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Neurosurgeon Sir Geoffrey Jefferson was a great exponent of the frontal lobectomy in the treatment of brain tumours, a procedure now considered to be somewhat controversial. Jefferson published a number of articles on the procedure between the 1930s and the 1950s expressing the success he had with the procedure. Stating that the procedure should only be carried out when absolutely necessary he was firmly of the opinion that it gave patient the best chance of long survival and did not have any great detrimental effects on cognitive function, memory, or emotion and in fact improved a patient’s condition in comparison to their condition with the tumour. In his 1937 article however Jefferson gives this somewhat dismissive remark on the effects on intellectual capacity observed in his patients:

“The patients in this series were not of any considerable mental stature; their occupations were not such as would easily bring to light faults in the higher synthesis of ideas.”

 

VFA.7.203 – ink drawing at operation after the right frontal lobe has been removed, n.d.

Within the collection of Jefferson’s Patient Files (JCN) there are at least twenty examples of the procedure being performed between the years 1932 and 1939 along with examples of temporal, occipital, and cerebellar lobectomies. Of these twenty examples, twelve are known for certain to have died.  A number of these patient files link directly to descriptions he gives in published works as well as to items of medical art produced by the artist Dorothy Davison. However, the existence of a number of patient files which contain descriptions of the procedure that are not referenced in his published works give a greater insight into the overall success and efficacy of the procedure.

 

VFA.7.201 – frontal lobectomy performed on patient 1935/82

Patient 1935/82 is one patient for whom we hold their patient file and a medical illustration and who also features in Jefferson’s 1937 article. A 44 year-old male clerk from Withington, he was operated on in April 1935 with uncertain results. Although stable after his 5 ¼ hour surgery, showing no signs of memory loss, and able to hold a conversation he did however display other signs of agitation including a tremor in the hands and feet, continuation of his seizures (although less often), and coldness in his feet. He died not long after the procedure was performed from uncertain causes preventing the further monitoring of his condition.

 

Sources:

Jefferson, ‘Removal of right or left frontal lobes in man’, BMJ, 1937, 2(3995), pp.199-206

Jefferson, ‘Tumours of the frontal lobe’, Postgraduate Medical Journal, 1939, 15(163), pp.170-8

Jefferson, ‘Tumours of the frontal lobe’,  Postgraduate Medical Journal, 1950, 26(293), pp.133-40