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Egas Moniz (1874–1955)
  1. L F Haas

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    Moniz had a distinguished political career before beginning serious neurological investigation at what some would consider the advanced age of 51. He was named Antonio Caetano de Abreu Freire Egas Moniz. His godfather added Egas Moniz and Moniz took this name when a student in Pamplita—Egas Moniz was a hero of the Portuguese resistance in the Portuguese wars against the Moors in the 12th century. Moniz graduated in 1899 from the University of Coimbri. He soon became professor of internal medicine with a special interest in diseases of the nervous system. Early fame was achieved following a scandalous book on sexology, written in 1901. In 1911 he became professor of neurology in Lisbon until his retirement in 1944. He was also pursuing a successful political career. Moniz supported a republican form of government, breaking with his family’s traditional support for the monarchy. His political beliefs led to several brief periods in jail, twice as a student for participating in demonstrations and later when, as Dean of the Medical School in Lisbon, he prevented police from entering the campus to quell student protest. In 1900 he was elected to parliament and was re-elected several times over the next 15 years. During the first world war he was Ambassador to Spain and after the war, Minister of External Affairs. He represented Portugal at the 1918 Versailles Peace Conference. Moniz retired from politics in 1926 following a coup d’etat that brought Antonio de Oliveira Salazaar to power.

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    This stable dictatorship ended liberaldemocracy in Portugal for the rest of Moniz’s life. In 1926, aged 51, he began his work on cerebral angiography. In collaboration with Almeida Lima he injected radio-opaque dyes into arteries, which enabled the cerebral vessels to be photographed. By 1927 it was possible to show that displacement in the cerebral circulation could infer the presence and location of brain tumours. A detailed account of the technique was published in 1931. Moniz became better known for his introduction, in 1935, of the operation of prefrontal leukotomy. It was for this work, described by the Nobel authorities as “one of the most important discoveries ever made in psychiatric medicine” that they awarded him the 1949 Nobel Prize for physiology or medicine. The operative technique was suggested to Moniz after hearing an account by John Fulton and Carlyle Jacobsen in 1935 of a refractory chimpanzee who became less aggressive after its frontallobes had been excised. Moniz invented a eukotome, which was a wire snare that passed into the posterior aspect of each frontal lobe and rotated in order to cut the white matter. He used the leukotome on December 27 1935, on two patients with paranoid schizophrenia. He named the procedure prefrontal leukotomy. Moniz had hoped that his pioneering work on angiography would be recognised with a Nobel Prize. He was nominated twice for the prize in 1928 and 1933.

    Gambling was one of Moniz interests, and he wrote a treatise on the history of playing cards. He prepared several biographies, including one of Pope John XXI, or Petrus Hispanus, the only physician ever to become Pope. In 1974, on the centenary of his birth, his portrait, the leukotome, and angiogram were shown in stamps issued by Portugal (Stanley Gibbons no 1558–1560, Scott no 1241–1243).

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