Trepanation: The First Recorded Surgery – Brain Surgery

 

Ancient Medical Procedures Still Baffle Scientists

 

 

By:  Dr. Rita Louise

Trepanation_illustration_France_1800sIn the modern age, when we think of surgery, we think of doctors working in sterile environments using finely crafted tools on an anestitised patient.  That was not always the case.  The history of early surgical techniques including stitching up lacerations, amputating limbs, and draining and cauterizing open wounds found their origin in deep antiquity.  These medical interventions, however, were not our first venture into the world of medicine.  The oldest medical procedure, which we have recorded evidence for, is a form of brain surgery called trepanation.

Trepanation is a surgical intervention used to treat health problems related to intracranial diseases.  It involves removing part of the bony structure that surrounds the brain, the cranium.  The word trepanation comes from the Greek word “trypanon” which means “a bore”.   The practice of trepanation involves drilling or scraping a hole into the skull to expose the thick membrane that surrounds the brain called the dura mater.   The dura mater is a layer of tissue that separated the skull and the brain.  Its function is to protect the brain from mechanical injury.

 

Contemporary View Of Trepenation

 

In today’s popular culture comes a belief that the practice of  is isolated to areas of Peru, the home of some of the most remarkable examples of cranial deformation found in the world.  We are astounded by the surgical prowess of our Peruvian ancestors, yet around the world, thousands of skulls have been discovered that show clear signs of trepanation.  This ancient practice was employed all over Europe and Russia, in Africa, Polynesia, China and in South America during some point in their history.  In some indigenous cultures, it is still performed today.

 

Early Studies Into Trepenation

 

The study of the origin of trepanation finds its roots in France.  The year was 1685 when French Benedictine monk Bernard de Montfaucheon discovered a skull with a hole drilled into it.  His discovery was initially overlooked by the scientific community of the day until a second skull was unearthed by Alexander Francois Barbie du Bovage at Nogentles-Les-Vierges in 1816.  Examination of this skull revealed that the hole in the skull was not the result of a head trauma due to an accident, injury or battle wound.  Instead, it was intentionally preformed on this individual.  What amazed researchers, who started investigating instances of trepanation beginning in the mid-1800’s, was that this procedure was performed on living people and in most cases they survived the surgery.

Exploration into ancient sites around France revealed hundreds of skulls with the tell-tale signs of trepanation.  Skulls discovered in the Cavern de l’Homme-Mort, the sepulchral grottoes of Baye and in the dolmen of Lozère all date back to the Neolithic era some 4-5000 years ago.  At one burial site in France, 120 prehistoric skulls were found, 40 of which had trepanation performed.

The holes bored into some of the earliest trepanned skulls were made by scraping away the cranial bone using a sharp stone such as a flake of obsidian or flint.  The holes in these skulls vary in size from a few centimeters in diameter to encompassing nearly half of the skull.

Of the skulls examined, more than 80 % of all individuals who received trepanation during the Neolithic lived months if not years after the procedure.  This is evidenced by the amount of healing that occurs around the trepanation site.  If no sign of healing is observed, it is conjectured that the individual died during or immediately after the surgery.  Yet many skulls investigated showed calcium deposits around the surgical site.  This is an indicator of new bone growth and a clear sign of healing.  In some instances, calcification completely sealed the trepanned hole.

 

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