That may be, maybe not, but after the operation, who would 857: – the Racconigi Hospital – where he instructed his Italian neuropsychiatric colleagues on leucotomy and also oversaw several operations. Leucotomy was featured at two Italian psychiatric conferences in 1937 and over the next two years a score of medical articles on Moniz's psychosurgery was published by Italian clinicians based in medical institutions located in 597:, which designated a neurological condition characterised by a certain hilarity and childishness in those with the condition. The picture of frontal lobe function that emerged from these studies was complicated by the observation that neurological deficits attendant on damage to a single lobe might be compensated for if the opposite lobe remained intact. In 1922, the Italian neurologist 463:, published a paper reviewing a range of surgical interventions that had been performed on the mentally ill. While generally treating these endeavours favorably, in their consideration of psychosurgery they reserved unremitting scorn for Burckhardt's surgical experiments of 1888 and opined that it was extraordinary that a trained medical doctor could undertake such an unsound procedure. 497: 420: 613:, had no apparent decrease in intellectual function and seemed, at least to the casual observer, perfectly normal. Brickner concluded from this evidence that "the frontal lobes are not 'centers' for the intellect". These clinical results were replicated in a similar operation undertaken in 1934 by the neurosurgeon 544: 382:. Burckhardt's decision to operate was informed by three pervasive views on the nature of mental illness and its relationship to the brain. First, the belief that mental illness was organic in nature, and reflected an underlying brain pathology; next, that the nervous system was organized according to an 1554:

diabolical. Just observing this thing was horrible, gruesome." When Dully asked Frank Freeman, then a 79-year-old security guard, whether he was proud of his father, he replied: "Oh yes, yes, yeah. He was terrific. He was really quite a remarkable pioneer lobotomist. I wish he could have gotten further."

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Rodney Dully, whose son Howard Dully had had a transorbital lobotomy performed on him by Walter Freeman when he was twelve years old, stated in an interview with his son that: "I only met him I think the one time. He described how accurate it was and that he had practised the cutting on, literally,

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A 1937 report detailed that in the United States there were then 477 psychiatric institutions with a total population of approximately 451,672 patients, almost half of whom had been resident for a period of five years or more. The report also observed that psychiatric patients occupied 55 per cent of

1221:, lobotomy is described as "frontal-lobe castration", a form of punishment and control after which "There's nothin' in the face. Just like one of those store dummies." In one patient, "You can see by his eyes how they burned him out over there; his eyes are all smoked up and gray and deserted inside." 840:

Throughout the remainder of the 1930s the number of leucotomies performed in most countries where the technique was adopted remained quite low. In Britain, which was later a major centre for leucotomy, only six operations had been undertaken before 1942. Generally, medical practitioners who attempted

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In the present state of affairs if some are critical about lack of caution in therapy, it is, on the other hand, deplorable and inexcusable to remain apathetic, with folded hands, content with learned lucubrations upon symptomatologic minutiae or upon psychopathic curiosities, or even worse, not even

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The frontal lobes had been the object of scientific inquiry and speculation since the late 19th century. Fulton's contribution, while it may have functioned as source of intellectual support, is of itself unnecessary and inadequate as an explanation of Moniz's resolution to operate on this section of

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The consequences of the operation have been described as "mixed". However, many lobotomy patients suffered devastating postoperative complications, including intracranial hemorrhage, epilepsy, alterations in affect and personality, brain abscess, dementia, and death. Ominous portrayals of lobotomized

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Frank Freeman, Walter Freeman's son, stated in an interview with Howard Dully that: "He had several ice-picks that just cluttered the back of the kitchen drawer. The first ice-pick came right out of our drawer. A humble ice-pick to go right into the frontal lobes. It was, from a cosmetic standpoint,

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Moniz wrote in 1948: 'sufferers from melancholia, for instance, are distressed by fixed and obsessive ideas ... and live in a permanent state of anxiety caused by a fixed idea which predominates over all their lives ... in contrast to automatic actions, these morbid ideas are deeply rooted

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The Freeman–Watts prefrontal lobotomy still required drilling holes in the skull, so surgery had to be performed in an operating room by trained neurosurgeons. Walter Freeman believed this surgery would be unavailable to those he saw as needing it most: patients in state mental hospitals that had no

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For Moniz, "to cure these patients", it was necessary to "destroy the more or less fixed arrangements of cellular connections that exist in the brain, and particularly those which are related to the frontal lobes", thus removing their fixed pathological brain circuits. Moniz believed the brain would

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published a detailed report on the results of bilateral lobectomies in animals that supported the contention that the frontal lobes were both integral to intellectual function and that their removal led to the disintegration of the subject's personality. This work, while influential, was not without

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in humans and led to more precise experimental neurosurgery in animal studies. Cases were reported where mental symptoms were alleviated following the surgical removal of diseased or damaged brain tissue. The accumulation of medical case studies on behavioural changes following damage to the frontal

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that "seldom in the history of medicine has a laboratory observation been so quickly and dramatically translated into a therapeutic procedure". Fulton's report, penned ten years after the events described, is, however, without corroboration in the historical record and bears little resemblance to an

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coined the term "surgically induced childhood" and used it constantly to refer to the results of lobotomy. The operation left people with an "infantile personality"; a period of maturation would then, according to Freeman, lead to recovery. In an unpublished memoir, he described how the "personality

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remarked: "The history of prefrontal lobotomy has been brief and stormy. Its course has been dotted with both violent opposition and with slavish, unquestioning acceptance." Beginning in 1947 Swedish psychiatrist Snorre Wohlfahrt evaluated early trials, reporting that it is "distinctly hazardous to

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Watts did not favor the transorbital method, and this difference of opinion contributed to the end of their partnership. Watts resisted the technique itself, Freeman's lack of sterile technique when performing it, and the idea of performing the procedure in an outpatient setting.Watts recalled that

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The transorbital lobotomy procedure, which Freeman performed very quickly, sometimes in less than 10 minutes, was used on many patients with relatively minor mental disorders that Freeman believed did not warrant traditional lobotomy surgery, in which the skull itself was opened. A large proportion

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basis for insanity. Chancing upon a preliminary communication by Moniz on leucotomy in the spring of 1936, Freeman initiated a correspondence in May of that year. Writing that he had been considering psychiatric brain surgery previously, he informed Moniz that, "having your authority I expect to go

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mental troubles must have ... a relation with the formation of cellulo-connective groupings, which become more or less fixed. The cellular bodies may remain altogether normal, their cylinders will not have any anatomical alterations; but their multiple liaisons, very variable in normal people,

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and, most especially, the frontal lobes, were responsible for more complex cognitive functions. However, this theoretical formulation found little laboratory support, as 19th-century experimentation found no significant change in animal behaviour following surgical removal or electrical stimulation

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in regions of the brain identified as association centers, a transformation in behaviour might ensue. According to his model, those mentally ill might experience "excitations abnormal in quality, quantity and intensity" in the sensory regions of the brain and this abnormal stimulation would then be

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In the early 20th century, the number of patients residing in mental hospitals increased significantly while little in the way of effective medical treatment was available. Lobotomy was one of a series of radical and invasive physical therapies developed in Europe at this time that signaled a break

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Puusepp admitted to his 1910 experimentation with psychosurgery in a 1937 publication. At that point he had completed a series of 14 leucotomies to relieve aggressive symptoms in patients. Convinced that the results had been positive in these cases, he felt that further research into psychosurgery

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Moniz began his experiments with leucotomy just three months after the congress had reinforced the apparent cause and effect relationship between the Fulton and Jacobsen presentation and the Portuguese neurologist's resolve to operate on the frontal lobes. As the author of this account Fulton, who

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The source of inspiration for Moniz's decision to hazard psychosurgery has been clouded by contradictory statements made on the subject by Moniz and others both contemporaneously and retrospectively. The traditional narrative addresses the question of why Moniz targeted the frontal lobes by way of

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Freeman performed the first transorbital lobotomy on a live patient in 1946. Its simplicity suggested the possibility of carrying it out in mental hospitals lacking the surgical facilities required for the earlier, more complex procedure. (Freeman suggested that, where conventional anesthesia was

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By the conclusion of this first run of leucotomies in February 1936, Moniz and Lima had operated on twenty patients with an average period of one week between each procedure; Moniz published his findings with great haste in March of the same year. The patients were aged between 27 and 62 years of

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that was 11 centimetres (4.3 in) in length and 2 centimetres (0.79 in) in diameter. It had a retractable wire loop at one end that, when rotated, produced a 1 centimetre (0.39 in) diameter circular lesion in the white matter of the frontal lobe. Typically, six lesions were cut into

621:. By the mid-1930s, interest in the function of the frontal lobes reached a high-water mark. This was reflected in the 1935 neurological congress in London, which hosted as part of its deliberations, "a remarkable symposium ... on the functions of the frontal lobes". The panel was chaired by 1070:

It is assumed that the transection of white substance of the frontal lobes impairs their connection with the thalamus and eliminates the possibility to receive from it stimuli which lead to irritation and on the whole derange mental functions. This explanation is mechanistic and goes back to the

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In the United States, approximately 40,000 people were lobotomized and in England, 17,000 lobotomies were performed. According to one estimate, in the three Nordic countries of Denmark, Norway, and Sweden, a combined figure of approximately 9,300 lobotomies were performed. Scandinavian hospitals

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Lobotomies were performed on a wide scale during the 1940s; Freeman himself performed or supervised more than 3,500 lobotomies by the late 1960s. Freeman performed his first transorbital lobotomy on Ellen Ionesco, a woman who suffered from bouts of manic depression and suicidal ideation. Freeman

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The use of lobotomy in the United States was resisted and criticized heavily by American neurosurgeons. However, because Freeman managed to promote the success of the surgery through the media, lobotomy became touted as a miracle procedure, capturing the attention of the public and leading to an

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Moniz rapidly disseminated his results through articles in the medical press and a monograph in 1936. Initially, however, the medical community appeared hostile to the new procedure. On 26 July 1936, one of his assistants, Diogo Furtado, gave a presentation at the Parisian meeting of the Société

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Pedro Almeida Lima, as early as 1933 of his psychosurgical idea. The traditional account exaggerates the importance of Fulton and Jacobsen to Moniz's decision to initiate frontal lobe surgery, and omits the fact that a detailed body of neurological research that emerged at this time suggested to

679:. He differed significantly from Burckhardt, however in that he did not think there was any organic pathology in the brains of the mentally ill, but rather that their neural pathways were caught in fixed and destructive circuits leading to "predominant, obsessive ideas". As Moniz wrote in 1936: 703:

The hypotheses underlying the procedure might be called into question; the surgical intervention might be considered very audacious; but such arguments occupy a secondary position because it can be affirmed now that these operations are not prejudicial to either physical or psychic life of the

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Intending to ameliorate symptoms in those with violent and intractable conditions rather than effect a cure, Burckhardt began operating on patients in December 1888, but both his surgical methods and instruments were crude and the results of the procedure were mixed at best. He operated on six

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patient. In Romania, Ody's procedure was adopted by Dimitri Bagdasar and Constantinesco working out of the Central Hospital in Bucharest. Ody, who delayed publishing his own results for several years, later rebuked Moniz for claiming to have cured patients through leucotomy without waiting to

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The frontal lobotomy procedure had severe negative effects on a patient's personality and ability to function independently. Lobotomy patients often show a marked reduction in initiative and inhibition. They may also exhibit difficulty imagining themselves in the position of others because of

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be used to render the patient unconscious.) In 1947, the Freeman and Watts partnership ended, as the latter was disgusted by Freeman's barbarism and neglectful modifications of the lobotomy from a surgical operation into a simple "office" procedure. Between 1940 and 1944, 684 lobotomies were

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and, most dramatically, to a presentation Fulton made with his junior colleague Carlyle Jacobsen at the Second International Congress of Neurology held in London in 1935. Fulton's primary area of research was on the cortical function of primates and he had established America's first primate

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Leucotomy was first reported in the Italian medical press in 1936 and Moniz published an article in Italian on the technique in the following year. In 1937, he was invited to Italy to demonstrate the procedure and for a two-week period in June of that year he visited medical centres in

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magazine article remarked that the nation's system of mental hospitals resembled "little more than concentration camps on the Belsen pattern"; a point the piece emphasized with documentary photography that depicted patient neglect and dilapidated material conditions within psychiatric

1451:, which allowed routine visualisation of the brain's peripheral blood vessels for the first time, he was twice nominated, unsuccessfully, for a Nobel Prize. Some have attributed his development of leucotomy to a determination on his part to win the Nobel after these disappointments. 893:

provided a guiding hand. Under the medical directorship of Emilio Rizzatti, the medical personnel at this hospital had completed at least 200 leucotomies by 1939. Reports from clinicians based at other Italian institutions detailed significantly fewer leucotomy operations.

