Drilling a hole in or removing a portion of the skullcase. When done medically, usually is intended to relieve pressure on the brain, but some have taken to doing it themselves at home (be sure to wear goggles to keep the blood out of your eyes!) claiming that having something like the soft spot in babies heads will help them regain some of the wonder and lucidity of childhood. Also the earliest known surgical procedure known to man, as evidenced from caveman fossils.

The practice of drilling a hole in one's skull to somehow make one smarter or more enlightened.

It seems to me that if anybody is dumb enough to drill a hole in their own head in the first place, it probably couldn't do anything but help. But, hey. That might just be crazy talk.

I first heard of this from a bunch of crazy-ass physics majors I knew. They were trying to build a beowulf type system to model some particle physics experiment that was over my head. The computer work was interesting though, so I was trying to get in on it, at least at the fringes.
Picture a bunch of lunatic college kids sitting around a table in a room stacked with old computers, oscilloscopes, and other electronic devices, most of which appear to have been gutted in the late 50's. None of them really know what they are doing, but they're trying. There's Jim, Pat, Rob, and two Mikes, known as Good Mike and Bad Mike. Good Mike and Bad Mike are the jokers. Pat is the intellegent slacker. Rob, from what I can tell, seems to be a regular joe. Jim knows his shit pretty well, and is somewhat in charge. They keep mentioning trepanation, and laughing. Finally I break down and ask what it is.
Good Mike: "Mike, show him."
Bad Mike: (laughs and turns to the computer) "You're gonna love this."
He pulls up a picture of a woman, screaming, with a drill held against her forehead.
Me: "Holy shit."
Pat: "Yeah. We're trying to talk Jim into doing it, since he's our fearless leader."

Later, I looked up trepanation online and learned a bit more. I don't know what happened to those guys. I got caught up in other things, other projects, and never heard if their efforts came to fruition. However, if someday a group of five lunatic physicists takes over the world, and their leader has a hole in his noggin, I won't be too surprised.
Also used for seasonal depression, clinical depression, chronic fatigue syndrome, concussions, tumors, headaches, insanity. Personal, non-medical reasons say that increased blood, and therefore oxygen, in the brain allows it to work better (enlightenment).

The goal is to reveal the meninges, but not to cut it, as that would let the fluid that protects the brain go all over.

When drilling through the skull, one may hit a couple bone vessels. Also, when peeling back the scalp on top of the head, the person performing the operation should remember that the scalp is attached to the skull with some tissue, and the scalp should be marked for major veins, and remember that head wounds bleed a lot. The drilling is amplified by the skull resonating.

The brain does pulse when exposed. First hand experiences say that one can feel a bit of water (it's actually spinal fluid) actually sloshing about in the hole.

Of a couple accounts I've read, one person thinks his state of mind was not increased because of the procedure, but simply because he was paying an extreme amount of attention to the details of his changes, and that this attention did some of the things the procedure was supposed to do, and that the only effects are simply psychological, not physiological. Far from the magic some hope for.

source: Bme (www.bmezine.com} for the experiences. Interesting interview.

Recent investigation by a german neurosurgeon has uncovered amazing facts about trepanation practiced as early as the Stone Age. Jürgen Piek has examined 116 prehistoric skulls found in the region of Mecklenburg-Vorpommern with modern imaging equipment. Six of the 116 skulls showed traces of trepanation.

Three of the "patients" appear to have survived the bloody procedure for an extensive period of time. X-ray images show that the bones of the head had fully healed after the operation. Two others at least remained alive for some time. Only one, a ten year old girl, bled to death under the knife, presumably a result of an accident.

Such a success rate, incredible for the Stone Age, indicates that the surgeon had extensive knowledge of human anatomy. There are some major veins in the membrane lining the inner skull which would quickly cause the patient to bleed to death if punctured. It seems these vessels were intentionally avoided.

The surgeons also took great care in wielding their flint knives to cut the bone of the skull. In order to avoid piercing the inner membrane after cutting through the bone, they cautiously scraped the bone away at a shallow angle. This procedure must have taken hours, perhaps days.

It is not clear how the patients were able to bear the intense pain of this lengthy operation. Anaesthetics as such were unknown at the time, but it is possible that poppy seeds were used for their soporific effect.

The success of these early trepanations would also not have been possible without skills at disinfection, wound treatment and postoperative care. The skulls showed no signs of infection. The prehistoric surgeons were probably aided by the fact that freshly cut flint knives were essentially germ free.

From the anthropological finds, trepanation seems to have been a common enough procedure. While some think it may have been practiced for reasons of religion or ritual, it's also likely that trepanation was used to relieve cranial pressure due to head injuries, and thus a useful and sometimes vital medical treatment.

There is some modern-day evidence of the feasibility of trepanation under seemingly primitive conditions: There is a Bantu tribe in Kenya where Stone Age style trepanation procedures were known and practiced until recently to aid victims of head injuries.


References
  • http://www.spiegel.de/wissenschaft/mensch/0,1518,137553,00.html
In the medical context, known as trephination.

The modern trepanation movement was started by Dr. Bart Huges, a Dutch savant, in 1962. It was his belief that in standing upright, evolved man suffered from blood loss to the brain due to gravity. He also realised that by cutting a hole in his skull he could simulate a return to soft-headed infancy and a brain unrestricted by the cerebral membrane of later development; what this had to do with restoring the volume of blood to the brain is hard to say.

1965. Ibiza: (we skip Dr. Huges' time in a Dutch mental hospital)
Dr. Huges meets his disciple-to-be, English acid-head Joey Mellen. Joey later goes on to write a book called Bore-Hole("'This is the story of how I came to drill a hole in my skull to get permanently high.") The book details Joey's two unsuccessful attempts to drill a hole through his skull with the help of friend Amanda Feilding and a hand-operated trepan. Third try was the charm, and he managed to open a small hole in the top of his skull. Later he used an electric drill to drill a hole in his forehead. Then he convinced Amanda to follow suit in 1970, making a film of the operation entitled Heartbeat in the Brain. She went on to stand for Parliament twice, her platform being that she would fight to get trepanation on the national health.

She now runs a charity called The Trepanation Trust, through whom interested parties can be put in contact with third-world surgeons willing to perform the operation.

It should also be noted that there are numerous cases in the psychiatric literature of schizophrenics drilling holes in their own heads in search of relief.

Let us also recall the 1981 David Cronenberg film Scanners in which we are told villian Daryl Revok drilled a hole in his head in an attempt to quiet the overheard thoughts of others.

More detailed info on trepanation, photos etc. can be found at www.trepanation.com.

The first migraine-plagued caveman
who countered his aching cranium
with crudely pounded flint (and lived)
surely shared his medical breakthrough.

Headcutting is old as woodcutting.
Andean shaman or Alpine physician,
a good doctor knew the value
of airing out a fevered brain.

In dark ages before Lister and Pasteur,
chirurgeons didn't know a virus
from a curse, but they needed a name
for the rusty saw they used to open
a blow-swelled skull: the trepane
saved careless courtiers from coma.

Modern surgeons' steel is clean, but treat
tyro trepanation with trepidation. Teen
mystics sing high of tuning third eyes
and praise their cordless doorknob drills
for opening new windows of perception
even as they lie blinded, bacterial feasts.

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