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Speaker 1: Welcome to Brainstuff, a production of iHeartRadio. Hey Brainstuff. Lorn

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Speaker 1: Vogelbomb here. If you had to guess and hadn't looked

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Speaker 1: at this episode's title, what would you think the oldest

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Speaker 1: known surgical procedure might be? Maybe a cesarean section, amputation, appendectomy.

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Speaker 1: It might sound strange, but the surgery that humans have

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Speaker 1: been trying their hand at since Neolithic times is trep

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Speaker 1: nation or trepanning, the practice of drilling a hole in

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Speaker 1: the skull to treat health problems related to intracranial diseases,

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Speaker 1: to release pressure from a head injury, or to provide

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Speaker 1: an escape patch for evil spirits. And now you might

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Speaker 1: think that having a caveman cut a hole in your

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Speaker 1: head would be a bad idea, and that's understandable, but

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Speaker 1: it appears to have been a pretty popular treatment all

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Speaker 1: the same. For the article this episode is based on,

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Speaker 1: How Stuff Works. Spoke by email with doctor mcgell Thria,

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Speaker 1: a medical historian and retired professor of neurosurgery in the

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Speaker 1: Mercer University School of Medicine in Macon, Georgia. He said

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Speaker 1: more than fifteen hundred terpanned skulls have been found throughout

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Speaker 1: the globe, from Europe and Scandinavia to North Africa, and

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Speaker 1: from Russia and China to North and South America, particularly

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Speaker 1: in Peru. Perhaps the greatest concentrations are found in the

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Speaker 1: Eurasian land Mass and South America. So yeah, it was widespread.

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Speaker 1: If you take all the skulls that we have from

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Speaker 1: the Late Neolithic period, but that's about four thousand and

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Speaker 1: to twelve thousand years ago, collected from all over the globe,

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Speaker 1: between five and ten percent of them have a hole

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Speaker 1: in them that was made while the person was still alive.

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Speaker 1: These skulls most commonly belonged to men, but women and

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Speaker 1: children weren't excluded from the procedure. The holes were definitely purposeful,

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Speaker 1: and sometimes the owners of these skulls seemed to have

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Speaker 1: survived the procedure, at least for a while. The big

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Speaker 1: question is why. According to Farrea, although we can't see

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Speaker 1: into the minds of primitive medical practitioners, a trepination seems

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Speaker 1: to have been a go to remedy for a variety

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Speaker 1: of maladies, perhaps by shamans in order to cure or

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Speaker 1: alter behaviors or mental illness. As some historians have suggested,

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Speaker 1: cranial surgery may have been performed on important members of

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Speaker 1: society or hunting groups in order to resuscitate them during

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Speaker 1: a grave illness or after sustaining a wound. The ancient

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Speaker 1: Roman medical practitioner Hippocrates and later Galen wrote about trepination

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Speaker 1: as a means of removing damage tissue and elevating depressed

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Speaker 1: skull fractures, but reasonably cautioned against penetrating the thick membrane

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Speaker 1: that encases the brain or the brain itself, as they

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Speaker 1: noted it resulted in serious complications such as infection, seizures,

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Speaker 1: and often death. Faria explained the Romans used instruments called

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Speaker 1: terrebri that resembled the more primitive toomeys of the Incas.

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Speaker 1: The terreb in turn, was the forerunner of the modern

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Speaker 1: burr whole manual drill. During the Middle Ages and the Renaissance,

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Speaker 1: trepination was performed not only for skull fractures, but also

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Speaker 1: for madness and epilepsy. A famous painting by Hieronymous Bush

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Speaker 1: depicts the extraction of the stone of madness. In the

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Speaker 1: European medical tradition, trepination was mostly practiced in the treatment

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Speaker 1: of epilepsy and mental health issues. Like mania and melancholy.

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Speaker 1: One surgical text from the twelve hundreds recommended trepination for epilepsy,

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Speaker 1: so that quote, the humors and air may go out

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Speaker 1: and evaporate, the humors being the leading medical theory of

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Speaker 1: the time and place, which stated that four bodily fluids

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Speaker 1: representing four elements or temperaments, ruled over our well being.

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Speaker 1: By the sixteen hundreds, trepination was beginning to be viewed

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Speaker 1: by the medical community as a last resort, though it

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Speaker 1: remained a go too for treating head wounds through the

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Speaker 1: eighteen hundreds. The procedure may have been the most popular

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Speaker 1: and successful in what's now Peru. Between the thirteen and

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Speaker 1: fifteen hundreds, used for treating skull fractures in the Inca Empire,

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Speaker 1: which outfitted soldiers primarily with bashing type weapons, the survival

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Speaker 1: rate for trepination reached over seventy percent. The history of

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Speaker 1: trepination is long and sometimes questionable, but it's important to

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Speaker 1: note that doctors do still practice it today for a

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Speaker 1: variety of different elements, though they don't call it trepination anymore.

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Speaker 1: That's a term used by medical historians these days. Burr

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Speaker 1: holes are made in the skull in order to biopsy

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Speaker 1: brain tissue or diagnosed brain lesions, treat skull fractures, remove

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Speaker 1: brain tumors, or cliff cerebral aneurysms. But when the hole

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Speaker 1: is enlarged, it's called a craniotomy. Today's episode is based

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Speaker 1: on the article you need It Like a Hole in

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Speaker 1: the Head, the ancient medical art trepination on houstofworks dot

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Speaker 1: com written I J. Justslyn Shields. Brainstuff is production of

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Speaker 1: I Heart Radio in partnership withoustuffworks dot Com and is

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Speaker 1: produced by Tyler Klang. Four more podcasts from my heart Radio.

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