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The clinician-historian Joel Braslow argues that from malarial therapy onward to lobotomy, physical psychiatric therapies "spiral closer and closer to the interior of the brain" with this organ increasingly taking "center stage as a source of disease and site of cure". For

819:. Nonetheless, Moniz's reported successful surgical treatment of 14 out of 20 patients led to the rapid adoption of the procedure on an experimental basis by individual clinicians in countries such as Brazil, Cuba, Italy, Romania and the United States during the 1930s. 1446:

Moniz, then 51 years old, devoted his considerable talents and energies to neurological research entirely. Throughout his career he published on topics as diverse as neurology, sexology, historical biography, and the history of card games. For his 1927 development of

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Lobotomies have been featured in several literary and cinematic presentations that both reflected society's attitude toward the procedure and, at times, changed it. Writers and film-makers have played a pivotal role in turning public sentiment against the procedure.

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The theoretical underpinnings of Moniz's psychosurgery were largely commensurate with the nineteenth-century ones that had informed Burckhardt's decision to excise matter from the brains of his patients. Although in his later writings Moniz referenced both the

522:. First developing an interest in psychiatric conditions and their somatic treatment in the early 1930s, Moniz apparently conceived a new opportunity for recognition in the development of a surgical intervention on the brain as a treatment for mental illness. 1063:, said: "Prefrontal lobotomy... has recently been having a certain vogue, probably not unconnected with the fact that it makes the custodial care of many patients easier. Let me remark in passing that killing them makes their custodial care still easier." 1429:

Professor of neurology at the University of Lisbon from 1911 to 1944, Moniz was also for several decades a prominent parliamentarian and diplomat. He was Portugal's ambassador to Spain during World War I and represented Portugal at the postwar

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the procedure adopted a cautious approach and few patients were leucotomised before the 1940s. Italian neuropsychiatrists, who were typically early and enthusiastic adopters of leucotomy, were exceptional in eschewing such a gradualist course.

408:. He reasoned, however, that removing material from either of the sensory or motor zones could give rise to "grave functional disturbance". Instead, by targeting the association centers and creating a "ditch" around the motor region of the 1392:, described psychiatry during the interwar period as a "funereal science". Likewise Egas Moniz, the inventor of leucotomy, referred to the "impotência terapeutica" (therapeutic impotence) of existing therapeutic remedies during the 1930s. 628:

Nor was Moniz the only medical practitioner in the 1930s to have contemplated procedures directly targeting the frontal lobes. Although ultimately discounting brain surgery as carrying too much risk, physicians and neurologists such as

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in 1848, this constituted an "accidental lobotomy", or that this event somehow inspired the development of surgical lobotomy a century later. According to the only book-length study of Gage, careful inquiry turns up no such

224:. A large number of patients were gay men. More lobotomies were performed on women than on men: a 1951 study found that nearly 60% of American lobotomy patients were women, and limited data shows that 74% of lobotomies in 1186:

describes a lobotomy as making "a Comanche brave look like a tyro with a scalping knife", and portrays the surgeon as a repressed man who cannot change others with love, so he instead resorts to "high-grade carpentry

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system (a motor center); and, finally, a modular conception of the brain whereby discrete mental faculties were connected to specific regions of the brain. Burckhardt's hypothesis was that by deliberately creating

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We have quoted this data to show not only how groundless but also how dangerous these operations were. We are unable to explain how their author, holder of a degree in medicine, could bring himself to carry them

1263:(the subject of the film) undergoing transorbital lobotomy (though the idea that a lobotomy was performed on Farmer, and that Freeman performed it, has been criticized as having little or no factual foundation). 559:

has sometimes been claimed as the father of lobotomy, was later able to record that the technique had its true origination in his laboratory. Endorsing this version of events, in 1949, the Harvard neurologist

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for a hypodermic needle, it is estimated that he leucotomised about 100 patients in the period up to the outbreak of World War II. Fiamberti's innovation of Moniz's method would later prove inspirational for

448:". Claiming a success rate of 50 percent, he presented the results at the Berlin Medical Congress and published a report, but the response from his medical peers was hostile and he did no further operations. 1059: 1075:

The Soviet Union officially banned the procedure in 1950 on the initiative of Gilyarovsky. Doctors in the Soviet Union concluded that the procedure was "contrary to the principles of humanity" and

4566:. Effect of therapeutic innovation on perception of disease and the doctor-patient relationship: a history of general paralysis of the insane and malaria fever therapy, 1910–1950. 198:

as a mainstream procedure in some countries. The procedure was controversial from its initial use, in part due to a lack of recognition of the severity and chronicity of severe and enduring

6356: 6119:. A psychosurgical chapter in the history of cerebral localization: the six cases of Gottlieb Burkhardt. In: Code, Christopher; Wallesch, C.-W.; Joanette Y.; Roch A. (eds). 5725:. Neurosurgery for psychiatric disorders: from the excision of brain tissue to the chronic electrical stimulation of neural networks. In: Sakas, D.E.; Simpson, B.A. (eds). 359: 1464:. Freeman, who would later play a central role in the popularisation and practice of leucotomy in America, also had an interest in personality changes following frontal lobe surgery. 909:

bone at the top of the socket and then inject alcohol or formalin into the white matter of the frontal lobes through this aperture. Using this method, while sometimes substituting a

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Before the 1930s, individual doctors had infrequently experimented with novel surgical operations on the brains of those deemed insane. Most notably in 1888, the Swiss psychiatrist

5219:Судьбы больных шизофренией: клинико-социальный и судебно-психиатрический аспекты [The fates of the ill with schizophrenia: clinico-social and forensico-psychiatric aspects] 5089:. Egas Moniz (1874–1955) and the "invention" of modern psychosurgery: a historical and ethical reanalysis under special consideration of Portuguese original sources. 1066:

Concerns about lobotomy steadily grew. Soviet psychiatrist Vasily Gilyarovsky criticized lobotomy and the mechanistic brain localization assumption used to carry out lobotomy:

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Joanette, Yves; Stemmer, Brigitte; Assal, Gil; Whitaker, Harry. From theory to practice: the unconventional contribution of Gottlieb Burckhardt to psychosurgery.

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according to the knowledge and technology of the time as the absence of a known correlation between physical brain pathology and mental illness could not disprove his thesis.

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the brain. Under an evolutionary and hierarchical model of brain development it had been hypothesized that those regions associated with more recent development, such as the

4649:

Cooper, Rachel. On deciding to have a lobotomy: either lobotomies were justified or decisions under risk should not always seek to maximise expected utility.

582:

of the frontal lobes. This picture of the so-called "silent lobe" changed in the period after World War I with the production of clinical reports of ex-servicemen with

1246:, portrays the dehumanizing lobotomy of a womanizing, quarrelsome poet who, afterward, is just as aggressive as ever. The surgeon is depicted as an inhumane crackpot. 750:

each lobe, but, if they were dissatisfied by the results, Lima might perform several procedures, each producing multiple lesions in the left and right frontal lobes.

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all hospital beds in America. Conditions within US mental hospitals became the subject of public debate as a series of exposes were published in the 1940s. A 1946

6212:

Out of Sight, Out of Mind: A Graphic Picture of Present-day Institutional Care of the Mentally Ill in America, Based on More Than Two Thousand Eye-witness Reports

1272:

centers on lobotomy, attitudes about mental health in general, in 1950s America. The protagonist, a young man whose mother had been lobotomized, takes a job as a

905:, first devised the transorbital procedure whereby the frontal lobes were accessed through the eye sockets. Fiamberti's method was to puncture the thin layer of 722:. The intention was to remove some of the long fibres that connected the frontal lobes to other major brain centres. To this end, it was decided that Lima would 5358:

Manjila, S.; Rengachary, S.; Xavier, A.R.; Parker, B.; Guthikonda, M.. Modern psychosurgery before Egas Moniz: a tribute to Gottlieb Burckhardt.

1148:' older sister Rose received a lobotomy that left her incapacitated for life; the episode is said to have inspired characters and motifs in some of his works. 950:

ahead". Moniz, in return, promised to send him a copy of his forthcoming monograph on leucotomy and urged him to purchase a leucotome from a French supplier.

5388:

Mareke, Arends; Fangerau, Heiner. Deep brain stimulation in psychiatric disorders. In: Fangerau, Heiner; Jörg, Fegert; Mareke, Arends (eds).

992:, Freeman at some point conceived of approaching the frontal lobes through the eye sockets instead of through drilled holes in the skull. In 1945 he took an 213:

of 1949 for the "discovery of the therapeutic value of leucotomy in certain psychoses", although the awarding of the prize has been subject to controversy.

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The authors neglected to mention, however, that in 1910 Puusepp himself had performed surgery on the brains of three mentally ill patients, sectioning the

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utilized media coverage and penned editorials for numerous interviews promoting the procedure and achieving accolades for his work in psychiatric care.

5649:. Alcune considerazioni sugli interventi chirurgici nelle malattie mentali [Some Considerations about Surgery in Mental Illness]. 573:

Moniz and other neurologists and neurosurgeons that surgery on this part of the brain might yield significant personality changes in the mentally ill.

