Frontal Lobotomies: a Darwinian Mental Health Holocaust

 

Frontal Lobotomies: a Darwinian Mental Health Holocaust[1]

by Jerry Bergman, PhD

The frontal lobotomy was a psychosurgery treatment based on the evolutionary belief that, as the human brain evolved, the newer sections evolved on top of the older parts. The evolutionarily older brain section was later called the ‘reptile brain.’[2] A lobotomy, the theory postulated, could reduce undesirable ‘reptile’ behavior.[3] In the end, as many as 35,000 persons were lobotomized, producing what neurologist Frank Vertosick called “a mental health holocaust.”[4] We now know most patients replaced their reptile behavior with a sluggish, disoriented, even moribund, countenance. Some were reduced to vegetative states, and many died of cerebral hemorrhaging or other complications.[5]

The Background

French surgeon and committed Darwinist, Paul Broca, concluded the prefrontal lobes were the part of the brain that separated humans from lower animals during evolution.[6] Broca, fascinated by evolution and its implications for brain study, once remarked, “I would rather be a transformed ape than a degenerate son of Adam.”[7]

The result of Broca’s insight was that mental illness researchers attempted to surgically separate the parts of the brain that they believed had recently evolved from the parts we had retained from our ancient reptile ancestors. If Broca and others involved in this history had believed the creation account that teaches the human brain was created perfect, it is unlikely that they would have concluded separating brain sections would result in a beneficial treatment.

The Reptilian Brain Complex

Structures derived from the human forebrain floor during early fetal development were labelled the reptilian brain complex. The term derives from the idea that comparative neuroanatomists once believed reptile forebrains were dominated by these structures which controlled raw emotions. It was believed this ‘reptilian brain’ was responsible for the instinctual behaviors involved in physical aggression, emotional outbursts, agitation, territoriality and, in short, reptile-like personality traits.[8] Lobotomy was even proposed as a way of achieving social control of the population, such as political discontents.[9]

The Triune Brain

The ‘triune brain’ concept then popular among Darwinists proposes the “forebrain comprises three separately evolved and to some degree independently functioning cognitive systems,” said Carl Sagan in 1977, showing how Broca’s Darwinian view continued unchallenged into the 1970s.[10] It proposed that the three brain levels are, the innermost brain was the reptilian brain, next the paleo-mammalian complex (the limbic system), and last, the putative more evolved neocortex, the higher-level brain.[11] These “three quite different mentalities” each had its own memory, motor abilities and emotion control, corresponding to a separate major evolutionary step.[12]  (Watch Carl Sagan teach this as fact in an episode from the original Cosmos series.)

The most primitive part consists of the spinal cord, hind brain, and midbrain which contains the basic machinery to run the body’s physiology. The reptile brain is surrounded by the limbic system, the theorized center of emotions. Last, is the neocortex, the most recent evolutionary accretion according to evolution.[13] Furthermore “it would be astonishing if the brain components beneath the neocortex were not to a significant extent still performing as they did in our remote ancestors.”[14]

Sagan concluded the triune brain “concept is in remarkable accord with the conclusions drawn independently” from brain studies.[15] It is not unexpected that the lobotomist would draw on this idea to support, and justify, their lobotomy practice.[16]  Even in our everyday language we draw on the reptilian brain inference, such as in the common expression, “a cold-blooded killer.” Sagan concluded his discussion of the triune brain by adding that, while metaphorical, “it may prove to be a metaphor of great utility and depth.”[17]

Early Application of the Reptile/Triune Brain Theory

One of the first persons to attempt to apply the theory of the reptilian brain to humans was Professor Gottlieb Burchardt. He experimented on six schizophrenia patients confined at the Neuchâtel asylum in Switzerland. Of the six, all whose condition was deemed incurable, Burchardt declared the four survivors were greatly improved, even cured.[18]  His report of the results at a 1889 Berlin medical conference was so favorable that it influenced others to attempt to replicate his procedure.

One person who replicated Burchardt’s work was Egas Moniz (1874–1955), clinical Professor of Neurology at the University of Lisbon.[19] He determined that the primitive “reptile brain” included the thalamus. Thus, he attempted to sever the connection between the reptile brain and the newer part, the frontal area. Moniz first used the technique on a female patient. He drilled holes in her head, then poured alcohol into the holes to destroy the white fibers connecting the frontal lobes to the rest of the brain.

