Saturday, July 21, 2018

Hole(s) in the Head: A Discussion of Trephanation


Figure 1: The Chios Skull (Tsermoulas et al. 2014)



We typically characterize early humans as being simple, primitive, and less than intelligent creatures who were concerned with just surviving, but as we learn more and more about our human ancestors we begin to realize that they were creative, resourceful, and incredibly gifted.  From creating some of the world's earliest artworks to skillfully manipulating the dead and everything in between we, as humans, have been complex for several millennia.  Today's blog post will further demonstrate our ingenuity by discussing a long standing medical procedure that has been practiced since at least the Neolithic Period and continues on today: trephanation.

Trephination, also referred to as trepanation, is a surgical procedure that involves the removal of part of the skull through drilling, cutting, boring, or scraping, leading to the exposure of the brain, meninges, and blood vessels without damaging them (Figure 1).  This remains one of the earliest neurosurgical methods practiced, dating back to 10,000 years ago in both Europe and South America.  It was practiced widely throughout the world, with evidence being found among groups in the Middle East, Asia, and Central America, as well. 

Trephination was practiced for two primary purposes: medical or supernatural.  Medical practitioners and religious officiants would perform this procedure either to relieve an individual of pain related to cranial trauma, migraines, headaches, or other identified medical ailment or to rid an individual of demonic possession or attack if the person was exhibiting symptoms related to such matters (e.g. seizures, mental illness, etc.)  Pieces of the skull would be carefully removed during the procedure, which was practiced on adults and children regardless of sex.  This procedure was so precisely done that most individuals survived (as evidenced by healing at the incision site) and often underwent additional procedures. 

Archaeological and bioarchaeological evidence has informed scholars and modern medical doctors of the practice.  Evidence of its practice has been found on cave paintings, ceramic vessels, as well as imprinted on the bodies themselves.  The ancient Greek scholar Hippocrates chronicled the practice in his medical texts.  Because of the prolific practice of this surgical technique and its success in assisting people in surviving traumatic injuries this practice continues today, although in strictly medical capacities for the most part (although there is evidence of some individuals practicing self-trepanning for mystical purposes).  The carrying on of this practice over the centuries may have led to a refinement of the technique.  Furthermore, trephanation demonstrates the importance of not doubting the ability of any human beings, particularly those we often overlook as less capable.  Our human ancestors overcame a great deal of challenges in spite of limited options available to them, and we continue to face and beat the odds even today.     

References


Chew, L. (2000). Trephination. Retrieved from http://home.wlu.edu/~lubint/touchstone/2000/Trephination-Chew.htm


Irving, J. (2013, May 01). Trephination. Ancient History Encyclopedia. Retrieved from https://www.ancient.eu/Trephination/
 

Moghaddam, N., Mailler-Burch, S., Kara, L., Kanz, F., Jackowski, C., & Losch, S. (2015). Survival after trepanation—Early cranial surgery from Late Iron Age Switzerland. International Journal of Paleopathology, 56-65.

Tsermoulas G, Aidonis A, Flint G.  2014.  The skull of Chios: trepanation in Hippocratic medicine.  J Neurosurg 121(2):328-32



 
 

10 comments:

Taylor Morris said...

I think this is very interesting because I have never heard of the Trephination procedure. Our ancestors did in fact overcome a lot despite many challenges. Looking at them as less capable is not right. They did many things that we couldn't even imagine to survive.

Unknown said...

Reading this blog leaves me with a few questions. What part of the skull is being removed that makes it possible for one to still love ? What made people because this procedure would stop any supernatural acts? Just seems weird to me , the procedure in general seems as though it’s painful and should be banned. However , to know medical physicians use this practice still today in astounding , even to know that they use it for traumatic relief in the skull is helpful but still seems very painful and very unbearable to deal with . The skull has always seemed to be the most prized possession of the body (as well as the heart) and seems that most procedures cannot help much without the risk of death. Interesting blog.
-Jazlyn Logan

Malacia Lowe said...

I've never heard of Trephination procedure until reading this post. I obtained new information about early procedures. Did people live after this particular procedure? Procedure seems very painful.

-Malacia Lowe

Unknown said...

I have never heard of trephination before reading this blog post. I found it to be very interesting because of how precisely this procedure was done and that most people that had the procedure survived. I also thought it was interesting that they did this procedure on people that had medical problems such as, headaches and migraines and they also had this procedure on people that were believed to have demonic possession.

Anonymous said...

This is my first time hearing of Trephination. Also, why is this even still being used today? and what part of the skull could they possibly use and still be able to love?
-Kyla Thomas

Anonymous said...

I know ive never heard of trephination but the blog was interesting. I think the thing that stuck out the most to me was that people who had "demonic" possession.Im glad I have new knowledge of this procedure.
-Jasmine Busby

Unknown said...

I have heard about this before, but I can't pn-point where, maybe a tv show. I wonder how one could survive while going through this although its interesting why is this still going on?

Lavonza marshall

Dr. Christine Elisabeth Boston said...

Lavonza, the reason why trephanation continues is that it has a medical purpose, specifically in relieving pressure on the brain when it becomes swollen. Therefore trephanation continues under appropriate medical supervision (or at least should).

Shawn Austin said...

Trephination is something I never heard of until this blog post but its a post that makes me think extensively. It says the process was done for supernatural purposes which makes me wonder if their any high profile case involving the process when it comes to the supernatural.

Anonymous said...

i found it surprising how many people survived and then lived decades after undergoing the procedure in a time without antibiotics

Petra Andrei