When was lobotomy invented

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Last updated: April 17, 2026

Quick Answer: The lobotomy was invented in 1935 by Portuguese neurologist António Egas Moniz, who performed the first procedure on a human patient that year. He was awarded the Nobel Prize in Physiology or Medicine in 1949 for this development, despite later controversy over its safety and ethics.

Key Facts

The first lobotomy was performed in 1935 by António Egas Moniz in Lisbon, Portugal.
Moniz received the Nobel Prize in 1949 for his work on psychosurgery, including the lobotomy.
Over 40,000 lobotomies were performed in the United States between 1939 and 1951.
Walter Freeman popularized the transorbital lobotomy in the 1940s, using an ice pick-like instrument.
The procedure declined in use by the 1960s due to ethical concerns and the advent of antipsychotic medications.

Overview

The lobotomy, a surgical procedure involving the severing of connections in the brain’s prefrontal cortex, was developed as a radical treatment for severe mental illness. It emerged in the 1930s when few effective psychiatric treatments existed, and doctors sought ways to calm agitated or violent patients.

Initially hailed as a breakthrough, the procedure quickly became widespread despite limited understanding of its long-term effects. While it reduced symptoms like anxiety and aggression, it often left patients emotionally blunted or severely impaired.

1935 marks the year Portuguese neurologist António Egas Moniz performed the first prefrontal leukotomy, later known as a lobotomy, on a human patient in Lisbon.
Moniz’s technique involved drilling holes into the skull and injecting alcohol or using wires to sever white matter in the prefrontal cortex, disrupting neural pathways.
In 1949, Moniz was awarded the Nobel Prize in Physiology or Medicine, a controversial decision later criticized due to the procedure’s severe side effects.
American neurologist Walter Freeman adapted the procedure in the 1940s, creating the transorbital lobotomy, which could be performed quickly without a traditional operating room.
Freeman used an ice pick-like instrument inserted through the eye socket, completing some 3,500 lobotomies himself, often in psychiatric hospitals with minimal oversight.

How It Works

The lobotomy aimed to alter behavior by disrupting connections between the prefrontal cortex and other brain regions, particularly those involved in emotion and decision-making. Though crude by modern standards, it was considered revolutionary at the time.

Prefrontal Leukotomy: This original technique, developed by Moniz, involved accessing the brain through drilled holes in the skull and severing white matter tracts using wires or alcohol injection.
Transorbital Lobotomy: Introduced by Walter Freeman in 1946, this method used a surgical instrument inserted through the roof of the eye socket to sever neural connections with a hammer.
Targeted Brain Region: The procedure focused on the frontal lobes, especially the connections between the prefrontal cortex and the thalamus, believed to regulate mood and impulse control.
Procedure Duration: A transorbital lobotomy could be completed in under 10 minutes, often without anesthesia beyond electroconvulsive shock to induce unconsciousness.
Immediate Effects: Many patients became calmer and less agitated, but also exhibited apathy, reduced initiative, and emotional flatness, sometimes described as a "surgical autism."
Long-Term Risks: Complications included seizures, incontinence, intellectual decline, and death—estimated at a 5% mortality rate during peak usage.

Comparison at a Glance

The following table compares key aspects of the lobotomy across different eras and techniques:

Technique	Year Introduced	Developer	Procedure Time	Mortality Rate
Standard Prefrontal Leukotomy	1935	António Egas Moniz	60–90 minutes	~3–5%
Transorbital Lobotomy	1946	Walter Freeman	Under 10 minutes	~5%
Multiple Subpial Transections	1980s	Rorden Todd	3–4 hours	~1%
Modern Psychosurgery (Cingulotomy)	1966	Ballantine	2–3 hours	~0.5%
Deep Brain Stimulation (DBS)	1987	Benabid	4–6 hours	~1%

While early lobotomies were irreversible and imprecise, modern neurosurgical interventions like cingulotomy and deep brain stimulation are highly targeted, reversible, and used only in extreme, treatment-resistant cases. These advancements reflect a shift toward ethical standards and technological precision absent in the lobotomy era.

Why It Matters

Understanding the history of the lobotomy is crucial for appreciating both the evolution of psychiatric treatment and the ethical boundaries of medical intervention. Though largely discredited, its legacy influences modern neuroscience and mental health policy.

The lobotomy era highlighted the dangers of medical overreach, especially when applied to vulnerable populations like psychiatric patients and children.
It spurred the development of informed consent laws and stricter oversight in psychiatric and surgical practices by the 1960s.
The procedure was used on over 40,000 people in the U.S., including famous cases like Rosemary Kennedy, whose condition worsened after surgery.
Its decline coincided with the introduction of chlorpromazine in the 1950s, the first effective antipsychotic medication, reducing reliance on surgery.
Modern psychosurgery is rare but still used in severe OCD or depression, with strict ethical guidelines and imaging technology for precision.
The lobotomy remains a cautionary tale in medical ethics, illustrating how enthusiasm for innovation can override patient welfare without proper safeguards.

Today, the lobotomy is remembered not as a medical triumph but as a symbol of the consequences when science outpaces ethics. Its history underscores the importance of balancing innovation with compassion and rigorous evaluation.