Trepanning is a process whereby a hole is drilled in the skull, and, with evidence going back to prehistoric times, it is one of the oldest surgical practices in history. Do they still do trepanning? Trepanation is still used today, often to treat bleeding on the brain.
What is the meaning of trepanation?
Trepanning, also known as trepanation, trephination, trephining or making a burr hole (the verb trepan derives from Old French from Medieval Latin trepanum from Greek trúpanon, literally "borer, auger") is a surgical intervention in which a hole is drilled or scraped into the human skull.
What is trepanning and how does it work?
Trepanning refers to the practice of making a hole in a patient's skull. It was and still is used to treat a wide variety of medical conditions, particularly as a way to release fluid buildup under the skull. Historically, it was also used to treat mental illnesses and for various spiritual reasons.
What is the origin of the word Trepan?
In another version of the etymology, a quite different triangular instrument for boring a hole in the skull was invented in 1639 by John Woodall, a London surgeon, who also called his instrument a tres fines, which became trefina and then trephine and, eventually, a synonym for trepan.
What does trephine mean in medical terms?
To bore or otherwise make a hole in (the skull), as in certain prehistoric cultures or in surgery using a trephine. trep′a·na′tion (trĕp′ə-nā′shən) n. The American Heritage® Medical Dictionary Copyright © 2007, 2004 by Houghton Mifflin Company. Published by Houghton Mifflin Company. All rights reserved. 1.
What is trepanning used to treat?
Trepanation is a treatment used for epidural and subdural hematomas, and surgical access for certain other neurosurgical procedures, such as intracranial pressure monitoring. Modern surgeons generally use the term craniotomy for this procedure.
Is trepanning painful?
With zero anesthesia, this made for a particularly painful, even life-threatening, procedure. However, the survival rate of these operations was surprisingly high. Even up to the modern day, trepanning has its strong adherents.
What is trepanation and why was it performed?
According to the French physician Paul Broca, ancient physicians were quite familiar with trepanation in which a hole was made in the skull by cutting or drilling it. They did so to alleviate pressure on the brain following an injury to the head, or to release evil spirits from the heads of mentally ill people (4).
What is medical Trephination?
Trepanation. Trephination is the surgical procedure in which a hole is created in the skull by the removal of circular piece of bone, while a trepanation is the opening created by this procedure (Stone and Miles, 1990).
Do people survive trepanning?
Many times, the person would survive and heal after the surgery. Researchers have found scarring from trepanation on skeletons, but the holes and injury to the skull had healed, according to research published in the American Journal of Physical Anthropology.
Is trepanning still used today?
Though trepanning is still used today to treat certain cases of traumatic brain injury, some have looked to this surgery for other potential benefits as well.
What is the hole in the skull called?
On the bottom of your skull, there is a distinctive hole. The technical name for the opening is the foramen magnum – the “great hole” that the spinal cord and other critical soft tissues run through.
When was trepanning used?
From the Renaissance until the beginning of the 19th century trephining was widely advocated and practiced for the treatment of head wounds. The most common use was in the treatment of depressed fractures and penetrating head wounds.
What is trepanning operation?
Trepanning is a technique used for drilling larger hole diameters where machine power is limited as it is not as power consuming as conventional drilling where the entire hole is converted into chips. The trepanning tool does not machine the whole diameter, only a ring at the periphery.
Why was trepanation used in psychology?
This was the first known surgical practice and evidence of it has been found as early as the Neolithic period (10,000 BC-3,000 BC). It is theorized that early cultures used trephination to release spirits from a person or as a cure for convulsions and headaches.
When did trepanning stop?
From the Renaissance until the beginning of the 19th century trephining was widely advocated and practiced for the treatment of head wounds.
Why did they drill holes in skulls?
This procedure — also known as “trepanning” or “trephination” — requires drilling a hole into the skull using a sharp instrument. Nowadays, doctors will sometimes perform a craniotomy — a procedure in which they remove part of the skull to allow access to the brain — to perform brain surgery.
