I suffer badly from headaches. Fortunately, if the pain gets too bad, I find a couple of analgesics will normally do the trick.
Analgesics have been around for more than a century and are based on three compounds which were discovered in the 19th century – salicyclic acid, pyrazolone and phenacetin. Drugs in these families have the ability to relieve mild to moderate pain through actions that recuse inflammation at source. All very handy and something we take very much for granted these days.
But prior to these discoveries, how did you go about getting some relief for your aching bonce?
Inevitably, there were many quack remedies, none more bizarre than that espoused in all seriousness by the 10th century oculist, Ali ibn Isa al-Kahhal. His idea was that you should lash a mole to your head. Probably useless but if you were glabrous it could serve as a temporary wig.
Scarier still was the practice of trepanning. This involved the drilling of or scraping a hole into the human skull to expose the dura mater – the thick membrane that covered the meninges that surround the brain. The idea was that the hole would relieve the pressure inside your head, the build-up of which was clearly causing your headaches. I suppose it kind of makes sense if you have no medical knowledge and are oblivious to the consequences.
There is evidence that trepanning was practised as long ago as the Neolithic times. Skulls have been found with neatly bored holes, too neat for a wound from a weapon. In one burial site in France, 40 skulls out of 120 dating from around 6,500 BCE were found to have trepanation holes – perhaps they had invented heavy metal rock as well! Some skulls that have been found reveal signs of the bone structure healing, suggesting that many survived the ordeal.
Hippocrates, for many the founder of modern medicine, gave specific instructions on the procedure and the influential medic, Galen, also gives helpful advice on the subject. Hieronymous Bosch’s painting pictured above shows the practice persisted well into the Medieval and Renaissance period and was used principally as a cure for various ailments including seizures and head fractures. There is evidence from graveyards that that the survival rate was high – it makes sense really, because if everyone who had the operation died, it would soon fall out of use.
Whilst a form of trepanation is still used today for various forms of neurosurgical procedures, it is generally not recommended as a cure for headaches. The instruments used for the surgery have improved too – gone are the classical trephines with sharp teeth and in are instruments with diamond-coated rims which are smooth to soft tissues and only cut the bone. Generally, these days, in a craniotomy the bone cut from the skull is replaced – if it is not, the procedure is known as a craniectomy.
Faced with the prospect of trepanation, I would have grabbed the nearest mole! Thank goodness for aspirins.