A cast of the trephined piece of skull, on display in the Archaeology Room

Trephined Skull

As you stroll through the Museum it’s not uncommon to hear the dulcet tones of Mr Phil Harding waxing lyrical about the local long barrows. It was at one of these long barrows in Bisley, that a portion of a skull dating back to the Neolithic Period was found. This piece of skull was special, not only because it was so old, but because it showed signs of an ancient practice known as trephination.

Also known as trepanning, trepanation or making a burr hole, trephination is the process of drilling, cutting or scraping a hole into the skull. It sounds painful and it most certainly was. It is the oldest surgical procedure for which we have archaeological evidence, with instances of trephination found in remains dating back as far 6,500 BCE – a long time before the advent of anaesthetic. Whilst we can’t be sure exactly why these procedures were performed, some clues exist in the form of cave paintings. They suggest that it was predominately performed on people who were behaving in an abnormal way, in an attempt to let out what was believed to be evil spirits. Today these abnormal behaviours may be recognised as symptoms of epilepsy, migraine, or certain mental health disorders and happily, are treated very differently.

Interestingly, there is evidence to suggest that in some instances a trephination procedure may have been performed on individuals suffering with head wounds. This would have been a form of primitive surgery to remove shattered bone and fluid build up beneath the skull, a stark contrast to the other more mystical documented applications.

Finds of trephined skulls show that the practice was most commonly performed on men, although examples do exist in the skulls of women and even children. It is worth noting that a substantial number of trephined skulls show signs of healing, indicating the person survived the procedure. In some instances there is even evidence of multiple trephination procedures taking place within a (particularly unfortunate) individual’s lifetime.

There is widespread evidence of the practice of trephination in many ancient cultures around the world. Skulls have been discovered in China, Mesoamerica and all across Europe; even the Greek physician Hippocrates documented it in his works. The practice has persisted and been documented throughout the centuries and even continues to take place today, albeit under different circumstances.

In modern medical practice trephination is used as treatment for epidural and subdural hematoma and is generally referred to as a craniotomy. However, contrary to early practice, the use of anaesthetic is standard (phew!) and the removed piece of skull is typically replaced as soon as possible.

Did you know?

More than 1500 trephined skulls dating back to the Neolithic Period have been found worldwide.


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