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::::''An article should not give undue weight to any aspects of the subject but should strive to treat each aspect with a weight appropriate to its significance to the subject. For example, discussion of isolated events, criticisms, or news reports about a subject may be verifiable and impartial, but still disproportionate to their overall significance to the article topic. ... Note that undue weight can be given in several ways, including, but not limited to, depth of detail, quantity of text, <u>prominence of placement</u>, and juxtaposition of statements.''
::::''An article should not give undue weight to any aspects of the subject but should strive to treat each aspect with a weight appropriate to its significance to the subject. For example, discussion of isolated events, criticisms, or news reports about a subject may be verifiable and impartial, but still disproportionate to their overall significance to the article topic. ... Note that undue weight can be given in several ways, including, but not limited to, depth of detail, quantity of text, <u>prominence of placement</u>, and juxtaposition of statements.''
::Contrary to what you say, the "ice-pick" material does not "accurately [summarise] the procedure"; in fact that technique was used only by certain practitioners (and only in the US, if I recall correctly). Most reader today don't even know what an ice-pick ''is'' -- have never seen one -- so that they're left to envision whatever awful thing their imaginations can come up with. This aspect of the topic is already described appropriately in the body of the article; including it in the lead could almost define inappropriate and undue weight. [[User:EEng|EEng]] ([[User talk:EEng|talk]]) 09:24, 10 October 2013 (UTC)
::Contrary to what you say, the "ice-pick" material does not "accurately [summarise] the procedure"; in fact that technique was used only by certain practitioners (and only in the US, if I recall correctly). Most reader today don't even know what an ice-pick ''is'' -- have never seen one -- so that they're left to envision whatever awful thing their imaginations can come up with. This aspect of the topic is already described appropriately in the body of the article; including it in the lead could almost define inappropriate and undue weight. [[User:EEng|EEng]] ([[User talk:EEng|talk]]) 09:24, 10 October 2013 (UTC)

== "Stunningly successful"? ==

I don't think this sentence is entirely supported by the source, and the concept of a "stunningly successful" lobotomy sounds odd (although those are indeed the words used in the article).
"At times, the operation has been "stunningly successful", allowing severely ill patients to once again work and socialize normally." This is what the source actually says:
"The results of the operations were mixed. Some patients died on the operating table; some committed suicide post-operation. Others were left severely brain damaged and were reduced to a state where they were largely unaware of their surroundings. On the other hand, on occasion the operation proved stunningly successful. In his book, The Last Resort (1998), Jack Pressman discusses the case of Rose Thorner who received a lobotomy in 1947 (pp. 264–270). Rose had been diagnosed as suffering from involutional melancholia. She had spent 10 years on a locked ward where she spent her time asking to be allowed to die, smearing faeces, and assaulting patients and staff. Post-lobotomy she was discharged to a lodging house, where she maintained a busy social life and did voluntary work at a local hospital. Friends considered her recovered and acquaintances found her “100 % normal”.The outcomes of other cases were more ambiguous. Post-lobotomy, patients might no longer be troubled, but still seemed to have lost something. Many had to remain in hospital but became more “manageable”. " [[User:Staug73|Staug73]] ([[User talk:Staug73|talk]]) 17:12, 16 July 2014 (UTC)

Revision as of 17:13, 16 July 2014

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Reference Checking

I found a dead reference link in the last sentence of the "Criticism" section and removed it, and was unable to find the referenced article elsewhere online (and it was in French anyway). The sentence itself may need to be rewritten as it essentially says that 15 psychosurgeries per year were performed at Mass General Hospital in 2001. 15 per year, in that one year? I also was unable to find another reference to support this claim, or any claim as to how often the hospital currently performs such surgeries. Maybe the article in general should be reference-checked as well. --Kangabell (talk) 22:41, 2 December 2011 (UTC)[reply]

The refs look pretty good to me - although I can't vouch all those mentioned in footnote 14, or for the Russian one. The ccne website appears to be having problems, but I expect the article will be back eventually. About the 15 a year - I expect it was someone writing in 2001, saying that MGH carried out 15 operations a year.Staug73 (talk) 09:58, 5 December 2011 (UTC)[reply]
Footnote 14 refs are good but I must have been insane to add so many. FiachraByrne (talk) 02:54, 7 November 2012 (UTC)[reply]

Massive Assumption in Opening

This article makes the massive assumption that the reader is already informed of the intended neurological outcome of the procedure.

DarkRabbitRevenge (talk) 20:06, 24 April 2012 (UTC)[reply]

It isn't actually all that clear what neurological outcome was intended, in a lot of cases -- beyond "improvement" of some sort. But I agree that the article is not very clearly written. Looie496 (talk) 20:22, 24 April 2012 (UTC)[reply]

Well there you go! If the article gave the impression that you just did in the outset then it would be a lot easier for "the lay" to understand a great many things about this disgusting act. I knew nothing but rumours about this procedure (which was nothing but "they put a hole in your head, and SOMETHING is relieved"... which was nothing at all), so when I arrived on this Wiki page I was under the impression that these Doctors actually had ONE SINGLE CLUE of what they were doing. Am I understood or am I just rambling? DarkRabbitRevenge (talk) 07:02, 1 May 2012 (UTC)[reply]

Explanation of laws pertaining to lobotomy

If I look up "ECT", I get a relatively detailed explanation of the laws surrounding the practice. If I look up this article, "lobotomy", I don't get any explanation. — Preceding unsigned comment added by 50.0.107.248 (talk) 16:02, 23 June 2012 (UTC)[reply]

I agree that this article should discuss the topic, but it is less important here, because while ECT is currently in wide use, no lobotomies have been done for over 30 years; no doctor in the developed world could get permission to do one; and any doctor who did would be treated as a criminal. Looie496 (talk) 16:21, 23 June 2012 (UTC)[reply]

Notable Cases

In the section Notable Cases the link for Rosemary Kennedy is unuseable. Link 55 leads to an online book with something like 300+ pages available for viewing except pages 271-273 which are blank and it says unavailable for viewing. The link 55 says to see page 271. Mylittlezach (talk) 00:04, 16 August 2012 (UTC)[reply]

In Google Books, books with a "preview", like this one, show a limited number of pages, but the specific pages you can see vary from visit to visit. This isn't really an online book, just a previous of a physical book, and there is nothing that can be done about it. Looie496 (talk) 02:43, 16 August 2012 (UTC)[reply]

Eslinger and Damasio

I removed the following section from the article for the moment. If I'm not mistaken it's attempting to show the effects of leucotomy/lobotomy based upon research on this patient in the mid-1980s? If that's so it's relevant but it needs a rewrite and, I think, the subheading should relate to something about the effects of the procedure rather than the name of these two researchers. Also it would need to contain a lot more research (it's a study of one patient, after all).FiachraByrne (talk)

Paul Eslinger and Antonio Damasio
Neuroscientists, Paul Eslinger and Antonio Damasio researched the effects of damage to the orbitofrontal cortex by using their patient, E.V.R. According to Damasio, decision-making regions of the brain are connected to the emotional centers, even after damage to the frontal lobe, a theory he tested on a subject referred to as E.V.R., who also had frontal lobe damage, specifically bilateral damage to his orbitofrontal cortices during removal of a brain tumor. What Damasio and Eslinger found was that the subject’s responses to social situations, moral reasoning and intelligence was superior, but he could not easily make decisions or meet his personal and professional responsibilities. For example, he would obsess over comparing restaurants or what to wear, leaving him the inability to make simple, quick decisions.[1] Eslinger and Damasio concluded that E.V.R lacked sympathetically mediated skin conductance responses to neutral and emotional visual images and that frontal lobe damage doesn’t affect memory or intelligence, but the emotional and cognitive centers of the brain.
Along with Eslinger and Damasio’s experiment on patient E.V.R., Carlyle Jacobsen and John Fulton also experimented on chimpanzees involving the removal of the tissue from the frontal lobe,[2] which resulted in the improvement of one of the animals' behavior. Their findings showed that damage to the frontal and prefrontal cortex led to an immense reduction in aggression, and the complete removal of the frontal cortex resulted in the chimpanzees’ inability to do certain tasks and the distress it caused when the chimps made mistakes.

