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Egas Moniz Was A Portuguese Neurologist

Research At The Time Suggested Surgery On The Frontal Lobes

Might Significantly Change Personality In The Mentally Ill

Moniz Shared His Surgery Idea With A Junior Colleague

That Colleague Was A Young Neurosurgeon Named Pedro Almeida Lima

Lima Had Earlier Assisted Moniz With His Brain Imaging Research

On 12 November 1935 Moniz Began A Series Of Brain Operations

The First Took Place At The Hospital De Santa Marta In Lisbon

Moniz Did Not Perform The Surgery Himself

He Lacked Training In Neurosurgery And Gout Impaired His Hands

So Lima Performed It Under General Anesthetic

The Intention Was To Remove Some Of The Long Fibers

Those Fibers Connected The Frontal Lobes To Other Major Brain Centers

Lima Made An Opening In The Side Of The Skull

Ethanol Was Injected Into The White Matter Of The Prefrontal Area

Moniz And Lima Used This Method For The First Eight Patients

Some Needed Repeated Injections For A Result They Considered Favorable

For The Ninth Patient They Introduced A Leucotome

The Leucotome Was A Tube With A Retractable Wire Loop At One End

Rotating The Loop Produced A Circular Lesion In The White Matter

By February 1936 Moniz And Lima Had Operated On Twenty Patients

Complications Were Observed In Each Of Them

They Ranged From Vomiting And Incontinence To Apathy

Moniz Asserted Those Effects Were Transitory

He Reported No Deaths In That Series

The 1949 Nobel Prize In Physiology Or Medicine Was Divided Equally

Egas Moniz Received One Half Of The Prize

The Other Half Went To Walter Rudolf Hess

Hess Was A Swiss Physiologist

His Discovery Concerned The Functional Organization Of The Interbrain

The Citation Called It A Coordinator Of The Internal Organs

Hess Had No Involvement With Leucotomy

So The Prize Was Shared For Two Different Discoveries

Moniz Was Cited For The Therapeutic Value Of Leucotomy

The Citation Said That Value Was In Certain Psychoses

In The United States The Surgery Was Later Renamed A Lobotomy

Before 1949 Moniz Had Been Nominated Twice Without Success

Those Nominations Were For Cerebral Angiography

He Had Developed It In 1927

It Made The Brain's Peripheral Blood Vessels Routinely Visible

His Prize Came Instead For His Work In Psychosurgery

Psychosurgery Was An Entirely Different Area From Brain Imaging

The Prize Speech Noted Certain Limitations Of The Operative Method

It Ranked Leucotomy Among The Top Discoveries In Psychiatric Therapy

Nobel's Site Says Lobotomy Was Widespread In The 1940s And 1950s

It Became Apparent Lobotomy Could Lead To Serious Personality Changes

Its Use Declined Drastically When Drugs For Mental Illness Arrived

Doubts About The Operation Were Voiced Well Before The Prize

José De Matos Sobral Cid Had Supplied Moniz With His First Patients

He Was The Medical Director Of A Mental Hospital In Lisbon

At A Paris Meeting In July 1936 He Denounced Leucotomy

He Said The Patients Returned To His Care Were Diminished

Sobral Cid Also Described A Degradation Of Personality

Soviet Reviewers Were Alarmed By The Operation's Severe Complications

The Soviet Union Officially Banned The Procedure In 1950

Soviet Doctors Called It Contrary To The Principles Of Humanity

By The 1970s Numerous Countries Had Banned The Procedure

So Had Several US States

The Award To Moniz Has Itself Been Subject To Controversy

Lobotomy Was Later Seen As One Of Modern Medicine's Greatest Mistakes

Moniz Himself Was Attacked For Understating The Complications

He Was Also Faulted For Inadequate Documentation And Poor Follow Up

1981 Nobel Laureate Torsten Wiesel Called The Award A Terrible Mistake

There Have Been Calls For The Nobel Foundation To Rescind The Award