Dr. Gottlieb Burckhardt--the pioneer of psychosurgery

The first attempt at psychosurgery--intentional damage to the intact brain for the relief of mental illness--was undertaken in 1888 by the Swiss psychiatrist Gottlieb Burckhardt. Six chronic schizophrenic patients underwent localized cerebral cortical excisions. Most patients showed improvement and became easier to manage, although one died from the procedure and several had aphasia or seizures. Burckhardt, a learned neuropsychiatrist, presented his results in 1890 and in 1891 published his scientific rationale and detailed clinical outcome in a scholarly paper. Nevertheless his approach had shocked the medical community as reckless and irresponsible. Burckhardt was ridiculed, his academic endeavors ceased and his surgical endeavor largely ignored. Nevertheless he continued practice as a fine psychiatrist and mental hospital director. Burckhardt's career and interesting ideas on higher cerebral functions are reviewed and placed in perspective regarding the development of "modern" psychosurgery almost one-half century later.