Southern Doctors

The night after the Southern Medical Association began its annual meeting in Baltimore last week there was not a respectable hotel room for rent in the city. Doctors with pocketbooks filled and minds agog commuted from Washington 40 miles away. No medical meeting had "been so well attended since the 1920s.

Well rewarded were the troubled Southern doctors by two medical diversions at the convention: 1) an operation by which Drs. Walter Freeman & James Winston Watts of Washington actually cut the ability to worry out of the brain; 2) operations by which Dr. Hugh Hampton Young of Baltimore remodels anal, urinary and genital defects. Psychiatrists and brain surgeons stormed at each other concerning the good sense of Drs. Freeman & Watts's work.

Lobotomy. Dr. Freeman, a poetaster in his spare time, was nervous when he rose to tell a fascinated audience how he and Dr. Watts ameliorated chronic anxiety, insomnia and nervous tension in six patients during the past two months. In addition the patients were relieved of various "disorientations, confusions, phobias, hallucinations and delusions."

First the surgeons cut two-inch-long slits into the patient's scalp down to the bone. Each slit lies slightly more than an inch away from the midline of the skull and crosses a line running across the head from ear to ear. At each junction of the ear-to-ear line and the slits in the scalp, Drs. Freeman & Watts drill a hole with a dentist's bur. The bur holes permit passage of a leucotome, or lobotomy cannula, a hollow needle through which a loop of wire can be slipped.

In the operations, explained Dr. Freeman, this instrument "is inserted in the anteromedial [front and centre] direction to a depth of four centimetres below the surface of the cortex. The stylet is pressed in, forming a loop near the distal end of the instrument. The leucotome is rotated through one complete circle, cutting a sphere or core of white matter in the pre-frontal area about ten millimetres in diameter. The stylet is withdrawn a few millimetres thus replacing the loop within the cannula. A second core is cut at a depth of three centimetres and a third at two centimetres. The leucotome is then entirely removed from the brain and re-introduced in an anterolateral [front and side] direction into the same prefrontal lobe where cores are cut at a depth of 4.5 cm., 3.5 cm. and 2.5 cm. In like manner six spherical cuts or cores are made in the other frontal lobes."

All six Freeman-Watts "patients have become more placid, more content, more easily cared for by their relatives."

Up popped Dr. S. Spafford Ackerly of Louisville, famed among neurologists and psychiatrists for his post-operative treatment of a woman, who, despite an excision of a big chunk of her brain, remained placid and intelligent (TIME, May 27, 1935). Exulted bold Dr. Ackerly:

"This is a startling paper. I believe it will go down in medical history as a noted example of therapeutic courage."

But on the other hand, Dr. Samuel Bernard Wortis of Manhattan angrily exclaimed: "Dr. Freeman has obtained here a shock result, which can always change the course of a psychosis. I have seen mental patients in Bellevue Hospital who have become normal after such a shock as the fracture of a leg."

The country's foremost research psychiatrist, Dr. Adolf Meyer, was called on for comment. Said he: "I am not antagonistic to this work. I find it very interesting. . . . I, too, have hesitations at the thought of a great many of us having our distractibility or our worries removed. To call attention to these operations may start such an epidemic."

Many a lesser expert shouted his pro or con. But Dr. Freeman withstood all heckling, asserted: Our patients were treated by seasoned psychiatrists. Then they came to us. The results are permanent, appropriately, and not temporary. . . . We have not removed the idea by this operation. The idea is still there, but it has no emotional drive. . . . I think we have drawn the string, as it were, of the psychosis or neurosis.

Genitoplasty. Dr. Young told how a boy who was born without an anus acquired one through Dr. Young's bold plastic surgery. Such children, if they survive, must empty their bowels through a "colostomy" hole in their abdominal walls. Dr. Young's patient, now a college senior, functions normally. Other patients of Dr. Young were apparent hermaphrodites whom he made into sexually functioning men or women according to the dominance of male or female hormones. One girl "only shaves once a week" since Dr. Young removed a virilifying tumor from one of her ovaries. Another case was the rejuvenation (for two years) of a 48-year-oldster, achieved by castrating a Maryland criminal the instant he was certified dead by hanging: mincing and transplanting his glands.

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