Lobotomy Nation: The History of Psychosurgery and Psychiatry in Denmark (Mental Health in Historical Perspective)

This book tells the story of one of medicine's most (in)famous treatments: the neurosurgical operation commonly known as lobotomy. Invented by Portuguese neurologist Egas Moniz in 1935, lobotomy or psychosurgery became widely used in a number of countries, including Denmark, where the treatment had a major breakthrough. In fact, evidence suggests that more lobotomies were performed in Denmark than any other country. However, the reason behind this unofficial world record has not yet been fully understood. Lobotomy Nation traces the history of psychosurgery and its ties to other psychiatric treatments such as malaria fever therapy, Cardiazol shock and insulin coma therapy, but it also situates lobotomy within a broader context. The book argues that the rise and fall of lobotomy is not just a story about psychiatry, it is also about society, culture and interventions towards vulnerable groups in the 20th century. Jesper Vaczy Kragh is Senior Researcher in the Copenhagen Centre for Health Research in the Humanities (CoRe) at the University of Copenhagen, Denmark. He has worked on research projects on the history of forensic psychiatry, Nordic psychology, drug abuse in the 19th and early 20th century and the history of vulnerable groups, 1945-1980. He is Co-Editor of the book, Social Class and Mental Illness in Northern Europe (2020) Preface 6 Contents 9 List of Figures 11 List of Tables 14 1 White Incisions and Black Butterflies 15 Prologue 15 Introduction 23 Part I Towards Lobotomy 43 2 State Mental Health Services—Danish Hospitals and the Directorate, 1922–1952 44 3 Malaria and the Interwar Years—Malaria Fever Therapy and Other Innovations in Psychiatry, 1922–1937 60 Groping in the Dark 69 4 Shock and Coma—Insulin and Cardiazol Shock Therapy, 1937–1942 81 The Beginning 84 Internal Discussions 93 5 Psychiatric Cooperation—Shock Treatment, Diagnoses and Psychiatric Textbooks, 1938–1942 104 The Shock Committee 117 Pre-Lobotomy Status 119 Part II The Heyday of Lobotomy 129 6 Something Different—Lobotomy, Electroshock and Plans for Psychiatry, 1939–1947 130 New Therapeutic Perspectives 134 Plans for Psychiatry 145 7 The First of Many—Lobotomy and the State Mental Hospital in Vordingborg, 1940–1947 158 Oringe 161 8 The Apostles of the Knife—Lobotomy, the Directorate and the General Public, 1946–1956 180 Early Danish Operations 184 Psychiatry and the Press 191 Lobotomy in the Public Sphere 194 Psychiatry’s Position 206 9 Last Resort?—Selecting Patients for Lobotomies in Vordingborg, 1947–1956 227 Danish Hospitals and Diagnoses 229 The Disturbed wards 239 The Quiet wards 253 Ultimum Refugium? 257 10 Women and the Problem of Psychopathy—Gender and Control in Vordingborg, 1947–1956 270 Psychopathy in Vordingborg 274 Part III The Demise of Psychosurgery 296 11 A Question of Consent—Coercion and Consent to Lobotomy, 1946–1958 297 Continuity and Changes of Course 300 The Debate About Coercion and Consent 304 Consent in Practice 318 The Decision 326 12 Lobotomia Sequelae—The Side-Effects of Lobotomy, 1955–1983 342 From Heyday to Oblivion 347 Second Coming 355 Complications 357 The New Psychosurgery 366 A New Age 368 13 The Final Cut—Summary and Conclusion 397 Postscript 429 Appendix I: Diagnoses 431 Appendix II: Lobotomy Patients, Vordingborg State Mental Hospital 434 Appendix III 443 Author Index 445 Subject Index 450 Intro -- Preface -- Contents -- List of Figures -- List of Tables -- 1 White Incisions and Black Butterflies -- Prologue -- Introduction -- Part I Towards Lobotomy -- 2 State Mental Health Services-Danish Hospitals and the Directorate, 1922-1952 -- 3 Malaria and the Interwar Years-Malaria Fever Therapy and Other Innovations in Psychiatry, 1922-1937 -- Groping in the Dark -- 4 Shock and Coma-Insulin and Cardiazol Shock Therapy, 1937-1942 -- The Beginning -- Internal Discussions -- 5 Psychiatric Cooperation-Shock Treatment, Diagnoses and Psychiatric Textbooks, 1938-1942 -- The Shock Committee -- Pre-Lobotomy Status -- Part II The Heyday of Lobotomy -- 6 Something Different-Lobotomy, Electroshock and Plans for Psychiatry, 1939-1947 -- New Therapeutic Perspectives -- Plans for Psychiatry -- 7 The First of Many-Lobotomy and the State Mental Hospital in Vordingborg, 1940-1947 -- Oringe -- 8 The Apostles of the Knife-Lobotomy, the Directorate and the General Public, 1946-1956 -- Early Danish Operations -- Psychiatry and the Press -- Lobotomy in the Public Sphere -- Psychiatry's Position -- 9 Last Resort?-Selecting Patients for Lobotomies in Vordingborg, 1947-1956 -- Danish Hospitals and Diagnoses -- The Disturbed wards -- The Quiet wards -- Ultimum Refugium? -- 10 Women and the Problem of Psychopathy-Gender and Control in Vordingborg, 1947-1956 -- Psychopathy in Vordingborg -- Part III The Demise of Psychosurgery -- 11 A Question of Consent-Coercion and Consent to Lobotomy, 1946-1958 -- Continuity and Changes of Course -- The Debate About Coercion and Consent -- Consent in Practice -- The Decision -- 12 Lobotomia Sequelae-The Side-Effects of Lobotomy, 1955-1983 -- From Heyday to Oblivion -- Second Coming -- Complications -- The New Psychosurgery -- A New Age -- 13 The Final Cut-Summary and Conclusion -- Postscript -- Appendix I: Diagnoses