“I Need That Like I Need A Hole In The Head!”


(Photo Credit: The Medical Book)

Trepanning or trepanation is one of the earliest surgical procedures in history. The word trepanation is Greek for trypanon, meaning to drill or bore (Kang 142). In essence, a hole, or a series of holes, would be cut, drilled, or scraped into a patient’s skull using various instruments. Some of these tools were made up from obsidian rock, teeth from predators, flint, metal, and bow mechanisms that spun (Parker 16-17). This procedure left the brain, and hopefully, the meninges (the thin membrane surrounding the brain) untouched by the surgeon (Kang 142). Albucasis, a medieval Islamic surgeon warned practicing physicians against cutting into the meninges by stating that, “if the outer membrane turns black, you may be sure that he is doomed” (Pickover 18).


(Photo Credit: Medicine: The Visual Illustrated History)

Boring holes in the head was used for both practical and impractical medical treatments. On the practical side of things, the holes could assist with encephalitis (brain swelling) by giving the brain space to expand safely, reduce hemorrhaging, aid in the removal of skull fragments, and help with the assessment of brain tumors (Parker 17). Unnecessary drilling sessions derived from headaches, possessions, hitting one’s head, melancholy temperaments, and epileptic fits (usually related to insanity) (Kang 142). In a large-scale survey of neolithic skeletons, archaeologists suggest that about 1 in every 10 skulls bear evidence of trepanning (Parker 16). Although the procedure was dangerous and could lead to fatal brain damage and infection, a surprising amount of the unearthed skulls with these distinguishable holes prove that the person had managed to survive the surgery. How can we tell? Well, the holes, which are usually circular, have smooth edges, suggesting that new bone growth had occurred in that area during the person’s lifetime.


(New bone growth. Photo Credit: Medicine: The Definitive Illustrated History)

It remains unclear whether or not trepanning was used strictly as a medical procedure or if it has roots in ritualistic practices as well. It remains extraordinarily difficult for archaeologists to provide evidence that proves that skull-drilling had ritualistic origins. Some prehistoric dig sites have unearthed charms made from the removed skull fragments, but it is unclear whether they had a spiritual purpose (Pickover 18). In cases of suspected possession, a hole would be opened up in order to allow an exit space for the demon during an exorcism (Parker 17). In some instances, the hole was used as a means of reviving an important individual (Parker 17). The cavity, instead of being an exit, was an entrance for the escaped soul. Archaeologists working in Southern Russia managed to uncover multiple graves with various trepanned skeletons. What was unique about these trepanned skulls was the fact that the holes were on or above the obelion (near the top of the head) (Wylie).  This location was an uncommon find because it was dangerous to cut there! The risk of fatality was higher because that area is near the superior sagittal sines, where blood collects before it flows into the main veins of the brain (Wylie). The archaeologists concluded that so many skeletons must have had this done to them for reasons beyond practicality. Instead, they suggested that the individuals living in that region performed the dangerous procedure for ritualistic purposes (Wylie).



(Photo Credit: Quackery)

Evidence suggests that by the 17th century, trepanning had been carried out on almost all of the world’s continents (Parker 16). In the 18th century, the world saw a huge decline in the popularity of this surgical procedure due to the fact that medical specialization was beginning to take hold (Parker 17). People with mental disabilities no longer have to endure painful skull scraping anymore and, luckily, brain scooping (a topic for another day) was overshadowed by prescription drugs. Sophisticated methods of trepanning still do exist today in the medical world and are used for various issues which include encephalitis, hemorrhaging, and retrieving fragmented bits of skull.

(If that didn’t make you thankful for modern medicine, then I don’t know what will!)

Until Next Time:



  • Kang, Lydia & Pedersen, Nate. Quackery: A Brief History of the Worst Ways to Cure Everything. New York: Workman Publishing, 2017.
  • Parker, Steve. Medicine: The Definitive Illustrated History. London: DK Publishing, 2016.
  • Pickover, Clifford. The Medical Book. New York: Sterling Publishing, 2012.
  • Wylie, Robin. “Why our ancestors drilled holes in eachother’s skulls.” BBC. 29 Sugust, 2016. Accessed 1 November, 2018. http://www.BBC/earth/story/20160826-why-our-ancestors-drilled-holes-in-each-others-skulls.

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