Brain of Patient A. After Bilateral Frontal Lobectomy; Status of Frontal-Lobe Problem

PATIENT Joe A., on whom Dr. Walter Dandy performed a bilateral frontal lobectomy in 1930, died Aug. 31, 1949. Clinical descriptions have previously been recorded.1The necropsy is reported in this paper. A. was the first human being to undergo bilateral frontal lobectomy. Studies of A. were reported at the International Congress of Neurology in London in 1935. Egas Moniz was present at this meeting, where he described some of his early work on cerebal angiography. In the thinking which led him to initiate lobotomy, Moniz was much influenced by the London report of A.'s postoperative behavior and by Fulton and Jacobsen's description of chimpanzee behavior after a similar operation, described at the same meeting.2 Study of A. also has added to our understanding of frontal-lobe function. The role oflossof frontal tissue in symptom production has recently been minimized; some workers believe that the presence of