Half-Truthing the History of Lobotomy

Lobotomy: Telling Only Half of the Story
by Ignoring the Major Contribution of Darwinism

 

by Jerry Bergman, PhD

Lobotomy is in the news again[1] but, not unexpectedly, the importance of Darwinian concepts in the development of the lobotomy was totally ignored (see my 22 Jan 2019 article, “Frontal Lobotomies: A Darwinian Mental Health Holocaust”). One of several otherwise good articles accurately covered the history and why lobotomy  failed, adding that

Lobotomy is rarely, if ever, performed today, and if it is, “it’s a much more elegant procedure,” Lerner said. “You’re not going in with an ice pick and monkeying around.” The removal of specific brain areas (psychosurgery) is reserved for treating patients for whom all other treatments have failed.[2]

This article by Tanya Lewis at Live Science (Oct 2021) correctly defines the lobotomy procedure as “an umbrella term for a series of different operations that purposely damaged brain tissue in order to treat mental illness.”[3]

Another review of the procedure in the peer-reviewed journal Frontiers in Neuroscience (Feb 2019) covered the history of the lobotomy tragedy in some detail, but also totally ignored the contribution of Darwinism and evolution that justified the procedure.[4] That part of the history is very embarrassing today, no doubt, but at least the authors could have mentioned the evolutionary doctrine of the triune brain.  They did not. The Live Science article did admit that

Mental institutions played a critical role in the prevalence of lobotomy. At the time, there were hundreds of thousands of mental institutions, which were overcrowded and chaotic. By giving unruly patients lobotomies, doctors could maintain control over the institution.[5]

What both of these articles left out was a major part of the story: the influence of Darwinism. Let us review it again.

Broca’s Brain

On 13 September 1848, a 25-year-old railroad worker named Phineas Gage was struck in the head with a 43-inch-long iron tamping bar. Gage survived the accident but the injury affected his personality and behavior. In short, he was emotionally flat; both his positive and negative emotions were lost.[6] Shown pictures of enormous beauty or sickening horror, his response was usually the same: little demonstrative feeling, no matter how that emotion was measured.

A few years later, a leading French surgeon, committed Darwinist Paul Broca, concluded, partly on the basis of the famous Gage case, that the prefrontal lobes (the portion at the very front of the frontal lobes) are the part of the brain that separated humans from lower animals during evolution.[7] Broca was fascinated by evolution and its implications for brain function, and once remarked, “I would rather be a transformed ape than a degenerate son of Adam.”[8]

As a result of Broca’s work, mental illness researchers attempted to surgically separate the brain parts they believed had recently evolved from those that we had retained from our ancient reptile ancestors. If Broca and others involved in this history believed the creation account that teaches the human brain was created perfect as a functional whole, it is very unlikely that they would have concluded separating brain sections would result in a beneficial treatment for the problems they attempted to ameliorate by a surgical lobotomy.

The Reptilian Brain Complex

Structures evolutionists 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. Thus, this ‘reptilian brain’ was responsible for the instinctual behaviors involved in aggression, emotional outbursts, agitation, territoriality, and other reptile-like personality traits.[9]

The Triune Brain

The ‘triune brain’ concept was popular among Darwinists for decades. The triune brain hypothesis proposes the “forebrain comprises three separately-evolved, and [were] to some degree independently-functioning, cognitive systems.”[10] It proposed that humans inherited three brain levels which are (1) the innermost brain (the reptilian brain), next (2) the paleo-mammalian complex (the limbic system), and lastly, (3) the putative, more-evolved outer layer, the neo-mammalian complex or neocortex.[11]

These “systems were subdivided according to an evolutionary hierarchy, whereby the anatomically oldest structures… governed  the most ‘primitive’ body functions, such as respiration, blood pressure, and so on, while the newest structures… were assumed to govern ‘higher’ functions such as thought and voluntary movements…. the “frontal lobes [were] evolutionarily the highest brain structure.” These three basic brains show such great anatomical and chemical differences that “it is a wonder that nature was able to hook them up and establish any kind of communication among them.”[12] According to evolution, these structures were sequentially added to the forebrain during the course of evolution, and each brain section “corresponds to a separate major evolutionary step.” 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.”[13]

