Trephination, or trepanning, is the surgical removal of part of the skull. Historically, it was commonly practiced to treat skull fractures in many ancient cultures. The document describes the process of trephination, which involved carefully scraping away sections of the skull with sharp implements. Other methods like drilling or sawing were riskier and often fatal for the patient. The document also discusses three trephined skulls found in a cave in Menorca, Spain, which were possibly done for ritual or magical purposes rather than medical need. If so, the individuals were not treated differently in death.

2. What is it? “… the surgical removal of a portion of the skull.” (Ortner, 2003) … practiced for therapeutic treatment of skull fracture in other geographical areas and time periods (Moodie (1919:484) Hrdli č ka (1939:175)…“a very large proportion of aboriginal trephinings in America were true surgical or curative operations for the relief of the effects of head wounds..." Stewart (1958b:481)…[the] relief of pressure from skull fracture was the most frequent reason for trephination in Peru and Melanesia. Oakley et al. (1959:93)…trephination practiced by medicine men in Bolivia in the 1950's.

3. The Process Trephinations vary in terms of the extent of bone removed, the depth to which bone is removed, and methods used. If trauma is being treated, the size of the injury and the judgment, are, of course, major factors. Choice of Removal: the outer table of bone and diploë both tables of bone, exposing the dura

4. Methods widely used method was careful scraping through the bone with a sharp implement to the desired depth The scraping method provides the greatest control over the cutting process and tried to involve the lowest risk of damaging the brain Other methods included drilling by breaking or cutting the intervening bone and sawing or cutting directly into the bone. Such methods usually involved the death of the patient, either right after surgery or a short time later.

5. La Cova des Càrritx Three young trephined individuals; one child and two adults There were abrasions of scraping and drilling done Dr. Campillo analyzed the skulls and decided it might have been motivated by ritual and/or magic This might have attributed to a certain profile: male, perhaps with authority within the community These cases were failed attempts of those who died instantly or within a week If these three were perhaps “magical” they were not treated any differently, in a funerary sense. the skulls and the post-cranium were separated throughout the tomb as was tradition.

6. References Hrdlirka A. (1939). Trepanation among prehistoric people, especially in America . Ciba Symposia 1:170-177. Lull, V, Micó, R, Herrada, C.R, Risch R. (2000) Rituales de vida y muerte en la prehistoria de Menorca. La Cova des Càrritx. Cinsell Insular de Menorca. Obra Social y Cultural. Moodie R. (1919) . Ancient skull lesions and the practice of trephining in prehistoric times . Surgical Clinic of Chicago 3:481-496. Oakley K, Brooke M, Akester A, and Brothwell D. (1959). Contributionson trepaning or trepanation in ancient and modern times . Man59:92-96. Ortner, J.D. (2003) Identification of Pathological Conditions in Human Skeletal Remains . Academic Press. Stewart T. (1958b) . Stone Age skull surgery: A general review with emphasis on the New Word . In Annual Report of the Smithsonian Institution, 1957, Publication 4314. Washington, D.C.: US Government Printing Office, pp. 469-491.