6079:. Contributing editors Dagi, T. Forcht; Epstein, Mel H.. Park Ridge, IL: The American Association of Neurological Surgeons; 1997. 6051:. The Prefrontal Area and Psychosurgery. In: Uylings, H.B.M.; Van Eden, C.G.; De Bruin, J.P.C.; Corner, M.A.; Feenstra, M.G.P. (eds). 5238: 4381: 216:

The use of the procedure increased dramatically from the early 1940s and into the 1950s; by 1951, almost 20,000 lobotomies had been performed in the

1079:'through lobotomy' an insane person is changed into an idiot". By the 1970s, numerous countries had banned the procedure, as had several US states. 5117:. Some continuities and discontinuities in the pharmacotherapy of nervous conditions before and after chlorpromazine and imipramine. 1355:, who was the joint winner with Moniz of the Nobel Prize in 1949 for his work on the function of the midbrain, had no involvement with leucotomy. 609:

in 1930. The neurologist Richard Brickner reported on this case in 1932, relating that the recipient, known as "Patient A", while experiencing a

96: 1333: 1134:, a Polish violinist and composer, was diagnosed with schizophrenia and died at the age of 26 following a lobotomy performed on him in England. 1020:

the hospital reprimanded Freeman, stating that he was “not a surgeon and if he wants to operate he’ll have to apply for surgical privileges.”

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The first prefrontal leucotomy in the United States was performed at the George Washington University Hospital, on 14 September 1936, by the

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Experimental modifications of Moniz's operation were introduced with little delay by Italian medical practitioners. Most notably, in 1937

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neurophysiology laboratory at Yale in the early 1930s. At the 1935 Congress, with Moniz in attendance, Fulton and Jacobsen presented two

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may have arrangements more or less fixed, which will have a relation with persistent ideas and deliria in certain morbid psychic states.

432:

patients in total and, according to his own assessment, two experienced no change, two patients became quieter, one patient experienced

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This article is about the operation that severs connections within the brain. For the operation that removes a lobe of the brain, see

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were another common complication of surgery. Emphasis was put on the training of patients in the weeks and months following surgery.

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Protection on Human Subjects: Use of Psychosurgery in Practice and Research: Report and Recommendations for Public Comment. Part 3

4487: 6686: 5434: 172: 5957:. Egas Moniz and the Origins of Psychosurgery: A Review Commemorating the 50th Anniversary of Moniz's Nobel Prize. 4610:. An interpretation of frontal lobe function based upon the study of a case of partial bilateral frontal lobotomy. 6279: 4404: 210: 1819:

Zajicek, Benjamin (2017). "Banning the Soviet Lobotomy: Psychiatry, Ethics, and Professional Politics during Late Stalinism".

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Frontal leukotomy and related psychosurgical procedures in the era before antipsychotics (1935–1954): a historical overview

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Brickner and Davidoff had planned, before Moniz's first leucotomies, to operate on the frontal lobes to relieve depression.

4076:(French national consultative committee on ethics, opinion #71: Functional neurosurgery of severe psychiatric conditions) 228:

from 1948 to 1952 were performed on female patients. From the 1950s onward, lobotomy began to be abandoned, first in the

4633: 4590: 1737: 6691: 1713: 4405:"'The Mountain' Review: Jeff Goldblum and Tye Sheridan Are Lost Souls in Rick Alverson's Beautiful, Fractured America" 6808: 6767: 6150: 5946: 5780: 5758: 5692: 5638: 5606: 5408: 5380: 5159: 4928: 4834: 4812: 4789: 4599: 4459: 4045: 1803: 1460:

The American neuropsychiatrist Walter Freeman also attended the Congress where he presented his research findings on

564: 4897:. Functional neurosurgical intervention: neuroethics in the operating rooms. In: Illes, Judy (ed.). 6629: 6483: 5993: 981:

and limited budgets. Freeman wanted to simplify the procedure so that it could be carried out by psychiatrists in

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and concluded that she underwent a lobotomy for the treatment of pain and anxiety in the last months of her life.

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to rescind the award; the Foundation has not done so, and its website still hosts an article defending lobotomy.

586:. The refinement of neurosurgical techniques also facilitated increasing attempts to remove brain tumours, treat 6237: 378:. He operated on six chronic patients under his care at the Swiss Préfargier Asylum, removing sections of their 6813: 6803: 5905: 5069: 4983:. Учение Павлова – основа психиатрии [Pavlov's teaching is the basis of psychiatry]. 4568: 1770: 412:, he hoped to break their lines of communication and thus alleviate both mental symptoms and the experience of 4692: 3814: 675:, in essence he simply interpreted this new neurological research in terms of the old psychological theory of 6312: 1883: 642: 319: 6334: 6264: 1435: 930:

Site of borehole for the standard pre-frontal lobotomy/leucotomy operation as developed by Freeman and Watts

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narrow localizationism characteristic of psychiatrists of America, from where leucotomy was imported to us.

554:

highlighted in red. Moniz targeted the frontal lobes in the leucotomy procedure he first conceived in 1933.

1122:, underwent a lobotomy in 1941 that left her incapacitated and institutionalized for the rest of her life. 436:

and died a few days after the operation, and one patient improved. Complications included motor weakness,

6535: 6057:. Amsterdam & New York: Elsevier; 1990. (Progress in Brain Research, Volume 85). 5478:

PREFRONTAL LEUCOTOMY IN THE TREATMENT OF MENTAL DISORDERS (1937) American Journal of Psychiatry 1844–1944

1109: 889:. The major centre for leucotomy in Italy was the Racconigi Hospital, where the experienced neurosurgeon 6255: 5477: 4624:

Why Wagner-Jauregg won the Nobel Prize for discovering malaria therapy for General Paresis of the Insane

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Implanted Minds: The Neuroethics of Intracerebral Stem Cell Transplantation and Deep Brain Stimulation

4436:

Acharya, Hernish J.. The Rise and Fall of Frontal Leucotomy. In: Whitelaw, W.A. (ed).

6400: 5968: 5041:. Functional and epilepsy neurosurgery. In: Johnson, Reuben; Green, Alexander (eds). 4941: 1461: 1389: 1025: 938: 755: 335: 278: 5204: 1410:

According to Puusepp, the three patients had manic depression or considered "epileptic equivalents".

6754: 5988: 5497:. New evidence of prefrontal lobotomy in the last months of the illness of Eva Perón. 1268: 915: 103: 4669:. Neuropatients in Historyland. In: Jacyna, Stephen J.; Casper, Stephen T. (eds). 4467:

Bechterev, V.; Puusepp, L.. La chirugie des aliénes [Surgery of the Insane].

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The 14 leucotomies reported by Puusepp in his 1937 paper were performed at the Racconigi Hospital.

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Macmillan, Malcolm. The Center for the History of Psychology, University of Akron, Ohio.

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Operative Neuromodulation. Functional Neuroprosthetic Surgery. Volume II: Neural Networks Surgery

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The Lobotomist: A Maverick Medical Genius and His Tragic Quest to Rid the World of Mental Illness

1234:, the protagonist reacts with horror to the "perpetual marble calm" of a lobotomized young woman. 646: 6317: 6302: 6228: 6727: 6696: 6370: 5141: 4847: 583: 6096: 6075: 6053: 5350: 4671: 4591:

Mental Ills and Bodily Cures: Psychiatric Treatment in the First Half of the Twentieth Century

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The Greatest Benefit to Mankind: A Medical History of Humanity from Antiquity to the Present

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a carload of grapefruit, getting the right move and the right turn. That's what he told me."

605:

The first bilateral lobectomy of a human subject was performed by the American neurosurgeon

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to establish it as an early and influential centre for the adoption of leucotomy in Italy.

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wrote a memoir of his late-life discovery that he had been lobotomized in 1960 at age 12.

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Albert Q. Maisel, "Bedlam 1946, Most U.S. Mental Hospitals are a Shame and a Disgrace",

6762: 6530: 6459: 5413: 5139:. Surgery of the mind and mood: A mosaic of issues in time and evolution. 4803: 4477: 4024: 4022: 1852: 1352: 1177: 1145: 1009: 960:

In 1937 Freeman and Watts adapted Lima and Moniz's surgical procedure, and created the

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patient, and also that recovery or improvement may be obtained frequently in this way.

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Hoenig, J.. Schizophrenia. In: Berrios, German E.; Porter, Roy (eds).

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In 2011, Daniel Nijensohn, an Argentine-born neurosurgeon at Yale, examined X-rays of

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age; twelve were female and eight were male. Nine of the patients were diagnosed with

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Historically, patients of frontal lobotomy were, immediately following surgery, often

6798: 6366: 6194: 6168: 6146: 6126: 6104: 6080: 6058: 5972: 5942: 5922: 5884: 5862: 5798: 5776: 5754: 5732: 5710: 5688: 5634: 5602: 5568: 5529: 5510: 5482: 5463: 5446: 5395: 5376: 5337: 5309: 5290: 5261: 5180: 5155: 5102: 5074: 5048: 5026: 4968: 4924: 4904: 4882: 4860: 4856: 4830: 4808: 4784: 4768: 4676: 4595: 4573: 4551: 4532: 4517:. New York & Edinburgh: William Wood & Co; E.S Livingstone; 1922. 4499: 4455: 4180: 4041: 4040:

Bangen, Hans: Geschichte der medikamentösen Therapie der Schizophrenie. Berlin 1992,

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functionally adapt to such injury. Unlike the position adopted by Burckhardt, it was

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Therapy 101: A Brief Look at Modern Psychotherapy Techniques & How They Can Help

5827:. Milestones in the development of neurology and psychiatry in Europe. 4612:

Research Publications – Association for Research for Nervous end Mental Disease

4019: 1856: 1138: 390:(a sensory center), a connecting system where information processing took place (an 179:. The surgery causes most of the connections to and from the prefrontal cortex, the 54: 6711: 6597: 6024: 5964: 5914: 5854: 5832: 5772:

Overcoming Depression Without Drugs: Mahler's Polka With Introductory Funeral March

5668: 5560: 5502: 5438: 5329: 5282: 5253: 5172: 5124: 5094: 5064: 5018: 4946: 4939:. Psychosurgery: An Evaluation of Two Hundred Cases over Seven Years. 4852: 4760: 4733: 4715: 4654: 4637: 4623: 4491: 3878: 3826: 1828: 1151:

It is often said that when an iron rod was accidentally driven through the head of

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initiated what is commonly considered the first systematic attempt at modern human

315: 260: 6231: [podcast]; 16 November 2005 [Retrieved 28 November 2009]. 6010: 4746: 1518:

Before operating on live subjects, they practised the procedure on a cadaver head.

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My Lobotomy Radio story: Interview with Sallie Ellen Ionesco, lobotomised in 1946

6211: 6185: 6163: 6121: 5879: 5815: 5793: 5749: 5727: 5705: 5620: 5597: 5524: 5390: 5304: 5152:

A History of Clinical Psychiatry: The Origin and History of Psychiatric Disorders

5043: 4963: 4899: 4877: 4825: 4546: 4527: 4068: 3967:"Jesper Vaczy Kragh: "Sidste udvej? Træk af psykokirurgiens historie i Danmark" ( 1528: 1367: 1119: 906: 787: 634: 578: 473: 441: 413: 405: 379: 199: 195: 160: 109: 3867:"Psychosurgery, ethics, and media: a history of Walter Freeman and the lobotomy" 3815:"Psychosurgery, ethics, and media: a history of Walter Freeman and the lobotomy" 3787: 6556: 6468: 5661:. Psychosurgery, Industry and Personal Responsibility, 1940–1965. 5506: 5128: 5098: 4641: 4513: 4495: 4382:"A Lobotomist Struggles To Hang on in the Brilliant, Blistering 'The Mountain'" 1655: 1313: 1260: 1255: 1242: 1089: 1054: 946: 942: 890: 763: 676: 610: 587: 460: 424: 383: 311: 221: 134: 5858: 5616:

Music's boy wonder: Composer, conductor, singer ... and he's only fifteen

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Something Cloudy, Something Clear: Tennessee Williams's Postmodern Memory Play

5022: 4658: 3883: 3866: 3831: 1798:(9th ed.). Belmont, California: Wadsworth/Thomson Learning. p. 101. 6792: 6503: 6364: 6236:

Jansson, Bengt. Nobel Media [Retrieved 24 January 2012].

