Evidence of trepanation is widespread, and has been traced back to neolithic times in Europe and at least 2500 years ago in South America. Below are pictures of an Incan skull from Peru (left). In ancient Peru trepanation was apparently fairly common--approximately 1000 Incan skulls have been identified. The picture on the right was discovered in Germany. One archaeological site in France identified 40 out of 120 skulls that had been trepanated. Many trepanated skulls have multiple holes, with the margins of "successful" surgeries often showing signs of healing. Sharper edged holes may indicate an "unsuccessful" surgery. Success rates have been estimated 75-80% in South America, and a remarkable 90% in Europe.
Why would anyone want to have a hole bored in their head? One can imagine that ancient humans might have used the technique to try and treat headaches, dizziness, epilepsy, evil spirits, tumors, head injuries, hematomas, etc.--virtually anything that might be related to the head. But, widespread use of trepanation and the presence of as many as 4, 5 or even 7 holes, might suggest a ritual aspect of the surgery. With the advent of modern medicine, trepanning has largely, gone the way of blood letting and bulbing, as an archaic treatment. There are modern, defensible uses of trepanation, to treat hematomas and assorted brain surgeries, but, of course, the bone is generally replaced after the surgical procedure (Many docs play golf. I wonder if they mumble to themselves "Always replace your divots," at the close of surgery.)
However, there are a few advocates of the surgery for its supposed psychological benefits. Bart Huges, sometimes spelled Hughes, saw trepanation as a "pathway to higher consciousness." A recurring theme that I see in advocates is that it is an attempt to increase blood flow to the brain in an attempt to recapture the plasticity and "happier and more energetic" state of mind in an infant. The rationale is that the flexible fontanel (soft spot) in a baby's cranium allows for more blood flow, which is restricted with hardening of the skull as we mature. The result of the surgery, as the "Trepanation Guide" expresses it, is that you are “…happier, more energetic and less prone to crippling bouts of ennui. You'll ascend to the child's plane of acute consciousness from which you disembarked to enter the lowly malaise of adulthood."
Hmm, to put it mildly, I have my doubts regarding the benefits.
Joey Mellen wrote a book called Bore Hole, which described his experiments with trepanation. His first attempt was unsuccessful. Mellen ended up hospitalized and was recommended for "psychiatric evaluation." His second attempt, with the aid of his girlfriend Amanda Fielding, worked. As Mellen described it,
“After some time there was an ominous sounding schlurp and the sound of bubbling. I drew the trepan out and the gurgling continued. It sounded like air bubbles running under the skull as they were pressed out. I looked at the trepan and there was a bit of bone in it. At last!”
There is an hour long documentary called "A Hole in the Head," which is available for purchase. I haven't seen the film, but it might be interesting.
If you want more info more on trepanation I recommend the Skeptic's dictionary and from this article from Charles D. Gross at Princeton.
Let me close with a couple videos. On the left is an interview with Bobby Lund, an advocate of trepanation, and on the right is a toe-tappin' light-hearted look at the process(along with some other interesting history of anatomy) from Zoochosis.
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