Like a hole in the head: An illustrated history of trepanation

Neurophilosopher has written an absolutely fantastic post on the history of trepanation – the surgical procedure that has been carried out since prehistoric times and involves drilling a hole in the head.

Neurophilosopher always has great articles but this is also wonderfully illustrated and has all the gory details of this fascinating procedure.

The trepanned skulls found at prehistoric European sites contained round holes, which varied in size from just a few centimetres in diameter to nearly half of the skull. They are most commonly found in the parietal bone, and also in the occipital and frontal bones, but rarely in the temporal bone. In the earliest European skulls, the holes were made by scraping the bone away with sharp stones such as flint or obsidian; later, primitive drilling tools were used to drill small holes arranged in circles, after which the piece of bone inside the circle was removed. The late Medieval period saw the introduction of mechanical drilling and sawing instruments, whose sophistication would continue to increase for several hundred years.

The article takes you through the prehistoric origns of the procedure, to how it developed around the world, to its modern uses for surgery and recreation (yes, recreation!).

The picture at the top is from a trepanned skull from the Hunterian museum in London that also showed signs of neurosyphilis infection. There’s more about it in a previous post.

I also found a good example of a trepanned skull in the National Museum of Ireland but unfortunately they don’t allow pictures and don’t have images of it available.

However, this article has an interesting snippet about the various examples of the procedure discovered in the country:

From Ireland several interesting examples are available. A trepanned skull of a thirteen-year-old child, probably early Christian, was recovered from Collierstown in Co. Meath (Martin, 1935). Two further trepanations each of late Mediaeval date, one from Ballinlough (Co. Laois) and the other from Maganey Lower (Co. Kildare), were found during recent excavations.

A fourth specimen was discovered in a stone-lined grave at the Abbey of Nendrum on Mahee Island in Strangford Lough (Martin). The abbey was destroyed in 974 A.D. by fire. It is highly likely that in those days “major surgery” was performed in monastic institutions (Fleetwood, 1951). Legend has it that Cennfaeladh, whose skull was fractured by a blow from a sword during the battle of Moyrath in Co. Down (637 A.D. ), was operated upon by St. Bricin, the Abbot of Tuaim Drecain, an accomplished surgeon and scholar (Fleetwood).

And this page has an image of a 7th century gargoyle-esque carving of St Bricin with trepanning tools in one hand and a skull in the other.

Apparently, the treatment worked so well that Cennfaelad, an Irish chieftan, recovered his intellect and improved his memory so that on his recovery he became a great scholar, whose name ‘Kennfaela the Learned’ is known in Irish literature to this day.

There’s more about this case, and about trepanning in Ireland, on this page, and, if you’ve got a subscription to JSTOR, which I don’t have unfortunately, there’s an academic article here. Do let me know if you can get hold of a copy!

Link to Neurophilospher on ‘An Illustrated History of Trepanation’.

3 thoughts on “Like a hole in the head: An illustrated history of trepanation”

  1. The trepanned skulls found at prehistoric European sites contained round holes, which varied in size from just a few centimetres in diameter to nearly half of the skull

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