You might think you need an extra hole in your head like... well, a hole in your head. But trepanation has been hailed as the "oldest surgery."

Medical professionals have long since abandoned the practice of drilling into the skull, but not everybody has followed suit. There are actual modern people — although, not doctors for the most part — who argue for modern trepanning. What on Earth are they thinking? Find out below.

Top image: Gavin Schaefer on Flickr.

All around the world, ancient skulls have been found with holes in them. Some people thought that this was some sort of ritual modification done after death, but when skulls started showing up with significant bone growth after the hole in the head was made, that theory was thrown out the window. It became apparent that societies all over the world thought the cure for what ails ya was knocking a hole in your head. The first trepanning procedures simply involved taking the skin off the head and scraping the bone away with stone tools. The holes could be only a few centimeters wide, or take up half the skull. Amazingly, about two-thirds of the patients lived through the procedure.

No one knows exactly why the earliest humans did this. Current surgeons occasionally remove parts of the skull to relieve pressure on the brain from blood or other fluids. The ancients could have done the same, which makes them fairly sophisticated in their medical knowledge. Later humans documented the use of trepanation to cure insanity or head aches. Others believed it would remove evil spirits. They were perhaps not quite as on the ball, medically speaking.


The on-the-ballness of modern trepanners is debatable. The father of the modern movement for legal and widespread trepanation done by doctors was Bart Huges, a Dutchman who believed we hit our best years as a baby with a soft head and a full diaper. The soft skull of a baby allows its brain to breathe and move, argued Huges. When we stand upright, our heads are drained of blood and we can't learn as much as fast. Then when our head hardens we can't even grow our brains anymore. As a result we become tired, depressed, and easily confused. To get our brains 'breathing' again, we need to create a vent to breathe out of, and a space to grow. Other advocates just say it gets them high.

Surgeons just think it makes them dumb. There have been cases when surgeons have used trepanation - permanent trepanation - to attempt to do exactly what trepanation should do. They tried it to relieve the symptoms of a condition that caused fluid to accumulate in the brain. The fluid put too much pressure on the tissue, choking off blood flow and oxygen availability. The trepanation, or craniotomy, was meant to relieve that pressure. It didn't work: The patients were no happier, and the procedure was abandoned.


Still, there is a website under the head of, International Trepanation Advocacy Group(Warning. It plays music automatically.), that advocates trepanation. It includes a paper which statest that trepanation significantly increases arterial blood flow in the brain.

Since surgeons still refuse, for the most part, to perform the technique, most trepanners still perform their procedures on themselves with a power drill. They drill their heads until they hit bone, and then scrape it away and dress the wounds. If they're very lucky, they can treat themselves to a local anesthetic during the procedure. The size of the hole varies greatly. Most modern trepanners make only finger-tip sized holes while others like large holes. (The debate over the size of the hole has prompted a feud in the community.) There have been self-trepanners who have run for government in the UK, who have written books about their experience, and who have simply tried to spread the idea of trepanation.

Surgeons still warn against it, since in the worst cases it can lead to infections, brain punctures, and death. And in the best case, there's still a hole in the patient's head.

Images by Luciana Cristante and AKSeabird on Flickr.

Via Science Blogs, The Straight Dope, and Salon.