Lisa Chew



trephination, skull, trepanation, trepan, neurosurgery, Hughes, trephine, Fielding, Mellen, trephanation


I. Abstract

Trephination is the oldest medical practice still currently performed.  The procedure itself involves drilling or otherwise removing a small piece of bone from the skull without damaging the brain.  There are two main purposes for trephination – medical and mystical.  In both ancient and modern times, medical trephination has been performed to relieve pressure caused by swelling of the brain as a result of a severe head trauma.  Ancient mystical trephination was used to release evil spirits that were thought to cause abnormal behaviors, mental illnesses, and headaches.  Modern mystical trephination, on the other hand, is done to increase the volume of brain blood and, thus, restore the creativity and happiness of childhood.  Therefore, even though trephination is a long-used procedure, its origins are based on several different systems of beliefs and practices throughout time.  


II. Scope and Purpose of the System

            In ancient times, trephination, a procedure involving the removal of a small piece of human skull, had both natural and supernatural purposes.  Current evidence shows that the procedure began about 10,000 years ago in Neolithic Europe and Pre-Columbian South America (Trepanation).  The most numerous and most expertly trepanned skulls of that time have been found in the area of present-day Peru and Bolivia.  At that time, battles between warring factions were common and often resulted in head injuries.  These injuries were often inflicted on innocent women and children and were caused by blows to the head with stone clubs.  If the person was not killed, the injury caused compression of the skull that may have resulted in abnormal behavior, headaches, and blood clots (Philips).  The medical practitioners of the time found that trephination reduced or completely reversed the symptoms.  Trephination was also used in ancient times to cure mental illness.  They believed that by trepanning the skull, the evil spirits that inhabited a person’s body could escape and, therefore, the person would be cured (Haeger). 

            In modern times, there are two completely different systems of trephination.  The first is medical trephination that is performed by doctors to relieve pressure of the brain after an injury, such as a head trauma caused by a car accident.  (This type will not be focused on in this paper because it bears little similarity to the other types of trephination).  The other type of trephination is done for mystical reasons.  The medical community does not support this type of trephination and, therefore, the twenty or so living individuals who are known to have this type of procedure have performed self-trephinations.  The purpose of this type of trephination is to increase what is known as the “bloodbrainvolume” (Mellen).  The supporters in this type of trephination believe that when the skull fuses as a person ages, one loses one’s natural creativity.  They argue that the volume of blood in the brain is reduced and the brain can no longer pulsate with the heartbeat because it is confined in the skull.  Therefore, they believe that cutting a small hole in the skull will allow the brain to pulsate again and increase the volume of the blood in the brain.  They believe that the resulting “expanded consciousness” will cause the person to be more creative, happier, and will return a depressed person to a normal state (Mellen).


III. Authority Structure

a. Sources and Criteria of Valid Knowledge

Apparently, the source of the knowledge began with an attempt to cure skull compression wounds inflicted during battle in Peru.  The practitioners were either trained surgeons called hampi-camayoc or shaman called sancoyoc (Philips).  The surgeons were highly trained and dealt mainly with the head traumas; the shaman were not trained to perform the operation but did so in rituals to release evil spirits from the brain.  When the trepanned individuals survived and there was a reduction in their symptoms, the surgeons and shamans took this as a sign that the operation worked and that continuing to do the operation would help other people.  The pieces of trepanned skull removed from the patients were thought to have magical powers and were sold for great profit by the surgeons and shaman (Haeger).

In modern times, a Dutch medical student named Bart Hughes proposed the practice of modern mystical trephination.  In the late 60’s, he often used psychoactive drugs such as LSD and believed that the mind-expanding qualities could be made permanent through trephination.  He trepanned himself with an electric drill and claims to have immediately felt the natural high that accompanied an increase in his brain pulsation.  He then proceeded to spread his message and recruit other people to be trepanned (Cridland).


b. Methods of Inquiry

            The support for trephination as a valid procedure comes from both empirical evidence and from the faith of believers.  Evidence of trephination in ancient people is uncovered through the excavation of burial sites.  The archeologists know that the individuals did not die from the trephination if there is a regrowth of bone called callus tissue.  For example, one researcher found that in the Yantyo tribe of Peru, 250 of 400 skulls found showed evidence of callus tissue growth (Haeger).  Another burial site near Cuzco resulted in the discovery that 83% of the skulls that had undergone trephination showed signs of regeneration (Fernandez).  

