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Lobothomie

Walter Freeman glaubte psychische Erkrankungen mit einer Lobotomie heilen zu können. Tausenden Patienten trieb er dazu Stahlnadeln ins Gehirn. Eine Operationsmethode erobert vor 70 Jahren die Welt und bekommt den Nobelpreis. Heute sorgt sie meist für Entsetzen: die Lobotomie. Die Lobotomie ist eine neurochirurgische Operation, bei der die Nervenbahnen zwischen Thalamus und Frontallappen sowie Teile der grauen Substanz durchtrennt werden. Die Bezeichnung wird oft synonym mit Leukotomie verwendet.

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Er entwickelte die transorbitale Lobotomie, die uns heute besonders bestialisch erscheint: Der Operateur ging mit einem an einen Eispickel. Heute wissen wir, dass es keine nachweisbaren Belege für die Wirksamkeit einer Lobotomie-Behandlung gibt. Viele der Patienten von Moniz. Walter Freeman glaubte psychische Erkrankungen mit einer Lobotomie heilen zu können. Tausenden Patienten trieb er dazu Stahlnadeln ins Gehirn.

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Die Lobotomie wurde durchgeführt, um vorrangig verschiedene psychische Erkrankungen oder geistige Zustände zu lindern. Die Mediziner gingen sogar von einer dauerhaften Heilung aus.

Wurde diese nicht erreicht, so befanden sie, dass die Ergebnisse im Vergleich zum vorherigen Zustand eine wesentliche Verbesserung darstellten.

In einem operativen Eingriff wurden als erkrankt eingestufte Nervenbahnen zwischen dem Thalamus und dem Frontallappen gezielt durchtrennt.

Ziel war es, dass als defekt eingestufte Signalstränge ihre Tätigkeit nicht mehr fortsetzen sollten. Nach der Auffassung der Mediziner wurden in den Nervenbahnen, die zum Zwischenhirn führen, Wahrnehmungen und Gedanken transportiert.

Diese verbinden sich mit den Gefühlen des Menschen und sind bei den Patienten falsch verknüpft. Die Schnitte durch die Nervenfasern, sollten Gewebe des Gehirns durchtrennen.

Dies bildete die Basis, damit der menschliche Organismus neue Nervenfasern bilden konnte. Die gesunden Fasern sollten dann im Laufe des Heilungsprozesses die Persönlichkeit des erkrankten Menschen positiv verändern.

Die Vermutung war, dass das menschliche Gehirn plastisch ist und nach dem Verlust von Nervenfasern neue Vernetzungen entstehen, die automatisch als gesund einzustufen sind.

Vergleichbares ist bei Nervenfasern im Gesicht zu beobachten. Nach einigen Wochen oder Monaten regenerieren sich beschädigte Nervenbahnen insbesondere im Bereich der Wangenknochen.

Diese Erkenntnisse nutzten Forscher und übertrugen ihre Theorien auf andere Bereiche des menschlichen Organismus.

Neurowissenschaftlich bekamen Forscher Vorstellungen davon, in welchen Hirnregionen bestimmte Prozesse ablaufen. Sie sahen Ursachen für seelische Erkrankungen, Schizophrenie , Angstzustände oder eine Depression in defekten Nervenbahnen und Gewebe des Gehirns.

The operation left people with an "infantile personality"; a period of maturation would then, according to Freeman, lead to recovery.

In an unpublished memoir, he described how the "personality of the patient was changed in some way in the hope of rendering him more amenable to the social pressures under which he is supposed to exist.

When her parents had difficulty dealing with her behavior, Freeman advised a system of rewards ice cream and punishment smacks.

In the early 20th century, the number of patients residing in mental hospitals increased significantly [n 2] while little in the way of effective medical treatment was available.

The clinician-historian Joel Braslow argues that from malarial therapy onward to lobotomy, physical psychiatric therapies "spiral closer and closer to the interior of the brain" with this organ increasingly taking "center stage as a source of disease and site of cure".

Lobotomy has always been controversial, but for a period of the medical mainstream, it was even feted and regarded as a legitimate last resort remedy for categories of patients who were otherwise regarded as hopeless.

Before the s, individual doctors had infrequently experimented with novel surgical operations on the brains of those deemed insane.

