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April 14, 1956


Author Affiliations

Oklahoma City

From the Department of Surgery (Neurosurgery), University of Oklahoma School of Medicine and University Hospital. Dr. Levy is now in New Orleans.

JAMA. 1956;160(15):1277-1280. doi:10.1001/jama.1956.02960500007003

• Five patients had varying degrees of obsessive-compulsive behavior, deep-seated hostility, and periods of depression in addition to chronic ulcerative colitis of such long standing and severity that colectomy was deemed inadvisable. These patients were selected for lobotomy because medical and psychiatric management had both failed.

In three cases the effects on the colon were strikingly beneficial; the frequency of defecations became normal, and the patients gained weight. In a fourth case a second operation for more exten sive division of the white matter had only temporary benefits, and a colectomy undertaken as a last resort was followed by a fatal septicemia. In the fifth case, the lobotomy was followed by the appearance of a voracious appetite, and intestinal obstruction with perforation ended in death a week later.

Chronic colitis can result in irremediable fibrosis and loss of sphincter control, after which lobotomy cannot afford complete relief. The indications for this operation were persistent bloody diarrhea despite intensive medical management, weight loss exceeding 25% of the normal, and psychiatric symptoms that proved refractory to treatment. In three patients selected by these criteria, lobotomy was followed by complete remission of their colitis.