The neurosciences: The danger that we will think that we have understood it all

In 1953, the same year in which he had operated on the brain of the famous amnesic H. M., the American neurosurgeon W. B. Scoville described the major achievements of contemporary neurosurgery, while at the same time disclosing his aspirations for the future:We have isolated, by the ‘undercutting’ technique, the anterior cingulate gyrus and the posterior orbital cortex in a series of fractional lobotomies performed on schizophrenic and neurotic patients. More recently, we have both stimulated and resected bilaterally various portions of the rhinencephalon in carrying out medial temporal lobectomies on schizophrenic patients and certain epileptic patients … orbital isolation has given a most gratifying improvement in depression, psychoneuroses, and tension states … Who knows but that in future years neurosurgeons may apply direct selective shock therapy to the hypothalamus, thereby relegating psychoanalysis to that scientific limbo where perhaps it belongs? And who knows if neurosurgeons may even carry out selective rhinencephalic ablations in order to raise the threshold for all convulsions, and thus dispense with pharmaceutical anticonvulsants?(Scoville, 1954).One doesn't need to be a neuroanatomist, with a detailed understanding of these brain structures to appreciate the optimistic tone. These were, no doubt, the high days of psychosurgery. They began in the 1930s when the Portuguese neurologist Egas Moniz attempted to treat mental illness by severing neural tracts in the frontal cortex. The approach became astonishingly widespread, apparently not without support from the popular press. Moniz was even awarded the Nobel Prize in 1949 for developing it.