Changing citation style

I'd like to change to change the citation style to a short footnoting system - sfn & harvnb. I'd also like to create a section in the bibliography for non paginated online sources, kind of like I'm doing here. Are there any objections to this? FiachraByrne (talk) 02:58, 7 November 2012 (UTC)[reply]

First, a technical note... see WP:ORDER:
"Bibliography", "Discography", or "Filmography" are occasionally used where appropriate; however, "Bibliography" is discouraged because it is not clear whether it is limited to the works of the subject of the article.
Then see also WP:FNNR and WP:FURTHER (and what they link to) for a somewhat, um, diffuse discussion of possible ways to list sources.
Beyond that... See if you get any ideas from Phineas Gage, which has an eclectic approach -- evolved over time and not entirely consistent, but I'm please with it if I do say so myself. Notice the split between "Notes" and "References" -- Notes (denoted by superscript letters) give additional substantive detail -- side stuff that would weigh down the main text -- along with pointers to sources; but References (superscript numbers) give only sources. This way the reader can tell, without jumping to the end of the article, whether a note/ref will have something substantive, or just boring ol' source information. "Further reading" is really a combination of suggested reading and "other works cited". Anyway, as I said maybe you'll get some ideas. I'd also appreciate feedback or comments on the Gage article.
EEng (talk) 04:42, 7 November 2012 (UTC)[reply]
Hi EEng! As you may have guessed I'm in one of my fitful periods of activity on wikipedia - which generally indicates I have real world work that I really should be doing instead. In regard to the Bethlem article I was using a notes/reference system as seen in this dif [1] but I abandoned it for a variety of subjective and aesthetic reasons. Perhaps that was premature. For this article would a Notes/Footnotes/References division be ok (where notes are explanatory footnotes, footnotes are short cites to actual sources and references contains the bibliographic details of works cited)? The Phineas Gage article is excellent - I think I last read it around 2009/10 and it has really improved. I presume you'll be putting it forward as a good article nominee or featured article candidate in the near future? I'll leave a more substantive comment on that article's talk page. FiachraByrne (talk) 10:08, 7 November 2012 (UTC)[reply]

Impact of lobotomy & zombie-like patients

I reverted this recent edit by editor ‎87.67.18.206 FiachraByrne (talk) 01:57, 23 January 2013 (UTC)[reply]

For example, lobotomy patients have difficulty putting themselves in the position of others because of decreased cognition and detachment from society.<ref name="Shutts1982">{{cite book|author=David Shutts|title=Lobotomy: resort to the knife|url=http://books.google.com/books?id=54BsAAAAMAAJ|accessdate=22 January 2013|year=1982|publisher=Van Nostrand Reinhold|isbn=978-0-442-20252-1}}</ref> The popular conception of a lobotomee is of a zombielike person who has been left in a barely cognizant state by their unfortunate encounter with the surgeon's knife.<ref name="Doonan2003">{{cite book|author=Simon Doonan|title=Wacky Chicks: Life Lessons from Fearlessly Inappropriate and Fabulously Eccentric Women|url=http://books.google.com/books?id=048lZeUTlicC&pg=PA228|accessdate=22 January 2013|date=21 April 2003|publisher=Simon and Schuster|isbn=978-0-7432-5459-5|pages=228–}}</ref>

I think there's a definite lack of discussion of the effects of the procedure in the article. But I think this should be elaborated in the body of the text first before being added to the lead (conversely, anything in the lead that is not now in the body of the text should be added to the body of the text and citations removed from the lead).
The first sentence is not actually an example of contemporary attitudes to lobotomy and the recognition of its side-effects. We'd need a source looking at medical responses to the procedure in the 1940s-60s really. At that time they rarely described its effects in these terms (quite vague in their statements and often to the effect that there was "something lacking" in those lobotomised but that this was discernible only to the trained - psychiatric - eye).
The second statement is, I guess, pretty true - but I'd really like a better source (e.g. a medical history or medical article). FiachraByrne (talk) 01:57, 23 January 2013 (UTC)[reply]
You may be need the book which contains then psychiatrists’ outlooks on lobotomy Alexander, G.J.; Scheflin, A.W. (1998). Law and Mental Disorder. Durham, NC: Carolina Academic Press. pp. 955-967. In the book, lobotomist Walter Freeman describes lobotomized people as people with killed soul. --Psychiatrick (talk) 03:36, 23 January 2013 (UTC)[reply]
I believe a medical response from the 1940s-60s cannot really be considered as contemporary (such as Freeman's who died 40 years ago). Science and ethics have evolved too much since then. I also believe that medical sources focus on the psychiatric results, but care little for the effects on cognition and other side effects (correct me if I am wrong.) In particular, Freeman didn't seem concerned with cognition, seeing how he hacked at Rosemary Kennedy's brain (lobotomy paragraph of the article) until she wouln't make sense anymore, and left her mentally incapacitated. Her case also indicates that the cognition change was something obvious, not a subtle change only visible to a trained professional. This view is coherent with the description of the prefrontal cortex and the fact that lobotomy is its removal. 87.67.18.206 (talk) 06:37, 23 January 2013 (UTC)[reply]
I have created a "side effects" paragraph with the text since you recommended it in the edit history. I hope this was appropriate.87.67.18.206 (talk) 07:51, 23 January 2013 (UTC)[reply]
I have removed the second sentence of the reinserted material. First, it was word by word plagiarized (copy-pasted) from its source. Don't ever do that again. Second, it was from an utterly unreliable source. Third, it doesn't belong in this section – the section must be about what the side effects actually are, not about what the "popular perception" of them is (or, if such popular perceptions were to be named, it must be clearly explained to what extent they are true, obviously on the basis of sources that meet the rigid standards of WP:MEDRS.) Fut.Perf. ☼ 08:08, 23 January 2013 (UTC)[reply]
Also, I asked you to register an account before you pursue any content dispute further. Please do that now. Fut.Perf. ☼ 08:10, 23 January 2013 (UTC)[reply]
Thanks Psychiatrick - I wasn't aware of that source. @87.67.18.206 - I mean contemporary with the period when lobotomies were carried out on a significant scale (particularly earlier responses from about 1940-50). We'd also need a secondary source - such as Psychatrick has provided above - to interpret those primary sources. At the time, when talking about negative effects of the procedure psychiatrists most often put it in terms akin to what Psychiatrick records Freeman as saying above (although the descriptions tended to be less extreme); they'd refer to loss in the spirit of the person, the moral sense, or some kind of ineffable quality of the human. There were some psychological assessments at the time but these tended to downplay any loss of intellectual function. Jack Pressman's Last Resort would be a good source for this for lobotomies in the US - I'll check what he has to say later. Braslow interprets the operation as tending to eliminate the subjectivity of the patient but Pressman's is a more sophisticated analysis. Also, we're not here talking about what were the objective changes consequent to the procedure (much harder to substantiate) but the psychiatric assessment of change in lobotomised patients, which is quite a different thing. In regard to Freeman's transorbital procedure, it was applied much more indiscriminately but was, at least in terms of brain tissue, actually less destructive than the prefrontal technique. Also, reflecting the mores of the time, often psychiatrists would have been less concerned with any loss of intellectual function for housewives, manual workers etc, as they may have believed that intellectual function was less important to such classes of people.
The popular perception question is interesting and certainly that is the current perception (and some patients were hugely damaged by the procedure). At the time, it was seen as a modern, scientific technique with the potential to cure or at least improve "chronic" or "troublesome" patients. There were ideals for clinical, social and managerial outcomes which we could go into. Popular perception is mostly determined by popular media - not sure of a good source for this. FiachraByrne (talk) 10:03, 23 January 2013 (UTC)[reply]
Since I started the conversation with this IP, I won't register until my ISP gives me a new IP. This way, I can be identified as the same user.87.67.18.206 (talk) 10:12, 23 January 2013 (UTC)[reply]
You're under no obligation to register and anyone who tells you otherwise is misinformed. FiachraByrne (talk) 10:24, 23 January 2013 (UTC)[reply]

IQ drop

I have found the following cognitive side effects. The IQ drop following a lobotomy is between 9.2 and 17 (for an individual with normal intelligence before the lobotomy). Normal intelligence is defined with an IQ above 90 as per http://en.wikipedia.org/wiki/IQ_reference_chart. The quote meets the rigid standards (scientific journal), however I don't know how to make a Wiki quote hence why I'm writing here. The book can be found here: http://onlinelibrary.wiley.com/doi/10.1111/j.2044-8341.1955.tb00890.x/abstract Porteus refers to the Porteus maze test: http://www.amsciepub.com/doi/abs/10.2466/pms.1956.6.3.135 "SOME COMMON‐SENSE IMPLICATIONS OF PSYCHOSURGERY SD Porteus - British Journal of Medical Psychology, 2011 - Wiley Online Library ... Individuals over 85 IQ in the Binet had an average decline of 9.2 IQ points after lobotomy while those under 85 IQ actually gained 2.6 points. In the Porteus those above 85 IQ in the Maze had an average decline of 17 IQ points, while those below 85 lost only 10 IQ points." 87.67.18.206 (talk) 10:12, 23 January 2013 (UTC)[reply]

There are lots of reports on changes consequent to leucotomy (sample below). A lot of studies from the 1950s would support the outcomes in the study you cite above. However, we need secondary sources (by which I don't mean WP:MEDRS sources but historical treatments) to evaluate this literature, I think.

Fleming, G. (1942). "Some preliminary remarks on prefrontal leucotomy". Journal of Mental Science. 88 (371): 282.

