Ancient Medical Practices: Trepanation, or The Skull Window of Hope

Welcome back to the History Nook.

Today we're exploring ancient medicine, where the cure was sometimes worse than the illness. This is the first in a series examining history’s most curious cures—from leeches to lizard spit, mummified powders to womb-whispering.

So grab your favourite mug, find a soft space to curl up, and let's wander a little deeper into the past. (And if you’re squeamish about medical things? You might want to sit this one out. Index certainly is.)

A Brief Hole in the Head

Imagine you're sitting in a dark cave. A warm fire crackles nearby—the only light flickering against the walls—and you're cradling your aching head. Beside you, someone sharpens a piece of flint. They lean in and say, calmly: “This may sting a little.”

Trepanation (or trepanning) is the act of drilling, scraping, or cutting a hole into the human skull. Think of it as ancient brain surgery—but with significantly less sterilisation and a generous helping of guesswork. The word comes from the Greek trypanon, meaning “to bore.” Apt in more ways than one.

And thank the stars above that the brain itself can’t feel pain—because oh, my dear, imagine if it could.

The Oldest Cure We’ve Got?

Trepanation is one of the oldest known medical practices, with evidence dating back to the Neolithic period—roughly 7,000 years ago. Trepanned skulls have been found all over the world: in Peru, France, Russia, and beyond. This wasn’t a single culture’s curiosity—it was a global fascination with what lay inside the head.

We even find representations of trepanation in ancient art: stone carvings and cave paintings that depict the procedure in progress. Tools have been found alongside the skulls—flint knives, obsidian scrapers—suggesting this was no back-alley hack job, but something closer to sacred surgery.

Why Bore a Hole in the First Place?

It was believed to treat all manner of physical and spiritual ailments. Head injuries, seizures, migraines, pressure from trauma, mental illness—or, in some cases, evil spirits trapped in the skull. In certain cultures, trepanation may have also played a role in initiation rites or shamanic ceremonies.

Basically: “You seem troubled, friend. Have you considered removing a small portion of your cranium?”

Did It Work?

Surprisingly… sometimes, yes. Many trepanned skulls show signs of healing, meaning the patient survived the procedure. Some even have multiple holes—suggesting not only survival, but repeated treatments.

One famous skull from Neolithic France shows five separate trepanations, each with signs of recovery. Which begs the question: was this person particularly prone to spiritual possession—or just incredibly unlucky?

Incredibly, the core concept of trepanation is still used today in modern neurosurgery (though with considerably more hygiene). Techniques like craniotomy involve removing sections of the skull to relieve pressure or access the brain. So, perhaps those ancient surgeons were onto something after all.

Further Reading: Classical Texts

• Celsus – De Medicina, Book VIII - A Roman perspective on surgical treatment of head injuries, including step-by-step instructions for trepanation. Gruesomely detailed, if you're curious.

• Hippocrates – On Injuries of the Head - The earliest and most comprehensive surviving account of trepanation in Western medicine. Shockingly methodical.

• Galen – Various Works - Offers anatomical insight into the skull and brain, blending philosophical thought with surprisingly practical advice.

  
  

I hope you enjoyed that brief window into the ancient world of trepanation.

Thank you for reading, and I hope you enjoyed your time in The History Nook today.

Until next time, stay curious, and keep warm.

🐾 Index’s Footnote 🐾

“This is why I knock things off shelves. It’s called trepanation prevention.”

— Dr. Index Meowgellan, Not That Kind of Doctor