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Hippocrates endorsed its use and it’s the world’s second oldest surgical procedure following circumcision. It’s called trepanation and it literally means drilling a hole in your head.

And if you think it’s a bygone practice, think again.

The practice of making a hole in the skull has been around since the Stone Age ⁠— archaeologists have found trepanned skulls dating back to 3000 B.C. Hippocrates, in his classic medical text “On Injuries of the Head,” endorsed trepanation for the treatment of head wounds. During the middle ages it was thought the procedure was able to liberate demons from the heads of the possessed and, later on, “enlightened” Europeans did it to cure maladies ranging from meningitis to epilepsy.

An instrument called a trepan is used to make the hole. The trepan goes into your skull and a chunk of your skull is extracted. Eventually the skin heals over the hole and you’re left with a small bump. Trepans have evolved from crude sharpened stones in the Neolithic age to hand cranked augers in the dark ages to electric drills used today.

That’s right, today in the 21st Century.

Currently there are doctors in the world who perform trepanation and will perform one on anyone 18 years or older who consents. They even have their own organization, The International Trepanation Advocacy Group, complete with web site. The following explanation comes from ITAC’s site and explains the trepanation’s rationale;

“Within the brain there are two fluid volumes, blood and water (cerebrospinal fluid). Blood supplies the brain cells with energy, water does not. The ratio between the two can and does vary, but total volume remains constant.When the skull seals at the end of growth (Ages 8-21) the brain can no longer pulsate on the heartbeat, since expansion possibility of the brain membranes is suppressed. The arteries and capillaries can no longer expand with each new surge of blood that comes from the heart. Hence a certain amount of blood falls from the brain and is replaced with water. At this point the energy and spontaneity associated with youth diminishes.

Trepanation, making a hole in the skull, restores the pulse pressure to the brain. The arteries and capillaries can expand again, filling with an increased amout of blood and displacing the same volume of water.A significant amount of energy, lost with adulthood, returns.”

Trepanation is somewhat akin to the practice of blood letting.

The founder of modern trepanation is a Dutch man by the name of Dr Bart Hughes. In 1962 he became convinced that the volume of blood in the brain controls ones degree and state of consciousness. Dr Hughes believed humans have been robbed of a high range of consciousness because we began to walk upright, putting the heart below the brain. This state of affairs could be corrected by standing on ones head, jumping from hot water into cold water, or taking various drugs. He noted that when we are born, our heads are unsealed. We have all heard of the “soft spot” on top of a baby ‘s head. He became convinced that the way to gain back the state of imagination and perception that one experiences as a child was to open a hole in the now-sealed adult skull.

In 1965, after years of experimentation, Dr. Hughes bored a hole in his skull using an electric drill, a scalpel, and a hypodermic needle (to administer a local anesthetic). This must have been the first intentional trepanation in hundreds of years.

He immediately began preaching the benefits of his new state of consciousness achieved. .

People having been trepanned report an increased ability to concentrate and stay in focus with the added benefit of feeling good all the while. They also cite an improved ability to listen. There is also a feeling of increased “consciousness” that they find difficult to describe.

Today’s neurosurgeons are more than naturally skeptical. Brain function decreases with age and even if it were possible, an increased blood flow⁠—which many scientists think is more related to brain function than blood volume⁠—would not reverse the process occurring in an older brain.

But all neurosurgeons readily agree on one point: a hole is the starting point for all neurosurgical procedures. Clinical trepanation is performed, for example, to evacuate hemorrhages and to relieve pressure in the cranial cavity caused by cerebral ulcers. But, for neurosurgeons, the hole is a means to an end, and they put the bone back in place.

Additionally surgeons point out that the risks of blood clots, brain injuries from drilling too deep, and infections outweigh the unproven benefits of trepanation.

It is estimated that between 40 to 60 Americans have been through the trepanation procedure.