The first patients submitted to leucotomy

An American blog that criticizes psychosurgery does biased descriptions concerning the first twenty leucotomyzed patients.

It is said for instance that patient eleven was diagnosed schizofrenic; actually Moniz hesitated between acute mania or schizofrenia.

Patient twelve is described as suffering from “cardiac neurosis”. As a matter of fact the diagnosis was anxiety neurosis based on a cardiopathy.

Patient thirteen is only reported in the psychosurgery blog as to have been excited for three months according to her son. The description by Moniz himself states that during those three months she had sleepless nights, left home at night, stole anything she could find, entered the neighbors’ homes, and imagined she was pregnant and should travel to Paris to deliver the baby. Moreover, thirty years before she had a period of melancholy that lasted five months, and 4 years before the melancholy lasted 2 years. During the latter period she remained all the time in bed without speaking to anyone.

It should also be added that the diagnosis of four of the patients was made by Moniz and his coworkers, the diagnosis of the other sixteen was made by a different group of psychiatrists in a different Hospital.

The followup of the first 20 cases operated by Almeida Lima and Egas Moniz revealed that 7 patients were cured, 7 other presented significant improvement, and in 6 changes could not be observed.

The American blog also criticizes the argument used to justify psychosurgery, i.e., the overload of Hospitals with patients. It mentions that most of those patients were not hospitalized or had been at the Hospital for a very short time. It should be remembered, though, that in Portugal at the time, because of the overload, patients remained with their families in spite of the burden it caused for their entourage.

The following gives an idea of how dramatic the situation was at the time in psychiatric Hospitals. Between 1940 and 1945, 40,000 patients died in France in psychiatric Hospitals, from hunger, cold, tuberculosis, neglect. A book entitled L’extermination douce by Max Lafon, describes this event.

The American blog does not mention any positive feature about psychosurgery. If it had no positive feature whatsoever it is difficult to understand why it was so widely used. It is known for instance that it “reliably decreased the symptoms of anxiety and depression” (DM Tucker et al. in Social and emotional self-regulation, Ann NY Acad Sci vol 769, p 213, 1995).