6073:. History of Psychosurgery. In: Greenblatt, Samuel H. (ed.). 6028: 5257: 4764: 3840: 1840: 1443: 1328: 1237: 816: 759: 690: 660: 481: 445: 409: 375: 217: 82: 6322: 6097:

Neurosurgical intervention for psychiatric illness: past, present and future

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has called the award of the Nobel Prize to Moniz an "astounding of judgment

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Cybernetics: Or the Control and Communication in the Animal and the Machine

953:

Upon receipt of Moniz's monograph, Freeman reviewed it anonymously for the

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Lima described his role as that of an "instrument handled by the Master".

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The pioneer of lobotomies, the Portuguese neurologist and Nobel Laureate

188: 5847:. Gottlieb Burckhardt – The Pioneer of Psychosurgery. 5750:

A History of Psychiatry: From the Era of the Asylum to the Age of Prozac

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Gottlieb Burckhardt and Egas Moniz – Two Beginnings of Psychosugery

419: 290: 6624: 6395: 5333: 4967:. 2nd ed. American Psychiatric Publishing, Inc.; 1999. 1678:"The dark history of gay men, lobotomies and Walter Jackson Freeman II" 1474: 1385: 978: 812: 343: 6256:

The Nobel Prize in Physiology or Medicine 1949 Walter Hess, Egas Moniz

6076:

A History of Neurosurgery: In Its Scientific and Professional Contexts

4878:

Origins of Neuroscience: A History of Explorations into Brain Function

4743:

Diefenbach, Gretchen; Diefenbach, Donald; Baumeister, Alan; West, Mark

4675:. Rochester, NY: University of Rochester Press; 2012. 4490:

30 December 2009; Retrieved 28 November 2009];8(1):61–81.

358: 252:. Some developed an enormous appetite and gained considerable weight. 119: 6706: 6639: 6634: 5913:

24 July 2008; Retrieved 29 November 2010];152(4):505–15.

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15 December 2011; Retrieved 26 November 2009];62(1/2):77–101.

4528:

A Critical Introduction to Twentieth-Century American Drama: Volume 2

4058:"La neurochirurgie fonctionnelle d'affections psychiatriques sévères" 3642: 3640: 1309: 1208: 910: 858: 791: 771: 742: 331: 314:" physical therapies devised during this experimental era, including 245: 58: 31: 4923:. 2nd ed. Belmont, California: Wadsworth; 2010. 3788:"Psychiatry | Mental Health, Treatment & Diagnosis | Britannica" 6589: 6494: 6425: 5233: 5073:. 1978 [Retrieved 22 January 2008];2(1):29–44. 1478: 1288: 997: 795: 737:

of the prefrontal area" so as to destroy the connecting fibres, or

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Bedlam 1946, Most U.S. Mental Hospitals are a Shame and a Disgrace

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Kotowicz, Zbigniew. Psychosurgery in Italy, 1936–39.

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from his own kitchen and began testing the idea on grapefruit and

507:

Leucotomy was first undertaken in 1935 under the direction of the

5723:

Sakas, Damianos E.; Panourias, L.G.; Singounas, E.; Simpson, B.A.

4333: 3009: 3007: 2516: 2514: 2512: 2510: 993: 882: 862: 850: 846: 746: 727: 225: 6099:. In: Miller, Bruce L.; Cummings, Jeffrey L. (eds). 5941:. New Brunswick, New Jersey: Transaction; 2007. 5192:

Kaempffert, Waldemar. Turning the Mind Inside Out.

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Neuroethics: defining the issues in theory, practice, and policy

4514:

The Mechanism of the Brain and the Function of the Frontal Lobes

3947: 3935: 1944: 1942: 1940: 1872:"A brief reflection on the not-so-brief history of the lobotomy" 48: 5601:. Cambridge: Cambridge University Press; 2002. 5525:

The encyclopedia of schizophrenia and other psychotic disorders

5417:. 30 January 2004 [Retrieved 17 November 2007]. 4826:

The Nobel prize: a history of genius, controversy, and prestige

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The patient he thought improved subsequently committed suicide.

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which had prevailed since the mid-nineteenth-century. The new "

233: 5816:

An Introduction to Physical Methods of Treatment in Psychiatry

5721: 5587:. Oxford: Blackwell Scientific Publications; 1950. 4299: 4297: 4295: 3911: 3004: 2507: 2475: 2296: 5357: 4999:. Moscow: Медицина ; 1973. Russian. p. 4. 3556: 3402: 3400: 2409: 2260: 1937: 1535:

that 15,000 leucotomies had been performed in the UK by 1962.

926: 874: 870: 854: 767: 485: 6303:'My Lobotomy': Howard Dully's Journey. NPR Radio Documentary 6054:

The Prefrontal Cortex: Its Structure, Function and Pathology

5166: 4699:. 12 January 2008 [Retrieved 31 March 2010]. 2994: 2992: 2979: 2977: 2252: 2094: 2092: 6215:. Philadelphia: Mental Health Foundation; 1947. 5624:. 6 February 2008 [Retrieved 11 July 2010]. 5545:. Philadelphia and London: W.B. Saunders; 1962. 4439:

The Proceedings of the 13th Annual History of Medicine Days

4292: 3573: 3571: 3528: 3459: 3433: 3431: 2872: 2870: 1927: 1925: 1910: 1898: 1738:"Race and Gender in the Selection of Patients for Lobotomy" 1197: 1096:... a terrible mistake", and there have been calls for the 878: 637:

had, before 1935, entertained the proposition. Inspired by

259:

The purpose of the operation was to reduce the symptoms of

5685:

The lobotomy letters: the making of American psychosurgery

5324:. On the history of psychosurgery in Russia. 5222:. Moscow: ЗАО Юстицинформ ; 2010. Russian. 5039:

Green, Alexander; Astradsson, A.; Stacey, R.J.; Aziz, T.Z.

4079: 3899: 3731: 3729: 3716: 3714: 3712: 3684: 3397: 3286: 3284: 3282: 3223: 2812: 2564: 2562: 2560: 2558: 2556: 2554: 2552: 2448: 2446: 2415: 2129: 2127: 2065: 6267:; 5 August 2004 [Retrieved 22 December 2011]. 5458:

Meduna, L.J.. Autobiography of L.J. Meduna.

5308:. Oxford: Oxford University Press; 1991. 5037: 4881:. Oxford: Oxford University Press; 2001. 4280: 4130: 3588: 3586: 3330:, p. 651. For Moniz's account of the procedure see, 3085: 2989: 2974: 2939: 2937: 2935: 2933: 2931: 2902: 2900: 2837: 2835: 2833: 2831: 2829: 2827: 2760: 2706: 2704: 2336: 2292: 2089: 1966: 1617: 1276:

for a doctor whose character is loosely based on Freeman.

4478:

The Origins of Psychosurgery: Shaw, Burckhardt and Moniz

4142: 4103: 3813:

Caruso, James P.; Sheehan, Jason P. (1 September 2017).

3568: 3471: 3428: 3181: 3179: 2867: 2784: 2655: 2653: 2353: 2351: 2326: 2324: 2311: 2309: 1922: 1638: 1636: 1634: 1632: 641:'s development of malarial therapy for the treatment of 602:

its critics due to deficiencies in experimental design.

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The originator of the procedure, Portuguese neurologist

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Mashour, George A.; Walker, Erin E.; Martuza, Robert L.

4321: 4251: 4205: 4124: 4013: 3923: 3726: 3709: 3672: 3369: 3279: 3255: 3164: 2549: 2537: 2443: 2369: 2300: 2139: 2124: 2006: 2004: 1954: 901:, the medical director of a psychiatric institution in 4851:. March 2001;48(3):647–57; discussion 657–59. 4309: 4091: 3753: 3741: 3583: 3357: 3267: 3152: 2962: 2928: 2897: 2824: 2772: 2701: 2077: 6238:

Controversial Psychosurgery Resulted in a Nobel Prize

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Last Resort: Psychosurgery and the Limits of Medicine

5481:. American Psychiatric Publishing; 1994. 4845:. Psychosurgery: A Historical Overview. 4747:

Portrayal of lobotomy in the popular press: 1935–1960

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and his younger Estonian colleague, the neurosurgeon

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Heller, A. C.; Amar, A.P.; Liu, C.Y.; Apuzzo, M.L.J.

5065:

Of Graver Import Than History: Psychiatry in Fiction

4193: 3603: 3601: 2886: 2186: 2014: 2001: 1607: 1605: 1284: 1167: 175:) that involves severing connections in the brain's 6093:

Weiss, Anthony P.; Rauch, Scott L.; Price, Bruce H.

