Gottlieb Burckhardt and Egas Moniz--two beginnings of psychosurgery

This article compares the repercussions of the two attempts at psychosurgery, the first in 1888 by the Swiss psychiatrist Gottlieb Burckhardt and the second by the Portuguese neurologist Egas Moniz. Both widely publicised their procedure, yet, Burckhardt was condemned and no one ventured to repeat his operation, whereas Moniz's leucotomy was accepted and it soon entered mainstream psychiatry. The change of Zeitgeist does not explain the difference as the thinking in the time of Burckhardt, dominated by Griesinger's 'mental illness is an illness of the brain' doctrine, would appear to be more favourable to psychosurgery than it was in the time of Moniz. Moniz reported far more favourable results, which no doubt impressed other practitioners. But most of all the adoption of psychosurgery was due to the interest in mental illness of nonpsychiatrists--neurologists and neurosurgeons--, and the arrival of the new treatment marks a change in the professional configuration of those who treat psychiatric afflictions. This article deals with the early adoption of psychosurgery. Further developments, such as the relation of psychosurgery to other treatments and the fall into disrepute of the technique, are outside the scope of this presentation.