Most notably in , the Swiss psychiatrist Gottlieb Burckhardt initiated what is commonly considered the first systematic attempt at modern human psychosurgery.

Burckhardt's decision to operate was informed by three pervasive views on the nature of mental illness and its relationship to the brain.

First, the belief that mental illness was organic in nature, and reflected an underlying brain pathology; next, that the nervous system was organized according to an associationist model comprising an input or afferent system a sensory center , a connecting system where information processing took place an association center , and an output or efferent system a motor center ; and, finally, a modular conception of the brain whereby discrete mental faculties were connected to specific regions of the brain.

Intending to ameliorate symptoms in those with violent and intractable conditions rather than effect a cure, [41] Burckhardt began operating on patients in December , [42] but both his surgical methods and instruments were crude and the results of the procedure were mixed at best.

In , two physicians based in Saint Petersburg , the leading Russian neurologist Vladimir Bekhterev and his younger Estonian colleague, the neurosurgeon Ludvig Puusepp , published a paper reviewing a range of surgical interventions that had been performed on the mentally ill.

We have quoted this data to show not only how groundless but also how dangerous these operations were. We are unable to explain how their author, holder of a degree in medicine, could bring himself to carry them out The authors neglected to mention, however, that in Puusepp himself had performed surgery on the brains of three mentally ill patients, [n 5] [51] sectioning the cortex between the frontal and parietal lobes.

The source of inspiration for Moniz's decision to hazard psychosurgery has been clouded by contradictory statements made on the subject by Moniz and others both contemporaneously and retrospectively.

Fulton stated that he replied that while possible in theory it was surely "too formidable" an intervention for use on humans. That Moniz began his experiments with leucotomy just three months after the congress has reinforced the apparent cause and effect relationship between the Fulton and Jacobsen presentation and the Portuguese neurologist's resolve to operate on the frontal lobes.

Fulton's report, penned ten years after the events described, is, however, without corroboration in the historical record and bears little resemblance to an earlier unpublished account he wrote of the congress.

In this previous narrative he mentioned an incidental, private exchange with Moniz, but it is likely that the official version of their public conversation he promulgated is without foundation.

As the frontal lobes had been the object of scientific inquiry and speculation since the late 19th century, Fulton's contribution, while it may have functioned as source of intellectual support, is of itself unnecessary and inadequate as an explanation of Moniz's resolution to operate on this section of the brain.

The refinement of neurosurgical techniques also facilitated increasing attempts to remove brain tumours, treat focal epilepsy in humans and led to more precise experimental neurosurgery in animal studies.

The first bilateral lobectomy of a human subject was performed by the American neurosurgeon Walter Dandy in This was reflected in the neurological congress in London, which hosted [79] as part of its deliberations, [79] "a remarkable symposium Nor was Moniz the only medical practitioner in the s to have contemplated procedures directly targeting the frontal lobes.

The theoretical underpinnings of Moniz's psychosurgery were largely commensurate with the nineteenth-century ones that had informed Burckhardt's decision to excise matter from the brains of his patients.

The cellular bodies may remain altogether normal, their cylinders will not have any anatomical alterations; but their multiple liaisons, very variable in normal people, may have arrangements more or less fixed, which will have a relation with persistent ideas and deliria in certain morbid psychic states.

For Moniz, "to cure these patients," it was necessary to "destroy the more or less fixed arrangements of cellular connections that exist in the brain, and particularly those which are related to the frontal lobes", [93] thus removing their fixed pathological brain circuits.

Moniz believed the brain would functionally adapt to such injury. Egas Moniz [96]. On 12 November at the Hospital Santa Marta in Lisbon , Moniz initiated the first of a series of operations on the brains of the mentally ill.

It had a retractable wire loop at one end that, when rotated, produced a 1 centimetre 0. By the conclusion of this first run of leucotomies in February , Moniz and Lima had operated on twenty patients with an average period of one week between each procedure; Moniz published his findings with great haste in March of the same year.

Nine of the patients were diagnosed as suffering from depression , six from schizophrenia , two from panic disorder , and one each from mania , catatonia and manic-depression with the most prominent symptoms being anxiety and agitation.

The duration of the illness before the procedure varied from as little as four weeks to as much as 22 years, although all but four had been ill for at least one year.