Hutton, E.L. (1942). "The investigation of personality in patients treated by prefrontal leucotomy". Journal of Mental Science. 88 (371): 275–81.

Strom-Olsen, R. (1943). "Results of prefrontal leucotomy in thirty cases of mental disorder". Journal of Mental Science. 89 (375): 165. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)

Meyer, A. (1945). "Neuropathological problems arising from prefrontal leucotomy". Journal of Mental Science. 91 (385): 411. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)

Reitman, F. (1945). "Autonomic Responses in Prefrontal Leucotomy: Preliminary Report". Journal of Mental Science. 91 (384): 318.

Berliner, F. (1945-09-15). "Prefrontal leucotomy: report on 100 cases". Lancet. 246 (6368): 325–8. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)

Frank, J. (1946). "Clinical survey and results of 200 cases of prefrontal leucotomy". Journal of Mental Science. 92 (388): 497.

Hutton, E. L. (1947). "Personality changes after leucotomy". Journal of Mental Science. 93 (390): 31.

Hutton, E. L. (1948). "The effect of leucotomy on creative personality". Journal of Mental Science. 94 (395): 322. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)

Garmany, G. (1948-04). "Personality Change and Prognosis after Leucotomy". The British Journal of Psychiatry. 94 (395): 428–438. doi:10.1192/bjp.94.395.428. ISSN 0007-1250. Retrieved 2011-08-09. {{cite journal}}: Check date values in: |date= (help)

McLardy, T. (1949). "Anatomical correlates of improvement after leucotomy". Journal of Mental Science. 95 (398): 182. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)

Petrie, A. (1949-04). "Preliminary Report of Changes after Prefrontal Leucotomy". The British Journal of Psychiatry. 95 (399): 449–455. doi:10.1192/bjp.95.399.449. ISSN 0007-1250. Retrieved 2011-08-09. {{cite journal}}: Check date values in: |date= (help)

Rosie, J. M. (1949-04). "The Results of Prefrontal Leucotomy in 68 Patients Not Discharged from Hospital". The British Journal of Psychiatry. 95 (399): 431–448. doi:10.1192/bjp.95.399.431. ISSN 0007-1250. Retrieved 2011-08-09. {{cite journal}}: Check date values in: |date= (help)

Freudenberg, R. K. (1949-10). "Investigation into Intellectual Changes Following Prefrontal Leucotomy". The British Journal of Psychiatry. 95 (401): 826–841. doi:10.1192/bjp.95.401.826. ISSN 0007-1250. Retrieved 2011-08-09. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)

Edwards, A. M (1950). "Preliminary Report on Transorbital Leucotomy". Journal of Mental Science. 96 (405): 935.

Stengel, E. (1950). "A follow-up investigation of 330 cases treated by prefrontal leucotomy". Journal of Mental Science. 96 (404): 633–62.

Freudenberg, R. K. (1950-01). "Experimental Studies on Frontal Lobe Functions in Monkeys in Relation to Leucotomy". The British Journal of Psychiatry. 96 (402): 143–156. doi:10.1192/bjp.96.402.143. ISSN 0007-1250. Retrieved 2011-08-09. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)

Stengel, E. (1950-07-01). "A Follow-Up Investigation of 330 Cases Treated by Prefrontal Leucotomy". Journal of Mental Science. 96 (404): 633–62. doi:10.1192/bjp.96.404.633.

Crown, S. (1951). "Psychological changes following prefrontal leucotomy; a review". Journal of Mental Science. 97 (406): 49. ISSN 0007-1250.

Crown, S. (1951-01). "Psychological Changes Following Prefrontal Leucotomy; A Review". The British Journal of Psychiatry. 97 (406): 49–83. doi:10.1192/bjp.97.406.49. ISSN 0007-1250. Retrieved 2011-08-09. {{cite journal}}: Check date values in: |date= (help)

Vidor, M. (1951-01). "Personality Changes Following Prefrontal Leucotomy as Reflected by the Minnesota Multiphasic Personality Inventory and the Results of Psychometric Testing". The British Journal of Psychiatry. 97 (406): 159–173. doi:10.1192/bjp.97.406.159. ISSN 0007-1250. Retrieved 2011-08-09. {{cite journal}}: Check date values in: |date= (help)

Klein, R. (1952). "Immediate Effects of Leucotomy on Cerebral Functions and their Significance: A Preliminary Report". Journal of Mental Science. 98 (410): 60.

Stengel, E. (1952). "The Patients' Attitudes to Leucotomy and its Effects". Journal of Mental Science. 98 (412): 382.

Klein, R. (1952-01). "Immediate Effects of Leucotomy on Cerebral Functions and their Significance: A Preliminary Report". The British Journal of Psychiatry. 98 (410): 60–65. doi:10.1192/bjp.98.410.60. ISSN 0007-1250. Retrieved 2011-08-09. {{cite journal}}: Check date values in: |date= (help)

Kostic, Slobodan (1953-10-01). "Experiences and Results in Prefrontal Leucotomy: A Clinical Study of 339 Leucotomized Patients". Journal of Mental Science. 99 (417): 786–95. doi:10.1192/bjp.99.417.786.

Pippard, J. (1955). "Personality changes after rostral leucotomy: a comparison with standard prefrontal leucotomy". The British Journal of Psychiatry. 101 (425): 774. ISSN 0007-1250.

Pippard, John (1955-10-01). "Second Leucotomies". Journal of Mental Science. 101 (425): 788–793. doi:10.1192/bjp.101.425.788.

Pippard, John (1955-10-01). "Rostral Leucotomy: A Report on 240 Cases Personally Followed up After 11/2 to 5 Years". Journal of Mental Science. 101 (425): 756–73. doi:10.1192/bjp.101.425.756.

Costello, C.G. (1956-07). "The effects of prefrontal leucotomy upon visual imagery and the ability to perform complex operations". Journal of Mental Science. 102 (428): 507–16. ISSN 1097-0088. {{cite journal}}: Check date values in: |date= (help)

Robin, A. A. (1958). "A Retrospective Controlled Study of Leucotomy in Schizophrenia and Affective Disorders". Journal of Mental Science. 104 (437): 1025.

Thorpe, F. T. (1958). "An evaluation of prefrontal leucotomy in the affective disorders of old age: A follow-up study". Journal of Mental Science. 104 (435): 403.

FiachraByrne (talk) 10:33, 23 January 2013 (UTC)[reply]
I'll try and write something later on this and maybe then we could add a quote box and quote a representative study. FiachraByrne (talk) 10:57, 23 January 2013 (UTC)[reply]

The modern papers on changes consequent to lobotomy:

Jasper, HH (1995). "A historical perspective. The rise and fall of prefrontal lobotomy". Adv Neurol. (66): 97–114. PMID 7771315.

Benson, DF; Stuss, DT; Naeser, MA; Weir, WS; Kaplan, EF; Levine, HL (1981). "Long-term effects of prefrontal leucotomy--an overview of neuropsychologic residuals". J Clin Neuropsychol. 3 (1): 13–32. PMID 7276194. {{cite journal}}: Cite has empty unknown parameter: |1= (help); Unknown parameter |month= ignored (help)

Stuss, DT; Kaplan, EF; Benson, DF; Weir, WS; Naeser, MA; Levine, HL (1981). "Long-term effects of prefrontal leucotomy". Arch Neurol. 38 (3): 165–9. PMID 7469849. {{cite journal}}: Unknown parameter |month= ignored (help)

--Psychiatrick (talk) 14:25, 23 January 2013 (UTC)[reply]

Ah - thanks Psychiatrick. Do you have access to these papers? I doubt that I do (although I haven't checked yet). Actually, I may be able to get hard-copies as I think there still is a physical library somewhere that still stocks actual physical journal volumes. FiachraByrne (talk) 18:13, 23 January 2013 (UTC)[reply]

Lobotomy in the Soviet Union

The above cited papers can be received from western libraries by their institutional subscribers among such western neuroscientists as Looie496. I am from Russia, not the West. Here I can add that the lobotomy was criticized and stopped in the Soviet Union after Soviet psychiatrist Vasily Gilyarovsky wrote in the journal Meditsinskiy Rabotnik (Medical Person) No 37 of 14 September 1950:

It is assumed that the transection of white substance of the frontal lobes impairs their connection with the thalamus and eliminates the possibility to receive from it stimuli which lead to irritation and on the whole derange mental functions. This explanation is mechanistic and goes back to the narrow localizationism characteristic of psychiatrists of America, from where leucotomy was imported to us.

Предполагается, что перерезка белого вещества лобных долей нарушает их связи с зрительным бугром и устраняет возможность поступления из него стимулов, приводящих к возбуждению и вообще расстраивающих психические функции. Это объяснение механистично и уходит своими корнями к узкому локализационизму, свойственному психиатрам Америки, откуда и перенесена к нам лейкотомия.

