Holes in the Head the Art and Archaeology of Trepanation in Ancient Peru
Neurosurgery as we know it today simply started to develop in the late 19th century. Even so, interventions that required drilling a hole in the skull, at present known as "trepanation," are much older. When did humans first perform these procedures, and why?
Epitome credit: Wellcome Collection
The term "trepanation" derives from the ancient Greek discussion "trypanon," which means "borer" or "auger" (drill).
Although in that location are some subtle differences in how people performed trepanation throughout the ages and in different parts of the world, the basics remain unchanged.
This process — also known every bit "trepanning" or "trephination" — requires drilling a hole into the skull using a sharp musical instrument.
Nowadays, doctors volition 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, dissimilar trepanation — which creates a permanent hole in the skull — the modernistic method requires replacing the bone segment that the surgeon removes.
It is also important to annotation that surgeons will merely perform a craniotomy for exceptional reasons, such as to remove a brain tumor or treat an aneurysm.
Why did our ancestors observe it necessary to pierce the skull, and when does trepanation date dorsum to? Researchers take been investigating these questions for years, and in this feature, we explain what they constitute.
The oldest discovered skulls showing show of trepanation date dorsum to the Mesolithic catamenia — around 6000 B.C. They emerged in North Africa, Ukraine, and Portugal.
Image credit: Wellcome Collection
According to Éric Crubézy — of the université Paul-Sabatie in Toulouse, France — and colleagues, "The oldest examples of trephination (Mesolithic) are small in size, [and] they appear in populations of hunter-gatherers distant from one another in time and in infinite."
Other examples of aboriginal trepanation — in which the skulls appear to bear the marks of a less rudimentary trepanation technique — come from the Neolithic period, from locations such every bit the Czech Republic, France, and some regions of South America.
However, trepanation did not die with our Rock Age forebears. It continued to evolve into modern times.
Both the ancient Romans and the aboriginal Greeks practiced trepanation in some form. This received attention from Hippocrates (c. 460 B.C.–c. 370 B.C.) and Galen (c. 130 A.D.–c. 210 A.D.), both forefathers of mod medicine.
At that place is besides evidence to suggest that trepanation continued to occur in parts of medieval Europe, such as Spain. However, co-ordinate to the authors of a 2011 case study, "medieval surgical trepanations are much less mutual and just a few cases are known for the whole of Europe."
Even so, in South America and Peru, the process appeared to accomplish a high in popularity and precision betwixt the 14th and 16th centuries A.D.
When it comes to the motivation behind the ancient practices of trepanation, there are more than questions than answers — particularly because dissimilar populations took this extreme measure for different reasons.
Image credit: Wellcome Drove
Fernando Ramires Rozzi and Alain Froment suggest that in the Neolithic era, people may take done it
The ii contend that our early ancestors may have practiced their skills on the skulls of animals, citing the example of a boar skull and a cow skull that bear the marks of trepanation.
Taking the case of the ancient cow'due south skull, Rozzi and Froment even consider the possibilty that trepanation may accept taken place when the animal was still alive — as a veterinarian intervention.
"[I]f cranial surgery observed on the moo-cow was performed in order to salve the animal, Champ-Durant [where archeologists found the skull] provides the primeval evidence of veterinary surgical practice," the researchers write.
"Alternatively," they add together, "if trepanation was used to practice techniques, the moo-cow from Champ-Durand would provide the earliest evidence of surgical experimentation on an creature, indicating that this do already existed in 4000 B.C."
Medical or spiritual reasons?
The Hippocratic Corpus — a reference drove of ancient Greek medical texts continued with the teachings of Hippocrates — also cites therapeutic reasons for trepanations.
One of the texts, Places in Homo, recommends trepanation for the prevention of complications related to skull fractures:
"Cases of fracture of the skull: […] if [the skull] is broken and in that location is a crack-fracture, information technology is dangerous. You lot should trephine this case, to prevent pus from flowing through the fracture of the bone and infecting the membrane; for, since in this narrow place information technology tin can get in simply not out, it causes distress and madness."
