April Book Review by Adriana Suarez
Dating back to Neolithic times, trephination, also known as trepanation, is one of the oldest surgical procedures in our history. This prehistoric procedure consisted of drilling a hole, or holes, into the skull with a hand drill known as a trephine. The purpose of the holes? Well, there are several theories as to why trephining was practiced during this time.
Source: National Library of Medicine
One theory proposes that trephining was used to release and ward off evil spirits by drilling a hole into the skull and keeping the piece that was removed as a charm. Other theories suggest that it could have been a religious ritual or a therapeutic practice. Evidence does suggest, however, that trephining was sometimes used to alleviate head wounds and injuries by releasing pressure after a blow to the head. Whatever the reason for trephination, evidence from skulls found in Neolithic excavated sites show that these holes were intentionally made; there was a purpose for the holes.
Evidence from other excavated sites shows that trephination was not just a Neolithic practice. Trephined skulls found in different parts of the world indicate that this practice spans time and culture. According to research, between 3000 and 2000 B.C. trephination was relatively common in South America, Western Europe, and Asia. In pre-Columbian Mesoamerica, trephined skulls were found largely in the remains of Andean civilizations. Writings from ancient Greece and ancient China suggest that trephination was practiced to “cure” bad blood and the humors. During the Classical and Renaissance periods of Europe, trephination was widely practiced, most commonly for the treatment of head wounds.
Source: National Library of Medicine
In more recent time, trephining became popular outside of the medical field among a small group of people. Groups like The International Trepanation Advocacy Group promoted trephining as a mean of enhancing one’s consciousness and mental health. The founder of the ITAG trephined himself and claimed trephination helped his metabolism and cured his depression. Unfortunately for him, the self-trephination movement did not garner much traction.
Today, traces of trephining are mostly found in the operating room. Doctors trephine skulls for a variety of neurosurgical procedures such as for hematomas and craniotomies. These procedures require drilling holes into the skull usually to remove pressure from the brain or to open the skull for access to the brain. Occasionally, fingernails or toenails may be trephined to relieve pressure and pain from blood buildup. Additionally, eyes are sometimes trephined during eye surgery. In all these instances, a hole is not made into the skull but into the nail or eye. Ouch!
As scary as it may sound, trephination has a high survival rate. Back in Neolithic times, the rate was much lower, under 50%, but over time that rate has increased. In pre-modern Europe, the survival rate increased to almost 80%! Today, we are fortunate that advanced technology and equipment allow neurosurgeons to trephine patients with much more ease and precision.
The medical field has certainly changed since the first practices of trephination, but trephination still lives on.
If you are interested in learning more about medical history, come visit the library and view our new exhibit on the history of modern surgery, where a trephine is on display! The library also has several titles on the history of medicine that are available for you to check out.
Titles include:
- Empire of the Scalpel: The History of Surgery by Ira Rutkow
- History of Medicine: A Scandalously Short Introduction by Jacalyn Duffin
- Medical Firsts: Innovations and Milestones That Changed the World by Tish Davidson
- If It Sounds Like a Quack: A Journey to the Fringes of American Medicine by Matthew Hongoltz-Hetling
- The Doctor Was a Woman: Stories of the First Female Physician on the Frontier Chris Enss
- Women In White Coats: How the First Women Doctors Changed the World of Medicine by Olivia Campbell
- The Doctors Blackwell: How Two Pioneering Sisters brought Medicine to Women and Women to Medicine by Janice P. Nimura
