本帖最后由 retro 于 2014-1-27 08:19 PM 编辑
(二)
据我所知,世上只有两个大脑受到隆重科学礼遇,一个是爱恩斯坦的。他们两者之间区别清楚:亨利是后天的;亨利生来没有这个价值。但生前,他的脑袋比爱恩斯坦的,更具医学研究价值。
亨利27岁那年,1953年8月25日,康州哈特福德医院(Hartford Hospital, Connecticut)脑神经外科医生威廉·斯科维尔( William Beecher Scoville),在亨利的额头上打了两个洞。手术中,他用工具把亨利脑子里的Frontal Lobes挖掉,又把两边的Medial Temporal Lobes切除。然后从亨利的脑袋里,斯科维尔医生一口气拿掉了一堆“名词”:Hippocampus,Parahippocampal Gyru,Uncus,Anterior Temporal Corte,还有Amygdala——这我不太懂,懒得查字典。

英俊的威廉·斯科维尔医生
手术细节,好像没有留下文字记载(斯科维尔医生1984年去世)。他的一个后人,卢克·迪特里克(Luke Dittrich)写过一篇长文“The Brain That Changed Everything”,里面作了一点描述:
A trepan is a sort of wide-mouthed serrated drill. The particular trepan he's using, like a lot of his surgical instruments, and like the operation itself, is of his own invention. To make this trepan, he bought a hole saw from a local auto-supply or machine shop for about a dollar, then attached it to a standard Hudson drill handle, the kind you crank by hand. Now he places the trepan down onto Henry's exposed skull, just above one of his eye sockets,and bears down.
译文:“孔钻是一种宽齿锯钻。那把他正在用的专门孔钻,象他许多手术器械,以及本次手术那样,是他自己拥有的发明。为了打造这把钻,他用大约一块钱,从一家汽配或者机械商店买来孔锯,然后给它配上一个标准的哈德森手摇钻,要你用手摇动的那种。现在他把孔钻放到亨利露出的头骨上,正好在他眼眶上面,向下旋转。”
手术用的那把手钻叫Trepan,是斯科维尔医生用哈德森手钻改造而成的。哈德森手钻,现已是古董;我见过用过,样子像一个很大的“弓”字,很不好使。钻孔的时候,需要一手握住顶端,向下用力,一手横着使劲摇动手把,如果合力掌握不好,钻头很容易走偏。卢克说他的祖父,斯科维尔是一个很有创意的医生,喜欢搞一些小发明;曾发明过一把手术钳子。但我一下子搞不明白:脑袋里一大堆神经脆弱的神经……一把土钻?
后来,我发现这把钻跟Orbital Undercutting有关——望文生义:“轨道下切”。于是沿着“轨道”切下去,查到斯科维尔医生1960年,在英国《皇家医学会志》发表的医学论文“Late Results of Orbital Undercutting”。拽过来一看,呵呵,居然能看懂大半截,搞懂了Orbital Undercutting的用意:
Complete lobotomy has been largely replaced by limited selective operations especially in the benign psychoneuroses and depressions, and in selected schizophrenic patient with a high cultural background. The classical standard lobotomy or leucotomy in now advocated only deteriorated schizophrenic patients of low cultural level requiring continuous restraint and nursing care. Even in such cases selective undercutting of the superior convexity of the frontal lobes gives comparable benefit with less personality blunting. However, the principal application for selective lobotomies is in the neuroses, depressions and certain senile states. Such selective lobotomies, especially orbital undercutting, should be the treatment of choice in those recurrent depressions requiring more than a limited course of shock treatment, in seriously disabling anxiety-tension states, in intractable obsessive-compulsive syndromes without excessive narcissism and egocentricity, and in certain anxious, agitated elderly people. Unexpectedly gratifying results are obtained in the latter group.(节选)
斯科维尔医生的大意是,对那些文化背景良好(high cultural background),病情较轻的精神病人,可以不用lobotomy手术。有些病人电疗无效,情绪紧张,精神失控,强迫固执,以及烦躁不安的老年患者,Orbital Undercutting是一个很好的选择。因为这种手术在病人的额头上进行,创伤较少。Blablabla……
不过,我还不敢肯定Orbital究竟是指眼眶,还是亨利额头上被钻出来的那两个圆洞。我理解,倾向后者。 |