The paper by Gilyarovsky proved to be enough to stop the practice of lobotomy in the Soviet Union for years to come.--Psychiatrick (talk) 02:58, 24 January 2013 (UTC)[reply]

Thanks Psychiatrick. We should set up a collaborative library of sources for such articles that all of us could access. Could you hazard a translation of the 1950 article title? Also, do you think that the resistance to lobotomy in Russia had anything to do with a rejection of brain localisation theories? FiachraByrne (talk) 03:08, 24 January 2013 (UTC)[reply]
Here are the data of the paper: Vasily Gilyarovsky (14 September 1950). “Pavlov’s teaching is the basis of psychiatry.” Meditsinskiy Rabotnik, No 37. In Russian: Василий Гиляровский. Учение Павлова — основа психиатрии // Медицинский работник № 37, 14 сентября 1950. Yes, I think that the resistance to lobotomy in Russia had something to do with a rejection of the assumption that each mental function, motion, emotion, etc. is strictly and entirely localized in a certain part of cerebrum. I am also influenced by Russian neuroscientists and think each mental function evokes the activation of all parts of cerebrum, not only one of its parts. This activation of all the parts of cerebrum related to various cognitive and emotional processes would be impossible if each mental function were strictly localized in only one part of cerebrum. There is the paper on the theme: Лихтерман, Л.Б.; Лихтерман, Б.Л. (2001). "История запрета психохирургии в СССР". "Вопросы нейрохирургии" им. Н.Н. Бурденко [Zhurnal Voprosy Neirokhirurgii Im N N Burdenko] (2): 35–38. PMID 11558172. {{cite journal}}: Unknown parameter |month= ignored (help); Unknown parameter |trans_title= ignored (|trans-title= suggested) (help) --Psychiatrick (talk) 14:54, 24 January 2013 (UTC)[reply]
Thanks again for the clarification. Could you also check footnotes 41 and 42 to make sure that they're ok? FiachraByrne (talk) 03:02, 25 January 2013 (UTC)[reply]
Footnotes 41 and 42 are ok. --Psychiatrick (talk) 09:51, 25 January 2013 (UTC)[reply]
Further question: what was Gilyarovsky's official position within Soviet psychiatry at the time of that article? FiachraByrne (talk) 03:06, 25 January 2013 (UTC)[reply]
At the time of Vasily Gilyarovsky’s paper, Gilyarovsky within Soviet psychiatry held the position of the director of the Institute of Psychiatry of the USSR Academy of Medical Sciences (now the Institute created by Gilyarovsky is called the Mental Health Research Center of the Russian Academy of Medical Sciences). Gilyarovsky’s opinion that “Pavlov’s teaching is the basis of psychiatry” became the official position, and the basis, of Soviet psychiatry after pavlovian session. As a result, psychosurgery and, in particular, lobotomy were banned in the Soviet Union. That was good I think not for neuroscientists, but for the mentally ill who did not want to be lobotomized. After pavlovian session, the best neuroscientists of the time were labeled as anti-Pavlov, anti-materialist, reactionaries and were discharged from their positions. --Psychiatrick (talk) 09:51, 25 January 2013 (UTC)[reply]

I have the Selected Works by Gilyarovsky in Russian. The book contains the information that lobotomy was banned in the USSR on the initiative of Gilyarovsky.

In the Don hospital, V.А. Gilyarovsky introduced new methods of active therapy. It is no exaggeration to say that this hospital applied all types of therapy except for leucotomy, of which he had always disapproved. It is known that this type of treatment was banned in the USSR on the initiative of V.А. Gilyarovsky. (Gilyarovsky, V.А. (1973). Selected Works. Moscow: Medicine. p. 4 [in Russian])

В Донской лечебнице В. А. Гиляровский внедрил новые методы активной терапии. Не будет преувеличением сказать, что в этой больнице применялись все виды терапии, за исключением лейкотомии, к которой он всегда относился отрицательно. Как известно, этот вид лечения был запрещен в СССР по инициативе В. А. Гиляровского. (Гиляровский В.А. Избранные труды. — Москва: Медицина, 1973. — С. 4.)

--Psychiatrick (talk) 13:51, 25 January 2013 (UTC)[reply]

OK. I have a few more questions as, on the basis of a very cursory search, I can't find anything substantive on lobotomy in the USSR based on English language sources (actually, the only country which is really adequately covered in the sources is the US; everything else is pretty fragmented). When was lobotomy first introduced into the USSR? Is it known how many operations were performed before the 1950 ban? How long did the ban remain in place before lobotomy/psychosurgery was reintroduced? FiachraByrne (talk) 22:20, 2 February 2013 (UTC)[reply]

The Soviet newspaper Pravda of 29 November 1950 wrote, “As early as 1944, professor M. Goldenberg, the head of the department of psychiatry at the Gorky Medical Institute, conducted an operation by the method of lobotomy.” Perhaps, lobotomy was first introduced into the Soviet Union in 1944. In his book Prodolzhenie “Zdes-2” published in 2007, Russian neurologist Doctor of Medical Sciences Leonid Boleslavovich Likhterman wrote that a report on the audit of the Bekhterev Leningrad Institute stated that 176 patients underwent leucotomy. Probably, only 176 patients in the Soviet Union underwent leucotomy from 1944 to 1950 when leucotomy was banned. The ban remained in place from 1950 to 1998 when psychosurgery in Russia was reintroduced and then again banned in 2002. See Hall, Wayne (2006). "Stereotactic neurosurgical treatment of addiction: minimizing the chances of another 'great and desperate cure'". Addiction. 101 (1): 1–3. doi:10.1111/j.1360-0443.2005.01363.x. PMID 16393184. Retrieved 2 February 2013. {{cite journal}}: Unknown parameter |month= ignored (help) --Psychiatrick (talk) 23:34, 2 February 2013 (UTC)[reply]
That's great Psychiatrick. 1944 could be right; a little late but most countries didn't start lobotomies on any scale until the mid 1940s (Italy was exceptional). Just to clarify, it is Boleslavovich's or your conclusion that there were probably only 176 leucotomies in the USSR from 1944–1950 and the introduction of the ban? Also, is there any mention of the Nobel Prize in 1949 in relation to the ban? FiachraByrne (talk) 23:58, 2 February 2013 (UTC)[reply]
It is my conclusion that there were probably only 176 leucotomies in the USSR from 1944 to 1950. By the way, Boleslavovich is Likhterman’s middle name. His surname is Likhterman. There is no mention of the Nobel Prize in 1949 in relation to the ban. Psychiatrick (talk) 00:11, 3 February 2013 (UTC)[reply]
Thanks for pointing out my mistake in regard to Likhterman's name; otherwise I probably would have perpetuated it. It's not so unusual that there might have been one surgeon or centre that dominated in the field of leucotomy in a given country (e.g. Wylie McKissock in the UK) but there must have been other neurosurgical centres in the USSR interested in the procedure. Puusepp was (re-)converted to the virtues of psychosurgery by 1937; that may have had some influence ... ?
OK. Rereading your post above you state: "...a report on the audit of the Bekhterev Leningrad Institute stated that 176 patients underwent leucotomy". Presumably that is the same institution that Puusepp worked with Bekhterev in the early 20th century? It makes sense, therefore, that that was the leading centre for leucotomy in the USSR if Puusepp was still attached to or influential within that neurosurgical unit. FiachraByrne (talk) 00:49, 3 February 2013 (UTC)[reply]
The Leningrad Institute where Vladimir Bekhterev had worked was named after him after he died. Psychiatrick (talk) 01:16, 3 February 2013 (UTC)[reply]
Very good. Now I wonder what kind of role Puusepp may have had, if any, in introducing leucotomy to the Bekhterev institute, given his role at the Racconigi hospital in Italy. FiachraByrne (talk) 02:02, 3 February 2013 (UTC)[reply]
I don’t know whether Ludvig Puusepp performed the psychosurgical operations by the method of lobotomy (i.e. on the frontal lobes) or not. According to the Soviet newspaper Pravda of 29 November 1950, M. Goldenberg in the Soviet Union was the first who performed psychosurgical operations by the method of lobotomy since 1944. Psychiatrick (talk) 14:36, 3 February 2013 (UTC)[reply]

40,000 lobotomies in the US?

