Monday, October 22, 2012

TREPAN, or How I Learned to Stop Worrying and Love the Insanity

Trepanation has always held a fascination as a medical oddity practice since the dawn of time.  Very early man practiced cutting holes in the skulls of “patients” and some of them survived to go back and have several more holes cut.

The exact reason why trepanation began in great antiquity is not known.  Anthropologists theorize it may have been shamanistic as much as medical.  Opening the skulls may have let evil sprits out, which may have been manifested as headaches, or perceived demonic possession, perhaps mental illness.  The point is that it must have been survivable and worked in some cases for it to be added to the list of medical/witch doctor treatments.

Trepanation continued to be practiced well out of the Paleolithic and into the Neolithic era and on into the Bronze Age, up to the present time.  The reasons may have changed, but the basic techniques have not:  you cut a hole in a person’s skull to gain a benefit for the patient.  Whether it is medical, spiritual, shamanistic or psychic, the practice continues to this day.

The original tools were sharp stone tools such as flint or obsidian cutters.  Anesthesia didn’t exist until the middle 19th century so trepanation was just one operation among others, such as amputation, that had to be done while the patient was able to feel pain.  The tools evolved from stone to bronze to iron to surgical steel and the forms of the tools took on a specific look for the very specific task of head boring.  Elaborate trepanation tools in cases were available to surgeons and many sets still exist and are collected today.

Outside of the shamanistic reasons for cutting holes in people’s heads, there are very real reasons for modern surgeons to perform this operation, such as preparation for brain surgery, relief of pressure and the like.  The present term for such an operation is craniotomy rather than the old-fashioned trepanation with its negative connotations.

There still continues to be a folk medicine movement involving trepanation for psychic or pseudo-science reasons.  I was rather surprised to find that there is a strong movement for non-medical trepanation and even for self-trepanation.  

All of you folks who enjoy an occasional horror movie or play the H. P. Lovecraft inspired role playing game, Call of Cthulhu, might find the information and links of some use in the Arkham Sanitarium.  For those few of you who are contemplating trepanation at home for fun and profit, keep up your medical insurance payments, you’ll need it.

The bottom line is:  Kids, don’t try this at home!