Trepanation—the technique of removing bone from the skull by scraping, sawing, drilling or chiseling—has long fascinated those interested in the darker side of medical history. One stock tale is that trepanning is one of the most ancient treatments for migraines. As I study the history of the migraine, it certainly has always caught my attention.
The word trepanation comes from the Greek trypanon, meaning a borer. The earliest known trepanned skulls date from around 10,000 BCE, and come from North Africa. There are trepanation accounts in the Hippocratic texts (5th century BCE), when it was used in cases of fracture, epilepsy, or paralysis, and in the second century CE Galen wrote of his experiments with trepanation on animals in his clinical studies.
But the reasons for trepanning remain largely unknown. While the famous 17th-century physician William Harvey may have suggested that the procedure was used for migraines, recent authors have acknowledged that there is little evidence to suggest this. So where did this persistent idea come from?