Do you have any sources reporting how many lobotomies were conducted in the United States? Do you think that there are such sources? The wikiarticle reads, "In the United States approximately 40,000 people were lobotomized." Approximately to what extent? The same is true for sources about lobotomies conducted in the Soviet Union. Psychiatrick (talk) 01:16, 3 February 2013 (UTC)[reply]
That section currently cites this article, but the 40,000 figure is derived from Jack Pressman's Last Resort (maybe El-Hai has a different estimate); I'll try and get the exact reference now. FiachraByrne (talk) 02:10, 3 February 2013 (UTC)[reply]
Pressman/Ed Shorter: 1936–1951 18,608 lobotomies in US (figures derived from Proceedings of the Third Research Conference on Psychosurgery', 1954).
Hmmm. I don't see the 40,000 figure in Pressman. Could be from Valenstein's 1986 book (Great and Desperate Cures) which I don't have to hand. I'll keep looking but the 40,000 figure is almost certainly some kind of estimate rather than based on any kind of hard data. FiachraByrne (talk) 02:21, 3 February 2013 (UTC)[reply]
Mical Raz (see article for full cite), citing Pressman and Valenstein, says that there "tens of thousands" of lobotomies in the US between 1935 and 1965. Pretty certain there's no definitive figure and not sure how they're estimating for period after 1951. Pressman may mention another figure so will reread. FiachraByrne (talk) 02:26, 3 February 2013 (UTC)[reply]
40,000 estimated figure for US is quoted in a Rotarian Magazine article dated 1977 [2]. Valenstein had a text out in 1973, Brain Control, and it could be from that ... It's likely a very rough estimate.FiachraByrne (talk) 02:59, 3 February 2013 (UTC)[reply]
Bah - 650 books say "it is estimated that 40,000 lobotomies were performed in the US" but I can't find out where they're taking this figure from. Must be Valenstein[3] FiachraByrne (talk) 03:04, 3 February 2013 (UTC)[reply]
I think the figure comes from the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research which investigated psychosurgery in 1976 and reported the following year. The Commission was created by Congress in 1974 to look at controversial areas of scientific research. Campaign by Peter Breggin was instrumental in getting the Commission to look at psychosurgery (not just lobotomy). The 40,000 figure is for number psychosurgical procedures since the end of WWII until 1977.FiachraByrne (talk) 03:17, 3 February 2013 (UTC)[reply]

No, Valenstein is already quoting the 40,000 figure in 1973 [4]. FiachraByrne (talk) 11:51, 3 February 2013 (UTC)[reply]

Thanks. Other sources give the figure up to 50,000 lobotomies carried out in the USA since the introduction of lobotomy. "Since its introduction, it has been estimated that somewhere between 40,000 and 50,000 lobotomies have been carried out in the USA alone. It has also been widely used in other countries. For example, in Great Britain around 10,000 lobotomics were carried out between 1942 and 1952, though the number has dropped sharply since that time." Quoted from Cox, Erika (2001). Psychology for A-Level. Oxford University Press. p. 677. ISBN 0198328389. Psychiatrick (talk) 12:16, 3 February 2013 (UTC)[reply]
Yeah - I've seen the 50,000 figure; most often they state between 40,000 and 50,000 but there's no indication of where this estimate is derived from. I'd really like to find the original instance of the 40,000 figure. FiachraByrne (talk) 12:41, 3 February 2013 (UTC)[reply]
Here's the Report from the 1977 Commission on Psychosurgery [5] It quotes the 40,000 figure but doesn't indicate where it comes from. I wonder did Peter Breggin have any role in coming up with this figure? It's not an unreasonable figure actually. Lobotomies peaked at 5,000 in the US in 1949. Precise figures stop at 1951 but it did undergo a slight decline from 1949-51. By 1951 there had been 18,604 lobotomies. Assuming a rate of about 5,000 lobotomies a year, there would have been 23,000 lobotomies in the US by 1952, 28,000 by 1953, 32,000 by 1954, 37,000 by 1955, and 42,000 by 1956. Interesting that there appears to be a decline before the introduction of antipsychotics in 1954. I think the same observation, that decline precedes the antipsychotics, has been made for the UK.
I think it's also instructive, however, that Pressman, whose history of lobotomy in the US is the best one by some distance, does not quote the 40,000 figure.FiachraByrne (talk) 12:06, 3 February 2013 (UTC)[reply]
Then again, that it peaked in 1949 might reflect the influence of the Nobel Prize. FiachraByrne (talk) 12:09, 3 February 2013 (UTC)[reply]
I guess it's possible that Freeman provided the estimate? [6] FiachraByrne (talk) 12:18, 3 February 2013 (UTC)[reply]
Yes, he did. "Freeman later estimated that of the 40,000 to 50,000 lobotomies done in this country between 1936 and the late 1950s, he had personally performed or directed 4,000 of them in at least 30 hospitals in 15 states." Quoted from Frackel, Glenn (14 June 1980). "'Operation Icepick' characterized age of lobotomy". Anchourage Daily News. Psychiatrick (talk) 12:46, 3 February 2013 (UTC)[reply]
Freeman gave that estimate of the number of lobotomies that he performed himself at his retirement. I don't think that is the source of the 40,000 figure. FiachraByrne (talk) 13:08, 3 February 2013 (UTC)[reply]
Jebus, now a paper is stating that by 1952 40,000 lobotomies had been performed worldwide Nijensohn, Daniel E. (2012-03). "New Evidence of Prefrontal Lobotomy in the Last Months of the Illness of Eva Perón". World Neurosurgery. 77 (3–4): 583–590. doi:10.1016/j.wneu.2011.02.036. ISSN 1878-8750. Retrieved 2013-02-03. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help). It cites this publication in support: Kaplan AD, Lambre J, Veppo AA: "Bimedial lobotomy in the treatment of pain." Second International Congress of Neurosurgery, Washington DC, 1961.FiachraByrne (talk) 12:57, 3 February 2013 (UTC)[reply]
Which reminds me we haven't covered lobotomy as a treatment for chronic pain.FiachraByrne (talk) 12:59, 3 February 2013 (UTC)[reply]

Inappropriate material

I'd like to note that currently the article contains two things added by the 87 IP editor that I don't think are appropriate:

  • In Notable cases, the line Josef Hassid, a famous Polish violonist and composer, was murdered with a bilateral prefrontal leucotomy at age 26 is not supported by our article about him.
  • In Literary and cinematic portrayals, the line It was the writers and film-makers who got across to the public the full horror of carving up the human brain like a Thanksgiving turkey. This may be the opinion of a newspaper writer, but it does not belong in a Wikipedia article without attribution.

I have already reverted these items once, and it is my policy never to repeat-revert the same material, so I'll have to leave these to others to deal with. Looie496 (talk) 17:47, 23 January 2013 (UTC)[reply]

LOL. Thank you. The language, if nothing else, is not encyclopedic. I haven't worked on the article in a while so I'll give it a good read through and edit/copy-edit. FiachraByrne (talk) 18:10, 23 January 2013 (UTC)[reply]
The "thanksgiving turkey" line was also, again, plagiarized. The IP editor really needs to stop doing that. Fut.Perf. ☼ 19:57, 23 January 2013 (UTC)[reply]
Josef Hassid (1923–1950), musical prodigy, born in Suwalki Poland, died in Longrove Psychiatric Hospital Surrey. Became psychotic at 18 years of age when on tour in London (already hailed as a musical genius at this point); diagnosis of schizophrenia (persecutory delusions, grimacing, posturing). First admission to psychiatric hospital in 1941 (St Andrews Northampton). 60 insulin comas over 3 months: no effect. 20 ECT sessions from Nov 1941: some improvement. After further course of 25 ECT discharged May 1942; returned to London. Relapsed Dec 1942; certified; admitted to Moorcroft House, Hillingdon, Middlesex. Insulin comas; attempted escape; transferred to Longrove ("evasive, inconsequential"; disinclined to speak; "brooding"; "laughed inanely"; "deluded"; "suspicious"). According to case notes, remains psychotic for 7 years. 20 Oct 1950, Bilateral leucotomy performed; fever 5 days later; signs of cerebral infection; died from complications subsequent to the operation (meningitis), 7 Nov 1950. COD: "suppurative meningitis due to Bacillus Pyocyaneus following prefrontal leucotomy performed for the treatment of dementia praecox and schizophrenia". Summary of: Feinstein, Anthony (March 1997). "Psychosurgery and the child prodigy: the mental illness of violin virtuoso Josef Hassid". History of Psychiatry. 8 (29): 55–60. doi:10.1177/0957154X9700802904. ISSN 1740-2360 0957-154X, 1740-2360. Retrieved 31 January 2013. {{cite journal}}: Check |issn= value (help) FiachraByrne (talk) 01:15, 3 February 2013 (UTC)[reply]
Actually, that cite can support almost all the text from the "Illness and death" section of the Hassid article, which is currently uncited; I'll add it now. FiachraByrne (talk) 01:19, 3 February 2013 (UTC)[reply]

In-pop-cult/literary portrayals/etc. material

I'm adding this at this point on the page because to some extent it follows from the immediately previous section. Hats off to BiancaFern ;) for taking the axe to the pop culture material. I had a very unpleasant time abt 2 years ago trying to get rid of the Shutter Island baloney and finally gave up.

In the context of another article, I proposed a standard for inclusion of pop culture material which, to my astonishment, not only gained unanimous consensus but actually converted someone who had proposed mention of a certain fictional work to the point of view that doing so would not, after all, be appropriate. (Some of you may have read about this historically unique achievement in connection with my having been nominated for the Nobel Prize for it.) Anyway, here (slightly tweaked) is what I proposed:

A fictional or semifictional portrayal of an article's subject is worth noting or discussing in the article on that subject to the extent that reliable secondary sources demonstrate that the portrayal adds to an understanding of the subject itself or of the subject's place in history or popular perception.

