ABSTRACT
This chapter considers evidence for the use of trepanation in prehistoric cultures as a cure for madness and discusses the use of trepanation in medieval society. It summarizes the contemporary use of trepanation within and outside of mainstream legitimate medical practice. Paul Broca considered whether trepanation might be a form of medical surgery, perhaps to relieve intracranial pressure. Broca settled on an explanation tied to the belief systems of ‘primitive’ cultures. He suggested that the surgery was conducted in order to allow evil spirits to escape from the cranium. Although Broca's demonic explanation of the purpose behind trepanning was widely accepted at the time of his writing and is the most cited explanation in textbooks, there were some alternative accounts. Trepanning was therefore carried out in order to try and trigger a return to life in unconscious or deceased individuals, stemming from the observation of cases of spontaneous recovery after unconsciousness from minor head wounds.
