Abstract

For over 40 years, certain mental illnesses have been treated by producing lesions in the medial part of the frontal lobes of an apparently normal brain. After a period of great optimism in the 1940s and 1950s when over 100,000 people around the world are believed to have had such an operation, the use of the leucotomy declined mainly because of high post-operative morbidity, failure to relieve symptoms of schizophrenia and the discovery of effective drugs. Antipathy towards leucotomy grew when fears were voiced that such operations might be used to control behaviour rather than to provide symptomatic relief. More recently, stereotactic techniques have been developed which produce much more selective and localised lesions with a much lower incidence of adverse effects. Are these modern operations justified?