History of Psychosurgery in The United Kingdom - Note On Terminology

Note On Terminology

Egas Moniz coined two terms to describe his operation: leucotomy (cutting of the white matter of the brain) and psychosurgery (surgery for psychiatric disorder). The American neurologist Walter Freeman and neurosurgeon James Watts adapted Moniz’s techniques and coined a new term: lobotomy (cutting of the lobe). In the United Kingdom, psychiatrists used the Freeman-Watts surgical technique but retained the terminology of Moniz – leucotomy and psychosurgery. In the 1940s, 1950s and 1960s the term leucotomy was used as a generic term with writers distinguishing between the standard, pre-frontal, or Freeman-Watts leucotomy on the one hand and modified leucotomies, such as rostral leucotomy, cingulotomy, etc., on the other. In the 1970s the term psychosurgery became more popular as a generic term, with individual operations being named according to the part of the brain in which tissue is destroyed, for example, cingulotomy, capsulotomy, subcaudate tractotomy, amygdalotomy, etc. The term leucotomy is still used to refer to the standard prefrontal leucotomies of the 1940s, 1950s, 1960s and 1970s, and is occasionally used as a generic term for psychosurgical operations. Some doctors prefer the term neurosurgery for mental disorder (NMD) to psychosurgery.

The American term lobotomy has never been used by medical writers in the UK to describe a psychosurgical operation on the frontal lobe. The standard Freeman-Watts operation, called a lobotomy in the USA, was called a leucotomy in the UK. Freeman later developed a psychosurgical technique in which an instrument is inserted through the eye-socket. It became known as a transorbital lobotomy in the USA and a transorbital leucotomy in the UK (where it was less popular). However the term lobotomy is occasionally used by British journalists synonymously with leucotomy, either to describe the standard operations of former decades or occasionally as a generic term for all psychosurgical operations.