Why do I have a hole in my skull?
While it's common for the shape of people's skulls to vary, a new dent or irregularity in your skull can occasionally indicate a serious health condition. Dents in your skull can be caused by trauma, cancer, bone diseases, and other conditions.
Did they used to drill holes in skulls?
Evidence of holes being drilled into the skull for medical purposes, or “trepanation,” has been traced back to the Neolithic period — about 4000 B.C. — and it might have been practiced even earlier.
What is trepanning used for?
Today, trepanning is usually used to treat subdural hematomas. Trepanning can also be used to gain access to the brain for certain kinds of scans a...
What is trepanning and why was it done?
Trepanning refers to the practice of making a hole in a patient's skull. It was and still is used to treat a wide variety of medical conditions, pa...
Is trepanning still used today?
Trepanation is still used today. It is used as part of brain surgery on humans and as part of veterinary medicine. Some fringe groups also practice...
Can someone survive trepanation?
Yes, it is possible to survive trepanation. The practice did result in death fairly often throughout history, but many skulls show evidence of heal...
What is a trepan?
Instrument used to trepan” [translation], “ trepanar ” (to trepan) is defined as “Med. To pierce the skull or other bone for the purpose of healing or diagnos is” [translation] and “ trepanación” (trepanation) as “Med. Action and effect of trepanning” [translation]. The medical etymological dictionary of the Universidad de Salamanca traces the origin of “trepan” to Greek: “Language of origin: Gr. In Gr. It changed from ‘drill’ to ‘surgical instrument to drill the skull’. In Hippocrates, 5th c. BC, it moved on to mediaeval Latin ‘trepanum’ and it appears in Spanish and mediaeval French.”7 [translation]. Thus, from a semantic and etymological point of view, cranial trepanation should be considered a bone perforation of the skull for the purposes of healing or diagnosis, but the latter cannot be demonstrated in the cranial openings of primitive cultures. On the other hand, the current neurosurgical meaning of “trepan” refers to a small hole made in the skull with a trepan or drill, but it is a fact that very large cranial openings were also made in primitive cultures that cannot be called craniotomies. In spite of all of this and taking this into consideration, in this study we will use the term “trepan” with the broad meaning of cranial opening of variable size and “trepanation” as the technical action and the consequence of trepanning, without any connotation regarding the size, techniques or intentions that led to carrying out such action ( Fig. 1 ).
What is the evidence for trepanning?
Fossil evidence of trepanning suggests that man has used high threshold physical techniques in the treatment of disease since Neolithic times (Martin 2000, Parry 1936 ). Bone etchings from China dating back to 1600 bc are said to provide some of the earliest evidence of acupuncture techniques. Older still are the sharpened stones called Bian shi, although it is questioned whether or not these were actually instruments of acupuncture ( Bai & Baron 2001 ). Harder evidence – in a softer format – comes from the silk scrolls found in Han Tomb No. 3 (dated to 168 bc) at Mawangdui, Changsha, China in the early 1970s. These manuscripts describe an early meridian system with 11 rather than 12 paired meridians and the use of moxibustion, which is a treatment involving the application of heat by burning the herb Artemisia vulgaris. The Pericardium meridian is missing ( Chen 1997) from these early manuscripts. There is also an emphasis on information derived from tactile examination of the living body ( Hsu 2005) rather than from dissection post-mortem. However, there is no description of acupuncture needling in these manuscripts ( Bai & Baron 2001 ). The discovery of Ötzi, the Tyrolean iceman frozen from 3200 BC, suggests the use of a therapeutic needling technique, with a needle made from bone, which may have developed in Europe ( Dorfer et al. 1999 ). It seems clear that acupuncture-like therapies have developed independently in different civilizations around the world and this is probably due to late evolutionary features in the mammalian nervous system, combined with intelligence, and the consequent use of tools in humans.
What was the modality of skull trepanning?