Carl Sagan believed that the “concept of the triune brain is in remarkable accord with the conclusions drawn independently from” brain studies.[14] Lobotomists drew on this idea to support and justify lobotomy. As a result, the triune brain hypothesis played a significant role in lobotomy theory.[15]  Even in everyday language we draw on the reptilian brain idea, such as in the expression “cold-blooded killer.”[16]

Early Application of the Reptilian/Triune Brain Hypothesis

One of the first persons to attempt to apply the dogma of the reptilian brain to humans was Professor Gottlieb Burckhardt. He attempted to replicate Phineas Gage’s accident in six schizophrenic patients. His report on the results at a Berlin medical conference was so favorable that it influenced others to attempt to replicate his procedure.  A Professor “Fulton was intrigued by this notion that one of the most primitive structures and one of the most recently advanced might in fact be directly connected.”[17]  Fulton was primarily interested in brain evolution based on the idea that evolution added newer brain structures to older, more primitive ones, the reptile brain, that controlled fighting, self-protection, aggression, sexual behavior, and other basic survival concerns.[18]

From what he learned by reading the work of Fulton, Clinical Professor of Neurology at the University of Lisbon Egas Moniz (1874–1955), introduced a surgical operation he called prefrontal leukotomy in 1936. It involved cutting the brain’s connecting fibers to separate the reptile brain from the more evolved brain. The operation, later called prefrontal lobotomy, consisted of incisions that destroyed connections between the prefrontal region and other brain parts. 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.

Moniz then proceeded to use his crude hacking procedure on a variety of mental patients, all of whom he declared to be improved.[19] Moniz was skilled at “presenting the unpalatable in such a way as to make it attractive” by referring to his “butchery as psychosurgery.”[20] Although he published at least 13 articles in scholarly journals and one monograph, he never did a proper scientific follow-up study on his patients. Today, we realize most of his patients replaced their aggression and irritability with a sluggish, disoriented, even moribund, countenance. Some were reduced to vegetative states, and some died of cerebral hemorrhaging or other complications.[21]

Dr. Walter Freeman Takes the Lead

Not long after, Dr. Walter Freeman, a Yale graduate, took the lead. Dr Freeman became professor at the George Washington University School of Medicine where he taught for 30 years. He was also a physician at St. Elizabeth’s Hospital in Washington, D.C.. Freeman learned of Moniz’s allegedly wonderful results. It set him on a course that would define his life’s work. Freeman soon experimented with a quicker method to lobotomize, namely to insert an ice pick and use a few mallet taps to break through the top of the eye socket, move it around, thereby attempting to sever the connection between part of the frontal cortex and the rest of the brain. Freeman concluded his more-promising area deserving focus was “the central vegetative [i.e., evolutionarily primitive] centers in the interbrain.”[22]

 

Lobotomies began to decline only in the mid- to late-1950s but were still occasionally used well into the 1980s.[23] Although critics of the technique always existed, opposition eventually became fierce because of the many serious failures and mixed results. A few patients did fairly well; many others did not.

Additionally, phenothiazine-based neuroleptic (anti-psychotic) drugs, such as chlorpromazine, became widely available. These drugs were, as a whole, much more effective than psychosurgery, and the medicine could be stopped if the results were problematic. Psychosurgery was not reversible and, once harm was done, little could be done to repair the damage.

Freeman Banned

Freeman was finally banned from operating only in 1967, after one of his long-term patients died from a brain hemorrhage following her third Freeman lobotomy. 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 including 4,500 in Sweden.[25] How many of these died from the operation is unknown, but the number was estimated at 1.5 to 6 percent, or as many as 45,000 persons.[26] Common serious problems included severe hemorrhaging, brain seizures, loss of motor control, partial paralysis, enormous weight gains, and intellectual and emotional malfunction.[27] If a major blood vessel was damaged or severed, it could cause death, as it did in close to 5% of the treated patients.[28]

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,”[29] a treatment that was then considered “one of the most important discoveries ever made in psychiatric therapy.”[30] The award is one more evidence that, in its heyday from the 1920s to the 1950s, lobotomy was “not an aberrant event but very much in the mainstream in psychiatry.” It was uncritically and enthusiastically supported and performed in leading university hospitals in countries around the world.[31] In view of the widespread support for the procedure, awarding a Nobel Prize is less ironic than it first appears, but still created credibility problems for science and medicine. A movement begun to revoke the prize failed.

