In 1946 Watts and Freeman1 reported on a small group of patients in whom intractable pain was relieved by bilateral prefrontal lobotomy. In this group there were 6 patients with mental disorders in whom the predominant symptom was unbearable pain and 3 patients with severe intractable pain due to organic disease. These authors stressed the distinction between perception of pain and reaction to pain. Perception of pain may be evaluated in terms of quality, intensity and temporal aspects, whereas reaction to pain is manifested by such symptoms as tachycardia, panting, bowel disturbances, anxiety, fear, terror, panic and prostration. Psychosurgery alters the patient's reactions to pain without materially changing his ability to feel the pain.
Scarff2 performed a unilateral prefrontal lobotomy on 33 patients for the relief of pain. The patients were studied for periods ranging from one month to ten months following operation. The unilateral procedure is said