Egas Moniz: The Controversial Father of Psychosurgery

António Caetano de Abreu Freire Egas Moniz (1874-1955) was a Portuguese neurologist who left an indelible, if controversial, mark on the field of psychiatry. Born in Avanca, Portugal, Moniz studied medicine at the University of Coimbra, graduating in 1899.

Moniz’s career was multifaceted:

-Professor of Neurology at the University of Lisbon (1911-1944)

-Politician and diplomat, serving as Portugal’s Minister for Foreign Affairs and ambassador to Spain

-Pioneer in medical research

His two major contributions to medicine were:

Cerebral Angiography (1927): A technique to visualize blood vessels in the brain using X-rays, which revolutionized the diagnosis of intracranial diseases.

Prefrontal Leucotomy (1935): Better known as lobotomy, this psychosurgical procedure involved severing connections in the brain’s prefrontal cortex.

For these contributions, particularly the leucotomy, Moniz shared the 1949 Nobel Prize in Physiology or Medicine with Walter Rudolf Hess.

However, Moniz’s legacy is deeply controversial. While initially hailed as a breakthrough for treating conditions like schizophrenia and severe anxiety, lobotomy later became infamous for its severe side effects, including irreversible personality changes. The procedure’s use declined rapidly with the introduction of antipsychotic medications in the 1950s.

Ironically, Moniz himself became a victim of violence when he was shot and paralyzed by a former patient in 1939, though he continued his work until his death in 1955.

Moniz’s work raises significant ethical questions about informed consent, the long-term impact of invasive psychiatric treatments, and the balance between scientific progress and patient welfare. His story serves as a cautionary tale in the history of medicine, highlighting the need for rigorous ethical considerations in psychiatric care.

Bibliography

1. Nobelprize.org. “Egas Moniz – Biographical.” The Nobel Prize.
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3. Tierney, A. J. (2000). “Egas Moniz and the Origins of Psychosurgery: A Review Commemorating the 50th Anniversary of Moniz’s Nobel Prize.” Journal of the History of the Neurosciences, 9(1), 22-36.
4. Kotowicz, Z. (2005). “Gottlieb Burckhardt and Egas Moniz—Two Beginnings of Psychosurgery.” Gesnerus, 62(1-2), 77-101.
5. Robison, R. A., Taghva, A., Liu, C. Y., & Apuzzo, M. L. (2013). “Surgery of the mind, mood, and conscious state: An idea in evolution.” World Neurosurgery, 80(3-4), S2-S26.
6. Pressman, J. D. (1998). “Last Resort: Psychosurgery and the Limits of Medicine.” Cambridge University Press.
7. Wikipedia contributors. “António Egas Moniz.” Wikipedia.
8. Damásio, A. R. (1977). “Egas Moniz, pioneer of angiography and leucotomy.” Mount Sinai Journal of Medicine, 44(5), 583-588.