Like a Hole in the Head

At one time or another, we have all heard it said: ‘I need this like I need a hole in the head’, which is not as unusual as it seems. 

Trepanning (from Greek trypanon, meaning ‘borer’) is probably the oldest surgery known to humankind and refers to boring, drilling, cutting, sawing, or scraping a hole in the human skull. The Dutch doctor, Bart Hughes, started the modern trepanning movement in Europe in the 1960s. He advocated that the increased volume of blood flow in the brain’s capillaries, caused by ‘a hole in the head’ achieved higher levels of consciousness and increased function in certain brain parts, in effect restoring the cranium to infancy, when the skull is unsealed. How prevalent the practice has become is evidenced by an article published on March 4, 2000, in the British Medical Journal that explicitly warns about the dangers of trepanning after many websites advocated do-it-yourself trepanation to treat depression and other illnesses.

Trepanning, although for different reasons, was practised as early as 10,000 BCE in Europe, South America, Asia, Polynesia, Melanesia, the Pacific Islands, and some parts of Africa. This cranial operation is of interest and importance to archaeology, to anthropology, and to medicine, and seems to have been widespread in certain areas. For example, out of 120 prehistoric skulls found at a burial site in France dated to about 6500 BCE, some 40 skulls had undergone trepanation. Similarly, amongst the exhibits at the New Grange Visitor Centre in Ireland is an example of a prehistoric trepanned skull. Hippocrates, the Father of Medicine (460-370 BCE), gave specific directions on trepanning in his classic medical text on Injuries of the Head and the Greek physician, Galen (c.130-210 CE), later elaborated further on the operation.

Anthropologists believe that the purpose behind this painful surgery related to extracting practically all head ailments. These included demons and evil spirits of the possessed and the removal of foreign bodies, real or imagined – so-called ‘stones of insanity’ – fractures, inflammations, headaches, vertigo, and deafness. Often, a patient demanded the operation, spurred on by the belief that black magic or an evil-working sorcerer had projected specific material objects into his head. Amazingly, in ancient times, most people seem to have survived the procedure.

Trepanation was performed while the patient was fully awake, often sandwiched between two planks or frames, held down and kept immobile by relatives and helpers. The cranium usually healed after a period, forming new bone. There is, however, disconcertingly abundant evidence of people undergoing the procedure several times! 

During the Middle Ages and the Renaissance Period, trepanation was frequently practiced. Barber surgeons often trepanned those suffering from ‘falling sickness’ and to relieve chronic headaches. Those patients dying after the procedure usually died of sepsis, and not the procedure itself. 

Bone pieces cut from the skull were usually kept as protective charms or ground up to cure various ailments. In Mesoamerica, there is archaeological evidence of trepanation, but also of skull mutilation and modification carried out after the death of captives and enemies. Pre-Columbian art depicts rulers adorned with their enemies’ modified skulls and skull racks displaying rows and rows of sacrificial victims’ skulls.