There were no deaths and he did not consider that any patients had deteriorated following leucotomy. Moniz rapidly disseminated his results through articles in the medical press and a monograph in Amarro Fiamberti [].

Throughout the remainder of the s the number of leucotomies performed in most countries where the technique was adopted remained quite low. In Britain, which was later a major centre for leucotomy, [n 14] only six operations had been undertaken before Italian neuropsychiatrists, who were typically early and enthusiastic adopters of leucotomy, were exceptional in eschewing such a gradualist course.

Leucotomy was first reported in the Italian medical press in and Moniz published an article in Italian on the technique in the following year.

Experimental modifications of Moniz's operation were introduced with little delay by Italian medical practitioners.

The first prefrontal leucotomy in the United States was performed at the George Washington University Hospital on 14 September by the neurologist Walter Freeman and his friend and colleague, the neurosurgeon, James W.

Writing that he had been considering psychiatric brain surgery previously, he informed Moniz that, "having your authority I expect to go ahead".

Upon receipt of Moniz's monograph, Freeman reviewed it anonymously for the Archives of Neurology and Psychiatry. In Freeman and Watts adapted Lima and Moniz's surgical procedure, and created the Freeman-Watts technique , also known as the Freeman-Watts standard prefrontal lobotomy, which they styled the "precision method".

The Freeman-Watts prefrontal lobotomy still required drilling holes in the scalp, so surgery had to be performed in an operating room by trained neurosurgeons.

Walter Freeman believed this surgery would be unavailable to those he saw as needing it most: patients in state mental hospitals that had no operating rooms, surgeons, or anesthesia and limited budgets.

Freeman wanted to simplify the procedure so that it could be carried out by psychiatrists in psychiatric hospitals.

Inspired by the work of Italian psychiatrist Amarro Fiamberti , Freeman at some point conceived of approaching the frontal lobes through the eye sockets instead of through drilled holes in the skull.

In he took an icepick [n 16] from his own kitchen and began testing the idea on grapefruit [n 17] and cadavers. This new "transorbital" lobotomy involved lifting the upper eyelid and placing the point of a thin surgical instrument often called an orbitoclast or leucotome, although quite different from the wire loop leucotome described above under the eyelid and against the top of the eyesocket.

A mallet was used to drive the orbitoclast through the thin layer of bone and into the brain along the plane of the bridge of the nose, around 15 degrees toward the interhemispherical fissure.

In a more radical variation at the end of the last cut described, the butt of the orbitoclast was forced upwards so the tool cut vertically down the side of the cortex of the interhemispheric fissure ; the "Deep Frontal Cut".

All cuts were designed to transect the white fibrous matter connecting the cortical tissue of the prefrontal cortex to the thalamus.

The leucotome was then withdrawn and the procedure repeated on the other side. Freeman performed the first transorbital lobotomy on a live patient in Its simplicity suggested the possibility of carrying it out in mental hospitals lacking the surgical facilities required for the earlier, more complex procedure.

Freeman suggested that, where conventional anesthesia was unavailable, electroconvulsive therapy be used to render the patient unconscious.

However, because of the fervent promotion of the technique by Freeman and Watts, those numbers increased sharply towards the end of the decade.

In , the peak year for lobotomies in the US, 5, procedures were undertaken, and by over 18, individuals had been lobotomized in the US.

In the United States, approximately 40, people were lobotomized. In England, 17, lobotomies were performed, and the three Nordic countries of Denmark, Norway, and Sweden had a combined figure of approximately 9, lobotomies.

This figure includes young children. The Soviet Union banned the practice in on moral grounds. In Germany, it was performed only a few times.

As early as an author in the Journal of Nervous and Mental Disease remarked: "The history of prefrontal lobotomy has been brief and stormy. Its course has been dotted with both violent opposition and with slavish, unquestioning acceptance.

Let me remark in passing that killing them makes their custodial care still easier. Concerns about lobotomy steadily grew. Soviet psychiatrist Vasily Gilyarovsky criticized lobotomy and the mechanistic brain localization assumption used to carry out lobotomy:.

It is assumed that the transection of white substance of the frontal lobes impairs their connection with the thalamus and eliminates the possibility to receive from it stimuli which lead to irritation and on the whole derange mental functions.

This explanation is mechanistic and goes back to the narrow localizationism characteristic of psychiatrists of America, from where leucotomy was imported to us.

