5 Methoden des historischen Loch-in-den-Kopf-bohrens aus einem großartigen Aufsatz über die Geschichte des ältesten chirurgischen Eingriffs der Welt, die Trepanation, die bis in die Steinzeit zurückreicht. Im Bild oben, verschiedene Methoden der Trepanation: (1) Abschaben (2) Ausstanzen (3) Prägen und Schneiden (4) rechteckige Schnitte.
Die gebräuchlichste Methode der Öffnung der Schädeldecke war das Abkratzen, wahrscheinlich weil man dafür keine spezialisierten Werkzeuge benötigte. Das Abkratzen des Schädelknochens, um ein Loch in den Kopf zu schaben, benötigt bei einem Erwachsenen bis zu einer Stunde, ohne Anästhesie versteht sich. Now you know.
Across time and space five main methods of trephination were used. The first was rectangular intersecting cuts as in Squier’s skull. These were first made with obsidian, flint, or other hard stone knives and later with metal ones. Peruvian burial sites often contain a curved metal knife called a tumi, which would seem to be well suited for the job. (The tumi has been adopted by the Peruvian Academy of Surgery as its emblem.) In addition to Peru, skulls trephined with this procedure have been found in France, Israel, and Africa.
The second method was scraping with a flint as in skulls found in France and studied by Broca. Broca demonstrated that he could reproduce these openings by scraping with a piece of glass, although a very thick adult skull took him 50 minutes “counting the periods of rest due to fatigue of the hand.” This was a particularly common method and persisted into the Renaissance in Italy.
The third method was cutting a circular groove and then lifting off the disc of bone. This is another common and widespread method and was still in use, at least until recently, in Kenya.
The fourth method, the use of a circular trephine or crown saw, may have developed out of the third. The trephine is a hollow cylinder with a toothed lower edge. Its use was described in detail by Hippocrates. By the time of Celsus, a first-century Roman medical writer, it had a retractable central pin and a transverse handle. It looked almost identical to modern trephines including the one I used as a graduate student on monkeys.
The fifth method was to drill a circle of closely-spaced holes and then cut or chisel the bone between the holes. A bow may have been used for drilling or the drill simply rotated by hand. This method was recommended by Celsus, was adopted by the Arabs, and became a standard method in the Middle Ages. It is also reported to have been used in Peru and, until recently, in North Africa. It is essentially the same as the modern method for turning a large osteoplastic flap in which a Gigli saw (a sharp-edged wire) is used to saw between a set of small trephined or drilled holes.