Trepanning

Surgical intervention in which a hole is drilled or scraped into the human skull

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Trepanated skulls from the Bronze Age

Trepanning, also known as trephination or trepanation, is a surgical intervention in which a hole is drilled or scraped into the human skull. This procedure has been practiced since prehistoric times and is one of the oldest surgical procedures known to humanity. The purpose of trepanning has varied throughout history, from medical treatment to spiritual and ritualistic practices.

History

Trepanning is one of the earliest forms of surgery, with evidence dating back to the Neolithic period. Archaeological findings have uncovered trepanned skulls from various ancient cultures, including those in Europe, Africa, and South America. The reasons for trepanning in ancient times are not entirely clear, but it is believed to have been performed to treat head injuries, relieve pressure from intracranial hemorrhage, or as part of spiritual or ritualistic practices.

In ancient Peru, the Inca civilization practiced trepanning extensively, and many trepanned skulls have been found in archaeological sites. The procedure was performed with stone tools, and evidence suggests that many patients survived the operation, as indicated by signs of bone healing.

Procedure

The procedure of trepanning involves removing a section of the skull bone to expose the dura mater, the outer membrane of the brain. In ancient times, this was done using primitive tools such as flint or obsidian. The technique varied from scraping to drilling, depending on the tools available and the cultural context.

Dr. John Clarke performing a trepanning operation

In the Middle Ages, trepanning was used to treat conditions such as epilepsy, headaches, and mental disorders. The procedure was often performed by barber surgeons, who were the medical practitioners of the time. The tools used for trepanning evolved over the centuries, with the introduction of metal instruments and more refined techniques.

Cultural and Spiritual Significance

In addition to its medical applications, trepanning has held cultural and spiritual significance in various societies. Some cultures believed that trepanning could release evil spirits or cure mental illness. In certain shamanistic traditions, it was thought to enhance spiritual experiences or increase consciousness.

Detail from a painting by Hieronymus Bosch depicting trepanning

Modern Trepanning

Today, trepanning is rarely performed as a standalone procedure. However, the concept of creating an opening in the skull is still used in modern neurosurgery, particularly in procedures such as craniotomy and burr hole surgery. These procedures are performed to relieve pressure on the brain, remove hematomas, or access the brain for surgical interventions.

Instruments

The instruments used for trepanning have evolved significantly over time. In ancient times, simple tools made of stone or bone were used. By the 18th century, more sophisticated metal instruments were developed, including trephines with serrated edges for cutting through bone.

Trepanning instruments from 1750

Related Pages

• Craniotomy
• Neurosurgery
• History of surgery
• Prehistoric medicine