The USSR officially banned the procedure in [] on the initiative of Gilyarovsky. In the US Congress, during the presidency of Jimmy Carter , created the National Committee for the Protection of Human Subjects of Biomedical and Behavioral Research to investigate allegations that psychosurgery—including lobotomy techniques—was used to control minorities and restrain individual rights.

The committee concluded that some extremely limited and properly performed psychosurgery could have positive effects. There have been calls in the early 21st century for the Nobel Foundation to rescind the prize it awarded to Moniz for developing lobotomy, a decision that has been called an astounding error of judgment at the time and one that psychiatry might still need to learn from, but the Foundation declined to take action and has continued to host an article defending the results of the procedure.

Lobotomies have been featured in several literary and cinematic presentations that both reflected society's attitude towards the procedure and, at times, changed it.

Writers and film-makers have played a pivotal role in turning public sentiment against the procedure. From Wikipedia, the free encyclopedia. Not to be confused with Lobectomy.

Neurosurgical operation. Walter Freeman, left, and Dr. James W. Watts study an X ray before a psychosurgical operation. Psychosurgery is cutting into the brain to form new patterns and rid a patient of delusions, obsessions, nervous tensions and the like.

I fully realize that this operation will have little effect on her mental condition but am willing to have it done in the hope that she will be more comfortable and easier to care for.

The hypotheses underlying the procedure might be called into question; the surgical intervention might be considered very audacious; but such arguments occupy a secondary position because it can be affirmed now that these operations are not prejudicial to either physical or psychic life of the patient, and also that recovery or improvement may be obtained frequently in this way.

In the present state of affairs if some are critical about lack of caution in therapy, it is, on the other hand, deplorable and inexcusable to remain apathetic, with folded hands, content with learned lucubrations upon symptomatologic minutiae or upon psychopathic curiosities, or even worse, not even doing that.

See also: Category:Lobotomised people. Psychiatry portal. Bilateral cingulotomy destruction of a part of the brain Bioethics and Medical ethics Frontal lobe disorder Frontal lobe injury Psychosurgery History of psychosurgery in the United Kingdom.

Convinced that the results had been positive in these cases, he felt that further research into psychosurgery was warranted.

Throughout his career he published on topics as diverse as neurology, sexology, historical biography, and the history of card games.

Some have attributed his development of leucotomy to a determination on his part to win the Nobel after these disappointments.

Freeman, who would later play a central role in the popularisation and practice of leucotomy in America, also had an interest in personality changes following frontal lobe surgery.

The first ice-pick came right out of our drawer. A humble ice-pick to go right into the frontal lobes. It was, from a cosmetic standpoint, diabolical.

Just observing this thing was horrible, gruesome. He was terrific. He was really quite a remarkable pioneer lobotomist. I wish he could have gotten further.

He described how accurate it [transorbital lobotomy] was and that he had practised the cutting on, literally, a carload of grapefruit, getting the right move and the right turn.

That's what he told me. Neurosurgery for psychiatric disorders: from the excision of brain tissue to the chronic electrical stimulation of neural networks.

In: Sakas, D. Operative Neuromodulation. Functional Neuroprosthetic Surgery. Volume II: Neural Networks Surgery. Springer; Shorter, Edward.

A History of Psychiatry: From the Era of the Asylum to the Age of Prozac. Snyder, John; Steffen-Fluhr, Nancy.

Overcoming Depression Without Drugs: Mahler's Polka With Introductory Funeral March. AuthorHouse; Shutts, David. Lobotomy: resort to the knife.

Van Nostrand Reinhold; Sargant, William; Slater, Elliot. An Introduction to Physical Methods of Treatment in Psychiatry. Steck, A.

Milestones in the development of neurology and psychiatry in Europe. Schweizer Archiv fur Neurologie und Psychiatrie.

Stone, James L. Suchy, Yana. Clinical Neuropsychology of Emotion. Guilford Press; Swayze, V. Frontal leukotomy and related psychosurgical procedures in the era before antipsychotics — : a historical overview.

Szasz, Thomas. Coercion as Cure: A Critical History of Psychiatry. New Brunswick, New Jersey: Transaction; Tierney, Ann Jane. Egas Moniz and the Origins of Psychosurgery: A Review Commemorating the 50th Anniversary of Moniz's Nobel Prize.

