Trepanation, the surgical removal of a piece of the skull to expose the dura mater, is perhaps the oldest surgical procedure for which there is archaeological evidence, dating back 7,000 to 10,000 years; more than 1,500 trephined Neolithic skulls have been found worldwide, in France, Siberia, China, East Africa, Mesoamerica and pre-Columbian South America, with survival rates rising from roughly 40 percent in prehistory to about 80 to 90 percent by the Iron Age and later. Why it was performed is genuinely disputed: proposed medical purposes include treating head wounds, skull fractures, epilepsy and hydrocephalus, while proposed spiritual purposes include releasing evil spirits believed to cause illness and producing bone fragments for use as talismans. The popular claim that trepanation was performed to cure headaches has no credible supporting evidence; it traces to a 1913 misreading, by the physician William Osler, of the anthropologist Paul Broca's earlier writing.
Facts
Open Questions
Origin Year8000 BCE
No single founding event: trepanned skulls are attested across independent Neolithic and Mesolithic sites worldwide with no earliest documented instance (see the open question on this entity, EntityId 269328, "When did trepanation originate as a medical practice?"). Archaeological evidence for the practice spans roughly 7,000 to 10,000 years before present (en.wikipedia.org/wiki/Trepanning, "Prehistoric evidence" section). Sources
Wikipedia: Trepanning
WikipediaAntiquity; Geographic Distribution; Historical Purposes; The headache mythQuote, Antiquity; Geographic Distribution; Historical Purposes; The headache myth
there is no credible evidence
Wikipedia: Trepanning
WikipedialeadQuote, lead
Trepanning, also known as trepanation, trephination, trephining or making a burr hole, is a surgical intervention in which a hole is drilled or scraped into the human skull.
Wikipedia: Trepanning
WikipediaPrehistoric evidenceQuote, Prehistoric evidence
Trepanation dates back to 7,000-10,000 years ago, is perhaps the oldest surgical procedure for which there is archaeological evidence.
Wikipedia: Trepanning
WikipediaOpen Questions: When did trepanation originate as a medical practice?View the Source Open Questions (2 open questions)
Why was trepanation performed in prehistoric and ancient societies?
Proposed medical purposes include treating head wounds, skull fractures, epilepsy and hydrocephalus; proposed spiritual purposes include releasing evil spirits believed to cause illness and producing bone-fragment talismans. Neither explanation can be confirmed or ruled out from skeletal evidence alone, and the two purposes are not mutually exclusive across the many independent cultures (Neolithic Europe, ancient China, pre-Columbian Peru and Mesoamerica, East Africa) that practiced trepanation. A widely repeated claim that it treated headaches has no credible supporting evidence and traces to a 1913 misreading by the physician William Osler of the anthropologist Paul Broca's earlier writing.
What would resolve this Direct textual or iconographic evidence from a trepanning culture stating its own purpose, or a rigorous cross-cultural study correlating trephination sites with skeletal trauma versus other markers, at a scale sufficient to separate medical from ritual practice.
Archaeology and Medical AnthropologyWikipedia: Trepanning
When did trepanation originate as a medical practice?
Trepanned skulls are attested across independent Neolithic and Mesolithic sites worldwide with no single earliest instance; unlike cataract surgery (Daviel, 1750) or vaccination (Jenner, 1796), the practice predates writing entirely and has no founding event to anchor an origin year.
What would resolve this Confirmed osteological dating of the earliest known trepanned skull, or a specialist paleopathology consensus on the practice's deepest attested horizon.
PaleopathologyWikipedia: Trepanning
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