Trepan: History of the World's Oldest Surgical Applications


In the 1860s, E.G. An American diplomat named Squier traveled to Peru, Cuzco. He saw an old skull when he visited the house of a wealthy woman who collected antiques. Discovered in an ancient Inca cemetery in Yuca Valley, this skull was dated back to the pre-Columbian period and had a large, rectangular hole in its upper front.

The skull has evoked the interest of Squier, a well-educated, specialist archeology and Latin American culture. So Squier brought his skull to New York in 1865 and offered it to members of the New York Medical Academy.

The Squier believed that the skull was an obvious proof that the ancient Peruvian people were practicing some sort of prehistoric brain surgery. The diagonal lines of the pier indicate human manipulation, and Squier suggests that it is likely that the drill would have been opened by a carving knife, a tool used by carvers to work on wood or metal. At this point, it was even more surprising that there were traces of improvement in the skull, indicating that the patient had been alive for at least another two weeks after surgical intervention.

Members of the medical community are skeptical about becoming suspicious and do not believe that cuts were made before death. Squier then applied to the opinion of the famous French surgeon and anthropologist Paul Broca. Looking at Broca's skull, the result was that early local communities had "advanced surgical" practices long before the Europeans were scarcer.

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Punching or scraping the skull dome to remove the outer skin of the brain and treat brain injuries is called trepanation. First mentioned in the Hypocratic Collection, this process is one of the oldest surgical applications in the world. trepanation in Greek means "punch") Today, the medical mosque calls this practice craniotomy.

Trepanation has been practiced in almost all parts of the world throughout history. It is known to have been practiced in ancient Greece and Rome, and is reported to continue to be practiced today in some parts of Africa, South America and the South Pacific. In Ancient Greece, trepanation was used to reduce the head pressure, to clean the skull parts of the brain after a traumatic accident, and to drain the brain. In the 18th century, it was used in the treatment of epilepsy and mental disorders, and from the Renaissance to the beginning of the 19th century, it was routinely practiced to heal the major injuries.

Victorian doctors at the time of Squier and Broca never thought that these "primitive" cultures had ever practiced such a method throughout history. Also, at that time, survival rates after surgical intervention were so low due to hospital-acquired infections that doctors were skeptical about the fact that ancient patients continued their lives for a long time after trepanation.

After accepting the correctness of Squier's claim, Broca began to find trepan scapes all over the world dated to the Neolithic Age. A large number of skulls pierced in Western Europe, South and North America were seized. Over the years it has become clear that trepan was practiced by many different societies, starting from the late Paleolithic Age.

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Practice methods varied from culture to culture. Pre-historic trepanas in Early Peru were carried out with a ceremonial knife used to cut or cut the bone called tumi . In Hippocrates's School of Medicine, a device called trephine was developed that was used to drill holes in the skull. It is known that in South Pacific, sharpened seashells are used for trepan, while flint and obsidian are used in Europe. When it came to the Renaissance period, a number of tools were developed for this process. However, due to the high infection rate, the application terminated soon.

Trepanning was practiced both in old age and in young people regardless of gender. In many cases, prehistoric patients could live for many years after practice. According to Charles Gross, professor of neuroscience at Princeton University, survival after application was estimated at 50 to 90 percent. However, what keeps the surgeon from practicing trepanning is uncertain in many cases.

"In Peru, the South Pacific and many other parts of the world, trepanation has emerged as a very practical treatment for head injuries," said John Verano, professor of anthropology at Tulane University, working on trepanation in Peru. Let's say someone has a scar on the skull that causes damage, in this case it's cleaning the scar, getting the broken skull parts, and letting the brain slightly swell, after which the brain swells. "

In some cases, there are obvious trauma indications in their skulls, indicating that there must be a underlying reason for trepanation practice. However, it is said that archaeologists have also found trephine skulls with no evidence of fracture due to the penetration of the bone into them. For example, there was no sign of any head injuries in the famous skull that Squier found. In addition, the skulls with more than one hole in them were also brought to the surface, indicating that patients sometimes have more than one surgical operation and survived.

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According to Verano, those who have witnessed this practice in Africa and the South Pacific today say that trepanis is still used to treat head injuries, headaches and intracranial pressure increase. In other parts of the world, trepan is thought to have been applied to evade evil spirits or to improve evil. But without any written source, it is not possible to know for certain why such surgical procedures are applied in the absence of obvious injury.

No anesthesia was applied to the patient who underwent trepanning. This brings to mind the question of whether or not the process is fatal.

Verano stated that patients should be unconscious during the trepan procedure if there is a head injury, and that the patient's consciousness is open during the procedure if there is no injury. "There are a lot of nerves in the head skin, burns. In this case the bleeding will be too much, but then stop. On the other hand, there are very few nerves in the skull, and there are no pain receptors in the brain. " Verano adds that if the ancient trepanation practitioners did not cut the outermost skin of the brain, then the patient would die of meningitis.

In modern Western hospitals today, trepanation is no longer considered a therapeutic procedure. More often, it is used to debride an injury (to clear the dead or infected tissue around it), to reduce the skull pressure, or to perform exploratory surgery. However, it is very impressive that this radical surgical method has been practiced for millennia, beginning with the prehistoric people, who are aware that brain functions control the body. So what will future people think about contemporary modern brain surgery?

Mental Floss. 1 January 2016.


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