            Modern mystical trephination is supported by the faith of the believers and their testimonials about its helpfulness.  The main proponents of modern mystical trephination are Bart Hughes, the originator, and his two main disciples, Amanda Fielding and Joseph Mellen.  All three trepanned themselves and crusade to get others, including the medical community, to respect mystical trephination as a valid procedure for curing mental illness and increasing creativity (Cridland).


c. Institutions and Professional Structure

In ancient times, there were two types of people who preformed trephinations – shaman (sancoyoc) and surgeons (hampi-camayoc).  The shaman were untrained but believed that they had the ability through God to release the evil demons that plagued other people.  If the performed ritual proved to be unsuccessful resulting in the continuation of the symptoms or the person’s death, the shaman would most likely claim that the person was not suitably purified before the ritual or that the demons refused to leave.  In fact, a number of skulls have been discovered that were trepanned as many as five times (Philips).  Surgeons, on the other hand, were trained as apprentices to other surgeons and learned the proper techniques for the procedure.  Trephinations performed by surgeons were actually very successful and most of the patients recovered.  In fact, 55-60% of the ancient skulls found show signs of callusing indicating that the patient survived the operation (Trepanation). 

      Today, the individuals themselves perform mystical trephinations.  They use power drills and trephining tools to drill holes in their own heads.  It is very dangerous and one man, Joe Mellen, almost killed himself in his first attempt at the procedure (Mellen).  The mystical trepanners are not held to any standards and only focus on of the objective of opening a hole in the skull.


IV. History

            According to the International Trepanation Advocacy Group, trephination has been performed “…on every continent through every time period and by every race of mankind…” (ITAG).  Therefore, it is difficult to do a chronological history of trephination throughout the ages.  There is evidence, however, that trephination began roughly about 10,000 years ago in both Pre-Columbian South America and in Neolithic Europe (Trepanation).  In Pre-Columbian South America, researchers believe that there was a center for trephination in the area that is present-day Peru and Bolivia based on the number and skill displayed on the trepanned skulls found (Philips).   In Europe, archeologists discovered the earliest trephinations among the skulls of the early Danubians (c. 3000 BC) and among the “battleaxe” people in areas now part of France (c. 2000 BC).  Trepanned skulls have also been found in Scandinavia, Germany, Czechoslovakia, Hungary, and Bulgaria dating from the late Bronze Age (Lisowski).  Trephination continued to be practiced throughout the Iron Age and throughout the era of Greek and Roman dominance.  During Mediaeval times, there is evidence that trephinations were performed in England, Ireland, France, Germany, and Italy.  Outside of Europe, there is less evidence of trephination probably attributed to the fact that “…fewer exhumations have been carried out in these parts…” (Lisowski).  In Asia, however, several skulls have been found that had been operated on during the Bronze Age in Jericho and three Iron Age skulls in Lachish.  Skulls were also found in Pakistan, Kashmir, and China.  The Ainu people of Hokkaido in northern Japan apparently practiced trephination as well.  Finally, skulls contemporary with those found in Palestine were discovered in Sakkara and Egypt (Lisowski).   

          The first modern mystical trephination was performed in Holland (Cridland).  The others have occurred mainly in England and North America. 


V. Representative Examples of Argumentation

            “This time I was not in any doubt.  The drill head went at least an inch deep through the hole.  A great gush of blood followed my withdrawal of the drill.  In the mirror I could see the blood in the hole rising and falling with the pulsations of the brain.”

This is the real life account of Joseph Mellen’s trephination of his own skull using an electric drill in the spring of 1970.  He claims that within four hours he felt his spirits rise until he felt a state of “freedom and serenity” that he claims has been with him ever since (Michell). 

            Joseph’s then-girlfriend, Amanda Fielding, became so inspired by Joseph’s trephination that she decided to trepan her own skull.  Joseph filmed her operation and she called it, Heartbeat in the Brain.  The video shows Amanda carefully preparing herself and then drilling a hole in the front of her skull.  At the end, blood is pouring down her face but she has a triumphant, blissful look on her face.  The film has soft music in the background and interspersed shots of her pet pigeon as “…a symbol of peace and wisdom” (Michell).    


VI. Suggested Position in Comparative Scales

a. Emphasis on traditional authority (5) --- or the testimony of experience (1)

Ancient medical trephination (3), Ancient mystical trephination (3), Modern medical trephination (5), Modern mystical trephination (1). 