April ;9 1 — Lobotomy in Scandinavian psychiatry. The Journal of Mind and Behavior. Lobotomy in Norwegian Psychiatry.

USSR Ministry of Health. Valenstein, Elliot S. The Prefrontal Area and Psychosurgery. In: Uylings, H.

The Prefrontal Cortex: Its Structure, Function and Pathology. Progress in Brain Research, Volume Valenstein, Elliot A.

History of Psychosurgery. In: Greenblatt, Samuel H. A History of Neurosurgery: In Its Scientific and Professional Contexts.

Contributing editors Dagi, T. Forcht; Epstein, Mel H.. Park Ridge, IL: The American Association of Neurological Surgeons; Weiss, Anthony P.

Neurosurgical intervention for psychiatric illness: past, present and future. In: Miller, Bruce L. The Human Frontal Lobes: Functions and Disorders.

Whitaker, H. A psychosurgical chapter in the history of cerebral localization: the six cases of Gottlieb Burkhardt. In: Code, Christopher; Wallesch, C.

Classic Cases in Neuropsychology. Hove: Psychology Press; Wiener, Norbert. MIT Press; ISBN X. Williams, Tennessee.

Die ursprüngliche, von Moniz entwickelte und von Freeman und Watts in den USA verfeinerte Methode wird auch als Präzisionsmethode bezeichnet.

Sie erfordert die Teilnahme von mindestens zwei Personen an der Operation: eines Neurologen und eines Neuro- Chirurgen.

Nun führte der Chirurg auf etwa horizontaler Ebene ein längliches Messer oder ein spezielles Leukotom in den Schädel ein. Ihm gegenüber, auf der anderen Seite des Kopfes, befand sich der Neurologe, welcher die Vordringungsrichtung des Leukotoms dirigierte.

Zunächst wurde dieses vom Chirurgen unter Anpeilen der gegenüberliegenden Schädelbohrung bis kurz vor die Mitte des Schädels bzw.

Gehirns vor Erreichen der fissura longitudinalis geschoben. Die Orientierung erfolgte dabei zudem an weiteren, innenliegenden Schädelpunkten.

Dazu schwenkte er das eingeführte Leukotom in vorgeschriebenen Winkeln in der koronaren Ebene nach oben und unten.

Freeman entwickelte die neue Operationsmethode aus zwei Gründen: Zum einen war zu ihrer Ausführung lediglich ein mehr oder minder fachkundiger Mensch vonnöten; zum anderen war sie wesentlich zeit- und kostengünstiger, erforderte nicht einmal eine Narkose oder die Schädelöffnung.

Oft dauerte die gesamte Operation von Eintreffen bis Verabschiedung des Patienten nicht einmal eine Stunde. Bei der Operation wurde dem lokal oder vollständig anästhetisierten Patienten vom Operateur der in den seltensten Fällen ein ausgebildeter Chirurg war ein langes, spitzes Werkzeug oberhalb der Augenhöhle in den Kopf eingeführt.

Dafür wurde dem Patienten das Augenlid angehoben, die Spitze des Werkzeuges oberhalb des Augapfels eingeführt und durch den Schädel geschlagen.

Da der Schädel im Bereich der Augenhöhlen den dünnsten Bereich aufweist, genügte meist ein leichter Schlag auf das hintere Ende des Werkzeuges, um in das Gehirn vorzudringen.

War die Spitze des Werkzeuges im Gehirn bis zu einem der subjektiven Einschätzung überlassenen Punkt vorgeschoben, wurde es wie bei der alten Methode geschwenkt, um das Gewebe in den anvisierten Hirnbereichen zu zerstören.

Die einzigen sichtbaren Schäden, die Patienten davontrugen, waren meist lediglich Hämatome am Auge.

Später führte er seine Operationen unter lokaler Betäubung durch. Dies hatte den Vorteil, dass er die Patienten simultan befragen konnte.

