The surgery cut nerve fibers in the brain's frontal lobe through holes in the skull.
The lobotomy, once a widely used method for treating mental illness, epilepsy and even chronic headaches, is generating fresh controversy 30 years after doctors stopped performing the procedure now viewed as barbaric.
A new book and a medical historian contend the crude brain surgery actually helped roughly 10 percent of the estimated 50,000 Americans who underwent the procedure between the mid-1930s and the 1970s. But relatives of lobotomy patients want the Nobel Prize given to its inventor revoked.
The lobotomy debate was discussed in an editorial in today's New England Journal of Medicine.
Lobotomy was pioneered in 1936 by Portuguese neurologist Egas Moniz, who operated on people with severe psychiatric illnesses, particularly agitation and depression. Through holes drilled in the skull, Moniz cut through nerve fibers connecting the brain's frontal lobe, which controls thinking, with other brain regions -- believing that as new nerve connections formed the patient's abnormal behavior would end.
Moniz, already widely respected for inventing an early brain-imaging method, gave sketchy reports that many patients benefited and was awarded the Nobel Prize for medicine in 1949.
The procedure was so in vogue that Rosemary Kennedy, former President Kennedy's mildly retarded sister, had a lobotomy in the 1940s at age 23. She remained in an institution until she died in January.
Other doctors used a more primitive version than Moniz, punching an ice pick into the brain above the eye socket and blindly manipulating it to sever nerve fibers.
By the late 1930s doctors were reporting many lobotomy patients were left childlike, apathetic and withdrawn -- not unlike the depiction in the novel and movie "One Flew Over the Cuckoo's Nest." Use eventually waned with the advent of effective psychiatric drugs in the mid-1950s and the growing use of electroshock therapy.
Modern views of lobotomy have led to a call to pull Moniz's Nobel prize.
"How can anyone trust the Nobel Committee when they won't admit to such a terrible mistake?" asks Christine Johnson, a Levittown, N.Y., medical librarian who started a campaign to have the prize revoked.
One member of Johnson's campaign, retired nurse Carol Noell Duncanson of Marietta, Ga., said her mother, Anna Ruth Channels, was lobotomized while pregnant to end chronic headaches in 1949. Channels, described as a brilliant and vivacious woman, was sent home incapacitated, Duncanson said.