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- History of NMD
- 1. Preface
- 2. A Prehistory of NMD
- 3. The Story of Phineas Gage
- 4. The Nineteenth Century: Gottleib Burckhardt
- 5. The 20th Century
- 6. Psychosurgery in Europe
- 7. The decline of lobotomy
- 8. A renaissance (of sorts)
- 9. Definitions of Neurosurgery for Mental Disorder
- 10. Psychosurgery under the spotlight
- 11. Conclusions
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A Brief History of Neurosurgery for Mental Disorder
A Prehistory of NMD
Trepanation (a.k.a. trephination), the deliberate creation of holes in a person’s skull, has been practised in various cultures for thousands of years. The trephined skull of a man in his fifties was discovered in France in 1996. Carbon dating revealed the skull to date from approximately 5100 B.C. Furthermore, the skull showed evidence of healing, suggesting that the man survived the procedure (Alt, Jeunesse, Buitrago-Tellez, et al, 1997). The practice was probably widespread throughout early human societies, and there is evidence of such procedures in parts of North Africa, Europe, Asia, and South America. Trephining knives have been discovered in excavated Inca settlements. Trepanation was frequently used to treat ‘spirit’ or ‘demonic’ possession, which was probably a primitive ‘diagnosis’ for many forms of mental illness, epilepsy, headaches, and other neurological conditions.
Trepanation (in various forms) has continued throughout the last two millennia. Such an intervention was being recommended for mood disorders in the 12th Century. Ruggio Frugardi, a physician from the Hippocratii School of Medicine at Salerno, Italy wrote that, “For mania and melancholy the skin at the top of the head should be incised in a cruciate fashion and the skull perforated to allow matter to escape” (Cited in O'Callaghan & Carroll, 1982, p. 4). Trepanation continues to be performed today by a small number of people, most of who believe that it can improve “brain pulsations” and hence overall well-being. The belief that brain pulsations have some impact upon health dates back to the work of Claudius Galen (c. AD 129 – c. AD 216) and despite there not being any scientific support for such beliefs, many modern devotees report positive health benefits (For example, see Henderson, 2000).
Alt, K. W., Jeunesse, C., Buitrago-Tellez, C. H., et al (1997) Evidence
for stone age cranial surgery. Nature, 387, 360.
Henderson, B. (2000). Trepanation. BMEzine.com.
Website. Last updated: Not Stated. Accessed: 16 April, 2006. Available at: http://www.bmezine.com/news/people/A10101/trepan/index.html
O'Callaghan, M. A. J. & Carroll, D. (1982) Psychosurgery:
A Scientific Analysis. Lancaster: MTP Press.
