William Clower

Discovering Trepanation: The Contribution of Paul Broca

PAUL BROCA WAS an icon of neuroscience and neurosurgery who also happened to be intrigued by trepanned skulls. His anthropological work established that, thousands of years ago, individuals not only trepanned skulls but also successfully performed these operations on living persons. After first commenting on a pre-Columbian Peruvian skull in 1867 (the first case of trepanning on a living person widely recognized as such), he turned to even older trepanned skulls found on French soil. In the 1870s, he theorized that the procedure originated as a means to treat convulsions in infants. As he saw it, Neolithic man attributed such convulsions to evil spirits, for which trepanation provided a ready means of escape. Because simple infantile convulsions resolve on their own, the practice would have seemed successful, and therefore it would have been propagated and expanded by later generations. Brocas theory skillfully integrated his anthropological and medical knowledge and helped to create the exciting environment in which scientists pondered what Neolithic and primitive people really knew regarding the brain and surgery.

Victor Horsley on "trephining in pre-historic times".

Victor Horsley was intrigued by newly discovered, ancient trepanned skulls, especially those that revealed that the operation was performed on living patients. He examined the man-made openings as an expert on the locus of the primate motor cortex and as a surgeon who had successfully removed parts of the motor cortex to treat Jacksonian epilepsy. He postulated that trepanation originated as a way to treat pain and epilepsy caused by depressed cranial fractures over the motor cortex. Like Broca before him, Horsley helped create the exciting Zeitgeist that led others in the late-1 800s to explore, ponder, and write about ancient trepanned skulls.