Later in the discussion (linked here: Talk:Lizzie Borden/Archive 2#popcult_discussion) I gave examples:

  • The play Macbeth is what most people know about the historical Macbeth
  • The film Lawrence of Arabia taught most people everything they know about T.E. Lawrence
  • The Dylan song "Hurricane" probably was a strong reason that Ruben Carter's case was reopened
  • War and Peace powerfully affected Russians' view of Napolean's invasion seventy years earlier, and did so with sufficient permanence that echoes of its thematic elements were incorporated into Russian propaganda of World War II
  • Turgenev's Fathers and Sons was a catlyst, in late 19th-century Russia, for discussion of social and political conditions, and would certainly have a place in an article on events leading to the Russian Revolution
  • The Protocols of the Elders of Zion would certainly be covered in a discussion of the history of popular perceptions of Judaism
  • Any comprehensive history of slavery in the US would include a discussion of Uncle Tom's Cabin
So it's not true that discussion of fictional or artistic presentations don't belong in factual articles. But the standard is high, and a minimum requirement is that secondary sources must discuss the work's effect on popular perception etc. -- lacking such sources, even such "obvious" statements about how a given work related to (returning to the topic at hand) Lizzie Borden, drawn from direct reading of the work itself, is WP:OR, which is a no-no.

Do others think such a standard could be usefully applied in this article?

EEng (talk) 02:09, 24 January 2013 (UTC)[reply]

Burn it with fire! Yes. Yes. Write a policy proposal. Ken Kesey's work probably has a claim but I'll have to look at the sources to confirm.FiachraByrne (talk) 02:40, 24 January 2013 (UTC)[reply]
Um, I'm not sure what Burn it with fire means but I gather it's an expression of enthusiasm. When you suggest writing a policy proposal, do you mean for an overall WP guideline? If so, then -- again -- I'm glad for the enthusiasm but for the moment I was just proposing we use it here on this article -- if someone has the fortitude to propose it as a WP-wide guideline I'd be flattered but I don't think I'm the person to do that.
Just from my own knowledge of literature and culture (US, anyway) I'd predict the following fates, under my proposed criterion, of works now mentioned in the article:
  • Absolutely qualifies for inclusion: Cuckoo's Nest
  • Likely: Frances; Bell Jar; Suddenly, Last Summer
  • Perhaps: All the King's Men, Fine Madness
  • Unlikely: Planet of the Apes
However, as they are presented in the article now, none of these carry cites meeting the burden of my prososed standard. The Grenander article goes partway, in that it describes how each work portrays lobotomy, but it doesn't (I don't think) say much or anything about how popular perceptions were affected. Gabbard seems like it might be likely to do the latter, but I don't see it there offhand either.
I'm still hoping to get more editors' thoughts on this. EEng (talk) 17:08, 24 January 2013 (UTC)[reply]


I think it should be mentioned in title only, movies, shows, books that revolve around the topic at least in part, but no information should be given outside a brief description. ie. "sucker punch follows a girl who is undergoing a lobotomy and slips into a fantasy world before the procedure is completed." or "planet of the apes has a character suffering the effects after a lobotomy was performed" for more on the plot reader can view the wiki for that title. we cant just erase fiction, its part of our existance and deserves a place. tag the section "fictional works around lobotomy" or similar. Kevintampa5 (talk) 19:13, 17 August 2013 (UTC)[reply]

Cut: 1970 Dictionary of Psychiatry entry on lobotomy

Primary source in this context - will replace with better text soon.FiachraByrne (talk) 21:01, 23 January 2013 (UTC)[reply]

According to the Psychiatric Dictionary[3] published in 1970:

Prefrontal lobotomy is of value in the following disorders, listed in a descending scale of good results: affective disorders, obsessive-compulsive states, chronic anxiety states and other non-schizophrenic conditions, paranoid schizophrenia, undetermined or mixed type of schizophrenia, catatonic schizophrenia, and hebephrenic and simple schizophrenia. Good results are obtained in about 98 percent of cases, fair results in some 35 percent and poor results in 25 percent are thereabouts. The mortality rate probably does not exceed 3 percent. Greatest improvement is seen in patients whose premorbid personalities were 'normal', cyclothymic, or obsessive compulsive; in patients with superior intelligence and good education; in psychoses with sudden onset and a clinical picture of affective symptoms of depression or anxiety, and with behaviouristic changes such as refusal of food, overactivity, and delusional ideas of a paranoid nature.[4]

Prefrontal lobotomy has also been used successfully to control pain secondary to organic lesions. In this case, the tendency has been to employ unilateral lobotomy, because of the evidence that a lobotomy extensive enough to reduce psychotic symptoms is not required to control pain.[4]

According to the same source, prefrontal lobotomy reduces:

anxiety feelings and introspective activities; and feelings of inadequacy and self-consciousness are thereby lessened. Lobotomy reduces the emotional tension associated with hallucinations and does away with the catatonic state. Because nearly all psychosurgical procedures have undesirable side effects, they are ordinarily resorted to only after all other methods have failed. The less disorganized the personality of the patient, the more obvious are post-operative side effects. ...[4]

Convulsive seizures are reported as sequelae of prefrontal lobotomy in 5 to 10 percent of all cases. Such seizures are ordinarily well controlled with the usual anti-convulsive drugs. Post-operative blunting of the personality, apathy, and irresponsibility are the rule rather than the exception. Other side effects include distractibility, childishness, facetiousness, lack of tact or discipline, and post-operative incontinence.[4]

Original Research cut

Cutting original research (but not my original text really) which I added some time ago (this was my first article); some of the points may be supportable so just putting here for the moment. FiachraByrne (talk) 23:27, 23 January 2013 (UTC)[reply]


The development of the leucotomy procedure by Moniz in 1936, took place at a time when all of the above therapeutic interventions were extreme and experimental forms of therapy, and most posed serious risks to the health of the patients who underwent them. Leucotomy was seen by many psychiatrists as no more severe than therapies such as insulin or cardiazol shock;[5] these apparently successful procedures conceived for the treatment of patients suffering severe mental illnesses helped to create the intellectual climate and medical and social warrants that allowed a surgical procedure as radical and irreversible as leucotomy to appear as a viable and even necessary proposition. Moreover,

Not appropriate for lead - stashing here

Not appropriate for lead so just storing here for the moment:

In Ottawa's psychiatric hospitals, for instance, the 153 lobotomies performed in 1953 were reduced to 58 by 1961, after the arrival in Canada of the antipsychotic drug chlorpromazine in 1954.[6][7]

Unnecessary detail

Removing detail more appropriate to article on Moniz, Burckhardt or psychosurgery. FiachraByrne (talk) 23:54, 23 January 2013 (UTC)[reply]

However, Kotowicz notes a difference, irregularly observed, among medical historians and medical practitioners in their location of the origin of psychosurgery. The latter group, he contends, tend to favour beginning the narrative with Burckhardt while the former group favour starting with Moniz.

Kotowicz, Zbigniew (2005). "Gottlieb Burckhardt and Egas Moniz–Two Beginnings of Psychosurgery". Gesnerus. 62 (1–2): 78–9.

In the context of early psychosurgery, Berrios unusually also refers to the operations performed in 1889 by a surgeon (Harrison Cripps) at the behest of the British psychiatrist Thomas Claye Shaw in which fluid was drawn from the brain of a patient diagnosed with General Paralysis of the Insane. While the purpose of the operation was aimed towards the alleviation of mental symptoms attendant on the condition the procedure did not aim to interfere directly with brain tissue and therefore it has been excluded from most conventional accounts of psychosurgery. Berrios, German E. (1991). "Psychosurgery in Britain and elsewhere: a conceptual history". In Berrios, German E.; Freeman, Hugh (ed.). 150 Years of British psychiatry, 1841–1991. Gaskell. pp. 181–5. ISBN 978-0-902241-36-7. {{cite book}}: Cite has empty unknown parameter: |coauthors= (help)CS1 maint: multiple names: editors list (link)

Two temp removals

Two removals: one sentence stating that while Burckhardt was reviled Moniz was accepted by the medical community (largely true); and one sentence stating that Moniz won the Nobel Prize in 1949. Both statements will be reinserted at a later point in article development. Parking them here in the meantime.FiachraByrne (talk) 15:02, 30 January 2013 (UTC)[reply]

{{quote box|salign=left|quote=Later, Burckhardt was condemned for his methodology while Moniz's more favorable results earned him acceptance within the psychology community.|source={{sfn|Kotowicz|2005|p=84|ps=}}}} {{quote box|salign=left|quote=Moniz was given the [[Nobel Prize in Physiology or Medicine|Nobel Prize in medicine]] in 1949 ''"for his discovery of the therapeutic value of leucotomy in certain psychoses".''|source=<ref>{{harvnb|Nobelprize.org|2013}}; {{harvnb|Kotowicz|2005|p=78 n. 2}}</ref>}}