The modality of trepanning had been practiced since prehistoric times. It was seen as a maneuver to let the unwanted spirits or vapors out of the head33 ; however, in the absence of a standardized technique and physician expertise, the prognosis of patients undergoing trepanning was dismal. It fell out of favor as less-invasive and painful options presented. Surgeons shifted toward a more conservative management routine.
How to tell if you have a compressed brain?
A great variety of symptoms … indicating a compressed state of the brain [among which] … the most frequent, as well as the most remarkable, are the following: Giddiness; dimness of sight; stupefaction; loss of voluntary motion; vomiting; an apoplectic stertor in the breathing; convulsive tremors in different muscles; a dilated state of the pupils, even when the eyes are exposed to a clear light; paralysis of different parts, especially of the side of the body opposite to the injured part of the head; involuntary evacuation of the urine and faeces; an oppressed, and in many case an irregular pulse. (volume 3, chapter 10, section 3) 70
What did Pott argue about trephine?
In the ongoing argument over whether to trephine, Pott was a strong proponent of intervention ( Figs. 1.29 and 1.30 ). In his classic work on head injury, 67 Pott appreciated that symptoms of head injury were the result of injury of the brain and not of the skull. He made an attempt to differentiate between “compression” and “concussion” injury of the brain:
Did ancient Egypt have trepanation?
Some authors state that trepanation was not frequently performed in ancient Egypt. Similarly, the Edwin Smith Papyrus (700 BCE), a copy of a much older papyrus describing surgical techniques, does not mention this type of procedure. Elliot Smith, a professor in Cairo, studied some 15 000 Egyptian skulls and found no traces of trepanation. 6,26,28–31
Why do people practice trepanation?
Occasionally, people will practice trepanation on themselves for various reasons. A rare few have the procedure done to "become enlightened" or to aid in their mental health in some way. For example, there is the case of Peter Halvorson. In the 1970s, he drilled a hole in his own head in an attempt to cure his own depression.
Why do people trepanate?
In ancient times, trepanation was thought to be a treatment for various ailments, such as head injuries. It may also have been used to treat pain. Some scientists also think that the practice was used to pull spirits from the body in rituals . Many times, the person would survive and heal after the surgery.
How long has trepanation been around?
Raphael Davis, a neurosurgeon and co-director of the Neurosciences Institute at Stony Brook University. "It's been done for about 5,000 years, making one of the oldest medical procedures known to the human race," Davis told Live Science.
What are some examples of unsuccessful trepanation?
One example of an unsuccessful procedure is a medieval woman who died while pregnant.
When did trepanation first appear?
In the south-central Andean highlands, trepanations first appeared around A.D. 200 to 600, according to the University of California. The treatment was largely practiced until the early 16th century. An article in the journal World Neurosurgery reported that trepanation was widely practiced throughout China thousands of years ago.
Where is the trepanation skull?
What Is Trepanation? This skull, excavated from a tomb in Jericho, Israel, in 1958, shows four separate holes made by the ancient surgical process of trephination.
What did Paul McCartney say about trepanning?
"Trepan" comes from the Greek word trypanon, which, fittingly, means "a borer."
What is a trepanning hole?
This procedure — also known as “trepanning” or “trephination” — requires drilling a hole into the skull using a sharp instrument.
What is the purpose of early trepanation?
The purpose of early trepanation remains unclear.
What is the procedure that removes the skull to allow access to the brain?
Nowadays, doctors will sometimes perform a craniotomy — a procedure in which they remove part of the skull to allow access to the brain — to perform brain surgery. However, unlike trepanation — which creates a permanent hole in the skull — the modern method requires replacing the bone segment that the surgeon removes.
Why is trepanation recommended in places in man?
One of the texts, Places in Man, recommends trepanation for the prevention of complications related to skull fractures:
Why is the 18th century called the Trepan century?
Medical historians refer to the 18th century as the “ trepan century .” This is because at that time, European surgeons became particularly interested in the possible uses of this practice.
When did trepanation begin?
The early origins of trepanation. The oldest discovered skulls showing evidence of trepanation date back to the Mesolithic period — around 6000 B.C. They emerged in North Africa, Ukraine, and Portugal. Share on Pinterest. Trepanation seems to have begun in the Stone Age. Image credit: Wellcome Collection.
