Neurosurgical Treatment of Certain Abnormal Mental States

Dr. Walter Freeman, Washington, D. C.: Prefrontal lobotomy consists in the surgical interruption of certain tracts in the white matter of the frontal lobes. It has been employed in the treatment of some of the intractable psychoses and neuroses. First reported by Egas Moniz of Lisbon in 1936, the operation was introduced into this country by Freeman and Watts and was later modified by them. It has been employed by them in some 80 cases during the past five years. The best results have been obtained in cases of involutional depression and the obsessive compulsive states. The technic is, briefly, as follows: The line of the coronal suture is marked out on the scalp, an incision is then made over this suture, and the skull is trephined 5 cm. above the zygoma. When hemostasis has been secured an instrument is introduced into the opening and the white matter is cut