Mortality rate for lobotomy

There is a very important issue to address. The issue is what is the mortality rate for lobotomy? See Strecker, Edward; Palmer, Harold; Grant, Francis (1942). "A Study of Frontal Lobotomy—Neurosurgical and Psychiatric Features and Results in 22 Cases with a Detailed Report on 5 Chronic Schizophrenics". American Journal of Psychiatry. 98 (4): 524–532. {{cite journal}}: Unknown parameter |month= ignored (help) The article reports that two patients of twenty-two patients subjected to frontal lobotomy died. The percentage of the proportion of two to twenty-two accounts for 9. It means that 9 percent of patients died following lobotomy. This mortality rate is very high. In most fatal cases, I think, lobotomized patients died from massive cerebral hemorrhage. --Psychiatrick (talk) 17:08, 2 February 2013 (UTC)[reply]

Reported mortality rates varied from 2–4 per cent; according to one source (Pressman I think) about 10 per cent of patients suffered from epilepsy after the operation. A 9 per cent mortality rate is way too high. I haven't looked at all at if there was variation in the mortality rate with the use of different procedures (transorbital, prefrontal, rostral, etc). I'm not quite finished with Moniz (I want to expand on the outcomes for his patients etc) and then I'd like to cover Italy before Freeman and the US (the first transorbital operations were performed in Italy) but the mortality rate, together with other outcomes, needs to be covered insofar as the sources (and ideally secondary sources, be they medical or historical) allows for such an evaluation. FiachraByrne (talk) 20:45, 2 February 2013 (UTC)[reply]
Source on lobotomies in Sweden calculating a mortality rate of 7.4 per cent based on 700 operations between 1943 and 1960 [7]. That's probably the highest rate I've seen on a decent sized sample. It wasn't so unusual to get very high mortality rates when the procedure was first introduced into a clinical setting (the first 20 or 40 patients). That 7.4 per cent looks pretty atypical to me though. Anyhow, we can gather sources and see what they say. FiachraByrne (talk) 21:09, 2 February 2013 (UTC)[reply]
Thank you very much. Psychiatrick (talk) 14:38, 3 February 2013 (UTC)[reply]

Psychosurgery in the United Kingdom

Psychosurgery in the United Kingdom is still used. See Christmas, David; Morrison, Colin; Eljamel, Muftah; Matthews, Keith (2004). "Neurosurgery for mental disorder". Advances in Psychiatric Treatment. 10: 189–199. doi:10.1192/apt.10.3.189. Retrieved 4 February 2013. It's English version of the article. Its Russian version for Russian speakers is available from here. Psychiatrick (talk) 00:09, 4 February 2013 (UTC)[reply]

Yes, they were operating on a small amount of patients in Dundee (I think), at least until a few years ago (I assume they still are?). They've tended to move away from removing/destroying tissue to stimulation - that had started in the 1970s I think. Focus is on those with severe epilepsy and extreme OCD (I think). But they don't perform lobotomies. See History of psychosurgery in the United Kingdom which gives an account.FiachraByrne (talk) 01:25, 4 February 2013 (UTC)[reply]
Quite a bit of WP:OR in that article History of psychosurgery in the United Kingdom; not so much inaccurate as overly reliant on medical papers from the 1940s etc. Needs secondary sources (medical/historical) to interpret those primary sources, ideally.FiachraByrne (talk) 13:50, 4 February 2013 (UTC)[reply]

Clarification

As far as I remember, Evgeny Zamyatin in his novel We used the term Great Operation to describe the operation on the frontal lobes. As for the source Serdyukova, O.I. [О.И. Сердюкова] (2011). "Проблема свободы личности в романе Э. Берджесса «Механический апельсин»" (PDF). Вісник Харківського національного університету імені В. Н. Каразіна. Серія: Філологія [The Herald of the Karazin Kharkiv National University. Series: Philology] (in Russian). 936 (61). Kharkiv: 144–146. {{cite journal}}: Unknown parameter |trans_title= ignored (|trans-title= suggested) (help) I can provide the quotation from the source: "У Е. Замятина роман «Мы» завершался лоботомией главного героя (а затем и всех граждан) с целью предотвращения возможных бунтов…" In English: "The novel We by E. Zamyatin ended with the lobotomy of the main character (and then all citizens) for the purpose of preventing possible riots…" --Psychiatrick (talk) 13:30, 4 February 2013 (UTC)[reply]

OK. I think, as that list is in chronological order, it should be the first item in that section. I'd also suggest using another phrase rather than "lobotomy"; such as a "frontal lobe operation" or "frontal lobe surgery". In the context of the article it's confusing to refer to lobotomy or leucotomy before the recognised date of the procedure's invention (even though there were lobotomy type operations before Moniz). FiachraByrne (talk) 13:44, 4 February 2013 (UTC)[reply]
The cited article by Serdyukova used the term "lobotomy" because Zamyatin’s description of the operation bears the strongest resemblance to lobotomy, although the term "lobotomy" was not yet used in 1924. But I don’t mind if you use the term "frontal lobe operation" for Zamyatin’s description of the operation. I have the other sources to quote: "In Zamyatin's We, for instance, freedom-loving dissidents are sent to the "Operations Department" for therapeutic lobotomies..." (Fiedler, Leslie (1996). Tyranny of the normal: essays on bioethics, theology & myth. D.R. Godine. p. 114.) "Zamyatin dramatizes the potential consequences of such thinking in We, in which the state persuades its citizens to be lobotomized into machinelike 'reliability', to become 'tractors in human form'." (Hughes, Jon (2006). Facing Modernity: Fragmentation, Culture and Identity in Joseph Roth's Writing in the 1920's. MHRA. p. 127. ISBN 1904350372.) Psychiatrick (talk) 15:32, 4 February 2013 (UTC)[reply]
In the Wikipedia article We (novel), it says:

In his last journal entry, D-503 indifferently relates that he has been forcibly tied to a table and subjected to the "Great Operation", (similar to a lobotomy),<ref>Erich Fromm's afterword to Nineteen Eighty-Four.</ref> which has recently been mandated for all citizens of the One State. This operation removes the imagination and emotions by targeting parts of the brain with X-rays. After this operation, D-503 willingly informed the Benefactor about the inner workings of the MEPHI. However, D-503 expresses surprise that even torture could not induce I-330 to denounce her comrades. Despite her refusal, I-330 and those arrested with her are sentenced to death, "under the Benefactor's Machine."


Could it be phrased like that? FiachraByrne (talk) 18:08, 4 February 2013 (UTC)[reply]
Yes, it could be phrased in this way. One can write "an operation like a lobotomy." By the way, Erich Fromm in his "Afterword to George Orwell’s 1984" (the link is available for all) uses the term "a brain operation similar to lobotomy" in relation to the "Great Operation" described in Zamyatin's novel We. There is also the free unabridged English version of Zamyatin’s novel We in Internet. I’ve again read the English version of We and found the necessary part of text in which Zamyatin describes the Great Operation on the frontal lobes: "The latest discovery of our State science is that there is a center for fancy-a miserable little nervous knot in the lower region of the frontal lobe of the brain. A triple treatment of this knot with X-rays will cure you of fancy, Forever! You are perfect; you are mechanized; the road to one-hundred-per-cent happiness is open! Hasten then all of you, young and old, hasten to undergo the Great Operation! Hasten to the auditoriums where the Great Operation is being performed!" Quoted from Zamiatin, Eugene (1952). We (PDF). New York: E.P. Dutton. p. 167. ISBN 0-525-47039-5. Psychiatrick (talk) 21:14, 4 February 2013 (UTC)[reply]
I've made a few changes. Could you check to see if it's ok?FiachraByrne (talk) 22:24, 4 February 2013 (UTC)[reply]
It's ok. You have phrased the paragraph in a better way than I did. Thanks a lot. Psychiatrick (talk) 00:08, 5 February 2013 (UTC)[reply]

Images

I uploaded a few images to wikicommons which could be used in this article, bio-articles on Freeman and Watts, or in the psychosurgery article. FiachraByrne (talk) 03:04, 14 February 2013 (UTC)[reply]

Images of Walter Freeman and James W. Watts from 1941 Saturday Evening Post article on lobotomy

Effects section seems lacking in detail

This article seems very in depth in most areas but I was surprised by the "effects" section. It would be interesting to know more post-procedure behavioral details. Also, would be interesting to know if there is anything known about lifespan and other issues after such a procedure. Kap 7 (talk) 22:24, 22 April 2013 (UTC)[reply]

I have expanded this section as the tag had been there nearly a year. I removed a couple of references - the Shutts because no-one had come up with clarification and the Freberg because it was only one sentence and the information has been included in the new paragraphs. The new references will be coming shortly. Staug73 (talk) 20:02, 19 May 2014 (UTC)[reply]
Here are the removed references: Freberg, Laura A. Discovering Biological Psychology. 2nd ed. Belmont, California: Wadsworth; 2010. ISBN 0-547-17779-8. Shutts, David. Lobotomy: resort to the knife. Van Nostrand Reinhold; 1982. ISBN 978-0-442-20252-1. Staug73 (talk) 20:08, 19 May 2014 (UTC)[reply]

Very interesting source

Focus of the article

I think that this article is better suited for an article titled "History of lobotomy". I came wanting to learn about the procedure, the reasoning behind it, the results obtained, and its side effects, but found that it was difficult to filter this information among all the information regarding the history of lobotomy. I do not mean to say that its history is not relevant for this article, but it should be one section of the article and not its main focus. It should start with a description of the procedure itself that should help non-specialists (like me - I am an economics graduate student) understand well what a lobotomy is.

