Working on the Mind

Dr Vernon Coleman

The following essay is taken from Vernon Coleman’s book `Paper Doctors’ which was first published in 1977 and which is now available again in a new paperback edition.

Working on the Mind

One-third of all the patients seen by general practitioners are said to have mental problems of one sort or another. It has been shown that 20 per cent of students at British universities suffer from some form of mental disorder at some stage in their university course. Only 35 per cent of a rural French population were free of psychiatric disorders, according to another study. In. Paris some 25 per cent of all cases of incapacity for work were caused by mental illness and in a Canadian study of 400,000 people only 20 per cent showed no mental disturbances. Most of these figures appear in a book entitled Health in 1980-90. A predictive study based on an international inquiry by Philip Selby which was sponsored by a drug company together with the Henry Dunant Institute of the Red Cross, and they give us a pretty good idea of what is likely to be the major medical problem of the future.

Medical researchers have, naturally, spent a good deal of effort on investigating possible cures for mental problems. The cures they have studied fall into several distinct groups. Firstly there are the pharmacological cures. Most of the major drug companies are already involved in the search for drugs to alleviate anxiety and depression and the number of drugs already on the market is growing at an astonishing rate. Most of the new drugs which, come out are said to be specific for particular types of psychological problem – for example, for phobic anxiety. Many researchers in this field are confident that within a few years they will be able to control most human emotions with the aid of specific drugs, although they admit that they must first come to a more complete understanding of biochemical and electrical pathways within the brain.

Though few researchers are modest enough to admit it, acquiring a total understanding of the way the brain works is likely to be a slow business. The brain contains three times as many cells as there are human beings on the earth and these cells are interconnected by a series of electronic and biochemical pathways which make even the most sophisticated modern computer look like an abacus. Since many of the computers we are making today are almost beyond our comprehension, the chances of anyone understanding the workings of the human brain must be that much less. In addition, there are philosophical problems, for some believe that it is quite impossible for the human brain ever to completely understand itself. The more you think about it the more perplexing this particular problem seems to be.

The next and probably so far most controversial area of brain control is brain surgery. Some brain surgery is, of course, lifesaving. There is, however, much brain surgery which is of less value; in particular I am referring to prefrontal leucotomy in which a part of the brain is permanently and deliberately damaged.

The first leucotomies were performed in the 1930s when it was thought that the frontal lobes were the source of delusions in mental patients. American workers removed the frontal lobes of chimpanzees in 1935 and thought that their animals were more contented afterwards. In the following year a neurosurgeon working in Portugal tested the theory, and injected alcohol into the frontal lobes of 20 schizophrenics.

Then, until the 1950s, thousands of patients had surgical operations to cut off their frontal lobes. Today such surgery is still performed frequently though there is no proper evidence to show that it does any good at all. Since those who have had the operation are rather quiet, apparently dim and contented people, few of them have complained.

Egas Moniz, when Professor of Neurology in Lisbon, was the first to develop leucotomy, though Walter Freeman, then Professor of Neurology at Washington University, took a great interest in the operation. During the ten years from 1940 to 1950 Freeman wrote 56 articles, most of them concerned with neurosurgery. The total number of papers written on the subject runs into thousands. In 1961 it was reported that about 500 operations a year were being performed in the United Kingdom and in 1970 according to Ashley Robin and Duncan Macdonald in Lessons of Leucotomy, one surgeon reported that he himself had performed over a thousand operations during the previous ten years. In 1972 it was estimated by Breggin in `Congressional Record’ that 50,000 operations had been performed in America and that Freeman had done 4,000 of these. In the British Medical Journal of 1971, it was estimated that 100,000 operations had been performed around the world.

Robin and Macdonald, in their careful study of the literature on leucotomy, assessed the reports in existence and concluded that 'Other methods of treatment e.g. tranquillising drugs, were as effective in improving non-operated patients as leucotomy.' They also reported that 'Neither patients with schizophrenia nor depression have a better prospect of discharge after leucotomy. The results in severely phobic and obsessional patients are inconclusive.’

Over 15,000 leucotomies had been performed in Great Britain by 1963. The operation, involving the cutting away or simply the deliberate damaging of part of the brain, was performed on patients with schizophrenia, depression, obsessional neurosis, anxiety states, hysteria, eczema, asthma, chronic rheumatism, anorexia nervosa, ulcerative colitis, tuberculosis, hypertension, angina and intractable pain due to carcinoma. Leucotomies had even been performed on patients suffering from anxiety caused by barbiturate toxicity.

In July 1975 it was announced in `The Lancet’ that at long last, a properly organised, controlled trial of psychosurgery was to be set up by the Royal College of Psychiatrists. The idea of the trial was to perform operations on 200 patients with severe mental disease who had failed to respond to conventional therapy. Unfortunately, the trial was heavily criticised by many experts. In the autumn of 1975, the College was still receiving many critical comments from observers who wanted to know how patients would be chosen, who would decide whether or not a particular patient was eligible and how anyone ill enough to need the operation could give consent for it to be done.