The Darwinian Approach Resurrected

A newer, more refined procedure using advanced procedures, called a cingulotomy, uses electrodes to destroy a coin-sized area of the frontal lobes called the cingulate gyrus. The research consisted of a review by neurosurgeon Frank Vertosick, who reviewed a 1996 trial by Harvard Medical School specialists. 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 [evolutionarily advanced] frontal lobes.” Consequently, the cingulate gyrus destruction operation can trace its intellectual heritage back to Freeman.[32]

Summary

As should be obvious to the reader, a central part of the history was ignored in the two latest new reports about the history of this now discredited procedure. Unfortunately, this kind of selective reporting is not uncommon.[33] Reporters seem reluctant to cast a bad light on evolutionary theory. As a result, major gaps exist in the general population about the blunders, frauds, and harm that occurred as a result of uncritical belief in Darwinism.

Dr. Walter Freeman doing a lobotomy on a patient in front of the hospital staff and others.

A diagram on how the lobotomy is done (the Freeman approach) from an old medical book.

References

[1] Lewis, Tanya. Lobotomy: Definition, procedure and history. Live Science, October 2021.

[2] Lewis, 2021.

[3] Lewis, 2021.

[4] Staudt, Michael, et al. Evolution in the Treatment of Psychiatric Disorders: From Psychosurgery to Psychopharmacology to Neuromodulation. Frontiers in Neuroscience, 15 February 2019.

[5] Lewis, 2021.

[6] Fleischman, John.  Phineas Gage: A Gruesome but True Story About Brain Science. Houghton Mifflin, Boston, MA, 2002, p. 67.

[7] Valenstein, Elliot. Progress in Brain Research. Volume 85, pp. 539–554, Chapter 27: “The Prefrontal Area and Psychosurgery,”1991, p. 540.

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

[9] MacLean, Paul. A Triune Concept of the Brain and Behaviour. University of Toronto Press, Toronto, Canada, 1974..

[10] Sagan, Carl. The Dragons of Eden. Random House, New York, NY,1977, p. 256.

[11] Harth, Erich. Windows on the Mind. William Morrow & Company, New York, NY, 1982, p. 116; MacLean, P. D., The Triune Brain in Evolution: Role in Paleocerebral Functions, Springer Publishing, New York, NY, 1990, pp. 7-9.

[12] MacLean, 1974, p. 7.

[13] Sagan, 1977, p. 60.

[14] Sagan, 1977, p. 57.

[15] Sagan, 1977, p. 52.

[16] Sagan, 1977, p. 79.

[17] Pressman, Jack D. Last Resort: Psychosurgery and the Limits of Medicine (Cambridge Studies in the History of Medicine). Cambridge University Press, New York, NY, 1998, p. 518.

[18] Pressman, 1998, p. 67; MacLean, 1974, p. 14.

[19] Valenstein,1991, p. 539.

[20] Donald, G. The Accidental Scientist: The Role of Chance and Luck in Scientific Discovery. Michael O’Mara Books, London, UK, 2017, p. 134.

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

[22] Pressman, 1998, p. 75.

[23]Vertosick, Jr., Frank. T. Lobotomy’s Back. Discover Magazine 18(10):66-72, 1997, p. 68.

[24] Donald, 2017, p. 139.

[25] Comer, R. Abnormal Psychology, Worth Publishers, New York, NY, 2013,.p. 358; Anonymous. The rise & fall of the prefrontal lobotomy. scienceblogs.com/neurophilosophy/2007/07/24/inventing-the-lobotomy.

[26] Comer, 2013, p. 458.

[27] Comer, 2013.

[28] Valenstein, 1991, p. 252.

[29] Jansson, Bengt. Controversial Psychosurgery Resulted in a Nobel Prize. The Nobel Prize in Physiology or Medicine, 1949: Walter Hess and Egas Moniz. From Nobel Lectures, Physiology or Medicine 1942-1962, Elsevier Publishing Company, Amsterdam, Netherlands, 1964. https://www.nobelprize.org/prizes/medicine/1949/moniz/article/

[30] Valenstein, 1991, p. 539.

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

[32] Vertosick, 1997, p. 72.

[33] Bergman, Jerry. Evolution’s Blunders, Frauds, and Forgeries. CMI Publishing, Atlanta, GA, 2017. .

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Dr. Jerry Bergman has taught biology, genetics, chemistry, biochemistry, anthropology, geology, and microbiology for over 40 years at several colleges and universities including 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 articles by Dr Bergman, see his Author Profile.