Tuesday, May 19, 2009

Trephination of the skull

Trephination of the skull
Undoubtedly the most extraordinary story in the history of surgery is that, long before man could read or write, as long ago as 10,000 BC, surgeons were performing the operation of trephination or trepanning – boring or cutting out rings or squares of bones from skull – and just as remarkably, their patients usually recovered from the procedure.

Although the word ‘trepanation’ and trephination’ today are interchangeable in common practice, trepanation comes form the Greek trypanon, meaning a borer, while trephination is or more recent French origin and indicates an instrument revolving around a central spike.

Trepanation thus connotes scraping or cutting, while trephination describes drilling the skull, as in modern neurosurgical operations.

Different techniques of trepanation in ancient times, and in recent primitive communities, involved scraping away bone, making a circular groove so that a central core of the bone would loosen, boring and cutting away the bone, or making rectangular interesting incisions in the skull.

This story begins in 1865 when a general practitioner Dr Prunires, who was also an amateur archeologist, discovered in a prehistoric stone tomb in Central French a skull which bore a large artificial opening on its posterior aspect.

With it, he found a number of irregular pieces of bone which might have been cut from another skull.

He postulated that the skull had been perforated so that it might be used as a drinking cup.

Soon after this, a number of other holed skulls were found in other parts of France and Professor Paul Broca (1824-1880), a distinguished French physician, suggested that these opening were the result of an operation of trepanation and that the instrument employed was a flint scraper.

Broca suggested that survivors of operation were endowed with mythical powers and that, when they died, portions of their skull, especially those that included a part of the edge of the artificial opening, were in great demand as charms.

Following these discoveries, thousands of such specimens have been discovered from many parts of the world: the United Kingdom, Denmark, Spain, Portugal, Poland, the Danube Basin, North Africa, Palestine, the Caucasus, all down the Western coastline of the Americas and especially in Peru, where more than 10,000 specimens have been excavated.
Trephination of the skull

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