Egas Moniz and the Nobel Prize in Physiology or Medicine

António Egas Moniz (1874 – 1955), was a Portuguese neurologist, known for his work on psychosurgery. He was the first professor of neurology of the University of Lisbon and was known for introducing the cerebral angiography in the 1930’s, a method of spotting intracranial diseases more effectively than any method had been capable so far.

As an interested observer of the human brain, he studied certain mental disorders such as schizophrenia and came to the conclusion that it was a question of the nervous connections between the two frontal lobes of the brain, and the thalamus, which is a part of the brain responsible for our sensory impulses and for regulating our consciousness. He  deducted that disconnecting the frontal lobes from the thalamus would be a way of calming the brain and the surges of schizophrenia, getting an individual back to his normal state.

Therefore, in 1936, with his associate Almeida Lima, he performed the first prefrontal leucotomy, which is a procedure that is more commonly known as “lobotomy”. It consists of disconnecting the frontal lobes from the remaining parts of the brain. Despite the fact that all his patients had complicated recovery states, more than two thirds of the operated patients, suffering from mania, schizophrenia, depression and other mental disorders, had seen their condition improved.

Initially, several of his colleagues opposed this practice, but soon it was one of the most utilized procedures to handle psychiatric conditions in the 1940’s and 1950’s. Indeed, the development of the prefrontal leucotomy gave the Nobel Prix in Physiology or Medicine to Egas Moniz in 1949, the first Portuguese Nobel Prize.

What we found incredible about this story is thinking how medicine is really a discipline of constant change and calling into question, that can be responsible for some of the greatest goods, but also for some atrocities committed against individuals. Indeed, while lobotomy was widely used for decades and was thought to be a very successful operation, it is today known to be responsible for driving the patients to become completely unresponsive, hardly capable of expressing emotions or taking initiatives, imagining or creating. This was true many times throughout history, such as with electroshock treatment to “cure” homosexual individuals.

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