Trepanation 6500 BC – We Begin Cutting and Drilling

Evil Spirits or Epilepsy?

Neuroscientist and medical historian Stanley Finger writes: “The claim that a special role in higher functions may have been assigned to the brain before the rise of the great civilizations stems from the discovery of deliberately cut or compressed skulls at a number of Neolithic [New Stone Age] sites." In fact, trepanation — the act of making a hole in the human skull by cutting, drilling and/or scraping — was once quite common. In prehistoric times, pieces of skull bone removed from patients may have been worn as a charm to ward off evil spirits. The reasons for this practice are unclear. Perhaps ancient people were trying to relieve severe headaches and epilepsy or to allow “evil spirits” to escape from the head. It is also unclear whether those undergoing the practice received anesthesia with coca leaves or alcohol. Interestingly, in a French burial site dating to 6500 BC, about a third of 120 prehistoric skulls had trepanation holes. Many examples of trepanned skulls show healing of the surrounding bone, suggesting that individuals often survived this gruesome procedure. In the Middle Ages and later, people underwent trepanation to relieve seizures and treat head injuries such as skull fractures.

Trepanation was practiced throughout the world, including Africa, pre-Columbian Mesoamerica and many parts of Europe. In Peru alone, more than 10,000 trepanned skulls have been unearthed. In Europe, holes in skulls range in diameter from a few centimeters to almost half the skull.

Abu al-Qasim al-Zahrawi (Albucasis) (936-1013)

Abu al-Qasim, one of the greatest medieval surgeons of Islam, used a drill in such procedures. He wrote, “Even if the operator is the most ignorant and timid of people, he cuts the bone with confident knowledge that nothing will happen to the membrane of the brain; yes, even if he is sleepy. However, if the dura (the outer membrane of the brain) turns black, you may know that he is doomed to die."

In recent years, some unusual individuals have performed trepanation on themselves because they believe that the procedure facilitates a path to enlightenment.

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