5765: 5687:. University of Rochester Press; 2013. 5135: 4345: 4245: 3847: 2726: 2695: 2683: 2526: 2379: 2248: 1384:, the Italian psychiatrist and joint inventor with 1190:Tennessee Williams criticized lobotomy in his play 1082:In 1977, the US Congress, during the presidency of 794:, as well as psychological effects such as apathy, 714:On 12 November 1935 at the Hospital Santa Marta in 650:determine if there had been a "lasting remission". 202:, so it was said to be an inappropriate treatment. 6289:article on lobotomy and contemporary psychosurgery 6249:; 1999–2012 [Retrieved 21 March 2009]. 5939:Coercion as Cure: A Critical History of Psychiatry 5553:. Psychosurgery in Sweden 1944–1964. 4693:He was bad, so they put an ice pick in his brain.. 4228: 4176:Coercion as Cure: A Critical History of Psychiatry 3765: 3443: 2912: 1978: 194:In the past, this treatment was used for treating 6318:Nobel Panel Urged to Rescind Prize for Lobotomies 5528:. 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Wiley; 2005. 4719:. 23 May 1977 [ 3651:Feldman & Goodrich 2001 3490:Feldman & Goodrich 2001 3348:Feldman & Goodrich 2001 3328:Feldman & Goodrich 2001 3308:Feldman & Goodrich 2001 3202:Feldman & Goodrich 2001 3147:Feldman & Goodrich 2001 3043:Feldman & Goodrich 2001 3014:Feldman & Goodrich 2001 2521:Feldman & Goodrich 2001 2482:Feldman & Goodrich 2001 2039:Feldman & Goodrich 2001 2011:Feldman & Goodrich 2001 1280: 1110:Category:Lobotomised people 10: 6830: 6191:New Harbinger Publications 5664:Social History of Medicine 5543:Modern clinical psychiatry 5507:10.1016/j.wneu.2011.02.036 5129:10.1177/0957154X0001104405 5099:10.3171/2010.10.FOCUS10214 4642:10.1177/0957154X0001104403 4496:10.1177/0957154X9700802905 4471:. 1912;34:1–17, 69–89. 4423: 4340:Gabbard & Gabbard 1999 3918:Tranøy & Blomberg 2005 3230:, Gross & Schäfer 2011 2862:Levin & Eisenberg 1991 2285:Mareke & Fangerau 2010 2269:Reevy, Ozer & Ito 2010 1137:Swedish modernist painter 1107: 514:(and inventor of the term 423:The Estonian neurosurgeon 334:shock therapy (1934), and 285: 239: 29: 6755:Clinical prediction rules 6753: 6720: 6648: 6606: 6588: 6544: 6492: 6457: 6423: 6414: 6401:Decompressive craniectomy 6386: 6377: 5859:10.1076/jhin.10.1.79.5634 5287:10.1017/S0025727300004646 5023:10.1136/bmj.313.7059.708a 4964:Psychiatry and the Cinema 4942:Journal of Mental Science 4659:10.1007/s11019-013-9519-8 4086:Ogren & Sandlund 2005 3942:Ogren & Sandlund 2005 3884:10.3171/2017.6.FOCUS17257 3832:10.3171/2017.6.FOCUS17257 3523:Sargant & Slater 1963 2289:Ford & Henderson 2006 1462:cerebral ventriculography 1390:electroconvulsive therapy 1118:, sister of US president 1026:electroconvulsive therapy 336:electroconvulsive therapy 155:is a discredited form of 144: 'lobe' and 116: 102: 90: 74: 66: 46: 41: 6809:Neurosurgical procedures 6029:10.1177/0957154X05052224 5258:10.1177/0957154X07087345 5203:Kolin, Philip. 5093:. 2011;30(2):8. 4765:10.1076/jhin.8.1.60.1766 3423:Gross & Schäfer 2011 3407:Gross & Schäfer 2011 3324:Gross & Schäfer 2011 3250:Gross & Schäfer 2011 3214:Gross & Schäfer 2011 3121:Gross & Schäfer 2011 3092:Gross & Schäfer 2011 2957:Freeman & Watts 1944 2245:Gross & Schäfer 2011 2099:Gross & Schäfer 2011 1882:: 302–04. 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1905:Noyes & Kolb 1962 1833:10.1353/bhm.2017.0002 1795:Biological psychology 1742:Wonders & Marvels 1319:Frontal lobe disorder 1304:Bilateral cingulotomy 1193:Suddenly, Last Summer 1068: 983:psychiatric hospitals 972:Transorbital lobotomy 929: 827: 701: 681: 639:Julius Wagner-Jauregg 615:Roy Glenwood Spurling 546: 499: 465: 434:epileptic convulsions 422: 361: 328:insulin shock therapy 295:Insulin shock therapy 293: 200:psychiatric illnesses 196:psychiatric disorders 165:neurological disorder 53:Lobotomy underway at 6682:Transcranial Doppler 6668:Cerebral angiography 6620:Spinal decompression 6164:Suddenly Last Summer 6019:. 2005 [ 5997:. 1996 [ 5909:. 1995 [ 5653:. 1937;100:3–16. 5433:. 2005 [ 5326:Acta Neurochirurgica 5237:. 2005 [ 4993:Gilyarovsky, Vasily 4981:Gilyarovsky, Vasily 4755:. 1999 [ 4632:. 2000 [ 4608:Brickner, Richard M. 4486:. 1997 [ 4149:Wood & Wood 2008 3521:, pp. 486 n.1; 2253:Joanette et al. 1993 2160:, pp. 190–225; 1527:It was estimated by 1449:cerebral angiography 1274:medical photographer 1219:1975 film adaptation 1178:Robert Penn Warren's 1144:American playwright 964:, also known as the 766:, and one each with 720:cerebral angiography 394:), and an output or 308:therapeutic nihilism 161:psychiatric disorder 70:Leucotomy, leukotomy 6678:Echoencephalography 6444:Thalamic stimulator 6159:Williams, Tennessee 5522:Noll, Richard. 5367:Macmillan, M.. 5091:Neurosurgical Focus 4734:Shame of the States 3871:Neurosurgical Focus 3819:Neurosurgical Focus 3565:, pp. 477, 487 3553:, pp. 477, 486 2410:Manjila et al. 2008 2261:Manjila et al. 2008 2235:, pp. 116, 129 2179:, pp. 600–05; 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2008. 6182: 6176: 6160: 6154: 6140: 6134: 6118: 6112: 6111:. p. 505–17. 6094: 6088: 6072: 6066: 6065:. p. 539–54. 6050: 6044: 6038: 6032: 6008: 6002: 5986: 5980: 5956: 5950: 5936: 5930: 5898: 5892: 5876: 5870: 5846: 5840: 5826: 5820: 5812: 5806: 5790: 5784: 5768: 5762: 5746: 5740: 5739:. p. 365–74. 5724: 5718: 5702: 5696: 5682: 5676: 5660: 5654: 5648: 5642: 5625: 5610: 5594: 5588: 5582: 5576: 5552: 5546: 5537: 5518: 5496: 5490: 5489:. p. 237–39. 5471: 5454: 5424: 5418: 5403: 5384: 5375:; 2000. 5363: 5354: 5345: 5323: 5322:Lichterman, B.L. 5317: 5298: 5269: 5242: 5223: 5212: 5199: 5188: 5163: 5146: 5138: 5132: 5116: 5110: 5088: 5082: 5062: 5056: 5040: 5034: 5006: 5000: 4994: 4988: 4982: 4976: 4960: 4954: 4938: 4932: 4918: 4912: 4896: 4890: 4874: 4868: 4844: 4838: 4822: 4816: 4800: 4794: 4782: 4776: 4744: 4738: 4730: 4724: 4716:Federal Register 4708: 4700: 4690: 4684: 4683:. p. 215–22. 4668: 4662: 4645: 4621: 4620:Brown, Edward M. 4615: 4609: 4603: 4587: 4586:Braslow, Joel T. 4581: 4565: 4564:Braslow, Joel T. 4559: 4540: 4524: 4518: 4507: 4472: 4463: 4449: 4443: 4417: 4416: 4414: 4412: 4400: 4394: 4393: 4391: 4389: 4377: 4371: 4361: 4355: 4349: 4343: 4337: 4331: 4325: 4319: 4313: 4307: 4306:, pp. 42–44 4301: 4290: 4284: 4278: 4273:, p. 250, 4269:Macmillan ( 4267: 4261: 4260:, pp. 50–51 4255: 4249: 4243: 4237: 4232: 4226: 4221: 4215: 4209: 4203: 4197: 4191: 4190: 4170: 4164: 4158: 4152: 4146: 4140: 4137:Gilyarovsky 1973 4134: 4128: 4127:, pp. 17–18 4123:, pp. 1–4; 4118: 4112: 4110:Gilyarovsky 1950 4107: 4101: 4095: 4089: 4083: 4077: 4075: 4074:on 20 July 2011. 