Even with a highly skilled neurosurgeon, the most effective anesthesia, and all the other advances of modern medicine, most of us would cringe at the thought of undergoing cranial surgery today. Yet for thousands of years, trepanation - the act of scraping, cutting, or drilling an opening into the cranium - was practiced around the world, primarily to treat head trauma, but possibly to quell headaches, seizures and mental illnesses, or even to expel perceived demons.According to a new study led by the University of Miami Miller School of Medicine's David S. D., clinical professor of physical medicine and rehabilitation, trepanation was so expertly practiced in ancient Peru that the survival rate for the procedure during the Incan Empire was about twice that of the American Civil War - when, more than three centuries later, soldiers were trepanned presumably by better trained, educated and equipped surgeons."We do not know how the ancient Peruvians prevented infection, but it seems that they did a good job of it.Neither do we know what they used as anesthesia, but since there were so many (cranial surgeries) they must have used something - possibly coca leaves."And just like in ancient Peru, we continue to advance our neurosurgical techniques, our skills, our tools, and our knowledge." Top image: More ancient skulls bearing evidence of trepanation - a tell-tale hole surgically cut into the cranium - have been found in Peru than the combined number found in the rest of the world.Credit: University of Miami Trepanation – the technique of removing bone from the skull by scraping, sawing, drilling or chiselling – has long fascinated those interested in the darker side of medical history. The leprechaun is perhaps one of the best-known creatures in Irish folklore.More than 800 prehistoric skulls with evidence of trepanation - at least one but as many as seven tell-tale holes - have been found in the coastal regions and the Andean highlands of Peru, the earliest dating back to about 400 BC.
Other well-known beliefs about leprechauns include the pot of gold that they are said to keep at the end of the rainbow, and their mischievous nature.But, from 1000 to 1400 AD, survival rates improved dramatically, to as high as 91 percent in some samples, to an average of 75 to 83 percent during the Incan period, the study showed."Over time, from the earliest to the latest, they learned which techniques were better, and less likely to perforate the dura," said Kushner, who has written extensively about modern-day neurosurgical outcomes.They learned, for example, not to perforate the protective membrane surrounding the brain - a guideline Hippocrates codified in ancient Greece at about the same time (5th century BC) that trepanning is thought to have begun in ancient Peru.The long-term survival rates from such "shallow surgeries" in Peru during those early years, from about 400 to 200 BC, proved to be worse than those in the Civil War, when about half the patients died.
Maybe there was something else, maybe a fermented beverage.