The Earliest Surgery (Was A Total Quack Job)

“Yes, I’ve been trepanned. That’s quite an interesting experience, especially for my brain surgeon, who saw my thoughts flying around in my brain.” —Keith Richards

In A Nutshell

Trepanning is a surgical operation in which a hole is made in the patient’s skull, usually with a drill, especially in modern surgeries, in order to relieve pressure or swelling on the brain. Evidence has been found to suggest it was conducted as early as 10,000 years ago, making it one of the earliest surgeries performed by humans. There are still those who believe it has benefits, like increasing blood flow, but there is no scientific evidence to back up their claims.

The Whole Bushel

Beginning as early as 10,000 years ago, humans have been performing the surgical operation known as trepanning. A hole is drilled or, in the case of the earliest surgeons, scraped into the patient’s skull, to relieve pressure or swelling on the brain. Originally thought to be a kind of superstition intended to release demons or spirits from someone’s head, recent evidence has suggested the early surgeons actually used trepanning to remove bits of bone or foreign objects which were usually the result of a head wound. The reason we know the early patients survived is the skulls found to have been trepanned also had evidence of healing, suggesting they could have lived for years after the operation.

The word “trepanation” comes from the Greek “trypanon,” which means “drill.” Early surgeons often used knives or rocks to cut or scrape a pre-planned hole into a patient’s head and, surprisingly, the rate of success was remarkably high. Using the skulls found by archaeologists, as many as 80 percent of the operations may have been successful. Ancient Peruvian surgeons are said to have been quite skilled, more so than their recent European counterparts, as evidenced by the fact some skulls showed varying degrees of healing on multiple trepanning holes. (One skull has even been found with five separate holes.)

Starting in the Middle Ages and lasting until the 19th century, European trepanning operations were not nearly as successful as those performed in early Mesoamerica. As many as 75 percent of patients who underwent surgery died during or shortly afterwards. However, it had nothing to do with the technical skill of the European doctors; it was simply infection, which was a huge issue until doctors realized it would be a good idea to wash their hands, clothing, and instruments.

Modern surgeons use trepanning to help deal with epidural and subdural hematomas, as well as provide the ability to observe intracranial pressure when performing other operations on the brain. However, some pseudoscientists suggest it has added benefits, such as increased blood flow. Many of the proponents of trepanning for non-medical uses have also performed self-trepanation, some using items such as a Black and Decker drill. However, no real scientific evidence has been found to support the claims made by the pseudoscientists.

Show Me The Proof

ABC: A History of Craniotomy
Cranial Surgery in Ancient Mesoamerica
Pre-Columbian Trephination