The word trepanation, or trephination, is derived from the Greek trypanon, meaning 'borer'. The act of trepanation is basically the drilling of a hole in the skull. There is evidence to suggest that the practice has been in use since prehistoric times. Skulls have been found in many archaeological digs throughout the world with precisely cut holes that appear to have been man made and with evidence, in many instances, of bone regeneration. This bone regeneration supports the thinking that the individuals involved survived the procedure and the precision of the hole suggests that they are not the result of intrusions by sharp weapons.

The Origin and Purpose of Trepanation

The reason why trepanation was originally practised is something without a definitive answer. Without doubt there must have been some curiosity about what lay within the human skull and its function. Primitive thought placed great weight on supernatural forces, like evil spirits, so trepanation may have been a means to relieve illness, pain or insanity caused by these spiritual entities by forcing them out of the hole. Even today swellings and malign anomalies within the structure of the brain represent considerable problems for advanced medical science and technology; so to a degree the act of trepanation shows that primitive man possessed much more advanced treatment procedures than are commonly recognised today.

The Value and Act of Trepanation

The basis of trepanation, in modern thinking, is to relieve pressure and swelling in the brain, but also to introduce more oxygen into the skull. The cranial bones are cut with a small cylindrical saw, called a trepan or trephine, equipped with a centre pin. The centre pin extends a short distance beyond the blade of the saw and is inserted first to prevent slippage. In modern surgery a metal plate is generally used to cover the hole once the operation is complete.

Modern Views of Trepanation

Trepanation is not considered an advisable course of action by common medical science for anything except serious cranial damage and brain swelling. With the dawning of enlightenment and higher technology less credence has been given to more apparently primitive medical techniques. However, there are many doctors around the world who still believe in the value of trepanation outside of emergency surgical procedures and also there are many individuals who experiment with the technique on an amateur basis. The introduction of increased levels of oxygen to the brain, apparently, provides a high or rush, which can be repeated and maintained, and may also heighten intelligence. The disadvantages of drilling holes in the head include possible damage to the cerebral membrane or complete, and unexpected, lobotomy. Death is also a high risk.