190.156.105.135 (talk) 05:13, 14 July 2013 (UTC)[reply]

Hmmmm. Now that you mention it, I see your point. I suspect that buried somewhere in there is an actual description of what lobotomy is, and the material needs to be rearranged to put that up front. And spinning off a separate article on History of Lobotomy might be a good idea. I haven't the energy, but some excellent editors are watching and with luck one will be inspired to spring into action. EEng (talk) 05:48, 14 July 2013 (UTC)[reply]

References from previous contributions

  1. ^ Barnes, Allison, Thagard, Paul. (1996). Emotional decisions. Proceedings of the Eighteenth Annual Conference of the Cognitive Science Society. 426-429.
  2. ^ "Lobotomy". Encyclopædia Britannica. Encyclopædia Britannica Online. Encyclopædia Britannica Inc., 29 Jun. 2012. 29 Jun. 2012 <http://www.britannica.com/EBchecked/topic/345502/lobotomy>.
  3. ^ Hinsie, Leland E. and Campbell, Robert Jean (1970). Psychiatric Dictionary. Fourth Edition. Oxford University Press.
  4. ^ a b c d Hinsie, Leland E. and Campbell, Robert Jean (1970). Psychiatric Dictionary. Fourth Edition. Oxford University Press: p. 438.
  5. ^ For instance, G.W.T.H. Fleming, editor of the Journal of Mental Science, which would later become the British Journal of Psychiatry, and Medical Superintendent of a private psychiatric institution in Gloucester, remarked: 'At first sight the operation [leucotomy] would appear to be a revolutionary proceeding; and so it is in some ways. It is, however, no more drastic than the convulsion or insulin treatments in which the patient is near enough the line which separates life and death'. Fleming, G.W.T.H. (1942). Some preliminary remarks on prefrontal leucotomy. Journal of Mental Science. 88 (371): 282.
  6. ^ Braslow, Joel. T. (1997). Mental Ills and Bodily Cures: Psychiatric Treatment in the First Half of the Twentieth Century. University of California Press: pp. 126–127
  7. ^ Shorter, Edward (1997). A History of Psychiatry: From the Era of the Asylum to the Age of Prozac. Wiley: pp. 390–391, n. 161.

(These can be moved to the relevant sections if desired by appending the template {{reflist-talk|title=References for this section|close=1}} .)

Ice pick

Opinions please on whether a reference to icepicks in the introduction should be deleted.

I reinstated some text in the introduction from an earlier version on the use of an ice-pick, with references (and there are ample references elsewhere, it's well-known and documented). This was contested and deleted, with a comment that the source supplied was not reliable (quite true). I reinstated the text with a reliable source, and it has been deleted again with the summary including "to include in lead can only be for shock value: "Oh, those horrible doctors! We today would know better!".

What I added is:

  1. Notable
  2. Relevant
  3. Reliably sourced (even by the leading exponent of the technique)

It accurately summarises the procedure, information which was previously missing from the introduction. It also goes some small way to responding to a previous point: "I suspect that buried somewhere in there is an actual description of what lobotomy is, and the material needs to be rearranged to put that up front".

These are the criteria for inclusion. I agree that this is shocking; but it is a shocking fact. It would be wrong for a Wikipedia editor to say something to the effect of "Oh, those horrible doctors! We today would know better!" (unless someone reliable has said this and is cited), but to remove correct text because of what readers may infer is not justified in a complete and unbiased work of reference.

Here is the text in question, with footnotes and references (the footnotes were already in the article, and are cited in the body):

An instrument which was essentially an ice-pick—and sometimes an actual kitchen ice pick was used—was simply passed through the eye-socket and struck with a hammer when in the right position.[1][n 1][n 2]

Notes

  1. ^ Walter Freeman had originally used ice picks for his modified form of the leucotomy operation that he termed transorbital lobotomy. However, because the ice picks would occasionally break inside the patient's head and have to be retrieved, he had the very durable orbitoclast specially commissioned in 1948.[2]
  2. ^ Frank Freeman, Walter Freeman's son, stated in an interview with Howard Dully that: "He had several ice-picks that just cluttered the back of the kitchen drawer. The first ice-pick came right out of our drawer. A humble ice-pick to go right into the frontal lobes. It was, from a cosmetic standpoint, diabolical. Just observing this thing was horrible, gruesome." When Dully asked Frank Freeman, then a 79-year-old security guard, whether he was proud of his father, he replied: "Oh yes, yes, yeah. He was terrific. He was really quite a remarkable pioneer lobotomist. I wish he could have gotten further."[3]

References

  1. ^ Blank, Robert H (1999). Brain Policy: How the New Neuroscience Will Change Our Lives and Our Politics. Georgetown University Press. p. 109. ISBN 0-87840-712X. Freeman is quoted in Blanks's book: "... thrusting an ice pick up between the eyeball and eyelid through the roof of the orbit actually into the frontal lobe of the brain and making the lateral cut by swinging the thing from side to side. It seemed fairly easy, though definitely a disagreeable thing to watch." Blank comments: "the pejorative term 'ice pick surgery' is accurate ... the first transorbital lobotomy was performed in his office using an ice pick with the name Uline Ice Co. on its handle"
  2. ^ Acharya 2004, p. 40
  3. ^ Dully 2005

Pol098 (talk) 08:35, 10 October 2013 (UTC)[reply]

My edit summaries said:
including this in lead is UNDUE for shock value; surgeons have often adapted everyday tools for novel procedures; "Discover Magazine" is hardly if at all more reliable than its corresponding TV program, esp. when article title refers to "Cuckoo doctor"
and
ice picks are [already] appropriately discussed in the article body (though some of [this] material could, perhaps, be usefully added there) but, I repeat, to include in lead can only be for shock value: "Oh, those horrible doctors! We today would know better!"
The salient guideline is WP:BALASPS (underlining added):
An article should not give undue weight to any aspects of the subject but should strive to treat each aspect with a weight appropriate to its significance to the subject. For example, discussion of isolated events, criticisms, or news reports about a subject may be verifiable and impartial, but still disproportionate to their overall significance to the article topic. ... Note that undue weight can be given in several ways, including, but not limited to, depth of detail, quantity of text, prominence of placement, and juxtaposition of statements.
Contrary to what you say, the "ice-pick" material does not "accurately [summarise] the procedure"; in fact that technique was used only by certain practitioners (and only in the US, if I recall correctly). Most reader today don't even know what an ice-pick is -- have never seen one -- so that they're left to envision whatever awful thing their imaginations can come up with. This aspect of the topic is already described appropriately in the body of the article; including it in the lead could almost define inappropriate and undue weight. EEng (talk) 09:24, 10 October 2013 (UTC)[reply]

"Stunningly successful"?

I don't think this sentence is entirely supported by the source, and the concept of a "stunningly successful" lobotomy sounds odd (although those are indeed the words used in the article). "At times, the operation has been "stunningly successful", allowing severely ill patients to once again work and socialize normally." This is what the source actually says: "The results of the operations were mixed. Some patients died on the operating table; some committed suicide post-operation. Others were left severely brain damaged and were reduced to a state where they were largely unaware of their surroundings. On the other hand, on occasion the operation proved stunningly successful. In his book, The Last Resort (1998), Jack Pressman discusses the case of Rose Thorner who received a lobotomy in 1947 (pp. 264–270). Rose had been diagnosed as suffering from involutional melancholia. She had spent 10 years on a locked ward where she spent her time asking to be allowed to die, smearing faeces, and assaulting patients and staff. Post-lobotomy she was discharged to a lodging house, where she maintained a busy social life and did voluntary work at a local hospital. Friends considered her recovered and acquaintances found her “100 % normal”.The outcomes of other cases were more ambiguous. Post-lobotomy, patients might no longer be troubled, but still seemed to have lost something. Many had to remain in hospital but became more “manageable”. " Staug73 (talk) 17:12, 16 July 2014 (UTC)[reply]

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