António Egas Moniz

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António Egas Moniz
Moniz.jpg
Born António Caetano de Abreu Freire Egas Moniz
(1874-11-29)29 November 1874
Avanca, Estarreja, Portugal
Died 13 December 1955(1955-12-13) (aged 81)
Lisbon, Portugal
Nationality Portuguese
Fields Neurologist
Institutions University of Coimbra (1902); University of Lisbon (1921–1944)
Alma mater University of Coimbra
Known for Prefrontal leucotomy, cerebral angiography
Notable awards Nobel Prize in Physiology or Medicine, 1949
Spouse Elvira (1884-1965)

António Caetano de Abreu Freire Egas Moniz (29 November 1874 – 13 December 1955), known as Egas Moniz (Portuguese: [ˈɛɣɐʒ muˈniʃ]), was a Portuguese neurologist and the developer of cerebral angiography. He is regarded as one of the founders of modern psychosurgery,[1] having developed the surgical procedure leucotomy—​known better today as lobotomy—​for which he became the first Portuguese national to receive a Nobel Prize in 1949 (shared with Walter Rudolf Hess).[2]

He held academic positions, wrote many medical articles and also served in several legislative and diplomatic posts in the Portuguese government. In 1911 he became professor of neurology in Lisbon until his retirement in 1944. At the same time, he pursued a demanding political career.

Education and career[edit]

Moniz was born in Avanca, Estarreja, Portugal as António Caetano de Abreu Freire Egas Moniz. He attended Escola do Padre José Ramos and Colégio de S. Fiel dos Jesuítas, studied medicine at the University of Coimbra, then trained in neurology in Bordeaux and Paris. In 1902, he became a professor in the Department of Neurology, but soon left that post on entering politics in 1903. He established the Partido Republicano Centrista and represented it in the Portuguese parliament from 1903 to 1917. Later he was Portugal's ambassador to Madrid (1917) and minister of foreign affairs (1918), in which function he attended the Paris Peace Conference, 1919. Meanwhile he continued to practice medicine and teach physiology and anatomy, and in 1911 he became a professor of neurology at the newly established University of Lisbon.[citation needed]

In 1920, he gave up politics and returned to medicine and writing full-time.[3] In 1927 Moniz developed cerebral angiography, a technique allowing blood vessels in and around the brain to be visualized; in various forms it remains a fundamental tool both in diagnosis and in the planning of surgeries on the brain.

For this, he was nominated twice for the Nobel Prize.[4] He also contributed to the development of Thorotrast for use in the procedure and contributed many lectures and papers on the subject.[5] He is considered a pioneer in the field.[6]

In 1936, he published his first report of performing a prefrontal leucotomy on a human patient,[3] and subsequently devised the leucotome for use in the procedure. He judged the results acceptable in the first 40 or so patients he treated, claiming, "Prefrontal leukotomy is a simple operation, always safe, which may prove to be an effective surgical treatment in certain cases of mental disorder."[7] He also claimed that any behavioral and personality deterioration that may occur was outweighed by reduction in the debilitating effects of the illness.[7][8] But he conceded that patients who had already deteriorated from the mental illness did not benefit much, and he did no long-term follow up. The procedure enjoyed a brief vogue, and in 1949 he received the Nobel Prize, "for his discovery of the therapeutic value of leucotomy in certain psychoses."[9]

In 1949, Moniz was shot by a patient, and subsequently used a wheelchair.[10][11][12] He continued in private practice until 1955, when he died just as his procedure was falling into disrepute.[3][13][14]

Legacy[edit]

Since falling almost completely from use in the 1960s, leucotomy has been deplored by many as brutally arrogant, and collateral derision has been directed at Moniz as its inventor.[15] Others suggest judging the inventor separately from the invention, characterizing Moniz' work as a "great and desperate" attempt to find effective treatment for severe forms of mental illness for which there was at the time no effective treatment at all.[15] Some claim it was aggressive promotion of lobotomy by other doctors (such as Walter Freeman) which led to its being performed in large numbers of cases now considered inappropriate.[7][16]

In 1957 Moniz's study centre, now known as the Egas Moniz Museum, was transferred to Santa Maria Hospital, and integrated in the Faculty of Medicine of the University of Lisbon, where there is also a statue of him. His art collection is on display at his country house in Avanca. The anatomical feature Egas Moniz's Siphon, the passage of the internal carotid artery through the interior of the temporal bone, is named for him.[citation needed]

Important publications[edit]

According to the Nobel Prize, his more important publications are:[3]

