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Article
June 1949

PREFRONTAL LOBOTOMY IN THE MANAGEMENT OF INTRACTABLE PAIN

Author Affiliations

MEDICAL CORPS, UNITED STATES ARMY

Arch Surg. 1949;58(6):731-738. doi:10.1001/archsurg.1949.01240030742001
Abstract

ON OCCASION pain is a useful thing. It may aid in achieving a diagnosis or it may merely bring a patient to a physician so that his ill may be diagnosed. Our purpose is not to talk about such pain but rather to discuss a treatment for pain which results from carcinoma, causalgia or some other condition in which the pain is serving no useful purpose. There are various methods of treating such pain; opiates, sedatives, alcohol injection, neurectomy, rhizotomy and cordotomy all have their place, but in certain, cases none of these may achieve the desired result. Prefrontal lobotomy, originally used for psychosis, has been proposed1 and used by a number of persons faced with this problem. Freeman and Watts2 first used prefrontal lobotomy for pain associated with involutional depression in 1936 and have since then performed it on approximately 25 patients having pain of solely organic

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