Ancient and modern medical trephinations as well as ancient mystical trephination are based on the traditional authority of the procedure.  The surgeons and shaman who performed the operations passed on the techniques to their successors as the proper way to deal with medical/psychological problems.  Modern mystical trephination is based solely on the testimonies of those that have been trepanned and claims that it helped them.


b. Centralization of authority (5)--- or decentralization (individual inquiry) (1)

Ancient medical trephination (2), Ancient mystical trephination (2), Modern medical trephination (5), Modern mystical trephination (1).

Ancient medical and mystical trephinations were performed all over the world with many different procedures and by people with varying levels of training.  At the time that these operations were originally performed, there was no way to even communicate between most of the different civilizations.  Modern medical trephination has a set procedure that is learned and followed by all surgeons.  Modern mystical trephination is based on individual inquiry and is performed solely by the interested individuals.


c. Emphasis on invisible (spiritual) realities (5) ---- or material, earthly ones (1)     

Ancient medical trephination (1), Ancient mystical trephination (5), Modern medical trephination (1), Modern mystical trephination (5).

Medical trephinations (ancient and modern) are meant to cure actual medical problems such as the swelling of the brain following a head trauma.  Mystical trephination (ancient and modern) is meant to cure mental illness, release evil spirits, or increase creativity.


d. Mainly spiritual/moral objectives (5) ---- or pragmatic aims (1)

Ancient medical trephination (5), Ancient mystical trephination (5), Modern medical trephination (5), Modern mystical trephination (5).

All types of trephination are meant to “heal” the person through either medical or mystical means.


e. Most power or reserved for a divine being (5) --- or realizable in individuals (1)

Ancient medical trephination (1), Ancient mystical trephination (1), Modern medical trephination (1), Modern mystical trephination (1).

The purposes for trephination are realizable in individuals and do not grant any special powers to the patients.  In ancient times, any person suffering from a real or believed malady could be trepanned.  In modern times, interested individuals can perform mystical trephination and doctors can perform the procedure on patients with head trauma.  No special powers are necessary for a person to be trepanned.


VII. Annotated Bibliography


Mellen, Joseph. “Hole in the Head.” Other Scenes Magazine. Nov. 1970.

            This is an article written by a man who was trepanned himself in the 1960’s.  It is a useful source because it gives insight into how he came to be trepanned and his beliefs about why trephination is a useful and important procedure.  A good source about modern mystical trephination.



Cridland, Timothy Colin. “Hole in the Head Gang.” Submit! Magazine. Dec. 1993.

            This article discusses the three main figures involved in modern mystical trephination – Bart Hughes, Joseph Mellen, and Amanda Fielding.  It describes how each came to be involved with the modern trephination movement.   


Fernandez, Omar. “Pre-Columbian Surgery.” Granma Weekly Review. Online. Internet. 29 Oct. 2000.

Available WWW:

            This article focuses on the practice of ancient medical and mystical trephination is Pre-Columbian South America.  It was not particularly useful because the paper was not focused on this particular area. 


Haeger, Knut. “Trepanation.” Online. Internet. 6 Nov. 2000

            Available WWW:

            This article is about the main motives for performing ancient and modern trephinations.  It was particularly useful because it talked about the different purposes for the procedure including both ancient mystical and ancient medical trephination.


International Trepanation Advocacy Group. “Introduction.” Online. Internet. 6 Nov. 2000.

            Available WWW:

            This was a useful source because it gave a basic overview of what trephination is and how it has been practiced over time.


Lisowski, F. P. “Prehistoric and Early Historic Trepanation.” Online. Internet. 11 Nov. 2000.

            Available WWW:

            This is a very useful source because it gives an expanded explanation of distribution of trephination over time as well as the geographic distribution of the procedure.  The article does a good job of bringing together researched evidence of trephination found around the world.


Michell, John. Eccentric Lives & Peculiar Notions. Harcourt Brace & Company, 1984.

            This book contains a chapter about self-trephination.  It deals mainly with modern mystical trephination.  It presents the story of how Bart Hughes, Amanda Fielding, and Joe Mellen came to be involved with each other and the idea of trephination.


Philips, Chris Ann. “Pre-Columbian Trephination.” Cyber Museum of Neurosurgery. 1990. Online. Internet. 29 Oct. 2000.

            Available WWW:

            This article looks at how ancient medical trephination began in Pre-Columbian South America.  This article contains several nice pictures showing ancient skulls that had been trepanned.  It was a useful resource although the article itself is very short.


“Trepanation.” The Subculture Pages. Online. Internet. 29 Oct. 2000.

            Available WWW:

            This article focuses on how trephination is performed around the world.  The article itself was interesting, but it was most useful because it gave links to other good sites on this topic.