Higher Human Forms: Voluntary Trepanation


Peter Halvorson, 1972. Michael Williamson/The Washington Post/Getty

Most of the body augmentation practices covered here in Higher Human Forms focus on symbolic transformations, but voluntary trepanation seeks to alter the functionality of the human brain through direct alteration of blood flow -- by drilling a hole in the skull.

Trepanation History

The procedure itself is the oldest from of neurosurgery, practiced by various civilizations for both medical and magical purposes since prehistoric times.

(Oxford Science Archive/Print Collector/Getty)

They sought to rid the patient of madness, demons, headaches, epilepsy -- as well as to treat cranial and brain injuries. Today, clinical trepanation (AKA craniotomy) remains a treatment used for epidural and subdural hematomas -- plus it gives us a surgical entry point for the brain itself.

While various so-called primitive cultures practiced trepanation with reasonable success, Western medicine largely abandoned the practice in the 1700s due to the high mortality rate. Even by the late 19th century, 80-90 percent of patients died from infection following Western trepanation. Over the course of his career, American neurosurgeon Harvey Cushing (1869 - 1939) was able to bring that mortality rate down to less than 10 percent.

Rise of the Neurosurgical Psychonaut

As shocking as it may seem, numerous individuals have undergone voluntary trepanation in an attempt to alter their own mindstate -- often as a means to improve their day-to-day mental state or even achieve a higher state of consciousness.

Bart Hughes
Mad Scientist Blog

Dutch former medical student Bart Hughes (1934-2004) stands as voluntary trepanation's pioneering visionary. In 1965, Hughes performed his own trepanation with an electric dental drill and surgical knife -- all while under local anesthetic.

His mescaline-induced theory amounted to this: When humans rose to bipedal stature, we disrupted the healthy flow of blood to the brain. If we could only allow blood to flow more freely into the cranium, we could reclaim a constant state of elevated consciousness. Hughes first considered making room for the increased blood flow by draining his cerebrospinal fluid through a hole in the base of his spine. Then he realized that, as a hole in the skull doesn't close, trepanation would create an expandable bladder of sorts to enable increased cerebral blood flow.

Others followed in Hughes' footsteps, including Amanda Fielding, director of the Beckley Foundation, which concerns itself with consciousness research and drug policy reform. In the early 1970s, Amanda trepanned herself (she filmed the procedure) and remains an outspoken advocate of the practice. She maintains the procedure improved her cerebral circulation and restores the "full pulse pressure of the heartbeat." Sluggish circulation and stagnant cerebral blood pools, she says, contribute to dementia and Alzheimer's disease.

Higher States of Consciousness

Trepenation remains a fringe procedure, but that doesn't mean there isn't some research to back it up. Both the International Trepanation Advocacy Group and the Beckley Foundation continue to research trepenation and its effect on cranial compliance: the measure of the degree to which brain fluids are able to move around within the cranium, activate neurons and washing out toxins.

Through the Beckley Foundation, Fielding continues to work with Russian physicist Yuri Moskalenko. In 2010, they released the following findings:

  • Trepanation acts to restore the elasticity of the cranial system to the healthy levels associated with youth.
  • Trepanation nearly doubles the volume of blood that enters the head with each heartbeat.
  • The altered pattern of cerebral spinal fluid movement within the brain of a trepanned individual acts as a more effective deliverer of nutrients and remover of toxic waste products.
  • The brain of a trepanned individual is less impacted by blood volume or pressure increases.
  • Trepanation increases the effect of external influences (breathing exercises, meditation, yoga, etc.) on the cerebral fluid circulation, enhancing their beneficial effects.
  • Trepanation is "safe to the extent that none of these changes exceed the normal limits of cerebral circulation."

I'm not suggesting you grab a drill and go at it, but the argument is rather compelling if you stop to think about what we are: a mindstate induced by an organic brain -- a brain that swirls with fluid activity within the closed confines of a skull. Alter the fluid system and you alter the resulting mindstate. That being said, many established neurosurgeons disagree with trepanation proponents. As Tim Hardwick points out over at Strange Horizons, experts argue that brain function is not limited by normal blood flow and that increased brain metabolism might actually stress the system.

Our taboos concerning trepanation remain strong, but the research into its theorized benefits continue. We're left with a crucial question: Does trepanation amount to mere body augmentation (which certainly alters the indivdual on a deeper level) or is it a true augmentation of mind and brain?

Higher Human Forms is an ongoing blog series profiling the many fascinating ways in which humans have reshaped their bodies throughout human history. To quote plastic surgeon Joe Rosen, "The body is a conduit for the soul, at least historically speaking. When you change what you look like, you change who you are."


About the Author: Robert Lamb spent his childhood reading books and staring into the woods — first in Newfoundland, Canada and then in rural Tennessee. There was also a long stretch in which he was terrified of alien abduction. He earned a degree in creative writing. He taught high school and then attended journalism school. He wrote for the smallest of small-town newspapers before finally becoming a full-time science writer and podcaster. He’s currently a senior writer at HowStuffWorks and has co-hosted the science podcast Stuff to Blow Your Mind since its inception in 2010. In his spare time, he enjoys traveling with his wife Bonnie, discussing dinosaurs with his son Bastian and crafting the occasional work of fiction.