In the words of Donald, Moniz was skilled at “presenting the unpalatable in such a way as to make it attractive” by referring to his “butchery as psychosurgery.”[20] Moniz then proceeded to use his crude hacking procedure on a variety of mental patients, all of whom he declared to be improved.[21] He never did a proper scientific follow-up study on his patients.

Dr. Walter Freeman Takes the Lead

Soon, Dr. Walter Freeman, a Yale graduate and Professor at the George Washington University School of Medicine, learned of Moniz’s allegedly wonderful results. It set Freeman on a course that would define his life’s work. His first victim was Alice Hammatt who was treated in 1936 after she was given the choice of being locked in an asylum for the rest of her life, or being lobotomized. She chose the operation.

Freeman soon experimented with a faster method to lobotomize, namely to use few mallet taps on an ice pick to break through the top of the eye socket. Then he would move it around to sever the connection between the frontal cortex and the rest of the brain. An advantage was he did not have to bore a hole through the thick skull bone, but only had to puncture a small hole behind the eyeball where the skull was very thin. For its enthusiasts, an ice-pick lobotomy could be done by anyone with a strong stomach, and could be done anywhere. The cheap ice pick procedure became the psychosurgical choice in state hospitals across the country.[22]

Freeman’s most famous case was 23-year-old Rosemary Kennedy, the oldest sister of the former American President, John F. Kennedy. She underwent a prefrontal lobotomy in an attempt to control her sometimes extreme emotional outbursts. After the surgery, Rosemary was left with the mental capacity of a toddler, unable to walk, or even follow simple directions. She never recovered.[23]

The Harm Done

The total number of persons lobotomized by Freeman alone was close to 3,500.[24] During the 1940s and 1950s, lobotomies were performed on close to 50,000 patients in the United States, and around 17,000 in Western Europe and 4,500 in Sweden.[25] Most were women and some were children as young as four.[26] How many of these died prematurely from the operation is unknown, but the number is significant, estimated at up to six percent, or as many as 45,000 persons.[27] Common serious problems included severe hemorrhaging, brain seizures, loss of motor control, partial paralysis, enormous weight gains, and intellectual and emotional malfunction. If a major blood vessel was damaged or severed, it could cause death, as it did in close to 5% of those treated.[28] Lobotomy was used to treat not only the mentally ill, but also the criminally insane. It was even used to ‘cure’ political dissidents.[29]

New anti-psychotic drugs, such as chlorpromazine, soon became widely available. These drugs were much more effective than psychosurgery, and could always be stopped if the side effects were problematic. Psychosurgery was not reversible, thus the surgical treatment method was soon superseded by chemical treatment.

As a result, the use of lobotomies began to decline only in the mid- to late-1950s, but was still occasionally used well into the 1980s.[30] Opposition eventually became fierce because of the many failures and mixed results. As a result, “Aside from the Nazi doctor Joseph Mengele, Walter Freeman ranks as the most scorned physician of the twentieth century.”[31]

The 1949 Nobel Prize Awarded for the Procedure

Amazingly, the 1949 Nobel Prize in Physiology or Medicine was given to Egas Moniz “for his discovery of the therapeutic value of leucotomy in certain psychoses”—a treatment that was then considered “one of the most important discoveries ever made in psychiatric therapy.”[32] The award is one more evidence that, in its heyday, lobotomy was “not an aberrant event but very much in the mainstream in psychiatry,” uncritically supported and performed enthusiastically in leading university hospitals in countries around the world.[33]

The fact is, the lobotomy fad “was ultimately created by physicians—in many instances, able men who had contributed significantly to medicine earlier in their careers.”[34] Freeman was even able to publish a textbook on his lobotomy technique with one of the most prestigious scientific publishers then and today.[35] This is in spite of the fact that the procedure was based “on the flimsiest of theories, and on completely inadequate evidence.”[36] Support of the press was critical in its widespread acceptance:

Outside the medical profession itself, lobotomy was promoted by the popular press. Magazines and newspapers, whose readers number in the millions, popularized each new ‘miracle cure’ with uncritical enthusiasm, while commonly overlooking its shortcomings and dangers. These popular accounts created enormous interest in lobotomy among patients and their relatives, many of whom had abandoned hope, and they sought out the physicians mentioned in the articles with the desperation of a drowning person reaching anything to stay afloat.[37]

In view of the widespread support for the procedure, awarding a Nobel is less ironic than it first appears, but still creates credibility problems for science and medicine. Only humans have large prefrontal lobes. Darwinism maintains that humans evolved from some ape-like creature which had fairly small frontal lobes. The solution to mental illness, therefore, must relate to this difference.[38] Since it did not seem to matter much where the cuts in the cerebrum were made, that evidence was inconsistent with the evolutionary “triune brain’ concept that had justified lobotomy in the first place.