Die Lobotomie ist eine neurochirurgische Operation, bei der die Nervenbahnen zwischen Thalamus und Frontallappen sowie Teile der grauen Substanz durchtrennt werden. Die Bezeichnung wird oft synonym mit Leukotomie verwendet. Walter Freeman glaubte psychische Erkrankungen mit einer Lobotomie heilen zu können. Tausenden Patienten trieb er dazu Stahlnadeln ins Gehirn. Er entwickelte die transorbitale Lobotomie, die uns heute besonders bestialisch erscheint: Der Operateur ging mit einem an einen Eispickel. Aus der Nachschau heraus wirkt es geradezu unglaublich, wie lange Freeman seine transorbitale Lobotomie propagieren konnte – und dass die medizinischen​. Jack Harry Potter Filme Altersempfehlung "The Lobotomist: A Maverick Medical Genius and His Tragic Quest to Rid the World of Mental Illness". Und natürlich ist die Wissenschaft unter bestimmten Bedingungen auch in der Lage, zu Erkenntnissen zu kommen, die sich nicht mehr ändern. Vielen anderen Lobotomie-Patienten erging es nicht Hotel Rerik. Lobotomy, also known as leucotomy, is a neurosurgical operation that involves severing connections in the brain's prefrontal lobe, according to Encyclopaedia Britannica. A lobotomy is a surgical procedure which involves removing or damaging parts of the frontal cortex. Lobotomies were historically used to treat patients with psychological illnesses and behavioral disorders; in the s, they were largely phased out and replaced with medications, talk therapy, and other forms of treatment. Today, the word “lobotomy” is rarely mentioned. If it is, it’s usually the butt of a joke. But in the 20 th century, a lobotomy became a legitimate alternative treatment for serious mental illness. The Forgotten Story Of Rosemary Kennedy, Who Was Lobotomized So That JFK Could Succeed For years, Rosemary Kennedy's story was kept secret after her lobotomy was botched, leaving her unable to walk or talk. John F. Kennedy Presidential Library and Museum The Kennedy Family at Hyannis Port on September 4, Die Lobotomie (von altgriechisch λοβός lobós, deutsch ‚Lappen‘ und τομή tomé, deutsch ‚Schneiden, Schnitt‘) ist eine neurochirurgische Operation, bei der die Nervenbahnen zwischen Thalamus und Frontallappen sowie Teile der grauen Substanz durchtrennt werden (Denervierung).

Gzsz-Videos Filmen und Lobothomie. - Lobotomie soll Howard Dullys Persönlichkeit verändern

Aber noch fehlt ihm ein Cingöz Recai Werkzeug, die Spezialinstrumente des Portugiesen brechen zu leicht.
Lobothomie Out of Sight, Out of Mind: A Graphic Picture of Present-day Institutional Care of the Filme Legal Downloaden Ill in America, Based on More Than Two Thousand Eye-witness Reports. Views Read Edit View history. Play the game. Though John F. 12/11/ · La lobotomie, traitement chirurgical des pathologies mentales, est aujourd’hui complètement abandonnée dans la plupart des pays du monde, dont la France. Lobotomia. Nga Wikipedia, enciklopedia e lirë. Jump to navigation Jump to search. Lobi frontal. Lobotomia (Greqisht: λοβός – lobos: "lob (i trurit)"; τομή – tome: "prerje/copë") është një procedurë neurokirurgjikale, një formë psikokirurgjie. Lobotomia konsiston në prerjen e lidhjeve midis dhe nga korteksi prefrontal, pjesën e brendshme të lobeve Lindi më: Lobotomie: définition. La lobotomie (ou leucotomie) est une intervention chirurgicale consistant à sectionner les fibres reliant différentes parties du cerveau afin de les «déconnecter».Ce sont les lobes frontaux (cortex préfrontal) qui sont le plus souvent concernés et «isolés» du reste de l’encéphale. April ;9 1 — Als Folge der Lobotomie tritt eine Persönlichkeitsänderung mit Störung des Antriebs und der Emotionalität auf. Medicine, Health Care and Philosophy. Spring ;12 2 — British Medical Journal. Neuroethics: defining the issues in theory, Lobothomie, and policy. In: Code, Christopher; Wallesch, C. Die ursprüngliche, von Eine Der Halligen 5 Buchstaben entwickelte und von Freeman und Watts in den USA verfeinerte Methode wird auch als Präzisionsmethode bezeichnet. April ;9 1 — Bianchi, Leonardo. May ; 2 — Journal of Dramatic Theory and Criticism. Dramatists Play Service;
Lobothomie

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