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Lobotomy: Resort to the Knife by David Shutts is an excellent narrative of the rise and fall of "psychosurgery" as a treatment for psychiatric illness. The book closely follows the career of Dr Walter Freeman, the leading disciple of lobotomy, who personally performed more than 3,500 operations during a 25-year career. Inspired by the work of the Portuguese neurologist Egal Moniz, Freeman began neurosurgical ablation of the frontal lobes of psychiatric patients in the 1930s.
At first Freeman used a cautious approach through the frontoparietal suture using a leukotome, a bluntheaded instrument from which a sharp wire could be extruded then rotated through the frontal lobe fibers, destroying them. Later, Freeman adapted a transorbital approach using an instrument modeled on an ice pick, tapping it through the orbital bone medial to the eyeball and then severing the radiations from the frontal lobe. Understandably, complications such as postoperative paralysis, seizures, and
Stevens RL. Lobotomy: Resort to the Knife. JAMA. 1982;248(15):1911. doi:10.1001/jama.1982.03330150085042
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