WEBVTT - How Did Trepanation Work?

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<v Speaker 1>Welcome to Brainstuff, a production of iHeartRadio. Hey Brainstuff. Lorn

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<v Speaker 1>Vogelbomb here. If you had to guess and hadn't looked

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<v Speaker 1>at this episode's title, what would you think the oldest

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

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<v Speaker 1>It might sound strange, but the surgery that humans have

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<v Speaker 1>been trying their hand at since Neolithic times is trep

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<v Speaker 1>nation or trepanning, the practice of drilling a hole in

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<v Speaker 1>the skull to treat health problems related to intracranial diseases,

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<v Speaker 1>to release pressure from a head injury, or to provide

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<v Speaker 1>an escape patch for evil spirits. And now you might

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<v Speaker 1>think that having a caveman cut a hole in your

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<v Speaker 1>head would be a bad idea, and that's understandable, but

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<v Speaker 1>it appears to have been a pretty popular treatment all

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<v Speaker 1>the same. For the article this episode is based on,

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<v Speaker 1>How Stuff Works. Spoke by email with doctor mcgell Thria,

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<v Speaker 1>a medical historian and retired professor of neurosurgery in the

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<v Speaker 1>Mercer University School of Medicine in Macon, Georgia. He said

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<v Speaker 1>more than fifteen hundred terpanned skulls have been found throughout

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<v Speaker 1>the globe, from Europe and Scandinavia to North Africa, and

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<v Speaker 1>from Russia and China to North and South America, particularly

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<v Speaker 1>in Peru. Perhaps the greatest concentrations are found in the

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<v Speaker 1>Eurasian land Mass and South America. So yeah, it was widespread.

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<v Speaker 1>If you take all the skulls that we have from

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<v Speaker 1>the Late Neolithic period, but that's about four thousand and

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<v Speaker 1>to twelve thousand years ago, collected from all over the globe,

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<v Speaker 1>between five and ten percent of them have a hole

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<v Speaker 1>in them that was made while the person was still alive.

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<v Speaker 1>These skulls most commonly belonged to men, but women and

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

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<v Speaker 1>and sometimes the owners of these skulls seemed to have

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<v Speaker 1>survived the procedure, at least for a while. The big

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

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<v Speaker 1>into the minds of primitive medical practitioners, a trepination seems

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<v Speaker 1>to have been a go to remedy for a variety

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<v Speaker 1>of maladies, perhaps by shamans in order to cure or

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<v Speaker 1>alter behaviors or mental illness. As some historians have suggested,

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<v Speaker 1>cranial surgery may have been performed on important members of

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<v Speaker 1>society or hunting groups in order to resuscitate them during

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<v Speaker 1>a grave illness or after sustaining a wound. The ancient

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<v Speaker 1>Roman medical practitioner Hippocrates and later Galen wrote about trepination

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<v Speaker 1>as a means of removing damage tissue and elevating depressed

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<v Speaker 1>skull fractures, but reasonably cautioned against penetrating the thick membrane

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<v Speaker 1>that encases the brain or the brain itself, as they

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<v Speaker 1>noted it resulted in serious complications such as infection, seizures,

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<v Speaker 1>and often death. Faria explained the Romans used instruments called

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<v Speaker 1>terrebri that resembled the more primitive toomeys of the Incas.

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<v Speaker 1>The terreb in turn, was the forerunner of the modern

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<v Speaker 1>burr whole manual drill. During the Middle Ages and the Renaissance,

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<v Speaker 1>trepination was performed not only for skull fractures, but also

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<v Speaker 1>for madness and epilepsy. A famous painting by Hieronymous Bush

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<v Speaker 1>depicts the extraction of the stone of madness. In the

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<v Speaker 1>European medical tradition, trepination was mostly practiced in the treatment

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<v Speaker 1>of epilepsy and mental health issues. Like mania and melancholy.

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<v Speaker 1>One surgical text from the twelve hundreds recommended trepination for epilepsy,

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<v Speaker 1>so that quote, the humors and air may go out

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<v Speaker 1>and evaporate, the humors being the leading medical theory of

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<v Speaker 1>the time and place, which stated that four bodily fluids

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<v Speaker 1>representing four elements or temperaments, ruled over our well being.

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<v Speaker 1>By the sixteen hundreds, trepination was beginning to be viewed

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<v Speaker 1>by the medical community as a last resort, though it

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<v Speaker 1>remained a go too for treating head wounds through the

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<v Speaker 1>eighteen hundreds. The procedure may have been the most popular

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<v Speaker 1>and successful in what's now Peru. Between the thirteen and

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<v Speaker 1>fifteen hundreds, used for treating skull fractures in the Inca Empire,

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<v Speaker 1>which outfitted soldiers primarily with bashing type weapons, the survival

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<v Speaker 1>rate for trepination reached over seventy percent. The history of

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<v Speaker 1>trepination is long and sometimes questionable, but it's important to

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<v Speaker 1>note that doctors do still practice it today for a

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

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<v Speaker 1>That's a term used by medical historians these days. Burr

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<v Speaker 1>holes are made in the skull in order to biopsy

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<v Speaker 1>brain tissue or diagnosed brain lesions, treat skull fractures, remove

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<v Speaker 1>brain tumors, or cliff cerebral aneurysms. But when the hole

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<v Speaker 1>is enlarged, it's called a craniotomy. Today's episode is based

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<v Speaker 1>on the article you need It Like a Hole in

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<v Speaker 1>the Head, the ancient medical art trepination on houstofworks dot

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<v Speaker 1>com written I J. Justslyn Shields. Brainstuff is production of

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<v Speaker 1>I Heart Radio in partnership withoustuffworks dot Com and is

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<v Speaker 1>produced by Tyler Klang. Four more podcasts from my heart Radio.

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