4073: 4062: 4054: 4048: 4038: 4032: 4031:, pp. 60–69 4026: 4017: 4016:, pp. 17–18 4011: 4005: 3999: 3993: 3992: 3990: 3988: 3982: 3976:. Archived from 3975: 3963: 3957: 3951: 3945: 3939: 3933: 3927: 3921: 3915: 3909: 3903: 3897: 3896: 3886: 3862: 3856: 3851: 3845: 3844: 3834: 3810: 3804: 3803: 3801: 3799: 3784: 3778: 3772: 3763: 3757: 3751: 3745: 3739: 3733: 3724: 3718: 3707: 3700: 3694: 3693:, pp. 73–75 3688: 3682: 3676: 3670: 3660: 3654: 3644: 3635: 3625: 3619: 3605: 3596: 3590: 3581: 3575: 3566: 3560: 3554: 3544: 3538: 3532: 3526: 3516: 3510: 3503: 3497: 3487: 3481: 3475: 3469: 3463: 3457: 3450: 3441: 3435: 3426: 3416: 3410: 3404: 3395: 3385: 3379: 3373: 3367: 3361: 3355: 3341: 3335: 3317: 3311: 3305: 3294: 3288: 3277: 3271: 3265: 3259: 3253: 3239: 3233: 3227: 3221: 3211: 3205: 3195: 3189: 3183: 3174: 3168: 3162: 3156: 3150: 3143: 3137: 3130: 3124: 3114: 3108: 3101: 3095: 3089: 3083: 3076: 3070: 3056: 3050: 3036: 3030: 3023: 3017: 3011: 3002: 2996: 2987: 2981: 2972: 2966: 2960: 2953: 2947: 2941: 2926: 2919: 2910: 2904: 2895: 2890: 2884: 2874: 2865: 2851: 2845: 2839: 2822: 2816: 2810: 2800: 2794: 2793:, pp. 72–73 2788: 2782: 2776: 2770: 2769:, pp. 48–50 2764: 2758: 2752: 2746: 2736: 2730: 2720: 2714: 2708: 2699: 2693: 2687: 2669: 2663: 2657: 2648: 2642: 2636: 2626: 2620: 2610: 2604: 2590: 2584: 2578: 2572: 2566: 2547: 2541: 2535: 2530: 2524: 2518: 2505: 2491: 2485: 2479: 2473: 2466: 2460: 2450: 2441: 2431: 2425: 2419: 2413: 2407: 2401: 2395: 2389: 2383: 2377: 2367: 2361: 2355: 2346: 2340: 2334: 2328: 2319: 2313: 2304: 2242: 2236: 2226: 2220: 2214: 2208: 2202: 2196: 2190: 2184: 2170: 2164: 2155: 2149: 2143: 2137: 2131: 2122: 2108: 2102: 2096: 2087: 2081: 2075: 2069: 2063: 2052: 2046: 2024: 2018: 2008: 1999: 1993: 1987: 1982: 1976: 1970: 1964: 1958: 1952: 1946: 1935: 1929: 1920: 1914: 1908: 1902: 1896: 1895: 1893: 1891: 1867: 1861: 1860: 1816: 1810: 1809: 1789: 1783: 1782: 1780: 1778: 1773:on 14 March 2016 1769:. Archived from 1759: 1753: 1752: 1750: 1748: 1733: 1727: 1726: 1724: 1722: 1699: 1693: 1692: 1690: 1688: 1673: 1664: 1663: 1651: 1645: 1640: 1627: 1621: 1615: 1609: 1600: 1599: 1597: 1595: 1581: 1565: 1561: 1555: 1551: 1545: 1542: 1536: 1525: 1519: 1516: 1510: 1507: 1501: 1497: 1491: 1488: 1482: 1473:The patient had 1471: 1465: 1458: 1452: 1427: 1421: 1417: 1411: 1408: 1402: 1399: 1393: 1379: 1373: 1362: 1356: 1350: 1297: 1292: 1291: 1259:depicts actress 1116:Rosemary Kennedy 1098:Nobel Foundation 1095: 1078: 1057:, the author of 990:Amarro Fiamberti 916:Walter Freeman's 899:Amarro Fiamberti 836: 776:manic-depression 710: 619:Spafford Ackerly 599:Leonardo Bianchi 550:animation: left 453:Saint Petersburg 406:mental pathology 348:patients' rights 316:malarial therapy 297:administered in 261:mental disorders 120:edit on Wikidata 112: 86: 85: 51: 39: 38: 21: 6829: 6828: 6824: 6823: 6822: 6820: 6819: 6818: 6789: 6788: 6787: 6782: 6749: 6745:Polysomnography 6733:Lumbar puncture 6716: 6644: 6602: 6580: 6552:Pituitary gland 6540: 6526:Hemispherectomy 6493: 6488: 6474:Ventriculostomy 6458: 6453: 6430:globus pallidus 6424: 6410: 6382: 6373: 6363: 6324:The Lobotomists 6276: 6271: 6206: 6180: 6158: 6139:Wiener, Norbert 6138: 6116: 6092: 6070: 6048: 6036: 6006: 5984: 5954: 5934: 5896: 5874: 5845:Stone, James L. 5844: 5824: 5810: 5788: 5766: 5745:Shorter, Edward 5744: 5722: 5700: 5680: 5658: 5646: 5621:The Independent 5592: 5580: 5550: 5494: 5422: 5321: 5279:Medical History 5136: 5114: 5086: 5061:Grenander, M.E. 5060: 5038: 5004: 4992: 4980: 4958: 4936: 4916: 4894: 4873:Finger, Stanley 4872: 4842: 4821:Feldman, Burton 4820: 4798: 4780: 4742: 4729:Deutsch, Albert 4728: 4704: 4688: 4666: 4619: 4607: 4585: 4563: 4522: 4448:Arnold, William 4447: 4426: 4421: 4420: 4410: 4408: 4401: 4397: 4387: 4385: 4378: 4374: 4362: 4358: 4350: 4346: 4338: 4334: 4326: 4322: 4314: 4310: 4302: 4293: 4285: 4281: 4268: 4264: 4256: 4252: 4244: 4240: 4233: 4229: 4222: 4218: 4210: 4206: 4198: 4194: 4187: 4171: 4167: 4159: 4155: 4147: 4143: 4135: 4131: 4121:Lichterman 1993 4119: 4115: 4108: 4104: 4096: 4092: 4084: 4080: 4071: 4060: 4056: 4055: 4051: 4039: 4035: 4027: 4020: 4012: 4008: 4002:Lichterman 1993 4000: 3996: 3986: 3984: 3983:on 5 March 2016 3980: 3973: 3965: 3964: 3960: 3952: 3948: 3940: 3936: 3932:, pp. 1–20 3928: 3924: 3916: 3912: 3904: 3900: 3863: 3859: 3852: 3848: 3811: 3807: 3797: 3795: 3786: 3785: 3781: 3773: 3766: 3758: 3754: 3746: 3742: 3734: 3727: 3719: 3710: 3701: 3697: 3689: 3685: 3677: 3673: 3661: 3657: 3645: 3638: 3630:, p. 227; 3626: 3622: 3614:, p. 293; 3610:, p. 182; 3606: 3599: 3591: 3584: 3576: 3569: 3561: 3557: 3545: 3541: 3533: 3529: 3517: 3513: 3504: 3500: 3492:, p. 652; 3488: 3484: 3476: 3472: 3464: 3460: 3451: 3444: 3436: 3429: 3417: 3413: 3405: 3398: 3386: 3382: 3374: 3370: 3362: 3358: 3352:Valenstein 1997 3350:, p. 651; 3342: 3338: 3318: 3314: 3306: 3297: 3289: 3280: 3272: 3268: 3260: 3256: 3240: 3236: 3228: 3224: 3212: 3208: 3196: 3192: 3184: 3177: 3169: 3165: 3157: 3153: 3144: 3140: 3131: 3127: 3115: 3111: 3102: 3098: 3090: 3086: 3080:Valenstein 1997 3077: 3073: 3067:Valenstein 1997 3065:, p. 541; 3063:Valenstein 1990 3057: 3053: 3045:, p. 650; 3041:, p. 541; 3039:Valenstein 1990 3037: 3033: 3027:Valenstein 1990 3024: 3020: 3012: 3005: 2999:Valenstein 1997 2997: 2990: 2984:Valenstein 1990 2982: 2975: 2967: 2963: 2954: 2950: 2942: 2929: 2920: 2913: 2905: 2898: 2891: 2887: 2875: 2868: 2852: 2848: 2840: 2825: 2817: 2813: 2807:Valenstein 1997 2801: 2797: 2789: 2785: 2777: 2773: 2765: 2761: 2753: 2749: 2737: 2733: 2721: 2717: 2709: 2702: 2694: 2690: 2682:, p. 226; 2670: 2666: 2658: 2651: 2643: 2639: 2627: 2623: 2615:, p. 226; 2611: 2607: 2591: 2587: 2579: 2575: 2567: 2550: 2542: 2538: 2531: 2527: 2519: 2508: 2500:, p. 486; 2492: 2488: 2480: 2476: 2467: 2463: 2451: 2444: 2432: 2428: 2420: 2416: 2408: 2404: 2396: 2392: 2384: 2380: 2372:, p. 276; 2368: 2364: 2356: 2349: 2341: 2337: 2329: 2322: 2314: 2307: 2299:, p. 366; 2295:, p. 208; 2291:, p. 219; 2287:, p. 138; 2271:, p. 485; 2267:, p. 326; 2259:, p. 486; 2251:, p. 727; 2243: 2239: 2231:, p. 428; 2227: 2223: 2215: 2211: 2203: 2199: 2191: 2187: 2175:, p. 404; 2171: 2167: 2156: 2152: 2144: 2140: 2132: 2125: 2117:, p. 337; 2109: 2105: 2097: 2090: 2082: 2078: 2070: 2066: 2053: 2049: 2041:, p. 650; 2025: 2021: 2013:, p. 650; 2009: 2002: 1994: 1990: 1983: 1979: 1971: 1967: 1959: 1955: 1949:Valenstein 1997 1947: 1938: 1930: 1923: 1915: 1911: 1903: 1899: 1889: 1887: 1868: 1864: 1817: 1813: 1806: 1790: 1786: 1776: 1774: 1761: 1760: 1756: 1746: 1744: 1734: 1730: 1720: 1718: 1716: 1700: 1696: 1686: 1684: 1674: 1667: 1652: 1648: 1643:Sutherland 2004 1641: 1630: 1622: 1618: 1610: 1603: 1593: 1591: 1583: 1582: 1578: 1573: 1568: 1562: 1558: 1552: 1548: 1543: 1539: 1529:William Sargant 1526: 1522: 1517: 1513: 1508: 1504: 1498: 1494: 1489: 1485: 1472: 1468: 1459: 1455: 1428: 1424: 1418: 1414: 1409: 1405: 1400: 1396: 1380: 1376: 1363: 1359: 1351: 1347: 1343: 1338: 1293: 1286: 1283: 1170: 1120:John F. Kennedy 1112: 1106: 1093: 1076: 1044: 1035: 974: 924: 838: 834: 825: 817:brain abscesses 815:, epilepsy and 808: 712: 708: 699: 656: 579:mammalian brain 528: 494: 442:sensory aphasia 414:mental distress 388:afferent system 380:cerebral cortex 356: 288: 242: 123: 108: 81: 80: 62: 35: 28: 23: 22: 15: 12: 11: 5: 6827: 6817: 6816: 6811: 6806: 6801: 6784: 6783: 6781: 6780: 6775: 6770: 6765: 6759: 6757: 6751: 6750: 6748: 6747: 6742: 6741: 6740: 6730: 6724: 6722: 6718: 6717: 6715: 6714: 6709: 6704: 6699: 6694: 6689: 6684: 6675: 6670: 6665: 6660: 6654: 6652: 6646: 6645: 6643: 6642: 6637: 6632: 6627: 6622: 6616: 6614: 6604: 6603: 6601: 6600: 6594: 6592: 6586: 6585: 6582: 6581: 6579: 6578: 6573: 6572: 6571: 6561: 6560: 6559: 6557:Hypophysectomy 6548: 6546: 6542: 6541: 6539: 6538: 6533: 6528: 6523: 6518: 6517: 6516: 6511: 6500: 6498: 6490: 6489: 6487: 6486: 6481: 6476: 6471: 6469:Cerebral shunt 6465: 6463: 6455: 6454: 6452: 6451: 6446: 6441: 6435: 6433: 6418: 6412: 6411: 6409: 6408: 6403: 6398: 6392: 6390: 6384: 6383: 6378: 6375: 6374: 6369:involving the 6362: 6361: 6354: 6347: 6339: 6333: 6332: 6320: 6315: 6310: 6305: 6300: 6291: 6282: 6275: 6274:External links 6272: 6270: 6269: 6260: 6251: 6242: 6233: 6221:Online sources 6218: 6217: 6203: 6177: 6155: 6135: 6113: 6089: 6067: 6045: 6033: 6003: 5981: 5951: 5931: 5893: 5871: 5841: 5821: 5807: 5785: 5763: 5741: 5719: 5697: 5677: 5655: 5643: 5626: 5611: 5589: 5577: 5547: 5538: 5519: 5491: 5472: 5455: 5419: 5404: 5385: 5364: 5355: 5346: 5318: 5299: 5270: 5243: 5224: 5213: 5200: 5189: 5164: 5147: 5133: 5111: 5083: 5057: 5035: 5001: 4989: 4977: 4955: 4933: 4913: 4891: 4869: 4839: 4817: 4795: 4777: 4739: 4725: 4701: 4689:Day, Elizabeth 4685: 4663: 4646: 4616: 4604: 4582: 4560: 4541: 4523:Bigsby, C.W.E. 4519: 4508: 4473: 4464: 4444: 4427: 4425: 4422: 4419: 4418: 4395: 4372: 4356: 4344: 4332: 4320: 4308: 4304:Grenander 1978 4291: 4287:Nijensohn 2012 4279: 4262: 4250: 4238: 4227: 4216: 4204: 4192: 4185: 4165: 4153: 4151:, p. 153. 