側頭葉白質切截術に就いて

Temporal Leucotomy

はしがき

　癲癇に対しては従来から各種の手術が試みられて居り，その効果に関する報告も少くない。しかもその多くは痙攣発作を対象として行われて居り，従来，特に好成績を得たものは甚だ少いようである。又最近では所謂temporal lobe epilepsyに対し側頭葉手術を行うようになり，その報告も，Bailey, Penfieldを初めとしてかなり多数に上つている。我国に於いては白木，佐野，渡辺氏らの側頭葉切除の報告があり，又これらと異つた方法で田中，松井氏の側頭葉白質切截術の報告もなされている。

　我々は従来の方法とは別個に，前頭葉白質切截術と殆んど同様に容易，且つ安全に施行し得る手術術式を考案した。そしてこの手術を癲癇5例，精神分裂病6例，計11例の患者に就き施行し，有益な知見を得たのでその結果に就き報告する。

A new method has been devised for temporal leucotomy, which enables us to perform safely the easier operation without giving rise to any critical situation. The way of performance is as follows:(1) to select definitely the spot to be perforated on the skull which is calculated on basis of Krönlein line, and then (2), to cut off a white matter of gy. temporalis superior et medius.

This method was already applied to six cases of schizophrenics and five of epileptics. In case of schizophrenics, it did scarcely prove effica-cious excepting a little alleviation of excitement, restlessness and irritability, while, in case of epileptics, a good effect was taken for derang-ed personality that is, irritability, impulsive-ness, explosiveness and twilight state of mind. No difficulties such as haemorrhage were re-cognized on and after the operation, from which no aphasia, apraxia, anosmia, ageusia, etc. were resulted.

This new method, therefore, is considered to have an instant effect on epileptics with devia-ted personality and psychic equivalent and be good for the nursing treatment thereof.