The risks of psychosurgery are great and the rewards unproven, so it is difficult to see how controlled clinical trials could ever be undertaken without the use of 'human guinea pigs'. Many doctors (and the number is increasing annually) believe that a psychiatrist who wrote to the `British Medical Journal’ in June 1973 had summed up the situation accurately: he argued that performing surgery on a delicate organ like the brain is rather like kicking a television set which doesn't work in the hope that a good kick will make it function normally again. Indeed, psychosurgery is even more illogical – it could perhaps better be compared to simply ripping out some of the insides of a television set to try to make it work.

The operation of pre-frontal leucotomy is a frightening example of an experimental procedure which has become an accepted part of medical practice without ever having been properly tested. Many papers have been written on the subject but the authors have invariably been practising neurosurgeons, reporting on uncontrolled trials.

The situation today is that the operation is still being performed by a small number of surgeons who refuse to accept that it is an invalid and unethical procedure. Meanwhile, the great majority of practising physicians believe that the operation is so worthless and dangerous that it would be unethical to perform a controlled clinical trial now. They believe that the operation should simply be abandoned and forgotten, to take its place in history with the other fantasy treatments such as blood-letting, and the removal of the intestines for constipation.

The result is an impasse. Those who doubt the operation's value will not involve themselves in trials. Those who do not doubt the operation's value will not involve themselves in trials. And so every year several hundred patients undergo leucotomies at the hands of the obstinate few.

While psychosurgery seems to offer only a crude method of controlling the brain, there are other more subtle methods of control currently being researched. The method with perhaps the most promise (if that is the right word) is the electronic stimulation of the brain. This system depends upon the mapping out of the brain and the identification of the sites within it where various categories of thought and emotion originate. To that extent electronic stimulation of the brain involves the same basic research as psychosurgery. There, however, the similarity ends. Instead of simply destroying part of the brain as the neurosurgeon does when performing psychosurgery, the researcher experimenting with electronic stimulation limits himself to trying to control parts of the brain.

For over a century doctors have known that if wires are poked into the brain and an electric charge passed through them, there will be different responses from different parts of the brain. A wire poked into one part will cause a leg to move, the same wire poked into another part of the brain will give the patient an erection. Today we know that with the aid of electronic stimulation, doctors can induce pleasure, eradicate pain and recall memories previously lost.

Doctors have now developed their techniques to such an extent that they fit small receivers onto the scalp so that electrical impulses can be fired into the brain from afar. The receivers fit under wigs or hats and are supplied with long-lasting batteries. Eventually, no doubt, receivers will be designed which can be fitted under the scalp.

With the electrodes in position the patient can be controlled quite effectively from a distance. He can be made to eat, to sleep or to work. His appetite, heart rate, body temperature and other factors can also be controlled. The system has great possibilities for helping obese patients to slim. It has also been said that it can be used to help the blind to see. Many wired-up patients have proved to have 'pleasure centres' which can be stimulated quite easily. Researchers have noted that patients stimulated in their right places suddenly start talking about sex or acting in a sexually flirtatious manner.

One doctor has predicted that in a not too distant future patients requiring anaesthesia will be taken to the operating theatre fully conscious and put to sleep with the aid of a current sent down an electrode into the brain. Another doctor has reported that he already has epileptic patients who are fitted with electrodes and transmitters of their own. When these patients feel a fit starting they simply press a button and abort the fit.

Researchers have shown that gentle cats can be transformed into aggressive beasts if certain parts of their brains are stimulated. In the 1950s Dr Delgado of the Yale University School of Medicine showed that two cats, normally quite friendly, could be made to fight fiercely if electrodes implanted in the brain were given impulses. Even when it continually lost its fights, the smaller of the two cats continued to be aggressive when stimulated. In one dramatic experiment Dr Delgado wired a bull with electrodes and then planted himself in the middle of a bullring with a cape and a small radio transmitter. The bull charged but was stopped by Dr Delgado pressing a button on his transmitter. The bull screeched to a halt inches away from its target. Dr Delgado has reported that 'Animals with implanted electrodes in their brains have been made to perform a variety of responses with predictable reliability as if they were electronic toys under human control.'

Similar experiments have been performed with human beings. The patients selected had all proved dangerous and had shown that they had uncontrollable tempers. By electronic stimulation every patient was controlled. More detailed accounts of these experiments can be read in Physical Control of the Mind by J.M.R. Delgado.

There are now so many neurosurgeons doing operations on the mentally ill (in some parts of America it is said, not entirely jokingly, that it is dangerous to complain of a headache) that other doctors are beginning to worry. There are many instances of patients who have had such surgery becoming worse afterwards; there are reported cases of patients who have had only exploratory operations improving just as much as patients who have destructive surgery; there are also worrying instances of neurosurgeons who have operated on children described as nuisances.

There will always be people who ignore ethical codes. There was a surgeon in the last century in England who achieved great fame by removing several thousand yards of intestine from patients complaining of constipation. These patients developed diarrhoea and lived miserable lives but Arbuthnot Lane, the surgeon, did well out of his work

Today we have doctors preparing brainwashing techniques for armed forces, fashionable physicians giving slimming drugs to gullible and weak-willed plump ladies; but perhaps worst of all, we have the psychosurgeons.’

This essay is a shortened version of a chapter taken from `Paper Doctors’ by Vernon Coleman. First published in 1977, Paper Doctors has been republished and is available via the bookshop on

Copyright Vernon Coleman 1977 and 2024