4141: 4129: 4113: 4102: 4100:, p. 148. 4090: 4078: 4049: 4033: 4018: 4006: 4004:, pp. 1–4 3994: 3958: 3946: 3934: 3922: 3910: 3898: 3857: 3846: 3805: 3794:. 19 July 2024 3779: 3764: 3762:, p. 184. 3752: 3740: 3725: 3708: 3695: 3683: 3671: 3665:, p. 76; 3655: 3649:, p. 76; 3636: 3620: 3597: 3582: 3567: 3555: 3539: 3527: 3511: 3498: 3482: 3470: 3458: 3442: 3427: 3421:, p. 74; 3411: 3396: 3390:, p. 75; 3380: 3368: 3356: 3346:, p. 81; 3336: 3312: 3295: 3278: 3276:, p. 292. 3266: 3254: 3244:, p. 29; 3234: 3222: 3206: 3190: 3188:, p. 237. 3175: 3163: 3151: 3138: 3125: 3119:, p. 99; 3109: 3096: 3084: 3071: 3061:, p. 77; 3051: 3031: 3018: 3003: 2988: 2973: 2961: 2948: 2927: 2911: 2896: 2885: 2879:, p. 52; 2866: 2860:, p. 51; 2846: 2823: 2811: 2795: 2783: 2771: 2759: 2747: 2741:, p. 48; 2731: 2725:, p. 48; 2715: 2700: 2688: 2664: 2649: 2637: 2621: 2605: 2595:, p. 25; 2585: 2573: 2548: 2536: 2525: 2506: 2496:, p. 80; 2486: 2474: 2461: 2455:, p. 80; 2442: 2426: 2414: 2402: 2390: 2378: 2362: 2347: 2335: 2320: 2305: 2283:, p. 37; 2237: 2221: 2219:, p. 520. 2209: 2197: 2185: 2165: 2150: 2138: 2123: 2103: 2088: 2086:, p. 218. 2076: 2064: 2047: 2019: 2000: 1988: 1977: 1965: 1953: 1936: 1921: 1917:Partridge 1950 1909: 1897: 1862: 1811: 1804: 1784: 1754: 1728: 1715:978-0472119448 1714: 1694: 1665: 1646: 1628: 1616: 1601: 1575: 1574: 1572: 1569: 1567: 1566: 1556: 1546: 1537: 1520: 1511: 1502: 1492: 1483: 1466: 1453: 1422: 1420:was warranted. 1412: 1403: 1394: 1374: 1357: 1344: 1342: 1339: 1337: 1336: 1331: 1326: 1321: 1316: 1314:medical ethics 1307: 1300: 1299: 1298: 1282: 1279: 1278: 1277: 1266:The 2018 film 1264: 1261:Frances Farmer 1247: 1243:A Fine Madness 1235: 1228:'s 1963 novel 1222: 1211:'s 1962 novel 1205: 1204:her, Doctor?". 1188: 1169: 1166: 1165: 1164: 1157: 1149: 1142: 1139:Sigrid Hjertén 1135: 1129: 1123: 1105: 1102: 1090:Torsten Wiesel 1055:Norbert Wiener 1043: 1040: 1034: 1031: 973: 970: 943:James W. Watts 939:Walter Freeman 923: 920: 891:Ludvig Puusepp 826: 824: 821: 807: 804: 764:panic disorder 700: 698: 695: 677:associationism 655: 652: 588:focal epilepsy 527: 524: 493: 490: 482:parietal lobes 461:Ludvig Puusepp 425:Ludvig Puusepp 384:associationist 355: 352: 287: 284: 279:Walter Freeman 241: 238: 222:United Kingdom 125: 124: 117: 114: 113: 106: 100: 99: 94: 88: 87: 78: 72: 71: 68: 64: 63: 55:Södersjukhuset 52: 44: 43: 26: 9: 6: 4: 3: 2: 6826: 6815: 6812: 6810: 6807: 6805: 6802: 6800: 6797: 6796: 6794: 6779: 6776: 6774: 6771: 6769: 6766: 6764: 6761: 6760: 6758: 6756: 6752: 6746: 6743: 6739: 6736: 6735: 6734: 6731: 6729: 6726: 6725: 6723: 6719: 6713: 6710: 6708: 6705: 6703: 6700: 6698: 6695: 6693: 6690: 6688: 6685: 6683: 6679: 6676: 6674: 6671: 6669: 6666: 6664: 6661: 6659: 6656: 6655: 6653: 6651: 6647: 6641: 6638: 6636: 6633: 6631: 6628: 6626: 6623: 6621: 6618: 6617: 6615: 6613: 6609: 6605: 6599: 6596: 6595: 6593: 6591: 6587: 6577: 6574: 6570: 6567: 6566: 6565: 6562: 6558: 6555: 6554: 6553: 6550: 6549: 6547: 6543: 6537: 6534: 6532: 6529: 6527: 6524: 6522: 6519: 6515: 6512: 6510: 6507: 6506: 6505: 6504:Psychosurgery 6502: 6501: 6499: 6496: 6491: 6485: 6482: 6480: 6477: 6475: 6472: 6470: 6467: 6466: 6464: 6461: 6456: 6450: 6447: 6445: 6442: 6440: 6437: 6436: 6434: 6431: 6427: 6422: 6419: 6417: 6413: 6407: 6404: 6402: 6399: 6397: 6394: 6393: 6391: 6389: 6385: 6381: 6376: 6372: 6368: 6360: 6355: 6353: 6348: 6346: 6341: 6340: 6337: 6330: 6326: 6325: 6321: 6319: 6316: 6314: 6311: 6309: 6306: 6304: 6301: 6299: 6297: 6292: 6290: 6288: 6283: 6281: 6278: 6277: 6266: 6261: 6257: 6252: 6248: 6243: 6239: 6234: 6230: 6225: 6224: 6223: 6222: 6214: 6213: 6204: 6200: 6196: 6192: 6188: 6187: 6178: 6174: 6170: 6166: 6165: 6156: 6152: 6151:0-262-73009-X 6148: 6144: 6136: 6132: 6128: 6124: 6123: 6114: 6110: 6106: 6102: 6098: 6090: 6086: 6082: 6078: 6077: 6068: 6064: 6060: 6056: 6055: 6046: 6042: 6034: 6030: 6026: 6022: 6018: 6017: 6012: 6004: 6000: 5996: 5995: 5990: 5982: 5978: 5974: 5970: 5966: 5962: 5961: 5952: 5948: 5947:0-7658-0379-8 5944: 5940: 5935:Szasz, Thomas 5932: 5928: 5924: 5920: 5916: 5912: 5908: 5907: 5902: 5894: 5890: 5886: 5882: 5881: 5872: 5868: 5864: 5860: 5856: 5852: 5851: 5842: 5838: 5834: 5830: 5822: 5818: 5817: 5808: 5804: 5800: 5796: 5795: 5789:Shutts, David 5786: 5782: 5781:1-4685-4962-6 5778: 5774: 5773: 5764: 5760: 5759:0-471-24531-3 5756: 5752: 5751: 5742: 5738: 5734: 5730: 5729: 5720: 5716: 5712: 5708: 5707: 5698: 5694: 5693:9781580464499 5690: 5686: 5678: 5674: 5670: 5666: 5665: 5656: 5652: 5644: 5640: 5639:0-00-637454-9 5636: 5632: 5627: 5623: 5622: 5617: 5612: 5608: 5607:0-521-52459-8 5604: 5600: 5599: 5590: 5586: 5578: 5574: 5570: 5566: 5562: 5558: 5557: 5548: 5544: 5539: 5535: 5531: 5527: 5526: 5520: 5516: 5512: 5508: 5504: 5500: 5495:Nijensohn, DE 5492: 5488: 5484: 5480: 5479: 5473: 5469: 5465: 5461: 5456: 5452: 5448: 5444: 5440: 5436: 5432: 5428: 5420: 5416: 5415: 5410: 5405: 5401: 5397: 5393: 5392: 5386: 5382: 5381:0-262-13363-6 5378: 5374: 5370: 5365: 5361: 5356: 5352: 5347: 5343: 5339: 5335: 5331: 5327: 5319: 5315: 5311: 5307: 5306: 5300: 5296: 5292: 5288: 5284: 5280: 5276: 5271: 5267: 5263: 5259: 5255: 5251: 5250: 5244: 5240: 5236: 5235: 5230: 5225: 5221: 5220: 5214: 5210: 5206: 5201: 5197: 5196: 5190: 5186: 5182: 5178: 5174: 5170: 5165: 5161: 5160:0-485-24011-4 5157: 5153: 5148: 5144: 5143: 5134: 5130: 5126: 5122: 5121: 5112: 5108: 5104: 5100: 5096: 5092: 5084: 5080: 5076: 5072: 5071: 5066: 5058: 5054: 5050: 5046: 5045: 5036: 5032: 5028: 5024: 5020: 5016: 5015: 5010: 5002: 4998: 4990: 4986: 4978: 4974: 4970: 4966: 4965: 4956: 4952: 4948: 4944: 4943: 4934: 4930: 4929:0-547-17779-8 4926: 4922: 4914: 4910: 4906: 4902: 4901: 4892: 4888: 4884: 4880: 4879: 4870: 4866: 4862: 4858: 4854: 4850: 4849: 4840: 4836: 4835:1-55970-592-2 4832: 4828: 4827: 4818: 4814: 4813:0-471-23292-0 4810: 4806: 4805: 4796: 4792: 4791: 4786: 4778: 4774: 4770: 4766: 4762: 4758: 4754: 4753: 4748: 4740: 4736: 4735: 4726: 4722: 4718: 4717: 4712: 4707: 4702: 4698: 4694: 4686: 4682: 4678: 4674: 4673: 4667:Cooter, Roger 4664: 4660: 4656: 4652: 4647: 4643: 4639: 4635: 4631: 4630: 4625: 4617: 4613: 4605: 4601: 4600:0-520-20547-2 4597: 4593: 4592: 4583: 4579: 4575: 4571: 4570: 4561: 4557: 4553: 4549: 4548: 4542: 4538: 4534: 4530: 4529: 4520: 4516: 4515: 4509: 4505: 4501: 4497: 4493: 4489: 4485: 4484: 4479: 4474: 4470: 4465: 4461: 4460:0-425-05481-0 4457: 4453: 4445: 4441: 4440: 4434: 4433: 4432: 4431: 4430:Print Sources 4406: 4399: 4383: 4376: 4369: 4365: 4360: 4353: 4348: 4341: 4336: 4329: 4328:Williams 1998 4324: 4318:, p. 100 4317: 4312: 4305: 4300: 4298: 4296: 4289:, p. 582 4288: 4283: 4276: 4272: 4266: 4259: 4254: 4247: 4242: 4236: 4231: 4225: 4220: 4214:, p. 271 4213: 4208: 4201: 4196: 4188: 4182: 4178: 4177: 4169: 4162: 4157: 4150: 4145: 4138: 4133: 4126: 4122: 4117: 4111: 4106: 4099: 4094: 4087: 4082: 4070: 4066: 4063:(in French). 