You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
Nowadays there are three ways of impairing the brain with therapeutic intent—deprive it of glucose, shock it with electricity and cut into its substance. Refinements of the latter vogue are considered in the above-listed papers.
Kolb reviews the literature of lobotomy with a bibliography of one hundred fifty-eight references. He divides the topic under the subtitles of Historical Perspective, Surgical Techniques, Neurophysiological Investigations, Psychological Investigations and Therapeutic Evaluation. For the psychotherapist the question of the therapeutic value of this operation is perhaps of most interest. 'The use of the technique on an experimental basis is justifiable but to conclude at this juncture, a decade after the initial operation, that it has indubitable merit as a therapeutic agent in a wide range of conditions is uncritical.' (Ethical objections to the experimentally justifiable procedure are dismissed as 'nonscientific moralizing'.) The author, pleading for more careful analyses, makes clear that the present statistics of therapeutic evaluation are a mess, with favorable results ranging from fifteen percent to eighty-eight percent. A remarkable figure emerges from five hundred ninety-nine cases of schizophrenia in the British Board of Control lobotomy series in which the discharge rate as recovered and improved was twenty-three percent. Bellak in his review of the literature on prognosis of schizophrenia without shock therapy reports of recovery rate between twenty-two percent and fifty-three percent and Rennie in a twenty-year follow-up of two hundred twenty-two cases of schizophrenia states twenty-seven percent recovered!
Another striking observation is that of the neurosurgeon Walker who reported that in obsessive-compulsive states, in which prefrontal lobotomy supposedly has its greatest value, the results for recovered and improved cases approximate those of psychoanalytic therapy. Kolb adds that while psychoanalysis is long and expensi