Evening star., 1952-05-14
MiIder Approach Found
In Broin Surgery Cases
Psychology Convention Told
Of Advances in Technique
By Thomos R. Henry


approaches to the radical boring holes
in the brains" Of psychotics now are in
order
New concepts of prefrontal lobotomy.
the revolutionary brain surgery first
introduced in America by Drs. Walter
Freeman and James A. Watts at George
Washington University Hospital about
Is years ago, were stressed at opening
sessions Of the American PSychiatric
Association here. In this operation
nerve paths are severed leading from the
frontal lobes of the brain Just back of
the forehead, presumably the centers Of
imagination and initiative, to the action
centers in other lobes.
Since the original operation, one Of
the most dramatic events in the history
of surgery, this technique has spread
over the world, with constant modiflca-
tions. It apparently has improved
greatly many types Of diSordered be-
havior. At the same time the patients
have lost initiative, imagination and
spontaneity.
Brain Damage Stressed.
The great trouble probably has been.
it was stressed here, that the brain has
been damaged much more than was
necessary. Study Of is brains Of persons
who have died at various intervals after
lobotomy was reported from Massa-
Ohusetts State hospitals. This has shown
that the brain damage was much more
extensive than had been anticipated.
even in some who showed great mental
improvement. A wholly different ap-
proach probably is necessary, said Drs.
Naomi Raskin, George Strassman and
Charlotte c. Van Wrinkle of the Massa-
chusetts institutions which participated
in the study.
Drs. Milton Greenblatt and Harry c.
Solomon of Harvard University told OF
much less disturbing results obtained
by a so-called "bimedal lobotomy."
The brain is two-sided, the left brain
controlling the right side OF the body
and vice versa. Drs. Freeman and
Watts, together with most who have
followed them have severed nerve paths.
more or less radically, on both sides.
In the Harvard modification the surgery
is performed only in the middle Of the
brain along the line where the two
halves meet.
This, Drs. Greenblatt and Solomon
said, proves clearly superior either to
the standard operation or to the sever.
ing of nerve paths on only one side.
It involves only half the cutting Of the
standard Freeman Watts operation but
at the same time affects both sides Of
the brain.
Definite Gain Reported.
'There is" they reported. "a reduce
ton in anxiety, tension. hostility, i'm
pulsivity and, most Importantly. there
is an overall improvement in initiative;
ability to form relationships, emotional
response and capacity for sustained
work. Patients are less interested in
solitary activity. and psychological tests
indicate definite gain in capacity for
abstraction"
Even with the standard operation.
Drs. Greenblatt and his colleague re-
ported. tests show that whatever I'M
provement Is achieved Is sustained for
five years or more.
Why the operation works at all still
is not clearly understood. AS q rule
it does not end delusions. The first
Freeman Watts operation. for example.
was on q young Government stenogra-
pher who believed she was being pursued
by the devil, who wanted to drag her
into hell.
rs the devil still chasing you?" DR..
u
the operation.
"Of course" she said. laughing. "Just
look. There he is standing by the door,"
Whats he saying to you?"
HE says he wants to drag me to hell"
She thought 1t was big joke. But she
still saw the devil.
Paradox of the Mind.
Little progress has been made In re-
solving this paradox of the mind
One of the most common forms Of
insanity is the so-called manic-depres-
sive psychosis. Patients swing back and
forth between extreme depression and
extreme exaltation. They are quite likely
to kill themselves in the depressed phase.
Generally, this is more or less tenn
porary. Patients often can be released
after few months Of treatment in q
mental hospital.
Unfortunately, they relapse over and
over again. During the past few years
psychiatrists at the Ontario Hospital at
London, Ontario, have experimental
with periodic electric shock treatments
Of recovered patients before an antici-
pated relapse took place. This they found
greatly reduced the number of recur-
rences. A few, however. got no benefit.
For these DR.. George H. Stevenson
and his associates have resorted to a
mild form Of the brain-cutting opera
ton. Six patients for whom other forms
Of treatment failed now have gone for
several years without any relapse.
DR.. Stevenson and his colleague, DR..
Archibald McCausland claimed com
plete clinical recoveries."
n;sa dva nj a 0n~ pnn..;r
There remain, Of course, the disad-
vantages of the operation-mainly the
reduced imagination and initiative. This
is especially unfortunate since manic
depressives often are brilliant individ-
uals. Psychiatric textbooks sometimes
classify Abraham Lincoln as q border
line case.
For the first two or four months after
such an operation the nervous system is
seriously upset. Then nature asserts it
self and a period Of adjustment begins.
1t results in apathy, extreme irritability
and feeling Of helplessness in a world
which has become disorganized and un-
real. This soon disappears and great
benefits can be achieved by various
forms of psychotherapy intended to get
the patient in touch with reality again,
1t was reported by DR.. James p. Cattell
OF the New York State Psychiatric In
stitute.