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OKAY BACK FROM THE HOSPITAL ARCHIVE 🏥

An Indian Journal Paper Studied Lobotomy In One Hospital

Lobotomy Or Leucotomy Removes Or Disconnects The Frontal Lobes

It Is One Type Of Psychosurgery

Psychosurgery Was Widely Used In The USA

It Was Also Common In The United Kingdom Australia And Japan

In India It Began At The Mysore Government Mental Hospital

Today That Hospital Is Called NIMHANS In Bengaluru

Its First Operations Were Around The Time Of Early Ones In Britain

The Operation Reached The Hospital Very Soon After The West Took It Up

It Gradually Spread To Other Indian Centers Like Ranchi And Madras

To Study Its Early Years The Authors Searched The Hospital's Registers

They Looked By Hand For Case Notes On Any Kind Of Psychosurgery

The First Operation Was On A Patient Admitted In 1939

So They Reviewed Patients Admitted From 1939 To 1947

The Hospital Logged 2,584 Admissions Across Those Years

In That Time 116 People Had Invasive Brain Procedures

Nine Epilepsy Patients Had Other Invasive Tests And Were Left Out

That Left 107 People Who Had Psychosurgery

Seventy Five Of Them Came From The Mysore Kingdom Itself

Others Came From Across India And Some From Far Away

103 Of The 107 Had An Operation Called Anterior Prefrontal Leucotomy

Most Patients Had Been In The Hospital For A Long Time

Their Condition Had Not Changed Much Since Admission

Yet Almost A Quarter Were Operated On Within A Month Of Being Admitted

Schizophrenia Was The Most Common Diagnosis Among The 107

55 Of Them Had It Which Is 51.5 Percent

The Harder Question Is Whether The Surgery Helped The Patients

At Discharge 36 Patients Were Recorded As Improved

That Is 33.7 Percent Of All 107

Another 27 Showed No Improvement

Eight Patients Died

Three Of Them Died Shortly After The Operation

The Others Died Several Months Later

For 36 More Patients No Outcome Was Noted

That Equals The Number Recorded As Improved

The Authors Say That Leaves Considerable Ambiguity About The Outcome

Doctors Wrote Specific Progress Notes On The Outcome For 37 Patients

In Multiple Cases Those Notes Did Not Always Match Discharge Notes

So Counting The Good Outcomes With Confidence Is Difficult

In Many Notes Improvement Seems To Match A Lack Of Initiative

So The Main Goal May Have Been Calmer And More Manageable Patients

The Authors Cannot Tell If Surgery Caused Some Of Those Changes

Some May Have Been Leftover Symptoms Of The Original Illness

At Least Two Thirds Of The Case Notes Had Enough Clinical Detail

Those Notes Covered The Procedure And The Outcome

Possible Side Effects Were Not Consistently Documented

The Notes Also Record Other Notable Details

Some Patients Were Operated On More Than Once

Those Repeat Operations Showed Little Evidence Of Benefit

One Patient Had Improved Well On Herbal Rauwolfia Extracts

Even So The Doctors Chose Surgery Over The Herbs

Another Patient Was A Man Admitted On A Magistrate's Order

He Had Been Found Wandering The Streets Alone

Doctors Performed A Prefrontal Leucotomy On Him

There Was No Record Of His Consent

Seeking And Recording Consent Was Likely Not Routine Back Then

Operations Did Not End With Those Early Years

The Last One At This Hospital Was Probably In The Mid 1970s

A Survey Of 1971 To 1976 Estimated 30 To 60 Operations Yearly In India

By Comparison The US Estimate Was About 400 A Year

For The UK It Was 200 To 250

Hundreds Of People Are Thought To Have Had The Operation In India

Yet Very Few Studies Describe Its Use Or Usefulness

In India It Was Praised As A Modern Treatment

Unlike In The West It Faced Hardly Any Strident Criticism

The Hospital's Records Show How Fast New Treatments Were Adopted Then

A Reappraisal Suggests Lobotomy Worked Less Well Than First Described

Hope Of A Cure May Have Seemed Better Than Life In An Institution

The Reality Now Appears Less Favorable Than Anyone Would Have Hoped