4059: 4053: 4047: 4046:3-927408-82-4 4043: 4037: 4030: 4025: 4023: 4015: 4010: 4003: 3998: 3979: 3972: 3970: 3962: 3955: 3950: 3943: 3938: 3931: 3926: 3920:, p. 107 3919: 3914: 3907: 3902: 3894: 3890: 3885: 3880: 3876: 3872: 3868: 3861: 3855: 3850: 3842: 3838: 3833: 3828: 3824: 3820: 3816: 3809: 3793: 3789: 3783: 3776: 3771: 3769: 3761: 3756: 3750:, p. 293 3749: 3744: 3737: 3736:Pressman 2002 3732: 3730: 3722: 3721:Pressman 2002 3717: 3715: 3713: 3705: 3704:Pressman 2002 3699: 3692: 3691:Pressman 2002 3687: 3680: 3679:Pressman 2002 3675: 3668: 3667:Kotowicz 2005 3664: 3663:Pressman 2002 3659: 3653:, p. 649 3652: 3648: 3647:Pressman 2002 3643: 3641: 3633: 3632:Pressman 2002 3629: 3624: 3618:, p. 506 3617: 3613: 3609: 3604: 3602: 3595:, p. 182 3594: 3589: 3587: 3580:, p. 478 3579: 3578:Kotowicz 2008 3574: 3572: 3564: 3563:Kotowicz 2008 3559: 3552: 3551:Kotowicz 2008 3548: 3543: 3536: 3535:Kotowicz 2008 3531: 3524: 3520: 3519:Kotowicz 2008 3515: 3509:, p. 182 3508: 3502: 3495: 3494:Kotowicz 2005 3491: 3486: 3480:, p. 483 3479: 3478:Kotowicz 2008 3474: 3467: 3466:Kotowicz 2008 3462: 3456:, p. 482 3455: 3454:Kotowicz 2008 3449: 3447: 3440:, p. 482 3439: 3438:Kotowicz 2008 3434: 3432: 3424: 3420: 3415: 3408: 3403: 3401: 3393: 3392:Kotowicz 2005 3389: 3384: 3377: 3376:Kotowicz 2005 3372: 3365: 3360: 3354:, p. 504 3353: 3349: 3345: 3344:Kotowicz 2005 3340: 3333: 3329: 3326:, p. 2; 3325: 3321: 3316: 3310:, p. 651 3309: 3304: 3302: 3300: 3292: 3291:Kotowicz 2005 3287: 3285: 3283: 3275: 3270: 3263: 3262:Pressman 2002 3258: 3251: 3247: 3246:Kotowicz 2005 3243: 3238: 3231: 3226: 3220:, p. 482 3219: 3218:Kotowicz 2008 3216:, p. 2; 3215: 3210: 3204:, p. 650 3203: 3199: 3198:Kotowicz 2005 3194: 3187: 3182: 3180: 3172: 3171:Kotowicz 2005 3167: 3160: 3155: 3149:, p. 651 3148: 3142: 3135: 3134:Kotowicz 2005 3129: 3122: 3118: 3117:Kotowicz 2005 3113: 3106: 3100: 3093: 3088: 3082:, p. 503 3081: 3075: 3069:, p. 503 3068: 3064: 3060: 3055: 3049:, p. 478 3048: 3047:Kotowicz 2008 3044: 3040: 3035: 3029:, p. 541 3028: 3022: 3016:, p. 650 3015: 3010: 3008: 3001:, p. 503 3000: 2995: 2993: 2986:, p. 541 2985: 2980: 2978: 2970: 2969:Pressman 2002 2965: 2959:, p. 532 2958: 2952: 2945: 2944:Pressman 2002 2940: 2938: 2936: 2934: 2932: 2924: 2923:Pressman 2002 2918: 2916: 2908: 2907:Kotowicz 2005 2903: 2901: 2894: 2893:Brickner 1932 2889: 2882: 2881:Kotowicz 2005 2878: 2877:Pressman 2002 2873: 2871: 2863: 2859: 2858:Pressman 2002 2855: 2850: 2843: 2842:Pressman 2002 2838: 2836: 2834: 2832: 2830: 2828: 2820: 2819:Pressman 2002 2815: 2809:, p. 541 2808: 2804: 2803:Pressman 2002 2799: 2792: 2787: 2780: 2779:Pressman 2002 2775: 2768: 2767:Pressman 2002 2763: 2756: 2751: 2744: 2740: 2739:Pressman 2002 2735: 2729:, p. 721 2728: 2724: 2723:Pressman 2002 2719: 2713:, p. 48. 2712: 2711:Pressman 2002 2707: 2705: 2698:, p. 721 2697: 2692: 2686:, p. 721 2685: 2681: 2677: 2673: 2672:Pressman 2002 2668: 2661: 2656: 2654: 2647:, p. 100 2646: 2641: 2635:, pp. 25 2634: 2631:, p. 2; 2630: 2625: 2619:, pp. 25 2618: 2614: 2609: 2603:, pp. 78 2602: 2601:Kotowicz 2005 2598: 2594: 2589: 2582: 2577: 2571:, p. 477 2570: 2569:Kotowicz 2008 2565: 2563: 2561: 2559: 2557: 2555: 2553: 2546:, p. 486 2545: 2544:Kotowicz 2008 2540: 2534: 2529: 2523:, p. 649 2522: 2517: 2515: 2513: 2511: 2503: 2499: 2498:Kotowicz 2008 2495: 2494:Kotowicz 2005 2490: 2484:, p. 149 2483: 2478: 2471: 2465: 2459:, p. 486 2458: 2457:Kotowicz 2008 2454: 2453:Kotowicz 2005 2449: 2447: 2440:, p. 486 2439: 2438:Kotowicz 2008 2435: 2430: 2423: 2422:Kotowicz 2005 2418: 2411: 2406: 2399: 2394: 2388:, p. 80. 2387: 2382: 2375: 2371: 2366: 2359: 2354: 2352: 2344: 2339: 2332: 2327: 2325: 2317: 2312: 2310: 2303:, p. 276 2302: 2298: 2294: 2290: 2286: 2282: 2278: 2274: 2270: 2266: 2263:, p. 1; 2262: 2258: 2257:Kotowicz 2008 2254: 2250: 2247:, p. 1; 2246: 2241: 2234: 2230: 2229:Pressman 2002 2225: 2218: 2213: 2207:, p. 216 2206: 2201: 2194: 2189: 2182: 2178: 2174: 2169: 2163: 2159: 2154: 2147: 2142: 2136:, p. 200 2135: 2134:Pressman 2002 2130: 2128: 2120: 2116: 2112: 2107: 2100: 2095: 2093: 2085: 2080: 2073: 2072:Pressman 2002 2068: 2062:, p. 149 2061: 2060:Pressman 2002 2057: 2051: 2044: 2043:Pressman 2002 2040: 2036: 2032: 2028: 2023: 2017:, p. 411 2016: 2012: 2007: 2005: 1997: 1992: 1986: 1981: 1974: 1969: 1962: 1957: 1950: 1945: 1943: 1941: 1933: 1928: 1926: 1918: 1913: 1906: 1901: 1885: 1881: 1877: 1873: 1866: 1858: 1854: 1850: 1846: 1842: 1838: 1834: 1830: 1826: 1822: 1815: 1807: 1805:9780495090793 1801: 1797: 1796: 1788: 1772: 1768: 1764: 1758: 1743: 1739: 1732: 1717: 1711: 1707: 1706: 1698: 1683: 1679: 1672: 1670: 1661: 1657: 1650: 1644: 1639: 1637: 1635: 1633: 1625: 1620: 1614:, p. 116 1613: 1608: 1606: 1590: 1586: 1580: 1576: 1560: 1550: 1541: 1534: 1530: 1524: 1515: 1506: 1496: 1487: 1480: 1476: 1470: 1463: 1457: 1450: 1445: 1441: 1437: 1433: 1426: 1416: 1407: 1398: 1391: 1387: 1383: 1378: 1372:institutions. 1370: 1369: 1361: 1354: 1349: 1345: 1335: 1332: 1330: 1329:Psychosurgery 1327: 1325: 1322: 1320: 1317: 1315: 1311: 1308: 1305: 1302: 1301: 1296: 1290: 1285: 1275: 1271: 1270: 1265: 1262: 1258: 1257: 1252: 1248: 1245: 1244: 1239: 1238:Elliott Baker 1236: 1233: 1232: 1227: 1223: 1220: 1216: 1215: 1210: 1206: 1203: 1199: 1195: 1194: 1189: 1185: 1184: 1179: 1176: 1175: 1174: 1162: 1158: 1154: 1150: 1147: 1143: 1140: 1136: 1133: 1130: 1127: 1124: 1121: 1117: 1114: 1113: 1111: 1104:Notable cases 1101: 1099: 1091: 1087: 1085: 1080: 1072: 1067: 1064: 1062: 1061: 1056: 1051: 1050: 1039: 1030: 1027: 1024:unavailable, 1021: 1017: 1013: 1011: 1005: 1001: 999: 995: 991: 986: 984: 980: 969: 967: 963: 958: 956: 951: 948: 944: 940: 937: 928: 919: 917: 912: 908: 904: 900: 895: 892: 888: 884: 880: 876: 872: 868: 864: 860: 856: 852: 848: 842: 837: 831: 820: 818: 814: 803: 801: 797: 793: 789: 785: 781: 777: 773: 769: 765: 761: 760:schizophrenia 757: 751: 748: 745:; this was a 744: 740: 736: 733: 729: 725: 721: 717: 711: 705: 694: 692: 691:unfalsifiable 685: 680: 678: 674: 670: 666: 665:Ramón y Cajal 662: 661:neuron theory 651: 648: 644: 640: 636: 632: 626: 624: 620: 616: 612: 608: 603: 600: 596: 595: 589: 585: 580: 574: 571: 566: 562: 553: 549: 545: 541: 539: 534: 526:Frontal lobes 523: 521: 517: 516:psychosurgery 513: 510: 503: 498: 489: 487: 483: 479: 475: 469: 464: 462: 458: 454: 449: 447: 446:word deafness 443: 439: 435: 426: 421: 417: 415: 411: 410:temporal lobe 407: 402: 397: 393: 389: 385: 381: 377: 376:psychosurgery 373: 365: 360: 351: 349: 345: 339: 337: 333: 329: 325: 321: 317: 313: 309: 301:in the 1950s. 300: 296: 292: 283: 280: 276: 272: 268: 266: 262: 257: 255: 251: 247: 237: 235: 231: 227: 223: 219: 218:United States 214: 212: 209:, shared the 208: 203: 201: 197: 192: 190: 186: 185:frontal lobes 182: 178: 174: 170: 166: 162: 158: 154: 150: 146: 143: 139: 136: 132: 121: 115: 111: 107: 105: 101: 98: 95: 93: 89: 84: 83:psychosurgery 79: 77: 73: 69: 65: 60: 56: 50: 45: 40: 37: 33: 19: 6778:CHADS2 score 6738:CSF tap test 6658:Neuroimaging 6612:spinal canal 6576:Brain biopsy 6508: 6406:Cranioplasty 6380:Neurosurgery 6323: 6295: 6287:Sunday Times 6286: 6220: 6219: 6210: 6184: 6162: 6142: 6120: 6100: 6074: 6052: 6040: 6014: 5992: 5985:Tranøy, Joar 5958: 5938: 5904: 5897:Swayze, V.W. 5878: 5848: 5828: 5814: 5792: 5770: 5748: 5726: 5704: 5684: 5662: 5650: 5630: 5619: 5596: 5584: 5554: 5542: 5523: 5498: 5476: 5459: 5430: 5412: 5389: 5368: 5359: 5325: 5303: 5278: 5247: 5232: 5217: 5208: 5193: 5168: 5151: 5142:Neurosurgery 5140: 5118: 5115:Healy, David 5090: 5068: 5042: 5012: 4996: 4984: 4962: 4940: 4920: 4898: 4876: 4848:Neurosurgery 4846: 4824: 4802: 4799:El-Hai, Jack 4788: 4750: 4732: 4714: 4697:The Guardian 4696: 4670: 4650: 4627: 4611: 4589: 4567: 4545: 4526: 4512: 4481: 4468: 4451: 4437: 4429: 4428: 4409:. 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