The researchers also found that the positive effects of treatment were often only temporary, and most patients relapsed in time, indicating that the damage caused by the treatment was either being repaired or other parts of the brain were taking over functions lost by the treatment.[39]

The End of the Procedure

The triune and reptile brain theories lost favor with most comparative neuroscientists in the post-2000 era.[40] The reasons include the hoped-for results of psychosurgery never materialized.[41]  Even though the evolutionary assumption was generally retained, the focus of treatment became health improvements in those suffering from mental illnesses.[42] Meanwhile, the damage done to countless patients before the procedure was finally abandoned was profound.

Today, the history of lobotomy and the harm it has done is largely ignored in the standard histories of psychology and psychiatry.[43]

After Freeman’s surgical privileges were removed, he transferred his case files to his van and took cross country trips at his own expense, one lasting six-months, to do a follow up on former patients and present papers at professional meetings.[44]  He claimed he followed up on several thousand patients.[45] Freeman’s assessments of the results of his technique, Vertosick claimed, “proved vague and unconvincing.”[46] Some people were happy with the results, or they claimed they were, but all too many were not.[47]

Conclusions

The leading scientists involved in developing the lobotomy procedure accepted evolution. They appealed to experimental evidence that seemed to show part of the brain was important in expressing so-called ‘primitive’ emotions. Consequently, their evolutionary worldview predisposed them to conclude that severing certain connections would produce a large reduction in these primitive behaviors. Lobotomy is now a very embarrassing part of medical history that we can look back on, wondering how and why it was ever widely accepted by both scientists and physicians.[48]

The Darwinian Approach Resurrected

A newer, more refined procedure using advanced techniques, called a cingulotomy uses electrodes to destroy a coin-sized area of the frontal lobes called the cingulate gyrus. The research of a trial by Harvard Medical School on 34 patients with totally intractable severe anxiety/depression caused by a variety of non-schizophrenic factors only around 1/3 improved.

Whether this procedure will prove successful in treating mental illness awaits future research and long term follow-up.[49] Ironically, the procedure is based on the theory that the cingulate gyrus, a “ribbon of brain tissue is thought to be a conduit between the limbic region, a primitive area involved in emotional behavior, and the [evolutionary advanced] frontal lobes.” Consequently, “cingulate can trace its intellectual heritage right back to the chimps Beckey and Lucy,” and even to Freeman himself.[50]

References.

 

[1] Based on my article Frontal Lobotomies and Darwinism—An Example of Harm to Life and Health. Journal of Creation. 32(3):119-123. 2018.

[2] Johnson, Jenell. 2016. American Lobotomy: A Rhetorical History, University of Michigan Press, Ann Arbor, MI, pp. 109–110.

[3] Comer, 2013, Abnormal Psychology, Worth Publishers, New York. 2013. p. 52.

[4]Vertosick, Frank.T. Jr., 1997. Lobotomy’s Back. Discover Magazine. 18(10):68, 70.

[5] Kang, L and Pedersen, N., 2017. Quackery: A Brief History of the Worst Ways to Cure       Everything, Workman Publishing, New York. p. 158.

[6]Valenstein, Elliot, 1991. Progress in Brain Research, Volume 85, pp. 539–554, chapter 27, ‘                The Prefrontal Area and Psychosurgery,’ p. 540.

[7] Brabrook, E.W., 1881. ‘Memoir of Paul Broca’, The Journal of the Anthropological Institute of Great Britain and Ireland 10: 242–261; Sagan, Carl. 1979, Broca’s Brain, New York: Random House. p. 6.

[8] MacLean, P. D., 1990. The Triune Brain in Evolution: Role in Paleocerebral Functions, Springer, New York.

[9] Mark, Vernon and Frank Ervin. 1970. Violence and the Brain. Medical Dept., Harper & Row.

[10] Sagan, Carl, 1977. The Dragons of Eden. New York: Random House. Watch this video clip from Cosmos.

[11]Harth, Erich, 1982. Windows on the Mind, Morrow, New York, p. 116.

[12] Sagan, 1977. p. 55.

[13] Sagan, 1977, p. 56.

[14] Sagan, 1977, p. 60.

[15] Sagan, 1977, p. 57.

