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Published Monday, March 9, 2015


An illustration of trepanning from France during the 1800s. (Via Wikimedia)

Trepanning AKA Trepanation, AKA Trephination


Imagine someone taking a really sharp rock and cutting your scalp, then flopping your scalp open like a wet rug and using a – probably – different rock to saw into your skull. They then make a roughly rectangular shape, pop out part of your skull bones, put your scalp back, and send you on your way.

This is the ancient art of trepanation.

Sometimes the hole would be more square, sometimes four cuts are made and sometimes five, depending on the method, and sometimes a round gouging tool would be used that produced round holes instead of square. But believe me when I tell you that this skull-hole-cutting thing was the hot body modification trend of the Neolithic Period, aka the Late Stone Age.

We know this because at some sites, like one in France from 6500 BCE, up to a third of all the skulls were trepanned. Around 5-10% of all the skulls ever found from the Neolithic have at least one hole in them. Some have two. And when I say all the skulls, I mean all the skulls from everywhere. People in China were doing it. People in the Americas were doing it.


What made it so popular?

A skull showing signs of multiple trepanations. (Via WellcomeImages.Org)

The truth is that no one knows. Documentation on trepanation is pretty slim, and what we know of the ancient sciences doesn’t shed a lot of light on the subject. One scientist, Dr. Plinio Prioreschi, theorized that the surgery was used to bring members of the group “back to life” after injuries or illness. Basically, if you have something like an intracranial hematoma (More on this later) a hole in your skull that allows the blood to drain can keep you alive. If you have the flu, not so much. But Neolithic shamans had no way to tell the difference between someone unconscious for getting clubbed in the skull and someone passed out with food poisoning. What they do know is that sometimes you cut a hole in someone’s skull and they come back, and sometimes they don’t.

And for the record, if you have a bad flu and the shaman cuts a hole in your head and you live, who are you to argue? So says Dr.Prioreschi, but in a really smart way.

Is there any evidence for that conjecture?

Aside from a lot of skulls with holes in them, no.

Another theory comes from Dr. Bart Hughes, who along with Joe Mellen and Amanda Fielding, is part of the modern trepanation movement. Dr. Hughes theorized that the brain changes the way it functions when the skull turns solid-ish around age 30. The skull does most of its growing between ages 0-3 and most of the rest between then and middle age (Though results may vary and technically the skull never stops growing a little bit). Hughes noted that learning big things and making big changes in your life tended to coincide with these periods.

What would happen,

Hughes wondered, if the skull were “flexible” all the time, giving the brain some, you know, room to fluctuate.

If you’re guessing that Dr. Hughes was one of those awesome LSD researchers from the swinging 60s, you are correct. But Dr. Hughes, along with Fielding and Mellen, went the extra mile and actually drilled a hole in his own skull. And then he probably said, Your move Dr. Prioreschi. Incidentally, because I know you’re wondering, Hughes lived to be 70, while Mellen and Fielding are both still alive at 77 and 73 respectively.

In a Vice interview, Mellen summarized Dr. Hughes’s philosophy thusly:

“Think of the brain as a pudding: It can expand and pulsate, but once the skull has completely sealed ’round it, it can no longer do that. The pulsation is suppressed and the blood passes through without pulsating. And this is why all of us want to get high.”

Both Mellen and Fielding...

Bart Hughes doing his own trepanation in 1965 (Via Cor Jaring, Wikimedia)

Continue to do research on the benefits of trepanation, and Fielding even ran for Parliament in 1979 and 1983 under the slogan Trepanation for the National Health.

Other modern practitioners include the Gusii and the Tende people of Kenya and Tanzania. The practice was widely carried out at least into the 1950s by the omobari omotwe (“head surgeon”). From what I can find, it was never done for reasons other than headaches after having a head injury. So no demonic possessions, psychosis, etc.

The other practitioners, of course, are neurosurgeons who make what are called “burr holes” in the skull to allow an intracranial hematoma (bleeding in the brain area) to drain. The doctor I spoke with wanted to make sure that I added the fact that the holes are not left “open” but are usually filled in with a surgical plate once the bleeding has been dealt with.

Is there any evidence...

That trepanation is actually good for anything other than relieving pressure on the brain in specific circumstances?

Short answer: No.

Slightly longer answer: Aside from the articles published by people who drilled holes in their heads, there are no studies to back up any claims of the medical benefits of trepanning. People say it cures their depression, or makes them high all the time, or helps them think better.

As Amanda Fielding herself said, “Could all of that be described as a placebo? There is, of course, that possibility, and I am very conscious of that.” But she adds, “I have to say I noticed enough of a change to keep me interested, and noticed it in the people who I knew well who also got trepanned. I noticed a fundamental change in all of them.”


Interested in learning more? – International Trepanation Advocacy Group

VICE interviews with Amanda Fielding and Joe Mellen


Looking for me? Reach me at, and on twitter @charleswriter.