In medieval Europe, however, the reasons for trepanation seemed to vary a lot more, depending on the culture that performed them.
For instance, Hungarian populations performed
According to the authors of the 2011 case study, trepanation possibly aimed to treat complaints ranging from physical injuries to mental health issues and epilepsy. In their conclusion, the researchers write that "this is the big question on trepanation."
"Its exercise," they add, "can be attributed to many reasons." For example:
- "magic/religious reasons such equally to complimentary people from daemons that could exist torturing them"
- "initiations every bit a mode of giving correct of passage to machismo or to plough someone into a warrior"
- "therapeutic reasons to treat tumours, convulsions, epilepsy, migraine, loss of consciousness, and behavioral changes"
- "the treatment of traumatisms similar skull fractures"
When it comes to the Inca population in Peru, still, contempo investigations have uncovered more clues. This was partly thank you to the wealth of skulls that present evidence of successfully healed trepanations.
In an interview for National Geographic, anthropologist John Verano — author of Holes in the Head: The Art and Archaeology of Trepanation — suggests that the Incas probable came upon trepanation past accident but discovered that information technology could be a useful medical intervention.
"[Trepanation] probably started as a very simple matter [for the Incas] — cleaning the scalp afterwards a blow to the head and doing some simple things similar picking out cleaved pieces of bone, which would be dead," Verano says.
"They learned early on that this was a treatment that could relieve lives. We have overwhelming evidence that trepanation was not done to increase consciousness or as a purely ritual activity merely is linked to patients with severe head injury, [especially] skull fracture," he notes.
Trepanation really continued to develop through modern times. This is, in part, why some people argue that it is the precursor of neurosurgery.
Image credit: Wellcome Collection
Medical historians refer to the 18th century as the "trepan century." This is because at that fourth dimension, European surgeons became particularly interested in the possible uses of this practice.
Allegedly, 18th century trepanation first took the form of veterinary handling; veterinarians would behave it out on domestic animals to treat various infections or remove tumors.
Throughout the century, doctors used trepanation to treat concussions and brain inflammation. Past the end of the 1700s, however, opinions in the medical community were divided as to whether this process was useful or harmful.
In the 19th century, trepanation rose and barbarous from medical favor, though trepanations were particularly popular during the American Civil War period (1861–1865). At this time, doctors recommended them for cleaning and treating caput wounds.
Somewhen, trepanation gave way to the sophisticated procedure of craniotomy. This, all the same, has not meant that trepanation has entirely fallen from favor.
Over the past couple of centuries, some people have become convinced that this ancient practice could offer them both physical and spiritual benefits.
For instance, British artist and lobbyist Amanda Feilding, Countess of Wemyss and March, decided to perform a cocky-trepanation in 1970. She was convinced that it would restore proper blood flow to the encephalon.
Feilding believed, every bit she later explained in an interview, that every bit our skull basic harden in infancy, blood flow to the brain is reduced. This, she believed, puts us at risk of neurodegenerative conditions — and trepanation could solve that problem.
Twice, in 1979 and 1983, she ran for the British Parliament, asking that the National Health Service (NHS) start providing trepanation to British citizens.
Apparently, trepenation too caught the imagination of musician John Lennon — to the bespeak where he may have tried to persuade Paul McCartney to undertake this procedure himself.
Trepanation was also a fad in the tardily 1990s, prompting professionals including Laurence Watkins to event
"There are lots of expert reasons for making a pigsty in someone's head, and in a neurosurgeon's hands it is not a risky procedure, but for someone doing information technology themselves, the risks are huge," warned Watkins, noting that the procedure could pb to infections and brain impairment.
Medical News Today agree: Trepanation is best left to the medical history books.
Disclaimer: All images in this commodity are from the Wellcome Collection, licensed under a Creative Commons Attribution iv.0 International Licence.
Source: https://www.medicalnewstoday.com/articles/326281
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