[16] Sagan, 1977, p. 52.

[17] Sagan, 1977, p. 79.

[18] Stone, James L, 2001. Dr. Gottlieb Burckhardt—The Pioneer of Psychosurgery, Journal of the History of the Neuroscience, 10(1):80.

[19] Alexander, Franz and Sheldon Selesnick. 1966. The History of Psychiatry. New York: Harper & Row. p. 284.

[20] Donald, G., 2012. When the Earth Was Flat: All the Bits of Science We Got Wrong, Michael O’Mara Books, London. p. 134.

[21] Valenstein, 1991, p. 539.

[22] Vertosick, 1997, p. 70.

[23] Sternburg, Janet. 2015. White Matter. A Memoir of Family and Medicine. Portland, OR: Hawthorne Books.

[24] Donald, G., 2017. The Accidental Scientist: The Role of Chance and Luck in Scientific Discovery, Michael O’Mara Books, London, p. 139.

[25] Comer, 2013, p. 358; Anonymous. The rise & fall of the prefrontal lobotomy, scienceblogs.com/neurophilosophy/2007/07/24/inventing-the-lobotomy.

[26] El-Hai, J., 2005. The Lobotomist: A Maverick Medical Genius and his Tragic Quest to Rid the World of Mental Illness, Wiley, New York pp. 174–175.

[27] Comer, R., 2013. Abnormal Psychology, Worth Publishers, New York,  p. 458.

[28] Valenstein, 1986, p. 252.

[29] Sternburg, 2015.

[30] Vertosick, 1997, p. 68.

[31] El-Hai, 2005, p. 1.

[32] Valenstein, 1991, p. 539.

[33] Valenstein, Elliot. 1986. Great and Desperate Cures: The Rise and Decline of Psychosurgery.  New York: Basic Books. p. xi, 4.

[34] Valenstein, 1986, p. 5.

[35] Freeman, Walter and James Watts. 1950.  Psychosurgery in the Treatment of Mental Disorders and Intractable Pain, Second Edition. Oxford: Blackwell Scientific.

[36] Valenstein, 1986, p. 62.

[37] Valenstein, 1986, p. 5.

[38] Vertosick, 1997, p. 71.

[39] Valenstein, 1991, p. 544.

[40] Kiverstein, J., and Miller,  M., The embodied brain: towards a radical embodied cognitive neuroscience, Frontiers in Human Neuroscience, 9(237):1–11, 2015.

[41] Donald, 2012.

[42] Franks, D., Handbook of the Sociology of Emotions, Springer, Boston, MA, chapter 2: The Neuroscience of Emotions, pp. 49–50. 2006.

[43] Alexander and Selesnick. 1966. p. 284; Schultz, Duane. 1969. A History of Modern Psychology. New York: Academic Press, 1969.

[44] Sternburg, 2014. p. 178.

[45] Valenstein, 1986, pp. 276-280

[46] Vertosick, 1997, p. 71.

[47] Sternburg, 2014. p. 178.

[48] Kang and Pedersen, 2017, pp. 145–150.

[49] Vertosick, 1997, p. 68.

[50] Vertosick, 1997, p. 72.

---

Dr. Jerry Bergman has taught biology, genetics, chemistry, biochemistry, anthropology, geology, and microbiology at several colleges and universities including for over 40 years at Bowling Green State University, Medical College of Ohio where he was a research associate in experimental pathology, and The University of Toledo. He is a graduate of the Medical College of Ohio, Wayne State University in Detroit, the University of Toledo, and Bowling Green State University. He has over 1,300 publications in 12 languages and 40 books and monographs. His books and textbooks that include chapters that he authored, are in over 1,500 college libraries in 27 countries. So far over 80,000 copies of the 40 books and monographs that he has authored or co-authored are in print. For more of his articles on CEH, see his Author Profile.

---

Dorothy Parker allegedly said, “I’d rather have a bottle in front of me than a frontal lobotomy.” If that’s a bottle of vegetable juice, we would agree. Whoever said it, somebody put it to music here.

Humor aside, what you have just read by Dr Bergman is no laughing matter. It’s another shocking example of the evil fruit of Darwinian thinking. His books show many others. Read The Darwin Effect and How Darwinism Corrodes Morality to become disgusted with the rotten fruit that issued from Darwin’s tree of death. And for more examples of stupid ideas that Darwinism launched, read Dr Bergman’s book, Evolution’s Blunders, Frauds and Forgeries. Ideas have consequences!    —Ed.