Egas Moniz and the origins of psychosurgery: a review commemorating the 50th anniversary of Moniz's Nobel Prize

Abstract

Modern psychosurgery began in 1936 with the work of the Portuguese neurologist, Egas Moniz, who attempted to treat the symptoms of mental illness by severing neural tracts in the frontal lobes. This procedure eventually became widespread and applied to thousands of institutionalized, psychotic patients in the United States and other countries. Despite serious side effects associated with psychosurgery, the apparent importance and validity of the treatment was recognized in 1949 when Moniz received the Nobel Prize for his innovation. Psychosurgery was largely replaced by anti-psychotic drugs in the mid-1950s, and the procedure and its practitioners rapidly fell into disrepute. This article reviews Moniz's career, the factors that led up to his first clinical trials of frontal lobe surgery, and the circumstances that allowed psychosurgery to flourish in the 1940s, eventually leading to Moniz's Nobel Prize.