Which European group performed trepanation after death?
For example, Hungarian populations performed ritual trepanation after death, but it remains unclear why other European groups resorted to carrying out trepanation while the person was still alive.
What is a trephination?
Trephination (known also as trepanning, trepanation, trephining, or making a burr hole), is a surgical procedure, which involves the drilling of a hole in the skull of a living person. Trephination is considered to be one of the oldest surgical procedures in the world, and evidence for this practice is found as early as the Neolithic period.
Why Was Trephination Performed?
The Greek physician Hippocrates deals extensively with head injuries in his On Wounds in the Head . In this work, five types of head wounds are described, and trephination is recommended for all but one of them. The objective of trephination was to allow blood to drain from the skull.
Why did trephination continue in Europe?
Trephination continued in Europe during the Middle Ages, thanks to the immense influence of Hippocrates and Galen on the practice of medicine in the West.
How many trephined skulls are there?
According to a 2015 article by Miguel A. Faria in Surgical Neurology International , more than 1500 trephined skulls have been found at Neolithic sites around the world, including Europe, the Americas, Russia, and China.
Why did Galen use trephination?
Therefore, trephination was a means to allow the blood from the injured part of the head to flow out before it turned bad. Later on, during the time of Galen, trephination was a standard procedure not only for draining blood, but also for relieving pressure, and to remove skull fragments after a traumatic accident.
Where are trephined skulls found?
A number of trephined skulls from the Graeco-Roman period, for instance, have been found in the area of modern-day Israel. At the site of Acco, for instance, a trephined skull from the Hellenistic-Roman period was unearthed, whilst another four were discovered in a Roman cemetery in the Jordan Valley near Jericho.
Who recommended trephination on animals?
Incidentally, the physicians of Galen’s time were not the only ones who practiced trephination on animals. For instance, a trephined cow skull from Champ-Durant, France, has been dated to the Neolithic period.
Where is trephining found?
The earliest detailed account of trephining is in the Hippocratic corpus, the first large body of Western scientific or medical writing that has survived. Although there is no question that there was a famous physician called Hippocrates in the fifth century BCE, it is not clear which of the Hippocratic works were written by him. The most extensive discussion of head injuries and the use of trephining in their treatment is in the Hippocratic work On Wounds in the Head.
Why is trephining not discussed in the Hippocratic treatise?
The Hippocratic doctors believed that stagnant blood (like stagnant water) was bad. It could decay and turn into pus.
When were trephined skulls discovered?
Trephined skulls have been discovered in widespread locations in every part of the world, in sites dating from the late Paleolithic to this century.
Who was the trepanator in China?
The possibility that trepanation was practiced in ancient China is suggested by the following story about Cao Cao and Hua Tua, from a historical novel attributed to Luo Guanzhong, written in the Ming dynasty (1368–1644) and set in 168–280 at the end of the Later Han dynasty. Cao Cao was commander of the Han forces and posthumously Emperor of the Wei dynasty, and Hua Tuo was (and still is) a famous physician of the time.
Is trepanning dangerous?
Doctors have warned about the dangers of trepanning after the launch of several websites promoting the “do it yourself ” surgery and the case of a Gloucestershire woman who drilled a 2 cm diameter hole in her skull. Concern has been expressed about the growing interest in trepanning for several conditions, including depression and chronic fatigue syndrome. Concern is also growing about the increasing promotion of trepanning, including videos, T-shirts, and a virtual trepanning shopping mall on the internet.
Is trephining a therapeutic procedure?
In modern neurosurgical practice, trephining is still an important procedure but it is no longer viewed as therapeutic in itself. It may be used for exploratory diagnosis, for relieving intracerebral pressure (as from an epidural or subdural hematoma), for debridement of a penetrating wound, and to gain access to the dura and thence the brain itself (for example, to provide a port through which a stereotactic probe can be introduced into the brain.)