Egas Moniz
Encyclopedia
António Caetano de Abreu Freire Egas Moniz (29 November 1874 – 13 December 1955), known as Egas Moniz (ˈɛɡɐʃ muˈniʃ), was a Portuguese neurologist
and the developer of cerebral angiography
. He is sometimes regarded as the founder of modern psychosurgery
, and developing the surgical procedure termed leucotomy (also known as lobotomy), for which he became the first Portuguese national to receive a Nobel Prize in 1949 (shared with Walter Rudolf Hess
).
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.
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). 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.
In 1920, he gave up politics and returned to medicine and writing full time. 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. He also contributed to the development of Thorotrast
for use in the procedure and contributed many lectures and papers on the subject. He is considered a pioneer in the field.
In 1936, he published his first report of performing a prefrontal leucotomy on a human patient, 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." He also claimed that the benefits, even if some behavioral and personality deterioration occurred, were outwieighed by what he saw as reduction in the debilitating effects of the illness. 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."
In 1939, Moniz was shot by a disaffected patient and subsequently used a wheelchair.
He continued in private practice until 1955, when he died just as his procedure was falling into disrepute.
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.
, his more important publications are:
Neurologist
A neurologist is a physician who specializes in neurology, and is trained to investigate, or diagnose and treat neurological disorders.Neurology is the medical specialty related to the human nervous system. The nervous system encompasses the brain, spinal cord, and peripheral nerves. A specialist...
and the developer of cerebral angiography
Cerebral angiography
Cerebral angiography is a form of angiography which provides images of blood vessels in and around the brain, thereby allowing detection of abnormalities such as arteriovenous malformations and aneurysms....
. He is sometimes regarded as the founder of modern psychosurgery
Psychosurgery
Psychosurgery, also called neurosurgery for mental disorder , is the neurosurgical treatment of mental disorder. Psychosurgery has always been a controversial medical field. The modern history of psychosurgery begins in the 1880s under the Swiss psychiatrist Gottlieb Burckhardt...
, and developing the surgical procedure termed leucotomy (also known as lobotomy), for which he became the first Portuguese national to receive a Nobel Prize in 1949 (shared with Walter Rudolf Hess
Walter Rudolf Hess
Walter Rudolf Hess was a Swiss physiologist who won the Nobel Prize in Physiology or Medicine in 1949 for mapping the areas of the brain involved in the control of internal organs. He shared the prize with Egas Moniz....
).
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
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 neurologyNeurology
Neurology is a medical specialty dealing with disorders of the nervous system. Specifically, it deals with the diagnosis and treatment of all categories of disease involving the central, peripheral, and autonomic nervous systems, including their coverings, blood vessels, and all effector tissue,...
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). Meanwhile he continued to practice medicine and teach physiology
Physiology
Physiology is the science of the function of living systems. This includes how organisms, organ systems, organs, cells, and bio-molecules carry out the chemical or physical functions that exist in a living system. The highest honor awarded in physiology is the Nobel Prize in Physiology or...
and anatomy
Anatomy
Anatomy is a branch of biology and medicine that is the consideration of the structure of living things. It is a general term that includes human anatomy, animal anatomy , and plant anatomy...
, and in 1911 he became a professor of neurology at the newly-established University of Lisbon.
In 1920, he gave up politics and returned to medicine and writing full time. In 1927 Moniz developed cerebral angiography
Cerebral angiography
Cerebral angiography is a form of angiography which provides images of blood vessels in and around the brain, thereby allowing detection of abnormalities such as arteriovenous malformations and aneurysms....
, 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. He also contributed to the development of Thorotrast
Thorotrast
Thorotrast is a suspension containing particles of the radioactive compound thorium dioxide, ThO2, used as a contrast medium in X-ray diagnostics in the 1930s and 40s ....
for use in the procedure and contributed many lectures and papers on the subject. He is considered a pioneer in the field.
In 1936, he published his first report of performing a prefrontal leucotomy on a human patient, and subsequently devised the leucotome
Leucotome
A leucotome or McKenzie Leucotome is a surgical instrument used for performing leucotomies, lobotomies and other forms of psychosurgery.Invented by Canadian neurosurgeon Dr. Kenneth G...
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." He also claimed that the benefits, even if some behavioral and personality deterioration occurred, were outwieighed by what he saw as reduction in the debilitating effects of the illness. 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
Nobel Prize in Physiology or Medicine
The Nobel Prize in Physiology or Medicine administered by the Nobel Foundation, is awarded once a year for outstanding discoveries in the field of life science and medicine. It is one of five Nobel Prizes established in 1895 by Swedish chemist Alfred Nobel, the inventor of dynamite, in his will...
,
"for his discovery of the therapeutic value of leucotomy in certain psychoses."
In 1939, Moniz was shot by a disaffected patient and subsequently used a wheelchair.
He continued in private practice until 1955, when he died just as his procedure was falling into disrepute.
Legacy
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. 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. 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.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
Internal carotid artery
In human anatomy, the internal carotid arteries are two major arteries, one on each side of the head and neck. They arise from the common carotid arteries where these bifurcate into the internal and external carotid artery, and they supply the brain....
through the interior of the temporal bone
Temporal bone
The temporal bones are situated at the sides and base of the skull, and lateral to the temporal lobes of the cerebrum.The temporal bone supports that part of the face known as the temple.-Parts:The temporal bone consists of four parts:* Squama temporalis...
, is named for him.
Important publications
According to the Nobel PrizeNobel Prize
The Nobel Prizes are annual international awards bestowed by Scandinavian committees in recognition of cultural and scientific advances. The will of the Swedish chemist Alfred Nobel, the inventor of dynamite, established the prizes in 1895...
, his more important publications are:
- 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 te 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.