Was Neurosurgery being pioneered over 10,000 years ago?

00:00 - Introduction
02:16 - Reading from source article I
03:33 - Trepanation or trephination?
05:21 - Reading from source article II
08:59 - Aesthetics? Antibiotics?
10:11 - Reading from source article III
11:41 - Five methods of trepanation
14:29 - The deeper chronological & geographical spread of trepanation.
16:10 - Evidence from North Africa
17:11 - Evidence from Iraq
17:41 - Evidence from Ukraine
18:30 - Practising on animals?
19:41 - A sophisticated procedure baked into the culture
24:05 - A rapid response team?
26:22 - Wrapping up & goodbyes

[briannelyons]

As someone who has been trepanned myself (a tumor like cyst in the brain nearly killed me 15 years ago) it is fascinating that it was done so long ago. I prefer the moden technique as i felt no pain and was home the next night.

[christianwhittaker]

When you see the amount of skulls found with head injuries from the Neolithic which has been discussed in previous episodes then "practice makes perfect" comes to mind .
Thank God I'm living now rather than then .

[cburawa]

So, indigenous tribes in the Amazon forests have been using medicinal plants for all kinds of illnesses. In fact, the Amazonian rainforest is often referred to as “the world’s largest pharmacy.” It seems to me that prehistoric people were capable of treating all sorts of medical issues.

[nilcarborundum]

Fascinating stuff, as ever! The courage of all the participants in the operation must have been immense. I would love to know of all the possible reasons for trepanation - the existing and most likely theories, anyhow - and also, what percentage of these were actually performed to heal wounds. Thank you, and keep them coming!

[roxiepoe]

As I am subject to vicious headaches, if a shaman said "You have an evil spirit (or the seed of a tree, or a boo-boo fart!) in your head and we will have to make a little hole to let it out." I would have just said, "Get your hammer. Nothing could be worse." Perhaps I should ask at my next check-up...

[smwzw]

I think that we underestimate the knowledge of anatomy that prehistoric humans had. They were butchering animals all of the time and they would at least had an appreciation for the physical structures inside the body. Also their skill in butchery is transferable. Cutting is cutting after all. As far as the courage to do this sort of thing we may be overthinking it. What we seize upon is the fact that it is our brain and our knowledge that this is the seat of our intelligence. Did ancient people see it that way? They may have had a more pragmatic attitude. If you have a head injury, then you do what is necessary to fix it. If you feel like your head is going to explode then you will let them fix it, especially if it has been done in the past. As far as anesthesia is concerned, there wouldn’t have been a problem if the patient was unconscious or comatose. The problems are mainly postoperative. The increase in intracranial pressure is dealt with as your skin stretches and your skull does not. Regarding postoperative infection it seems to me that they would have been aware of the risks from observing how wounds healed. Remember too that infection did not become a real problem until man started living with animals. They lived in a world where the biome may have been radically different. Any bacteria that they were exposed to would probably been familiar to their immune system. I would imagine that they did have natural remedies that were effective. Thousands of years of trial and error eventually provides solutions. We are uncomfortable with the drilling into the bone aspect but the pain sensors are in the skin and if there is already an open skull fracture you are halfway there already. Once the bone had been excised they probably sewed a skin flap over the area and if the patient recovered they may have done pretty well unless they fell and struck their head there,

[Kelticfury]

The mindset that leads us to think that humans born several thousand years before us were just mewling morons is doing all of us a disservice.

[clivehendricks]

I wouldn't say the practice is rare today. Craniectomy are a common procedure to reduce pressure due to swelling after head trauma. My Mom had this done a few years back after a fall. I would not be surprised by our ancient ancestors figuring this out and using trepanation to save the lives. The tradition could have risen from observation of different head wounds and survival rates. If the skull was cracked enough, its likely they would observe bulging of the skull due to swelling. I suspect it would become more common as conflict becomes more common.

[astridadler]

There are hundreds of plants against infections. Boneknit( comfrey) would have helped with healing bone and tissue.

[fellabay]

Actually, now that you mention it I've got a bit of a head ache...

[justahumanbeing]

Couldn't the bones of patients be tested for the presence of opioids? Are there no studies that have done this? It wouldn't be conclusive, but it may be a helpful line of inquiry. As always, love your work!🎉

[elainemunro]

I would like you to discuss cataract surgery as done by Egyptians, using a surprisingly similar tool to what has been used centuries later and as shown on their pictures on walls.

[bonitareardon]

Herbalists and medical practice has been around for as long as there were people getting gored by Aurochs, etc. Not to mention all the vagaries of childhood and childbirth. Sterile salt water is easy to produce, not to mention various herbal solutions that have healing properties. Famously Yarrow is able to staunch bleeding and would have been very useful for head wounds as well as wounds of the rest of the body.

[thomasm.karaffa]

Thanks so much for all your efforts. As a person who has a close connection to physical tasks, I have banged my finger more than once and drilled a hole in a fingernail to relieve the pain. I’m sure that our ancestors did similar. The leap to the skull seems extremely plausible and natural. The only way you survive is to constantly learn and adapt to whatever comes your way. My great grandmother from Italy who couldn’t read or write was setting broken bones and making casts with rope fibers she would pull apart and plastering it with egg, applying to the limb and holding tension until sufficiently dry. I believe these procedures were more commonplace out of necessity.

[lakesuperioraquamanproduct]

Love the whole Bert & Ernie act guys. Good show

[pofoto]

Great podcast ! Lots of information on this subject.

[weethree]

Excellent! Just like you, I now really want to know what "pharmaceuticals" they may have had in different places, to anaesthetise and disinfect… without some such things, the survival rate couldn't have been nearly so high.

[woofbarkyap]

It strikes me that "gatherers" would be eminently placed for discovering anaesthetic, healing, deadly and delicious plants. For me, it's not whether they were clever enough to study this stuff but how could they avoid it? You stroll along picking blackberries, get stung by nettles and discover dock leaves and that's entry-level child stuff. An adult gatherer would have many years of doing this daily, surrounded by others, both older and younger. The combination of discovery and education would have made them highly skilled in a way we can't really imagine.

[j.l.emerson]

What impresses me is not the skill of the healer who performed the procedure or his/her herbal skills. No. What impresses me is the hardiness of the patient. The patient endured the procedure, then endured whatever procedure or treatment that followed the trepanation. They often survived for years following this procedure & some even survived multiple procedures. Wow.

[woofbarkyap]

One wonders if the different methods reflect different cultures and time, or whether they were used for different ailments.