  • Alterações anátomo-patológicas na difteria (Anatomo-pathologic changes in diphtheria), Coimbra, 1900.
  • A vida sexual (fisiologia e patologia) (Physiological and pathological aspects of sex life), 19 editions, Coimbra, 1901.
  • A neurologia na guerra (Neurology in war), Lisbon, 1917.
  • Um ano de política (A year of politics), Lisbon, 1920.
  • Júlio Diniz e a sua obra (Julio Denis and his works), 6 editions, Lisbon, 1924.
  • O Padre Faria na história do hipnotismo (Abbé Faria in the history of hypnotism), Lisbon, 1925.
  • Diagnostic des tumeurs cérébrales et épreuve de l'encéphalographie artérielle (Diagnostics of cerebral tumours and application of arterial encephalography), Paris, 1931.
  • L'angiographie cérébrale, ses applications et résultats en anatomic, physiologie et clinique (Cerebral angiography, its applications and results in anatomy, physiology, and clinic), Paris, 1934.
  • Tentatives opératoires dans le traitement de certaines psychoses (Tentative methods in the treatment of certain psychoses), Paris, 1936.
  • La leucotomie préfrontale. Traitement chirurgical de certaines psychoses (Prefrontal leucotomy. Surgical treatment of certain psychoses), Turin, 1937.
  • Clinica dell'angiografia cerebrale (Clinical cerebral angiography), Turin, 1938.
  • Die cerebrale Arteriographie und Phlebographie (Cerebral arteriography and phlebography), Berlin, 1940.
  • Ao lado da medicina (On the side of medicine), Lisbon, 1940.
  • Trombosis y otras obstrucciones de las carótidas (Thrombosis and other obstructions of the carotids), Barcelona, 1941.
  • História das cartas de jogar (History of playing-cards), Lisbon, 1942.
  • Como cheguei a realizar a leucotomia pré-frontal (How I came to perform leucotomy), Lisbon, 1948.
  • Die präfrontale Leukotomie (Prefrontal leucotomy), Archiv für Psychiatrie und Nervenkrankheiten, 1949.

References[edit]

  1. ^ "neurosurgery". 
    Berrios, German E. (1997). "The origins of psychosurgery: Shaw, Burckhardt and Moniz". History of Psychiatry 8 (1): 61–81. doi:10.1177/0957154X9700802905. ISSN 0957-154X. PMID 11619209. 
  2. ^ "Comments by Carl Skottsberg, President of the Royal Academy of Sciences (Sweden), Nobel Medicine Prize Banquet 1949". Retrieved 2009-12-02. 
  3. ^ a b c d "Biography". Nobelprize.org. Retrieved 11 July 2010. 
  4. ^ "World of Scientific Discovery on Antonio Egas Moniz". bookrags.com. Retrieved 11 July 2010. 
  5. ^ Tondreau, Roderick L. (1985). "Egas Moniz 1874-1955". Radiographics 5 (6): 994–997. doi:10.1148/radiographics.5.6.3916824. PMID 3916824. 
  6. ^ Wolpert, Samuel M. (1999). "Neuroradiology Classics". American Journal of Neuroradiology (American Society of Neuroradiology) 20 (9): 752–1753. PMID 10543655. 
  7. ^ a b c Jansson, Bengt. "Controversial Psychosurgery Resulted in a Nobel Prize". Nobelprize.org. Retrieved 11 July 2010. 
  8. ^ Diefenbach, Gretchen J; Donald Diefenbach; Alan Baumeister; Mark West. "Portrayal of Lobotomy in the Popular Press: 1935-1960". unca.ed. Retrieved 11 July 2010. 
  9. ^ "The Nobel Prize in Physiology or Medicine 1949". The Nobel Foundation. Retrieved 2009-11-13. 
  10. ^ "He was forced to retire from his professorship when he turned 70 in 1943, but he stayed fairly active in the field until 1949 when a paranoid patient (who did not have a leucotomy) shot him four times." Finger, Stanley (1994). Origins of Neuroscience: A History of Explorations Into Brain Function. Oxford University Press. p. 292. 
  11. ^ "Aged 65, he was shot by a patient suffering from schizophrenia; partially recovered, he died on 18th December 1955." Tyrer, Peter; Silk, Kenneth R. (2008). Cambridge Textbook of Effective Treatments in Psychiatry. Cambridge University Press. p. 35. 
  12. ^ Jansson, Bengt (29 October 1998) "Controversial Psychosurgery Resulted in a Nobel Prize". Retrieved 05-02-2012
  13. ^ Helmes, Edward; Velamoor, VR (2009). "Long-Term Outcome of Leucotomy On Behaviour of People With Schizophrenia". International Journal of Social Psychiatry 55 (1): 64–70. doi:10.1177/0020764008091681. PMID 19129327. 
  14. ^ Feldman, Burton The Nobel Prize, pp. 286–289, Arcade Publishing, 2000 ISBN 1-55970-537-X
  15. ^ a b Abimbola, S. (Jan. 2006) Student BMJ Archive. "The white cut: Egas Moniz, lobotomy, and the Nobel prize". Retrieved 04-14-2010
  16. ^ Lerner, Barron H. (July 14, 2005). "Last-Ditch Medical Therapy — Revisiting Lobotomy". New England Journal of Medicine (.nejm.org) 353 (2): 119–121. doi:10.1056/NEJMp048349. PMID 16014881. 

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