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November 12, 1973

The New Psychosurgery

JAMA. 1973;226(7):779. doi:10.1001/jama.1973.03230070043011

Readers of the article by Mark and Neville (p 765) would do well to refer to a critique that appeared in Science (179:1109, 1973) where the author, Constance Holden, deals with the pros and cons of recent developments in psychosurgery. One learns that there is no agreement on its definition. Twenty or 30 years ago, the term might have been applied to the operation of prefrontal lobotomy, performed, too often in vain, to cure or ameliorate certain forms of psychosis for which there was no other remedy. Now, the targets, no longer cerebral lobes or portions thereof, are the deeply buried cingulum, thalamus, and amygdala—the supposed seats of such mysterious entities as emotion, behavior, and imagination. In place of the scalpel and electrocautery to whack away at brain tissue, we have the stereotaxically-placed electrode that can zero in precisely on any of these hidden islands and either stimulate or destroy