Modified Leucotomy Assessed by Forearm Blood Flow and Other Measurements

Abstract

The value of modified leucotomy in the treatment of psychiatric disorders is undergoing constant reappraisal. Ever since 1948 efforts have been made in the Department of Psychological Medicine of St. Thomas's Hospital and at Belmont Hospital to modify operative techniques and to learn more about the proper and discriminative selection of suitable patients within very varied diagnostic categories. A leading article in the British Medical Journal has called for renewed efforts along such lines. (Editorial, 1965). To enable various surgical procedures to be assessed and their merits and disadvantages compared more accurately, better objective methods of evaluating the effects of the operation are certainly required. Although several studies have been directed towards the measurement of intellectual function before and after operation (Mettler, 1949; Mettler and Landis, 1952; Tow, 1955) much less attention has been directed towards the objective assessment of personality changes and measurement of the reduction of key symptoms such as anxiety. Sykes and Tredgold (1964) emphasized what has been repeatedly stressed from this Department (Sargant, 1946, 1962; Sargant and Slater, 1944, 1948, 1954, 1963), that a decision to operate must take careful note of the individual symptoms, especially the degree of tension present. Falconer and Schurr (1959) consider that “the indication for operation should be, not the diagnostic label, but the tension and anxieties which the illness has produced”.