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July 26, 1965

Prefrontal Lobotomy

Author Affiliations

Sunnyvale, Calif

JAMA. 1965;193(4):322. doi:10.1001/jama.1965.03090040066026

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To the Editor:—  Richard M. Steinhilber, MD, in his reply to the question of Raymond Heitz, MD (JAMA192:579 [May 10] 1965), reflects accurately the current attitude of American psychiatrists toward lobotomy. "Other methods of management seem more humane and efficacious." Probably Dr. Heitz gave too few details of his patient's compulsive neurosis with the "severe hand-washing syndrome." He failed to paint the picture of a guilt-ridden person with a perpetual need to assuage his "fixed state of tortured self-concern" (Arnot) by useless and repetitive symbolic purification.A person over the age of 55, caught in the toils of this malignant psychoneurosis, is close to an involutional psychosis with agitated depression that responds poorly to all treatments except psychosurgery. Since this patient can look forward to many years of life, it behooves the physician to lighten the existence by a method that has proved both safe and effective for

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